Table 1 Characteristics of included studies and main findings
Authors (year) and study design | Country | PA measure | SB measure | Sleep measure | Mental Health outcome | N and Statistical Analysis | Age in years: Mean and/or range | Sex/Gender | Main findings |
|---|---|---|---|---|---|---|---|---|---|
Baillot et al., (2022) [101] Cross-sectional | Canada | Accelerometer (ActiCal—right hip) MVPA | Questionnaire (self-reported screen time use) | Questionnaire (average hours/day) | General mental health (self-rated) | 10,515; Logistic regression | M = 45; Range = 18–79 | 49.64% female | Meeting 1* guideline was associated with significantly better odds of very good or excellent mental health among Obese 1 group; No associations observed for Normal Weight, Overweight and Obese 2 groups |
Bang et al., (2020) [102] Cross-sectional | Canada | Accelerometer (Actical – right hip) MVPA | Questionnaire (weekly recreational ST; Parent-reported for ages 6–11 years, Child-reported for ages 12–17 years) | Questionnaire (average hours/day; Parent-reported for ages 5–11 years, Child-reported for ages 12–17 years) | Emotional difficulties (SDQ); General mental health (youth only) | 4,250 (2773 children; 1477 youth); Logistic regression | Range = 5–17 | 48.7% Female (5–11 years); 48.8% Female (12–17 years) | Children: Meeting any number or specific combination of guidelines was not associated with less emotional difficulties compared to meeting none of the guidelines Youth: Meeting 2 + * (total) guidelines and the SL + PA* (combination) guidelines were associated with more favorable scores for emotional difficulties compared to meeting none of the guidelines Youth: Meeting any number or specific combination of guidelines was not associated with better mental health compared to meeting none of the guidelines |
Blodgett et al., (2023) [103] Cross-sectional | United Kingdom | Accelerometer (activPAL—thigh) LPA and MVPA | Accelerometer (activPAL—thigh worn) SB | Accelerometer (activPAL—thigh worn) SL | Depression (anti-depressant medication prescription and visited doctor due to depressive symptoms) | 4738; CoDA, including ISM | M = 46 | 52.3% female | CoDA: SL was associated with greater risk of depression, whereas LPA and MVPA were associated with lower risk of depression ISM: - + MVPA/-SL or SB or LPA: lower risk of depression - + LPA/-SL or SB: lower risk of depression - + SL/-MVPA or LPA or SB: greater risk of depression |
Brown, Cairney, et al., (2021) [53] Cross-sectional | Canada | Questionnaire (weekly MVPA via IPAQ-SF) | Questionnaire (average daily time spent using devices during free time) | Questionnaire (average sleep duration) | Flourishing (FS); Self-Esteem (RSE); Resiliency (two-item measure) | 1166; Latent profile analysis | M = 16 | 54% female | Sleep patterns were similar (adequate amount) across profiles so profiles were characterized by differences in ST & MVPA Flourishing: High MVPA/Low ST * > Low MVPA/Low ST > High MVPA/High ST & Low MVPA/High ST Self-Esteem: High MVPA/Low ST * > Low MVPA/Low ST & High MVPA/High ST & Low MVPA/High ST Resiliency: High MVPA/Low ST > Low MVPA/Low ST; High MVPA/Low ST = High MVPA/High ST; High MVPA/High ST > Low MVPA/Low ST; High MVPA/Low ST & Low MVPA/Low ST & High MVPA/High ST > Low MVPA/High ST |
Brown, McPhee et al., (2021) [59] Cross-sectional | United States | Questionnaire (parent-reported days of physical activity per week with 60 or more minutes) | Questionnaire (parent-reported average daily hours of recreational screen time use) | Questionnaire (parent-reported hours of sleep most weeknights) | Depression and Anxiety (parent indicated whether child received diagnosis from doctor) | 8554; Logistic regression | Children with Neuro-developmental disorders: 12 | 37.3% female | Meeting 1 or 2* guidelines was associated with the lowest odds of anxiety and depression compared to meeting none |
Brown and Ronen (2021) [60] Cross-sectional | United States | Questionnaire (parent-reported days of physical activity per week with 60 or more minutes) | Questionnaire (parent-reported average daily hours of recreational screen time use) | Questionnaire (parent-reported hours of sleep most weeknights) | Depression and Anxiety (parent indicated whether child received diagnosis from doctor) | 663 (Active epilepsy); 526 (Previous epilepsy); Logistic regression | Active epilepsy: 11; Previous epilepsy: 12; Range = 6–17 | 50.5% Female (Active Epilepsy); 37% Female (Previous Epilepsy) | Meeting any number of guidelines was not associated with reduced odds of anxiety compared to meeting none of the guidelines Meeting 1 or all 3* guidelines was associated with the lowest odds of depression compared to meeting none |
Brown, Kwan, et al., (2021) [57] Cross-sectional and longitudinal | United States | Questionnaire (weekly MVPA frequency) | Questionnaire (average weekly hours of ST) | Questionnaire (average hours of nightly SL) | Depressive symptoms (CES-D) | 6436; Latent profile analysis | M = 16 | 51.7% female | Sleep patterns were similar (adequate amount) across profiles, so profiles were characterized by differences in ST & MVPA Cross-sectional and longitudinal (1-year later): Depressive symptoms: High MVPA/low ST profile (profile 1)* < High MVPA/High ST = Low MVPA/Low ST = Low MVPA/high ST |
Brown and Kwan (2021) [54] Cross-sectional | Canada | Questionnaire (weekly MVPA via IPAQ-SF) | Questionnaire (average daily time spent using devices during free time) | Questionnaire (average hours of nightly SL) | Flourishing (FS); Self-Esteem (RSE); Resiliency (two-item measure) | 1118; ISM | M = 16 | 54.5% Female | Flourishing (> = 8 h sleep): - + MVPA/-SL or ST: more favorable scores Flourishing (< 8 h sleep): - + MVPA or SL/-SB: more favorable scores Self-Esteem: - + MVPA or SL/-SB: more favorable scores Resiliency: - + MVPA or SL/-SB: more favorable scores |
Brown, Faulkner et al., (2022) [104] Cross-sectional | Canada | Questionnaire (weekly MVPA via IPAQ-SF) | Questionnaire (average hours of weekday recreational ST) | Questionnaire (average hours of nightly SL) | Psychological Distress (K10); Mental wellbeing (WEMWBS) | 15,080; Latent profile analysis | M = 21 | 67.1% Female | Sleep patterns were similar (adequate amount) across profiles, so profiles were characterized by differences in ST & MVPA Psychological Distress: High MVPA/Low ST* < Very high MVPA/Low ST = Low MVPA/Low ST < High MVPA/High ST = Low MVPA/High ST Mental well-being: High MVPA/Low ST * = Very High MVPA/Low ST *; Low MVPA/Low ST = High MVPA/High ST > Low MVPA/High ST |
