Associations between accelerometry measured physical activity and sedentary time and the metabolic syndrome: A meta‐analysis of more than 6000 children and adolescents

BACKGROUND: Metabolic syndrome is increasingly prevalent in the pediatric population. To prevent an early onset, knowledge about its association with modifiable lifestyle factors is needed. OBJECTIVES: To estimate the prevalence of the metabolic syndrome and examine its cross‐sectional associations with physical activity and sedentary time. METHODS: Participants were 6009 children and adolescents from 8 studies of the International Children's Accelerometry Database. Physical activity and sedentary time were measured by accelerometer. Metabolic syndrome was defined based on International Diabetes Federation criteria. Logistic regression models adjusted for sex, age and monitor wear time were used to examine the associations between physical activity, sedentary time and the metabolic syndrome in each study and effect estimates were combined using random‐effects meta‐analysis. RESULTS: The overall prevalence of the metabolic syndrome was 2.9%. In crude models, a 10 min increase in moderate‐to‐vigorous intensity physical activity and vigorous‐intensity physical activity were inversely associated with the metabolic syndrome [OR 0.88, 95% CI 0.82‐0.94, OR 0.80, 95% CI 0.70‐0.92]. One hour increase in sedentary time was positively associated with the metabolic syndrome [OR 1.28, 95% CI 1.13‐1.45]. After adjustment for sedentary time, the association between moderate‐to‐vigorous‐intensity physical activity and the metabolic syndrome remained significant [OR 0.91, 95% CI 0.84‐0.99]. Sedentary time was not associated with the metabolic syndrome after adjustment for moderate‐to‐vigorous intensity physical activity [OR 1.14 95% CI 0.96‐1.36]. CONCLUSIONS: Physical activity of at least moderate intensity but not sedentary time is independently associated with the metabolic syndrome.