Associations of different types of physical activity and sedentary behavior with self-rated health in children and adolescents: a systematic review of research from 2010 to 2024

Liang, Yahan; Zhu, Xihe; Yang, Ji-Hye; Wang, Fei; Zhang, Danqing; Yang, Xingyi; Chen, Sitong; Liu, Yang

doi:10.1186/s12966-025-01747-2

International Journal of Behavioral Nutrition and Physical Activity

Table 2 Characteristics of the included studies (n = 47)

From: Associations of different types of physical activity and sedentary behavior with self-rated health in children and adolescents: a systematic review of research from 2010 to 2024

Author, publish year	Sample size (F%) Age or grade	Measuring tool		Findings
Author, publish year	Sample size (F%) Age or grade	PA	SB	PA and SRH (frequency or duration, if available)	SB and SRH (frequency or duration, if available)
Cross-section studies
Park, 2024 [37]	166,590 (48.3%) 7–12 grades	Q	Q	PA: in 2019 ( +), 2020 ( +), 2021 ( +)	SB for study purpose: in 2019 (-), 2020 (-), 2021(-) SB for purpose other than study: in 2019 (-), 2020 (-), 2021(-)
Moran et al., 2024 [38]	11,859 (49.9%) 13–15 years	Q	NA	MVPA (≥ 1 h/d): 1–2 d/wk ( +), 3–4 d/wk ( +), 5–6 d/wk ( +), 7 d/wk ( +)	NA
Liang et al., 2024 [32]	4227 (52.12%) 8–17 years	Q	Q	M: MVPA (≥ 1 h/d): weekdays ( +), weekends ( +); school-based PA (> 1 h/d) ( +); extracurricular VPA (> 1 h/d) ( +) F: MVPA (≥ 1 h/d): weekdays ( +), weekends ( +); school-based PA (> 1 h/d) (O); extracurricular VPA (> 1 h/d) ( +)	M: Recreational screen time (> 2 h/d): weekdays (O)^a, weekends (O)^a; homework (> 2h/d): weekdays (O)^a, weekends (O)^a F: Recreational screen time (> 2h/d): weekdays (-)^a, weekends (-)^a; homework (> 2h/d): weekdays (O)^a, weekends (O)^a
Du et al., 2024 [39]	7993 (47.5%) 10–15 years	NA	Q	NA	Internet use (-)^b
de Sales et al., 2024 [40]	1182 (48.5%) 11–17 years	Q	NA	MVPA ( +)	NA
Gonzalez-Alvarez et al., 2023 [41]	1250 (49.9%) 12–17 years	Q	Q	PA: 1–2 times/wk (O), 3–4 times/wk (O), 5–6 times/wk ( +), ≥ 7 times/wk ( +)	SB: little time (O), moderate time (O), lot of time (O)
Wang et al., 2023 [42]	426 7–12 grades	Q	NA	MVPA ( +)	NA
Shi et al., 2023 [43]	2407 (46.8%) 10–17 years	Q	Q	MVPA (≥ 1 h/d) ( +)	Recreational screen time (> 2h/d) (O)^c
Yang et al., 2023 [44]	8213 (48.1%) 8 grade	Q	Q	Exercise: 0.25–0.5 h/d ( +), > 0.5 h/d ( +); housework: 0.5–1 h/d (O), > 1 h/d ( +)	TV: 1–2 h/d ( +), > 2 h/d ( +); online and playing games: 1–2 h/d (-), > 2 h/d (-); homework time on school: 2–4 h/d (O), > 4 h/d (O); homework time off school: 2–4 h/d (O), > 4 h/d (-)
Kyan et al., 2022 [10]	6768 (50.7%) 10–14 years	Q	Q	MVPA (≥ 1 h/d): elementary school students (O), junior high school students ( +)	Recreational screen time (> 2h/d): elementary school students (O)^c, junior high school students (O)^c
Karchynskaya et al., 2022 [45]	888 (44.0%) 11–15 years	Q	NA	MVPA (≥ 1 h/d): 7 d/wk ( +), 5–7 d/wk ( +); organized leisure time sport activity ( +)	NA