Brown, Hill, et al., (2022) [85] Cross-sectional | Canada | Questionnaire (weekly MVPA via IPAQ-SF) | Questionnaire (average daily hours of recreational ST via International Sedentary Assessment Tool); Questionnaire (average daily sitting time—SB) | Questionnaire (average hours of nightly SL) | Suicidal ideation; Suicidal planning | 17,633; Logistic regression with covariate balancing propensity score weighting | M = 22 | 67.1% female | Meeting the PA + SL, SB + SL or all 3* guidelines was associated with the lower odds of suicidal ideation compared to meeting none Meeting the PA + SL* guidelines was associated with the lower odds of suicidal planning compared to meeting none |
Bu al., (2021) [62] Cross-sectional | China | Questionnaire (weekly MVPA via IPAQ-SF) | Questionnaire (daily SB via IPAQ-SF) | Questionnaire (sleep duration via PSQI) | Anxiety symptoms (Chinese version of SAS) | 1846; Logistic regression | M = 21 | 64% Female | Meeting any number of guidelines less than all three was associated with greater odds of anxiety symptoms |
Burns et al., (2020) [105] Cross-sectional | United States | Questionnaire (days of physical activity per week with 60 or more minutes; days per week of muscle strengthening activity) | Questionnaire (average daily hours of recreational ST) | Questionnaire (hours of school-night sleep) | Perceived loneliness; Prolonged sadness | 1897; Logistic regression | M = 16 | 48.4% Female (weighted) | Meeting the PA + SL*, ST + SL, or all 3 guidelines was associated with lower odds of perceived loneliness compared to meeting none Meeting all PA + ST, ST + SL, or all 3* guidelines was associated with lower odds of prolonged sadness compared to meeting none |
Cabanas-Sánchez et al., (2021) [79] Cross-sectional and longitudinal | Spain | Accelerometer (ActiGraph wGT9x—wrist worn) LPA and MVPA | Accelerometer (ActiGraph wGT9x—wrist worn) SB | Accelerometer (ActiGraph wGT9x—wrist worn) SL | Depressive symptoms (GDS-10); Loneliness (three-item loneliness scale); Happiness (Cantril Ladder of Life Scale); Global mental health (12-item Short Form Health Survey) | 2,489 (cross-sectional); 1,679 (prospective); CoDA, including ISM | Cross-sectional: M = 72; Longitudinal = 71 | 53.07% Female (cross-sectional); 51.70% Female (prospective) | Cross-sectional: CoDA: The 24-h movement composition was associated with depressive symptoms and happiness, and time spent in MVPA (relative to other behaviors) was associated with more favorable scores for both outcomes. No association was observed for the 24-h composition with general mental health or loneliness, although MVPA was associated with more favorable scores for loneliness (relative to other behaviors) ISM: - + MVPA/-SL or SB: lower depression symptoms - + SL or SB/-LPA: lower depression symptoms - + LPA or SL/-SB: better general mental health - + MVPA/- SB, LPA or SL: lower loneliness - + MVPA/- SB, LPA or SL: higher happiness Longitudinal: CoDA: The 24-h movement composition was not associated with depressive symptoms, loneliness, happiness or general mental health, although time spent in SL (relative to other behaviors) was associated with less favorable scores for depressive symptoms and time spent in MVPA was associated with more favorable scores for general mental health ISM: - + SB/-SL: lower depression symptoms ISM: - + MVPA/- SB, LPA or SL: better general mental health |
Cao et al., (2020) [106] Cross-sectional | China | Questionnaire (days of physical activity per week with 60 or more minutes) | Questionnaire (average daily time spent using screen-based devices) | Questionnaire (typical hours of nightly sleep) | Depressive symptoms (CESD) | 4178; Cluster analysis | M = 14 | 53.4% Female | Depressive symptoms: Active = High SL < High ST = Low MVPA/Low SL |
Carson et al., (2019) [67] Cross-sectional | Canada | Accelerometer (Actigraph GT3X-BT – non-dominant wrist) LPA and MVPA | Questionnaire (parent-reported recreational ST) | Accelerometers (Actigraph GT3X-BT—non-dominant wrist) | Behavioral and emotional problems (parent report; CBCL) | 539; Linear regression | M = 3 | 47.9% Females (outcome data present); 49.9% Female (exposure data present) | Meeting any number of guidelines was not associated with differences in total problems or internalizing problems compared to meeting all three guidelines Compared to meeting the PA and ST guidelines, meeting none of the guidelines was associated with higher total problems. Compared to meeting the ST and SL* guidelines, meeting none was associated with higher total problems and internalizing problems |
Chao et al., (2022) [63] Cross-sectional | China | Questionnaire (weekly MVPA and walking via IPAQ-SF) LPA & MVPA | Questionnaire (average daily sitting time via IPAQ-SF) SB | Questionnaire (typical hours of nightly sleep) | Anxiety symptoms (SAS) | 1475; CoDA, including ISM | M = 21 | 68.0% Female | CoDA: The 24-h movement composition was significantly associated with anxiety ISM (5–15 min): - + LPA/-SL: higher anxiety symptoms - + MVPA/-SL: higher anxiety symptoms - + LPA/-SB: higher anxiety symptoms - + MVPA/-SB: higher anxiety symptoms - + MVPA/-LPA: lower anxiety symptoms - + SL/-MVPA: lower anxiety symptoms |
Chong et al., (2021) [78] Cross-sectional and longitudinal | Australia | Accelerometer (GENEActiv—wrist-worn) LPA and MVPA | 1) Accelerometer (GENEActiv—wrist-worn) SB 2) Questionnaire (average time spent engaging in sedentary and screen-based activities on weekdays and weekends during a typical week) ST | Accelerometer (GENEActiv—wrist-worn) Sleep | Emotional problems, total difficulties (SDQ); Psychological Distress (K10) | 127 (cross-sectional); 88 (longitudinal); CoDA | Cross-sectional: M = 12, Range = 10–12; Longitudinal: M = 13, Range = 11–13 | 57.5% Female (cross-sectional); 59% Female (longitudinal) | Cross-Sectional: CoDA: The 24-h movement composition was significantly associated with emotional problems and total difficulties, but not psychological distress. Relative to other behaviors, SL was associated with lower emotional problems scores, whereas SB and LPA were associated with higher scores; SL was associated with lower total difficulties scores, whereas LPA and ST were associated with higher scores; ST was associated with higher psychological distress scores Prospective (1 year): CoDA: No association between 24-h movement composition and emotional problems, total difficulties, or psychological distress |
