Associations between Sedentary Behavior, Cardiorespiratory Fitness, Physical Activity Intensity, and Cardiovascular Risk in Adolescents: A Prisma-Based Systematic Review and Meta-Analysis

Moch Yunus; Tisnalia Merdya  Andyastanti; Agung  Kurniawan; Hartati Eko  Wardani

doi:10.55927/ajha.v5i1.16011

Authors

Moch Yunus Faculty of Medicine, Universitas Negeri Malang
Tisnalia Merdya Andyastanti Faculty of Medicine, Universitas Negeri Malang
Agung Kurniawan Faculty of Medicine, Universitas Negeri Malang
Hartati Eko Wardani Faculty of Medicine, Universitas Negeri Malang

DOI:

https://doi.org/10.55927/ajha.v5i1.16011

Keywords:

Sedentary Behavior, Cardiorespiratory Fitness, Adolescents, Cardiometabolic Risk, BMI, Waist Circumference, Blood Pressure

Abstract

This study aims to systematically review the relationship between sedentary behavior (SB) and various cardiometabolic health indicators in adolescents. The method used was a literature synthesis of 21 international and local studies reporting associations between SB and cardiorespiratory fitness (CRF), body mass index (BMI), waist circumference, blood pressure, and clustered cardiometabolic risk scores. The analysis results indicate that SB is consistently negatively associated with CRF, with correlations ranging from r = −0.21 to −0.45, as well as reductions in VO₂max of −0.30 to −0.65 standard deviations. In addition, adolescents in the highest SB quartile had a 1.25–1.85 times greater risk of obesity, BMI increases of 0.3–1.2 kg/m², larger waist circumference, and elevated systolic blood pressure of 2–6 mmHg. SB was also positively associated with clustered cardiometabolic risk scores (+0.28 to +0.52 SMD), reflecting systemic effects on blood glucose, lipids, and insulin resistance. These findings confirm that sedentary behavior is an independent risk factor for cardiorespiratory fitness and cardiometabolic health in adolescents, therefore interventions emphasizing reduced sedentary duration, increased moderate to vigorous physical activity, and regular active breaks represent important strategies for preventing cardiometabolic diseases from an early age.

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