Wang et al., 2022 [46]	116,828 (51.8%) 11–15 years	Q	NA	VPA: 7 times/wk ( +)^d	NA
de Fátima Guimarães et al., 2022 [47]	263 (100%) 12–17 years	Q	Q	F: MVPA (≥ 1 h/d) ( +)	F: Recreational screen time (> 2h/d) (-)
Pierannunzio et al., 2022 [48]	58,976 (49.4%) 11,13 and15 years	Q	NA	M: MVPA (≥ 1 h/d, ≥ 4 d/wk): 11 ( +), 13 ( +), 15 ( +) years old; out-of-school VPA (≥ 2 d/wk): 11 (O), 13 ( +), 15 ( +) years old F: MVPA (≥ 1 h/d, ≥ 4 d/wk): 11 (O), 13 ( +), 15 ( +) years old; out-of-school VPA (≥ 2 d/wk): 11 ( +), 13 ( +), 15 ( +) years old	NA
Badura et al., 2021 [49]	45,900 11,13 and15 years	Q	NA	Organized leisure time sports activity ( +)	NA
Tebar et al., 2021 [50]	100,873 (51.9%) 14.3 years	Q	Q	M: PA (≥ 300 min/wk) ( +) F: PA (≥ 300 min/wk) (O)	M: SB (≥ 4 h/d) (-)^e F: SB (≥ 4 h/d) (-)^e
Moral-García et al., 2020 [51]	516 (48.1%) 12–16 years	Q	NA	PA ( +)	NA
Marques et al., 2019 [52]	5024 (52.8%) 10–17 years	Q	Q	PA (≥ 1 h/d) ( +)	Recreational screen time (≥ 2 h/d) (O)
Jodkowska et al., 2019 [22]	1173 (100%) 15 years	Q	Q	F: Physical education (attend all and almost all classes) ( +), out-of-school VPA (≥ 2 d/wk) ( +), MVPA (≥ 1 h/d) ( +)	F: Recreational screen time (> 2 h/d) (-)^f, social media (> 2 h/d) (-)^f
Werneck et al., 2018 [53]	984 (58.8%) 10–17 years	NA	Q	NA	M: Computer and video game (-), TV (O) F: Computer and video game (O), TV (O)
Hwang et al., 2018 [12]	104,750 (46.1%) 7–12 grades	Q	NA	VPA (≥ 3 d/wk) ( +)^g, muscle strengthening activity (≥ 3 days/wk) ( +)^g, moderate PA (≥ 5 d/wk) (O)^g	NA
Li et al., 2018 [9]	4966 (50.7%) 15–16 years	Q	Q	M: PA (≥ 3 times/wk) (O)^h1 F: PA (≥ 3 times/wk) (O)^h1	M: TV: 2–3 h/d (O)^h2, 3–4 h/d (O)^h2, > 4 h/d (O)^h2; video games: 0–1 h/d (O)^h2, 1–2 h/d (O)^h2, 2–3 h/d (O)^h2, > 3 h/d (O)^h2; telephone: 0–0.5 h/d (O)^h2, 0.5–1 h/d (O)^h2, > 1 h/d (O)^h2; mobile phone email use: 2–3 h/d (O)^h2, 3–4 h/d (O)^h2, > 4 h/d (O)^h2; computer: 2–3 h/d (O)^h2, 3–4 h/d (O)^h2, > 4 h/d (O)^h2 F: TV: 2–3 h/d (O)^h2, 3–4 h/d ( +)^h2, > 4 h/d (O)^h2; video games: 0–1 h/d (-)^h2, 1–2 h/d (O)^h2, 2–3 h/d (O)^h2, > 3 h/d (O)^h2; telephone: 0–0.5 h/d (O)^h2, 0.5–1 h/d (O)^h2, > 1 h/d (O)^h2; mobile phone email use: 2–3 h/d (O)^h2, 3–4 h/d (O)^h2, > 4 h/d (-)^h2; computer: 2–3 h/d (O)^h2, 3–4 h/d (O)^h2, > 4 h/d (-)^h2
Curtin et al., 2018 [26]	832 (49.8%) 10–17 years	Q	NA	School-based organized sports (≥ 1 times/wk) (O), after school/saturday school-based organized sport (≥ 1 times/wk) (O), sport outside of school (≥ 1 times/wk) (O)	NA
Silva et al., 2017 [54]	1342 10–17 years	NA	Q	NA	M: TV in weekdays: 2.1–4.0 h/d (O)ⁱ, > 4.0 h/d (O)ⁱ; TV in weekend: 2.1–4.0 h/d (-)ⁱ, > 4.0 h/d (-)ⁱ; video games/computer in weekdays: 0.1–2.0 h/d (O)ⁱ, 2.1–4.0 h/d (O)ⁱ, > 4.0 h/d (O)ⁱ; video games/computer in weekend: 0.1–2.0 h/d (O)ⁱ, 2.1–4.0 h/d (O)ⁱ, > 4.0 h/d (O)ⁱ F: TV in weekdays: 2.1–4.0 h/d (O)ⁱ, > 4.0 h/d (O)ⁱ; TV in weekend: 2.1–4.0 h/d (O)ⁱ, > 4.0 h/d (O)ⁱ; video games/computer in weekdays: 0.1–2.0 h/d ( +)ⁱ, 2.1–4.0 h/d ( +)ⁱ, > 4.0 h/d (O)ⁱ; video games/computer in weekend: 0.1–2.0 h/d ( +)ⁱ, 2.1–4.0 h/d (O)ⁱ, > 4.0 h/d (O)ⁱ