Christian et al., (2022) [107] Cross-sectional | Australia | Accelerometer (ActiGraph GT3X +—hip worn) | Questionnaire (parent-reported hours per day of recreational ST) | Questionnaire (parent-reported average daily sleep) | Emotional problems, total difficulties (SDQ) | 1363; Linear regression | M = 3 | 47.98% female | For boys (but not girls), meeting the PA + SL, SB + SL*, or all 3 guidelines was associated with lower total difficulties compared to meeting none of the guidelines Meeting any combination of the guidelines compared to meeting none was not associated with more favorable scores for emotional problems for boys and girls |
Colley et al., (2018) [108] Cross-sectional | Canada | Accelerometer (ActiCal—right hip worn) LPA and MVPA | Accelerometer (ActiCal—right hip worn) Sedentary time | Questionnaire (typical hours of daily sleep) | General mental health | 10,621; ISM | M = 45; Range = 18–79 | 52.2% Female | - + LPA or SL/-SB: better mental health |
Curtis et al., (2020) [109] Cross-sectional | Australia | Accelerometer (GENEActiv—wrist-worn) LPA and MVPA | Accelerometer (GENEActiv—wrist-worn) SB | Accelerometer (GENEActiv—wrist-worn) Sleep | Depression & Anxiety (DASS-21) | 430; CoDA, including ISM | M = 41 | 74% Female | The 24-h movement composition was not associated with depression or anxiety |
Curtis et al., (2023) [110] Cross-sectional | Australia | Accelerometer (Fitbit Charge 3—wrist) LPA and MVPA | Accelerometer (Fitbit Charge 3 -wrist) SB | Accelerometer (Fitbit Charge 3 -wrist) SL | Depression & Anxiety (DASS-21) | 322; ISM | M = 40.4 (5.9) | 58.1% Female | ISM(15 min) anxiety: - + LPA/-SL: lower anxiety scores - + LPA/-SB: lower anxiety scores ISM (15 min) depression: - + LPA/-SL: lower depression scores - + LPA/-SB: lower depression scores |
de Faria et al., (2022) [111] Cross-sectional | Brazil | Accelerometer (ActiGraph wGT3x—right hip) LPA and MVPA | Accelerometer (ActiGraph wGT3x—right hip) SB | Accelerometer (ActiGraph wGT3x—right hip) SL | Depression/anxiety (GHQ-12) | 217; CoDA, including ISM | M = 16; Range = 15–17 | 49.3% Female | CoDA: The 24-h movement composition was significantly associated with depression/anxiety. Relative to other behaviors, time spent in SB was associated with higher depression/anxiety, whereas LPA associated with lower depression/anxiety ISM (10 + min): - + LPA/-SB: lower depression/anxiety - + MVPA/-LPA: higher depression/anxiety |
Del Pozo et al., (2020) [112] Cross-sectional | United States | Accelerometer (ActiGraph AM-7164—hip worn) LPA and MVPA | Accelerometer (ActiGraph AM-7164—hip worn) SB | Questionnaire (average hours of daily sleep) | Depressive symptoms (PHQ-9) | 3233; CoDA, including ISM | M = 47 | 52.1% Female | CoDA: Time spent in SB (relative to other behaviors) was associated with greater depressive symptoms ISM: - + MVPA or SL/-SB: lower depressive symptoms |
Dumuid et al., (2022) [82] Cross-sectional | Australia | Accelerometer (GENEActiv—wrist worn) LPA and MVPA | Accelerometer (GENEActiv—wrist worn) SB | Accelerometer (GENEActiv—wrist worn) SL | Life satisfaction (BMDSLSS); Psychosocial Quality of Life (PedsQL 4.0); Total difficulties (SDQ); Depression (MFQ-Short) | 1182; CoDA, including Goldilocks method | M = 12 (0.4) | 49% Female | The 24-h movement composition was significantly associated with life satisfaction, psychosocial QoL, depression, and total difficulties Goldilocks Day for each outcome: Life satisfaction: SL = 11.4 h; SB = 7.5 h; LPA = 2.9 h; MVPA = 2.2 h Psychosocial QoL: SL = 9.7 h; SB = 10.5 h; LPA = 1.7 h; MVPA = 2.1 h Depression: SL = 11.4 h; SB = 8.4 h; LPA = 2.3 h; MVPA = 1.9 h Total difficulties: SL = 11.4 h; SB = 7.3 h; LPA = 3.0 h; MVPA = 2.2 h |
Duncan et al., (2022) [113] Longitudinal | Canada | Questionnaire (weekly MVPA) | Questionnaire (average hours of recreational ST per day) ST | Questionnaire (average hours of sleep per day) SL | Depressive symptoms (CESD-R); Anxiety symptoms (GAD-7); Flourishing (FS); Emotional dysregulation (DERS) | 2645; ISM | Grade = 9–12 | 64.4% Female | ISM (10 min): Depressive symptoms: - + MVPA/-SL: greater depressive symptoms - + MVPA or SL/-ST: lower depressive symptoms Anxiety symptoms: - + MVPA/-SL: greater anxiety symptoms - + SL/-ST: lower anxiety symptoms Emotional Dysregulation: - + MVPA/-SL: greater emotional dysregulation - + MVPA or SL/-ST: lower emotional dysregulation Flourishing: - + MVPA or SL/-ST: greater flourishing |
Fairclough et al., (2021) [55] Cross-sectional | United Kingdom | Accelerometer (ActiGraph wGT9x—non-dominant wrist) LPA and MVPA | Accelerometer (ActiGraph wGT9x—non-dominant wrist) SB | Accelerometer (ActiGraph wGT9x—non-dominant wrist) SL | Self-Esteem (RSE); Depressive symptoms (MFQ); Total difficulties (SDQ) | 359; CoDA, including ISM | Primary school: M = 10.4 (0.7 SD) Secondary school: M = 12.0 (0.3 SD) Full sample: M = 11.5 (1.4 SD) | 49.0% Female (Primary school); 53.0% Female (Secondary school); 50% Female (full sample) | Full Sample: CoDA: The 24-h movement composition was associated with internalizing problems, but not depression, self-esteem, or total difficulties. Relative to other behaviors, SB was associated with greater internalizing problems ISM (5–20 min): - + SB/-SL or MVPA: higher internalizing problems Primary school sample: CoDA: The 24-h movement composition was not associated with depression, self-esteem, total difficulties or internalizing problems Secondary school sample: The 24-h movement composition was not associated with any of the mental health outcomes |
Fairclough et al., (2023) [56] Cross-sectional | United Kingdom | Accelerometer (ActiGraph GT9X—non-dominant wrist) | Accelerometer (ActiGraph GT9X—non-dominant wrist) | Accelerometer (ActiGraph GT9X—non-dominant wrist) SL | Total difficulties, internalizing problems (SDQ) | 301; CoDA, including Goldilocks method | M = 11.1 (1.6) | 60.13% Female | The average time-use composition was significantly associated with total difficulties (mental health) but not internalizing problems. ST was positively associated with overall total difficulties, whereas SL was negatively associated with total difficulties Inter-daily stability was negatively associated (less variability) with total difficulties (mental health) but not internalizing problems Intra-daily variability was not significantly associated with overall mental health or internalizing problems The most favorable composition: Total difficulties: SL = 10 h, ST = 6.5 h, LPA = 6.9 h, and MPA and VPA = 43 min |
