Association between meeting the 24-hour movement guidelines and cardiometabolic risk factors in toddlers, preschoolers, children, and adolescents: A systematic review and meta-analysis

This study evaluated adherence to the 24-Hour Movement Guidelines (24-HMG) among youth aged 2-17 and its association with cardiometabolic risk factors (CMRFs). Searches were conducted using four databases. 38 observational studies met the inclusion criteria. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using fixed- or random-effects models. Only 8.39% of participants adhered to all components of the 24-HMG, with adherence decreasing with age. Meta-analysis results indicated that adherence to 24-HMG was significantly associated with favourable CMRFs, including: Overweight/obesity (OR = 0.59, 95%CI = 0.47-0.74), waist circumference (OR = 0.29, 95%CI = 0.09-0.92)], triglycerides (OR = 0.86, 95%CI = 0.79-0.94), high density lipoprotein cholesterol (OR = 1.04, 95%CI = 1.02-1.05)],systolic blood pressure (OR = 0.99, 95%CI = 0.98-0.99)], glucose (OR = 0.97, 95%CI = 0.96-0.97), and insulin (OR = 0.55, 95%CI = 0.31-0.96)]. No association was found with diastolic blood pressure (OR = 0.99, 95%CI = 0.99-1.00). No significant association was observed between adherence to any single guideline (physical activity, sedentary behaviour and sleep) component and overall CMRFs. Subgroup analysis showed that European populations had higher adherence to all three guidelines (P < 0.01) and significantly lower waist circumference compared to North American populations (P = 0.03). Adherence to the full 24-HMG is low among youth but offers notable protection against cardiometabolic risks. Following individual components alone does not yield the same health benefits.