Sedentary behavior and dietary intake in children, adolescents, and adults. A systematic review.

CONTEXT Sedentary behavior is implicated in youth and adult overweight and obesity. However, the relationship between sedentary behavior and weight status is often small or inconsistent, with few studies controlling for confounding factors such as diet and physical activity. Diet has been hypothesized to covary with some sedentary behaviors. It is opportune, therefore, to review whether dietary intake is associated with sedentary behavior in young people and adults. This may allow for better interpretation of the diversity of findings concerning sedentary behavior and weight status. EVIDENCE ACQUISITION Published English-language studies were located from computerized and manual searches in early 2010. Included studies were observational studies assessing an association between at least one sedentary behavior and at least one aspect of dietary intake in children (aged <11 years), adolescents (aged 12-18 years), or adults (aged >18 years). EVIDENCE SYNTHESIS Fifty-three studies, totaling 111 independent samples, were eligible for this review. Sedentary behavior in children (n=19, independent samples=24), adolescents (n=26, independent samples=72), and adults (n=11, independent samples=14) appears to be clearly associated with elements of a less healthy diet including lower fruit and vegetable consumption; higher consumption of energy-dense snacks, drinks, and fast foods; and higher total energy intake. Strengths of association were mainly in the small-to-moderate range. CONCLUSIONS The association drawn mainly from cross-sectional studies is that sedentary behavior, usually assessed as screen time and predominantly TV viewing, is associated with unhealthy dietary behaviors in children, adolescents, and adults. Interventions need to be developed that target reductions in sedentary time to test whether diet also changes.