Feng et al., (2022) [68] Cross-sectional | China | Questionnaire (weekly MVPA via IPAQ-SF) | Questionnaire (SB via IPAQ-SF; time over the last7days spent on ST) | Questionnaire (average sleep time over past 7 days) | Depression, Anxiety, Stress (Chinese Version of DASS-21) | 2476; Linear mixed models | M = 36 | 76.3% Female | Meeting the PA + ST*, ST + SL, or all 3 guidelines was associated with more favorable scores for depression compared to meeting none of the guidelines Compared to meeting none of the guidelines, meeting 1 or all 3* guidelines were associated with more favorable scores for depression Meeting the PA + ST or SL + ST* guidelines was associated with more favorable scores for anxiety compared to meeting none of the guidelines Compared to meeting none of the guidelines, meeting 2* or 3 guidelines was associated with more favorable scores for anxiety |
Fung et al., (2023) [114] Cross-sectional and longitudinal | United States | Questionnaire (parent-reported days of physical activity per week with 60+ minutes) | Questionnaire (parent-report average daily time they spent engaging in recreational ST) | Questionnaire (parent-reported average daily hours of sleep) | Internalizing problems, total problems (CBCL) | 10,574 (Baseline); 9273 (Follow-up); Linear mixed models | Baseline: M = 10; Follow-up: M = 12 | 48% Female (baseline); 47.7% Female (Follow-up) | Baseline: Meeting any combination of guidelines (all 3*) was associated with the more favorable scores for internalizing problems and total problems compared to meeting none of the guidelines Follow-up: Meeting SL + ST, ST + PA or all 3* guidelines were associated with more favorable scores for internalizing problems and total problems compared to meeting none of the guidelines T2-T1: Meeting ST + PA* guidelines was associated with more favorable scores for internalizing problems compared to meeting none of the guidelines, whereas meeting the SL + ST* guidelines were associated with more favorable scores for total problems |
GarcÃa- Hermosos (2022) [58] Cross-sectional and longitudinal | United States | Questionnaire (physical activity frequency) | Questionnaire (weekly hours of recreational ST) | Questionnaire (sleep duration) | Depression (self-reported diagnosis, symptoms and/or depression medication usage); Suicidal ideation | 7069; Poisson regression | Baseline: M = 15; Follow-up: M = 37 | 56.8% Female | Baseline: Meeting all 3 guidelines was not associated with lower risk of depression compared to meeting none of the guidelines Meeting all 3* guidelines was associated with lower incidence rates of suicidal ideation compared to meeting none of the guidelines Follow-up: Meeting all 3* guidelines in adolescence and adulthood was associated with higher reduced risk of depression and suicidal ideation in adulthood |
Gilchrist et al., (2021) [115] Cross-sectional | Canada | Questionnaire (MVPA using SHAPES) | Questionnaire (average daily time spent using devices) | Questionnaire (average hours of daily sleep) | Depressive symptoms (CESD-R-10); Anxiety symptoms (GAD-7); Flourishing (FS) | 46,413; ISM | Grade 9–12 | 51.5% Female |  < 8 h sleep: - + SL/-ST or MVPA: lower anxiety symptoms - + MVPA or SL/-ST: lower depressive symptoms - + SL/-MVPA: lower depressive symptoms - + MVPA or SL/-ST: greater flourishing scores - + MVPA/-SL: greater flourishing scores  >  = 8 h sleep: - + MVPA/-ST: lower anxiety symptoms - + ST/-SL: higher anxiety symptoms - + MVPA or SL/-ST: lower depressive symptoms - + MVPA or SL/-ST: greater flourishing scores - + MVPA/-SL: greater flourishing scores |
Hajo et al., (2020) [116] Cross-sectional | Canada | Accelerometer (ActiGraph wGT3x—hip) LPA and MVPA | Accelerometer (ActiGraph wGT3x—hip) SB | Questionnaire (average hours of daily sleep) | Mood states (POMS) | 342; Profiles with chi-squared tests | M = 43 | 94% Female | Engaging in healthy amounts of 3/3* movement behaviors, 2/3 behaviors and 0/3 behaviors were associated with more favorable scores than 1/3 behaviors |
Hinkley et al., (2020) [117] Longitudinal | Australia | Accelerometer (ActiGraph GT1M – right hip) | Questionnaire (parent-reported average ST on weekdays and weekends) | Questionnaire (parent-reported average daily sleep) | Quality of Life (PQoL); Self-worth (SPPC); Total difficulties (SDQ) | 1002 (T1), 567 (T2), 568 (T3); Linear and logistic regression | M = 4.6 (0.70) Range = 3–5 | 53% Female | Meeting all 3 guidelines was not associated with more favorable scores for quality of life, self-worth or total difficulties compared to meeting none of the guidelines |
Hofman et al., (2022) [118] Cross-sectional | The Netherlands | Accelerometer (GENEActiv—non-dominant wrist) LPA and MVPA | Accelerometer (GENEActiv—non-dominant wrist) SB | Accelerometer (GENEActiv—non-dominant wrist) SL | Depressive symptoms (CESD); Anxiety (HADS) | 1943; CoDA, including ISM | M = 71 | 52% Female | - + MVPA/-SL or SB: lower depressive symptoms - No effects of ISM on anxiety symptoms |
Hou et al., (2023) [119] Cross-sectional | United States | Questionnaire (parent-reported days of physical activity per week with 60 or more minutes) | Questionnaire (parent-reported average daily hours of recreational screen time use) | Questionnaire (parent-reported hours of sleep most weeknights) | Depression and Anxiety (parent indicated whether the child received diagnosis from doctor); Resilience (parent indicated whether child stays calm and in control) | 907; Multivariable Logistic Regression | M = 12.22 (2.78) | 54.58% Female | Meeting SL + SB* guidelines had lower odds of depression and anxiety compared to meeting none of the guidelines Meeting the SL + PA* guidelines had higher odds of resilience compared to meeting none of the guidelines |