Lachytova et al., 2017 [55]	1111 (47.2%) 14–16 years	Q	Q	VPA: 1 times/wk (O), 2–3 times/wk (O), 4–6 times/wk ( +), everyday ( +)	TV (≥ 2 h/d) (-)^j, computer (≥ 2 h/d) (O)^j
Granger et al., 2017 [56]	12,770 (51.4%) 15 years	Q	Q	MVPA (≥ 1 h/d) ( +)	Recreational screen time (≥ 4 h/d) (O)^k
Husu et al., 2016 [8]	851 (52.0%) 7–14 years	A	A	Steps ( +), light PA ( +), MVPA (O)	SB (-)
Smith et al., 2015 [57]	1689 (46.8%) 11–12 years	Q	Q	Out-of-school PA (O)^l1	SB (O)^l2
Meireles et al., 2015 [27]	974 11–17 years	Q	Q	Active PA (≥ 300 min/wk) (O)^m, active PA (≥ 300 min/wk) ( +)^m	TV (O), video games/computer (O)
Martinez-Lopez et al., 2015 [28]	2293 (50.2%) 12–16 years	Q	Q	M: MVPA (≥ 1 h/d, > 4 d/wk) ( +)ⁿ¹ F: MVPA (≥ 1 h/d, > 4 d/wk) ( +)ⁿ¹	M: TV (≥ 4 h/d): weekdays (O)ⁿ², weekend (O)ⁿ²; computer (≥ 4 h/d): weekdays (-)ⁿ², weekend (O)ⁿ²; homework (≥ 4 h/d): weekdays (O)ⁿ², weekend (O)ⁿ² F: TV (≥ 4 h/d): weekdays (O)ⁿ², weekend (O)ⁿ²; computer (≥ 4 h/d): weekdays (O)ⁿ², weekend (O)ⁿ²; homework (≥ 4 h/d): weekdays (O) ⁿ², weekend (O)ⁿ²
Kantomaa et al., 2015 [30]	2229 (48.4%) 15–16 years	Q	NA	M: Out-of-school PA: the middle tertile (O), the highest tertile ( +) metabolic equivalent of task h/wk F: Out-of-school PA: the middle tertile (O), the highest tertile ( +) metabolic equivalent of task h/wk	NA
Herman et al., 2015 [58]	7725 (49%) 12–17 years	Q	Q	M: PA: ≥ 3.0 kilocalories per kilogram per day ( +)^o1 F: PA: ≥ 3.0 kilocalories per kilogram per day ( +)^o1	M: Recreational screen time (> 2 h/d) (-)^o2 F: Recreational screen time (> 2 h/d) (-)^o2
Badura et al., 2015 [59]	10,503 (50.8%) 11,13 and15 years	Q	NA	Individual sports ( +), team sports ( +)	NA
Moor et al., 2014 [23]	117,460 (53.3%) 11–15 years	Q	Q	MVPA (≥ 1 h/d, ≥ 5 d/wk) ( +)^p1	TV (> 2 h/d) (-)^p2, computer games (> 2 h/d) (-)^p2, computer (> 2 h/d) (-)^p2
Herman et al., 2014 [14]	527 (46.3%) 8–10 years	A	Q & A	M: VPA ( +), MVPA (≥ 1 h/d) ( +)^q1, light PA (O) F: VPA (O), MVPA (≥ 1 h/d) (O)^q1, light PA (O)	M: Video games/computer (> 2 h/d) (O)^q2, reading (> 1 h/d) (O)^q2, TV (> 2 h/d) (O)^q2, homework (> 1 h/d) (O)^q2, SB (O)^q2 F: Video games/computer (> 2 h/d) (-)^q2, reading (> 1 h/d) ( +)^q2, TV (> 2 h/d) (O)^q2, homework (> 1 h/d) (O)^q2, SB (O)^q2
Spein et al., 2013 [60]	598 15–16 years	Q	NA	Out-of-school VPA (≥ 1 times/wk) in Sami ( +)^r, VPA (everyday) in Inuit ( +)^r	NA
Afridi et al., 2013 [25]	414 (46.1%) 14–17 years	Q	NA	MVPA (≥ 3 d/wk) (O)^s	NA
Tabak et al., 2012 [24]	600 (50.8%) 13 years	Q	Q	MVPA: Rural ( +)^t1, urban ( +)^t1	TV: rural (O)^t2, urban (O)^t2; computer: rural (O)^t2, urban (O)^t2
Richter et al., 2012 [61]	6997 (49.9%) 11–15 years	Q	NA	M: MVPA (≥ 1 h/d, ≥ 6 d/wk) (O)^u F: MVPA (≥ 1 h/d, ≥ 6 d/wk) ( +)^u	NA
