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Epidemiology and Population Health

Joint associations between weekday and weekend physical activity or sedentary time and childhood obesity



To evaluate the single and joint associations of objectively measured moderate-to-vigorous physical activity (MVPA) and sedentary time on week and weekend days with obesity in children from 12 countries across all inhabited continents.


A multinational, 12-country cross-sectional study of 5779 children aged 9–11 years was conducted. Time spent in MVPA and sedentary behaviors was assessed by waist-worn accelerometry. Logistic regression was used to examine the independent and joint associations of MVPA and sedentary time on weekdays and weekend with the odds of obesity.


After adjustment for all confounding factors, the odds ratios (ORs) of childhood obesity were the highest among children with a low level of MVPA on both weekdays and weekend (OR 4.67), high among children with a high level of MVPA on weekdays and a low level of MVPA on weekend (OR 1.99) and high among children with a low level of MVPA on weekdays and a high levels of MVPA on weekend (OR 2.20), compared to those with a high level of MVPA on both weekdays and weekend. Similarly, the ORs of childhood obesity were significantly higher among children with a high level of sedentary time on both weekdays and weekend (OR 1.87) compared with those with low levels of sedentary time on both weekdays and weekend.


Lower levels of MVPA or higher levels of sedentary time on either weekdays or weekend were associated with increased odds of obesity in 9–11 year old children in 12 countries.

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The International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) was funded by The Coca-Cola Company. Dr. Hu was partly supported by a grant from the National Institute of Diabetes and Digestive and Kidney Diseases (R01DK100790) and the National Institute of General Medical Sciences (U54GM104940) of the National Institutes of Health. With the exception of requiring that the study be global in nature, the funder had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; and preparation, review or approval of the manuscript.

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Correspondence to Gang Hu.

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Li, N., Zhao, P., Diao, C. et al. Joint associations between weekday and weekend physical activity or sedentary time and childhood obesity. Int J Obes 43, 691–700 (2019).

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