Janssen et al., (2017) [69] Cross-sectional | Canada | Questionnaire (days of physical activity per week with 60 or more minutes; days per week of muscle strengthening activity) | Questionnaire (daily hours of ST) | Questionnaire (average weekday and weekend sleep duration) | Life satisfaction (Cantril ladder); Emotional problems (9 item scale) | 20207–21821; Linear regression | Range = 10–17 | 52.8% Female | Emotional problems: Meeting all 3* guidelines < Meeting 2 guidelines < Meeting 1 guidelines < Meeting None Life satisfaction: Meeting all 3* guidelines > Meeting 2 guidelines > Meeting 1 guidelines > Meeting None Meeting any combination of guidelines was not associated with the more favorable scores for emotional problems or life satisfaction compared to meeting none of the guidelines |
Kandola et al., (2021) [120] Longitudinal | United Kingdom | Accelerometer (Axivity AX3—wrist) LPA and MVPA | Accelerometer (Axivity AX3—wrist) SB | Questionnaire (average hours of daily sleep) | Depressive symptoms (PHQ-9); Anxiety symptoms (GAD-7) | 60235; ISM | M = 55.9 (7.7) | 56% Female | - + LPA, SL or MVPA/-SB: lower depressive symptoms - + LPA/-SB: higher anxiety symptoms - + MVPA or SL/-SB: lower anxiety symptoms |
Kitano et al., (2020) [121] Cross-sectional | Japan | Accelerometer (Active Style Pro HJA750-C—hip) LPA and MVPA | Accelerometer (Active Style Pro HJA750-C—hip) SB | Questionnaire (average hours of daily sleep) | Psychological distress (K6) | 1095; CoDA, including ISM | M = 50 | 68.6% Female | During workday: CoDA: The 24-h movement composition was significantly associated with psychological distress. Relative to other behaviors, SL was associated with lower psychological distress whereas SB and LPA were associated with greater psychological distress ISM:—+ SL/-SB or LPA: lower odds of psychological distress During non-workday: CoDA: The 24-h movement composition was not associated with psychological distress |
Kuzik et al., (2020) [122] Cross-sectional | Canada | Accelerometer (ActiGraph wGT3x—hip) LPA and MVPA | Accelerometer (ActiGraph wGT3x—hip) SB | Accelerometer (ActiGraph wGT3x—hip) SL | Socio-emotional development (CSBQ) | 95; CoDA, including ISM | Range = 3–5 | 30.5% Female | The 24-h movement composition was not associated with internalizing problems. Relative to other behaviors, MVPA was negatively associated with internalizing problems (when influential observations removed) ISM (30-min): - + MVPA/ -SB: lower internalizing problems scores (when influential observations removed) - + MVPA/-SL: lower internalizing problems scores (when influential observations removed) |
Kuzik et al., (2022) [123] Cross-sectional | Canada | Accelerometer (ActiGraph WGT3X-BT—right hip) | Questionnaire (parent-reported, hours of screen time) | Accelerometer (ActiGraph WGT3X-BT—right hip) | Socio-emotional development (CSBQ) | 95; Multiple regression | Range = 3–5 | 30.5% Female | Meeting any combination of guidelines was not associated with more favorable scores for internalizing problems compared to meeting none of the guidelines |
Larisch et al., (2020) [124] Cross-sectional | Sweden | Accelerometer (ActiGraph wGT3x—right hip) LPA & MVPA | Accelerometer (ActiGraph wGT3x—right hip) SB | Accelerometer (ActiGraph wGT3x—wrist worn) SL | Anxiety and depressive symptoms (HADS); Well-being (WHO-Five well-being scale) | 370; CoDA, including ISM | M = 41 | 68% Female | The 24-h movement composition was not associated with depression, anxiety or mental well-being. There were no effects of reallocating time across SL, SB, LPA, MVPA |
Le et al., (2022) [125] Longitudinal | Australia | Accelerometer (ActiGraph wGT3x—wrist) LPA and MVPA | Accelerometer (ActiGraph wGT3x—wrist) SB | Accelerometer (ActiGraph wGT3x—wrist) SL | Daily affect (12-items from PANAS-E) | 361: ISM | M = 22.62 (5.34) | 72.6% Female | - + MVPA/-SL, SB or LPA: greater high arousal positive affect - No changes for high arousal negative affect, low arousal negative affect or low arousal positive affect |
Lee et al., (2018) [126] Cross-sectional | South Korea | Questionnaire (days of physical activity per week with 60 or more minutes) | Questionnaire (average screen time duration per weekday and weekend) | Questionnaire (average daily sleep duration for weekdays and weekends) | Happiness (1- item measure) | 50,987; Logistic regression | M = 15; Range = 12–17 | 49.0% Female | Meeting all 1, 2 or all 3* guidelines was associated with more favorable scores for happiness compared to meeting none of the guidelines (total guidelines) Meeting the PA + ST*, PA + SL, or all 3 guidelines were associated with more favorable scores for happiness compared to meeting none of the guidelines (specific guidelines) |
Li et al., (2022) [70] Cross-sectional | 7 countries: Brazil, Finland, Hong Kong, Mainland China, Singapore, South Korea, USA | Questionnaire (parent-reported days of physical activity per week with 60 or more minutes) | Questionnaire (parent-reported average ST) | Questionnaire (parent-reported average nightly sleep on weeknight) | Quality of life (1-item; parent reported satisfaction of life) | 1165; Linear regression | M = 13.1 (2.2) | 24.4% Female | Meeting an increasing number of guidelines was associated with more favorable scores for quality of life compared to meeting none of the guidelines Meeting any combination of guidelines was associated with similar benefits for quality of life compared to meeting all of the guidelines. Compared to meeting all three, meeting none was associated with lower quality of life |
Liang et al., (2021) [64] Cross-sectional | China | Questionnaire (weekly MVPA via IPAQ-SF) | Questionnaire (SB via IPAQ-SF) | Questionnaire (Chinese version of the PSQI) | Depression (Chinese version of PHQ-9); Anxiety (SAS) | 1846; MANCOVA | M = 21; Range = 18–26 | 64% Female | Meeting any combination of guidelines (all 3*) was associated with more favorable scores for depression compared to meeting none of the guidelines Meeting the SL + PA*, SL + SB, or all 3 guidelines was associated with more favorable scores for anxiety compared to meeting none of the guidelines |