Zullig et al., 2011 [62]	245 (55.5%) 7–8 grades	Q	Q	M: Sports team ( +)^v1, VPA (≥ 1d/wk) (O)^v1, physical education (≥ 1d/wk) (O)^v1 F: Sports team ( +)^v1, VPA (≥ 1d/wk) (O)^v1, physical education (≥ 1d/wk) (O)^v1	M: TV (≥ 1 h/d) (O)^v2 F: TV (≥ 1 h/d) (O)^v2
Foti et al., 2010) [31]	12,193 9–12 grades	Q	NA	M: MVPA (≥ 1 h/d) ( +)^w1 F: MVPA (≥ 1 h/d) (O)^w1	TV (≥ 3 h/d): Non-Hispanic white (-)^w2, Non-Hispanic black (O)^w2, Hispanic (O)^w2; computers (≥ 3 h/d): Non-Hispanic white (-)^w2, Non-Hispanic black (O)^w2, Hispanic (-)^w2
Longititunal studies
Joensuu et al., 2024 [63]	249 (41.8%) 7 grade	Q & A	NA	M: Self-reported PA ( +), accelerometer based MVPA (O) F: Self-reported PA (O), accelerometer based MVPA (O)	NA
Nigg et al., 2015 [11]	334 (55.1%) 9–12 years	Q	Q	MVPA (O)	Recreational screen time (O)
Liu et al., 2015 [64]	5238 (51.8%) 6–12 years	Q	NA	M: Outdoor PA ( +) F: Outdoor PA (O)	NA
Spengler et al., 2014 [65]	953 (54.5%) 11–17 years	Q	NA	M: PA ( +) F: PA (O)	M: Recreational screen time (O) F: Recreational screen time (O)
Jerdén et al., 2011 [66]	788 12–13 years	Q	NA	M: Out-of-school VPA (> 3times/wk) ( +), out-of-school PA (> 3times/wk) (O) F: Out-of-school VPA (> 3times/wk) ( +), out-of-school PA (> 3times/wk) (O)	NA
Elinder et al., 2011 [67]	2489 (51.8%) 15 years	Q	NA	M: VPA: > 4 h/wk ( +)^x F: VPA: > 4 h/wk (O)^x	NA

PA physical activity, SB sedentary behavior, VPA vigorous physical activity, MVPA moderate to vigorous physical activity, M male, F female, Q questionnaire, A accelerometer, NA not applicable, d day, wk week, h hour
The findings in Table 2 showed the associations between higher levels of PA/SB and better SRH: significant positive association (“ + ”), significant negative association (“-”), or no significant association (“O”). To ensure consistency in the analysis, we standardized the presentation of results from those that reported data differently (e.g. higher SB positively associated with poorer SRH). Their original findings are as follows (see Supplementary Table 3 for details):
^a Compared to > 2 h/d of recreational screen time (reference group), ≤ 2 h/d of recreational screen time was significantly positively associated with better SRH in girls, not boys. Compared to > 2 h/d of homework, ≤ 2 h/d of homework had no significant association with better SRH in boys and girls
^b internet use was significantly positively associated with poorer SRH
^c Compared to > 2 h/d of recreational screen time, ≤ 2 h/d of recreational screen time had no significant association with better SRH
^d Compared to VPA every day, VPA 4–6 times a week, 2–3 times a week, once a week, once a month, less than once a month, or never was significantly positively associated with poorer SRH
^e Compared to ≥ 4 h/day of SB, < 4 h/day of SB was significantly positively associated with better SRH in girls and boys
