Based on 88 eligible observational studies , level of evidence grading and quantitative meta-analyses indicated that there is limited available evidence that the total volume or patterns of sedentary behaviour are associated with health in children and adolescents when accounting for moderate-intensity to vigorous-intensity physical activity or focusing on studies with low risk of bias .
Quality evidence from studies with robust design s and methods , objective measures of sitting , examining associations for various health outcomes , is needed to better underst and if the overall volume or patterns of sedentary behaviour are independent determinants of health in children and adolescents
Sedentary behaviour has emerged as a unique determinant of health in adults .
Studies in children and adolescents have been less consistent .
We review ed the evidence to determine if the total volume and patterns ( i.e. breaks and bouts ) of objective ly measured sedentary  behaviour  were associated with adverse health outcomes in young people , independent of moderate-intensity to vigorous-intensity physical activity .
A cluster-randomized controlled trial to reduce sedentary behavior and promote physical activity and health of 8-9 year olds: The Transform-Us! Study
Background Physical activity ( PA ) is associated with positive cardio-metabolic health and emerging evidence suggests sedentary behavior ( SB ) may be detrimental to children 's health independent of PA . The primary aim of the Transform-Us ! study is to determine whether an 18-month , behavioral and environmental intervention in the school and family setting s results in higher levels of PA and lower rates of SB among 8 - 9 year old children compared with usual practice ( post-intervention and 12-months follow-up ) . The secondary aims are to determine the independent and combined effects of PA and SB on  children 's cardio-metabolic health risk factors ; identify the factors that mediate the success of the intervention ; and determine whether the intervention is cost-effective . Methods / design A four-arm cluster-r and omized controlled trial ( RCT ) with a 2 × 2 factorial design , with schools as the unit of r and omization . Twenty schools will be allocated to one of four intervention groups , sedentary behavior ( SB-I ) , physical activity ( PA-I ) , combined SB and PA ( SB+PA-I ) or current practice control ( C ) , which will be evaluated among approximately 600 children aged 8 - 9 years in school year 3 living in Melbourne , Australia . All children in year 3 at intervention schools in 2010 ( 8 - 9 years ) will receive the intervention over an 18-month period with a maintenance ' booster ' delivered in 2012 and children at all schools will be invited to participate in the evaluation assessment s. To maximize the sample and to capture new students arriving at intervention and control schools , recruitment will be on-going up to the post-intervention time point . Primary outcomes are time spent sitting and in PA assessed via accelerometers and inclinometers and survey . Discussion To our knowledge , Transform-Us ! is the first RCT to examine the effectiveness of intervention strategies for reducing children 's overall sedentary time , promoting PA and optimizing health outcomes . The integration of consistent strategies and messages to children from teachers and parents in both school and family setting s is a critical component of this study , and if shown to be effective , may have a significant impact on educational policies as well as on pedagogical and parenting practice s . Trial registration ACTRN12609000715279 ; Current Controlled Trials IS RCT
Based on 88 eligible observational studies , level of evidence grading and quantitative meta-analyses indicated that there is limited available evidence that the total volume or patterns of sedentary behaviour are associated with health in children and adolescents when accounting for moderate-intensity to vigorous-intensity physical activity or focusing on studies with low risk of bias .
Quality evidence from studies with robust design s and methods , objective measures of sitting , examining associations for various health outcomes , is needed to better underst and if the overall volume or patterns of sedentary behaviour are independent determinants of health in children and adolescents
Sedentary behaviour has emerged as a unique determinant of health in adults .
Studies in children and adolescents have been less consistent .
We review ed the evidence to determine if the total volume and patterns ( i.e. breaks and bouts ) of objective ly measured sedentary  behaviour  were associated with adverse health outcomes in young people , independent of moderate-intensity to vigorous-intensity physical activity .