Liang et al., (2023) [127] Cross-sectional | China | Questionnaire (days of physical activity per week with 60 or more minutes) | Questionniare (time spent on screen-based activities) | Questionnaire (1-item from the Chinese version of the PSQI) | Well-being (Chinese version of the World Health Organization Five-Item Wellbeing Index); Resilience (Chinese version of the CD-RISC-10); depression (Chinese version of the PHQ-9); anxiety (Chinese version of the GAD-7) | 67821; Linear regression | M = 13 | 48.1% Female | Specific combinations Meeting any combination of the guidelines (all 3*) was associated with more favorable scores for depression, well-being and resilience compared to meeting none of the guidelines Meeting any combination of the guidelines (ST + SL*) was associated with more favorable scores for anxiety compared to meeting none of the guidelines Total guidelines Meeting any number of guidelines (all 3*) was associated with more favorable scores for depression, anxiety, well-being and resilience compared to meeting none of the guidelines |
Liu et al., (2022) [128] Cross-sectional | United States | Questionnaire (days of physical activity per week with 60 or more minutes) | Questionnaire (hours per day of recreational ST) | Questionnaire (hours of school-night sleep) | Suicidality (1 question for ideation, plan, attempt, and attempt with medical treatment in last 12 months) | 73074; Logistic regression | Grades = 9–12 | 49.9% Female | Meeting all 3* guidelines was associated with lower odds of suicidal ideation and planning compared to meeting none of the guidelines for boys but not girls No differences in suicidal attempts were observed for different numbers of guideline adherence among boys and girls |
López-Gil et al., (2022) [129] Cross-sectional | Spain | Questionnaire (weekly MVPA IPAQ-SF) | Questionnaire (parent-ST use on weekdays and weekends) | Questionnaire (parent-reported average daily sleep) | Total difficulties (SDQ) | 3772; Logistic regression | M = 10; Range = 4–5 (preschool), 6–12 (children), 13–14 (adolescents) | 49.4% Female | Meeting less than all 3 guidelines was associated with greater total difficulties compared to meeting all three guidelines among the total sample, males and females |
Lu et al., (2021) [130] Cross-sectional | China | Questionnaire (days of physical activity per week with 60 or more minutes) | Questionnaire (HBSC average daily ST hours) | Questionnaire (HBSC average hours of sleep per night) | Depressive symptoms (Chinese version of PHQ-9); Anxiety (GAD-7) | 5357; Logistic regression | M = 12 | 44.4% Female | Meeting ST + PA, SL + ST or all 3* were associated with lower depressive symptoms, whereas meeting SL + ST or all 3* were associated with lower anxiety symptoms compared to meeting none of the guidelines Meeting 1, 2 or 3* guidelines were associated with lower depressive and anxiety symptoms compared to meeting none of the guidelines |
Luo et al., (2022) [131] Cross-sectional | China | Questionnaire (CNHS, time spent exercising in various sports were used to calculate meeting PA guideline) | Questionnaire (CHNS, time spent on screen, reading books, and other sedentary behaviors used to calculate meeting SB guideline) | Questionnaire (CHNS; self-reported amount of sleep each night) | Mental health (3-items assessing vitality, well-being and optimism) | 4134; Logistic regression | M = 67 | 67.38% Female | Meeting 2 or all 3* guidelines were associated with more favorable mental health scores compared to meeting none of the guidelines Meeting the PA + SL* guidelines was associated with more favorable mental health scores compared to meeting none of the guidelines |
Luo et al., (2023) [132] Cross-sectional | China | Questionnaire (frequency and duration of PA) | Questionnaire (average daily time spent using screen-based devices) | Questionnaire (daily sleep duration) | Depression (PHQ-9); Anxiety (GAD-7) | 9420; Logistic regression | M = 14.53 (0.69) | 45.2% Female | Meeting the PA + SL, ST + SL, or all 3* had lower odds of depression and anxiety compared to not meeting the guidelines |
McNeill et al., (2020) [74] Cross-sectional and longitudinal | Australia | Accelerometers (ActiGraph GT3X +—right hip) MVPA | Questionnaire (parent-reported recreational ST on weekdays and weekends) | Questionnaire (parent-reported average daily sleep duration) | Total difficulties (Educator-reported version of the SDQ) | 247; Linear Regression | M = 4; Range = 3–5 | 40% Female | Meeting any number or specific combination of guidelines was not associated with more favorable scores for total difficulties compared to meeting none of the guidelines |
Meyer et al., (2020) [133] Cross-sectional and longitudinal | United States | Accelerometer (SenseWear—armband) LPA and MVPA | Accelerometer (SenseWear—armband) SB | Accelerometer (SenseWear—armband) SL | Mood (POMS) | 423; ISM | M = 28; Range: 21–35 | 50% Female | Baseline: -No effects of replacing Total SB with SL, LPA, or MVPA 12-months: - + MVPA or LPA/-SB: more favorable mood scores |
Ohta et al., (2023) [134] Cross-sectional | Japan | Questionnaire (GPAQ, Japanese version) | Questionnaire (GPAQ, Japanese version) | Questionnaire (typical hours and minutes of nightly sleep) | Depressive symptoms (CES-D) | 640; Logistic regression | M = 64.1 (14.0) | 58.3% Female | Meeting the SB + PA or all 3* guidelines were associated with lower odds of depression compared to not meeting the guidelines Meeting 2 or 3* guidelines was associated with lower odds of depression compared to not meeting the guidelines |
Peralta et al., (2022) [71] Cross-sectional | Switzerland | Questionnaire (average hours per week spent in MVPA) | Questionnaire (hours spent on electronic media on weekday and weekend) | Questionnaire (average hours spent asleep on weekday and weekend) | Life Satisfaction (Cantril ladder) | 2534; Linear regression | Range = 5—16 | 51.5% Female | Meeting 2 or all 3* guidelines was associated with greater life satisfaction scores compared to meeting none of the guidelines Meeting the PA + ST*, ST + SL, or all 3 guidelines was associated with greater life satisfaction scores compared to meeting one guideline |
Perez et al., (2022) [135] Cross-sectional | United States | Questionnaire (NHANES two items to assess MVPA in last 30 days) | Questionnaire (average hours of screen use per day in last 30 days) | Questionnaire (average hours of sleep in 24 h period) | PTSD (Primary Care PTSD; PC-PTSD-5); Suicide Ideation (item from NSDUH); Psychological Distress (K6) | 17166; Logistic regression and multivariate models | Range = 18–45 +  | 16.7% females (weighted) | Meeting all 3* or some of the guidelines were associated with more favorable scores for psychological distress and PTSD compared to meeting none of the guidelines among men Meeting some of the guidelines was associated with more favorable scores for psychological distress among women Meeting all three* or some of the guidelines was associated with more favorable scores for suicidal ideation compared to meeting none of the guidelines for men and women |