^f Compared to > 2 h/d of recreational screen time and social media, ≤ 2h/d of recreational screen time and social media were significantly positively associated with better SRH
^g Compared to < 3 d/wk of VPA and muscle-strengthening activity, ≥ 3 d/wk of VPA and muscle-strengthening activity were significantly negatively associated with poorer SRH. Compared to < 5 d/wk of moderate PA, ≥ 5 d/wk of moderate PA had no significant association with poorer SRH
^h1 Compared to ≥ 3 times/wk of PA, ≤ 2 times/wk of PA had no significant association with poorer SRH
^h2 Compared to ≤ 2 h/d of TV, mobile phone email use and computer, > 2 h/d of TV, mobile phone email use and computer were not associated with poorer SRH in boys. In girls, 3–4 h/d of TV were significantly negatively associated with poorer SRH, and > 4 h/d mobile phone email use, and computer were significantly positively associated with poorer SRH in girls. Compared to 0 h/d of video games and telephones, > 0 h/d of video games and telephones were not associated with poorer SRH in boys. In girls, 0–1 h/d of video games was significantly positively associated with poorer SRH
ⁱ Compared to ≤ 2 h/d of TV, > 2 h/d of TV had no significant association with poorer SRH on weekdays in boys and girls, but was positively associated with poorer SRH on weekends in boys, not girls. Compared to 0 h/d of video games/computer, 0.1 to 2.0 h/d of video games/computer were significantly negatively associated with poorer SRH on weekdays and weekends in girls. 2.1 h/d to 4 h/d of video games/computers were significantly negatively associated with poorer SRH in girls on weekdays, not weekends. > 4.0 of video games/computers were not significantly associated with poorer SRH on weekdays and weekends. In boys, > 0 h/d of video games/computer was not significantly associated with poorer SRH on weekdays and weekends
^j Compared to ≥ 2 h/d of TV, < 2 h/d of TV was significantly positively associated with better SRH. Compared to ≥ 2 h/d of computers, < 2 h/d of computers had no significant association with better SRH
^k Compared to ≥ 4 h/day of recreational screen time, < 4 h/day of recreational screen time had no significant association with better SRH
^l1 out-of-school PA had no significant association with poorer SRH
^l2 SB had no significant association with poorer SRH
^m Compared to active PA, insufficient PA had no association with poorer SRH, but inactive PA was significantly positively associated with poorer SRH
ⁿ¹ Compared to ≥ 1 h/d of MVPA > 4 d/wk, ≤ 4 d/wk was significantly positively associated with poorer SRH
ⁿ² Compared to < 4 h/d of TV, computer, and homework, ≥ 4 h/d of TV and homework were not significantly association with poorer SRH in girls and boys. ≥ 4 h/d of computers on weekdays was positively associated with poorer SRH in boys, not girls. ≥ 4 h/d of computers on weekends was not associated with poorer SRH in boys and girls