Porter et al., (2023) [136] Cross-sectional | Canada | Questionnaire (IPAQ) | Questionnaire (average daily hours of recreational ST via International Sedentary Assessment Tool); Questionnaire (average daily sitting time—SB) | Questionnaire (average hours of nightly SL) | Psychological distress (Kessler-10); Mental wellbeing (WEMWS) | 17874; Linear regression (Propensity score weighted) | M = 21.6 (2.94) | 65.2% Female | Meeting all 3* guidelines concurrently was associated with more favorable scores for psychological distress and mental well-being for those with and without chronic health conditions and disabilities |
Sampasa-Kanyinga et al., (2020) [137] Cross-sectional | Canada | Questionnaire (days of physical activity per week with 60 or more minutes) | Questionnaire (average daily time spent using devices in last 7 days) | Questionnaire (average nightly sleep on school night) | Suicidal Ideation (1 item); Suicide Attempts (1 item) | 10183; Logistic regression | M = 15 | 49% Female | Meeting any combination of the guidelines was not associated with differences in suicidal ideation and attempts compared to meeting none of the guidelines among boys ages 11–14 years Meeting all 3* guidelines was associated with more favorable scores for suicidal ideation and attempts compared to meeting none of the guidelines for boys ages 15–20 years Meeting the PA + ST* guidelines was associated with more favorable scores for suicidal ideation compared to meeting none of the guidelines among girls ages 11–14 years, but no differences were observed for suicidal attempts Meeting the PA + SL* guidelines was associated with more favorable scores for suicidal ideation compared to meeting none of the guidelines among girls ages 11–14 years, but no differences were observed for suicidal attempts |
Sampasa-Kanyinga, Colman, Dumuid, et al., (2021) [138] Longitudinal | Canada | Questionnaire (average daily MVPA) | Questionnaire (average daily time they spent using devices during their free time) | Questionnaire (average hours of daily sleep) | Depressive symptoms (CESD-R-10) | 14620 (2,836 younger boys, 2264 older boys, 5060 younger girls, 4460 older girls); CoDA, including ISM | M = 15 | 46% Female | Younger boys: CoDA: Relative to other behaviors, a favorable association was observed for SL with depressive symptoms, whereas an adverse association was observed for ST ISM: - + SL/-MVPA or ST: lower depressive symptoms Younger girls and older boys: - CoDA: Relative to other behaviors, a favorable association was observed for SL with depressive symptoms, whereas an adverse association was observed for ST - + SL/-MVPA or ST: lower depressive symptoms - + MVPA/-ST: lower depressive symptoms Older girls: - Relative to other behaviors, favorable association was observed for SL and MVPA with depressive symptoms, whereas an adverse association was observed for ST - + SL or MVPA/-ST: lower depressive symptoms - + SL/-MVPA: higher depressive symptoms |
Sampasa-Kanyinga, Chaput, et al., (2021) [139] Cross-sectional | Canada | Questionnaire (days of physical activity per week with 60 or more minutes) | Questionnaire (average daily time they spent using devices during their free time) | Questionnaire (average nightly sleep on weekdays and weekend days) | Depression and Anxiety (K6) | 6364; Structural equation modeling | M = 15.1 (1.8) | 48.3% Female (weighted) | Meeting the ST + SL*, PA + SL, or all 3 guidelines were associated with more favorable scores for anxiety symptoms compared to meeting none of the guidelines Meeting any combination of guidelines (ST + SL*) was associated with more favorable scores for depression symptoms compared to meeting none of the guidelines |
Sampasa-Kanyinga, Colman, Goldfield, et al., (2021) [140] Cross-sectional | Canada | Questionnaire (YRBSS; days of physical activity per week with 60 or more minutes) | Questionnaire (YRBS; average hours of ST per day) | Questionnaire (parent-reported number of hours of sleep child gets on most nights) | Internalizing problems (parent-reported CBCL) | 11875; Negative binomial regression | M = 10; Range = 9–11 | 47.9% Female | Meeting any combination of guidelines (all 3*) was associated with more favorable scores for internalizing problems compared to meeting none of the guidelines |
Sampasa-Kanyinga et al., (2022a) [72] Cross-sectional | Canada | Questionnaire (YRBSS; days of physical activity per week with 60 or more minutes; weekly frequency of muscle strengthening activity) | Questionnaire (YRBS; average hours of ST per day) | Questionnaire (hours of school-night sleep) | Self-Esteem (RSE) | 6932; Logistic regression | M = 15; Range = 11–20 | 56.8% Female | Meeting any combination of guidelines (all 3*) was associated with more favorable scores for self-esteem compared to meeting none of the guidelines Meeting 1, 2 or all 3* guidelines were associated with more favorable scores for self-esteem compared to meeting none of the guidelines |
Sampasa-Kanyinga et al., (2022b) [141] Cross-sectional | Canada | Questionnaire (days of physical activity per week with 60 or more minutes) | Questionnaire (average hours of ST per day) | Questionnaire (hours of school-night sleep) | Mental health (1 item) | 5739 (2017), 6960 (2019); Logistic regression | M = 15.2 (1.8) | 51% Female (2017); 50.6% Female (2019) | Meeting 1, 2 or all 3* guidelines were associated with more favorable scores for mental health compared to meeting none of the guidelines among the 2017 and 2019 samples Meeting any combination of guidelines was associated with more favorable scores for mental health compared to meeting none of the guidelines among the 2017 (PA + SL*) and 2019 (all 3*) samples |
St. Laurent, et al., (2023) [142] Cross-sectional | United States | Accelerometer (Actiwatch Spectrum—non-dominant wrist) LPA and MVPA | Accelerometer (Actiwatch Spectrum—non-dominant wrist) SB | Accelerometer (Actiwatch Spectrum – non-dominant wrist) SL | Internalizing behaviors (CBCL) | 388; CoDA, compositional linear regression | M = 51.5 months (9.46); R = 33 – 70 months | 44.4% Female | No association was observed for the 24-h composition with internalizing behaviors |
Sun et al., (2023) [143] Cross-sectional | China | Questionnaire (days of physical activity per week with 60 or more minutes) | Questionnaire (HBSC average daily ST hours) | Questionnaire (Chinese version of the PSQI) | Subjective well-being (WHO-5) | 1098; Linear regression | M = 11.6 (0.8) | 48.5% Female | Meeting 1, 2 or all 3* guidelines were associated with more favorable scores for subjective well-being compared to meeting none Meeting the PA + SL*, PA + SB or all 3 guidelines were associated with more favorable scores for subjective well-being compared to meeting none |
Taylor 2021 [75] Longitudinal | New Zealand | Accelerometer (ActiCal—waist) LMVPA | Accelerometer (ActiCal—waist) SB; Questionnaire (parent-reported average daily time spent using devices) ST | Accelerometer (ActiCal—waist) SL | Anxiety, Depression & Resilience (BASC-2: 2–5 year old scale) | 528; Linear regression | Range = 1- 5 | 48.5% Female | Meeting all 3* guidelines was associated with more favorable scores for depression at 5 years of age compared to meeting none of the guidelines, but no differences were observed at age 1 and 3 years Meeting all 3* guidelines at 1 year of age was associated with more favorable scores for anxiety at 5 years of age compared to meeting none of the guidelines, but no differences were observed when meeting guidelines at age 3 and 5 years Meeting all 3* guidelines was not associated with differences in resilience at 1, 3 and 5 years of age compared to meeting none of the guidelines |
Taylor et al., (2023) [144] Cross-sectional and longitudinal | New Zealand | Accelerometer (Actical—waist) LMVPA | Accelerometer (Actical—waist) SB | Accelerometer (Actical—waist) | Anxiety, Depression & Resilience (BASC-2) | 392; CoDA; Linear regression | Range = 2–5 | 49.7% Female | Cross-sectional: Relative to other behaviors, a favorable association was observed for MVPA with anxiety and resilience Longitudinal: No significant associations were observed for mental health at 2 and 3.5 years of age compared to 5 years |
Vanderlinden et al., (2023) [145] Cross-sectional | Belgium | Accelerometer (Actigraph wGT3X-BT—non-dominant wrist) LMVPA | Accelerometer (Actigraph wGT3X-BT—non-dominant wrist) SB | Accelerometer (Actigraph wGT3X-BT—non-dominant wrist) SL | Mental wellbeing (WEMWBS) | 410; CoDA, including ISM | M = 71.3 (6.3) | 71% Female | CoDA: No behaviors were associated with well-being in the full-adjusted model ISM: No significant associations |
Wang et al., (2022) [73] Cross-sectional | United States | Questionnaire (parent-reported days of physical activity per week with 60 or more minutes) | Questionnaire (parent-reported average screen time per day in last week) | Questionnaire (parent-reported average hours of sleep on a weeknight in last week) | Flourishing (3 questions; parent-reported) | 634; Logistic regression | M = 14; Range = 10–17 | 29.3% Female | Meeting an increasing number of the guidelines was associated with more favorable flourishing scores compared to meeting none of the guidelines (total guidelines) Meeting all 3* guidelines was associated with more favorable flourishing scores (specific guidelines) |
Zhang et al., (2022) [146] Cross-sectional | China | Questionnaire (LPA & MVPA via the PPAQ-C) | Questionnaire (SB via the PPAQ-C) | Questionnaire (typical hours of nightly sleep) | Anxiety (GAD-7) | 873; ISM | Range =  < 30—> 35 | 100% Female | Full sample: - + MVPA, SL or SB/-LPA: lower anxiety scores - + SL/-MVPA or SB: lower anxiety scores  < 7 h nightly sleep: - No effects for reallocating time across behaviors  >  = 7 h nightly sleep: - No effects for reallocating time across behaviors |
Zhang et al., (2023) [147] Cross-sectional and longitudinal | China | Questionnaire (daily MVPA via IPAQ-SF) | Questionnaire (average hours of recreational ST) | Questionnaire (typical hours of nightly sleep) | Depression (PHQ-9); Anxiety (GAD-7) | 906; Linear regression | M = 14.3 (0.9) | 49.0% Female | Cross-sectional: Meeting 1, 2 or all 3* guidelines were associated with lower depression and anxiety symptoms compared to meeting none of the guidelines Meeting PA + ST, ST + SL, or all 3* guidelines were associated with lower depression and anxiety symptoms compared to meeting none of the guidelines Longitudinal: Meeting 1, 2, or all 3* guidelines were associated with lower depression and anxiety symptoms compared to meeting none of the guidelines 6 months later Meeting ST + SL or all 3* guidelines were associated with lower depression and anxiety symptoms compared to meeting none of the guidelines 6 months later |
Zhu et al., (2019) [61] Cross-sectional | United States | Questionnaire (parent-reported days of physical activity per week with 60 or more minutes) | Questionnaire (parent-reported average screen time per day in last week) | Questionnaire (parent-reported average hours of nightly sleep) | Anxiety and depression (parent indicated whether child received diagnosis from doctor) | 20,708; Logistic regression | Range = 5–17 | 49.0% Female (6–11 years); 48.9% Female (12 -17 years) | Meeting any combination of guidelines (all 3*) was associated with reduced risk of depression compared to meeting none of the guidelines among 12–17 year olds, whereas meeting the PA + SL* and ST + SL guidelines was favorable for 6–11 year olds Meeting all 3* guidelines was associated with reduced risk of anxiety compared to meeting none of the guideline among 12–17 year olds, whereas no differences were observed for guideline adherence among 6–11 year olds |
Zhu et al., (2023) [148] Cross-sectional | China | Accelerometer (Active Style Pro HJA-750C) | Questionnaire (parent-reported hours per day of recreational ST) | Questionnaire (parent-reported average nightly sleep) | Internalising problems (SDQ—Chinese version) | 200; Logistic regression | M = 57.5 months (10.0 months) | 49% Female | Weekend: Meeting no guidelines*, PA + SL, or PA + ST had the higher odds of internalizing problems compared to meeting all 3 guidelines Weekday: Meeting any specific combination of guidelines was not associated lower odds of internalizing problems compared to meeting all 3 guidelines |