^o1 Compared to active PA (≥ 3.0 kilocalories per kilogram per day), moderately (1.5–2.9 kilocalories per kilogram per day) and inactive PA (< 1.5 kilocalories per kilogram per day) were significantly positively associated with poorer SRH
^o2 Compared to ≤ 2 h/d of recreational screen time, > 2 h/d of recreational screen time was significantly positively associated with poorer SRH
^p1 Compared to ≥ 1 h/d of MVPA ≥ 5 d/wk, < 5 d/wk was significantly positively associated with poorer SRH
^p2 Compared to < 2 h/d of TV, video games, and computers, > 2 h/d of TV, video games, and computers was significantly positively associated with poorer SRH
^q1 Compared to ≥ 1 h/d of MVPA, < 1 h/d of MVPA was significantly positively associated with poorer SRH in boys, not girls
^q2 Compared to ≤ 2 h/d of video games/computer and TV, > 2 h/d of video games/computer was significantly positively associated with poorer SRH in girls, not boys. > 2 h/d of TV was not significantly associated with poorer SRH in boys and girls. Compared to ≤ 1 h/d of reading and homework, > 1 h/d of reading was significantly negatively associated with poorer SRH in girls, not boys. > 1 h/d of homework was not significantly associated with poorer SRH in boys and girls. Compared to low tertiles of SB, the highest tertiles of SB were not significantly associated with poorer SRH in boys and girls
^r Compared to seldom PA (0 times a week, less than weekly or never), frequent PA (1 or more times a week or every day) was significantly negatively associated with poorer SRH
^s Compared to ≥ 3 d/wk of MVPA, < 3 d/wk of MVPA had no significant association with poorer SRH
^t1 MVPA was significantly negatively associated with poorer SRH
^t2 TV and Computer had no significant association with poorer SRH
^u Compared to MVPA (≥ 1 h/d, ≥ 6 d/wk), MVPA (≥ 1 h/d, < 6 d/wk) was significantly positively associated with poorer SRH in girls, not boys
^v1 Compared to ≥ 1 d/wk of VPA and physical education, < 1d/wk of VPA and physical education had no significant association with poorer SRH. Compared to participants in team sports, no participant in team sports was significantly positively associated with poorer SRH in boys and girls
^v2 Compared to < 1 h/d of TV, ≥ 1 h/d of TV had no significant association with poorer SRH in boys and girls
^w1 Compared to MVPA (≥ 1 h/d, 7 d/wk), MVPA (≥ 1 h/d, < 7 d/wk) was significantly positively associated with poorer SRH in boys, not girls
^w2 Compared to < 3 h/d of TV, ≥ 3 h/d of TV was significantly positively associated with poorer SRH in non-Hispanic white, but not in non-Hispanic black, and Hispanic. Compared to < 3 h/d of computers, ≥ 3 h/d of computers was significantly positively associated with poorer SRH in non-Hispanic white and Hispanic, but not non-Hispanic black
^x Compared to > 4 h/wk of VPA, 2–4 h/wk and < 2 h/wk of VPA were significantly positively associated with poorer SRH in boys, not girls

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