BACKGROUND: The distribution of time across physical activity, sedentary behaviors, and sleep appears to be essential for the management of obesity. However, the impact of reallocating time among these behaviors, collectively known as 24-h movement behaviors, remains underexplored. OBJECTIVE: This study examines the theoretical effects of reallocating time between 24-h movement behaviors on obesity indicators across different age groups. METHODS: We performed a pooled data meta-analysis of 9818 participants from 11 observational and experimental studies. To estimate the time spent in movement behaviors, we reprocessed and harmonized individual-level raw accelerometer-derived data. Isotemporal substitution models estimated theoretical changes in body mass index (BMI) and waist circumference (WC) associated with time reallocation between movement behaviors. We performed the analysis separately for children, adolescents, adults, and older adults. RESULTS: Even minor reallocations of 10 min led to significant changes in obesity indicators, with pronounced effects observed when 30 min were reallocated. The most substantial adverse effects on BMI and WC occurred when moderate-to-vigorous physical activity (MVPA) was reallocated to other movement behaviors. For 30-min reallocations, the largest increase in BMI (or BMI z-score for children) occurred when MVPA was reallocated to light-intensity physical activity (LPA) in children (0.26 units, 95% confidence interval [CI] 0.15, 0.37) and to sedentary behavior (SB) in adults (0.72 kg/m2, 95% CI 0.47, 0.96) and older adults (0.73 kg/m2, 95% CI 0.59, 0.87). The largest increase in WC was observed when MVPA was substituted with LPA in adults (2.66 cm, 95% CI 1.42, 3.90) and with SB in older adults (2.43 cm, 95% CI 2.07, 2.79). Conversely, the highest magnitude of the decrease in obesity indicators was observed when SB was substituted with MVPA. Specifically, substituting 30 min of SB with MVPA was associated with a decrease in BMI z-score by - 0.15 units (95% CI - 0.21, - 0.10) in children and lower BMI by - 0.56 kg/m2 (95% CI - 0.74, - 0.39) in adults and by - 0.52 kg/m2 (95% CI - 0.61, - 0.43) in older adults. Reallocating time away from sleep and LPA showed several significant changes but lacked a consistent pattern. While the predicted changes in obesity indicators were generally consistent across age groups, inconsistent findings were observed in adolescents, particularly for reallocations between MVPA and other behaviors. CONCLUSIONS: This investigation emphasizes the crucial role of MVPA in mitigating obesity risk across the lifespan, and the benefit of substituting SB with low-intensity movement behaviors. The distinct patterns observed in adolescents suggest a need for age-specific lifestyle interventions to effectively address obesity. Emphasizing manageable shifts, such as 10-min reallocations, could have significant public health implications, promoting sustainable lifestyle changes that accommodate individuals with diverse needs, including those with severe obesity.

Australian Catholic University Banyo QLD Australia

Australian Catholic University North Sydney NSW Australia

Australian Catholic University Strathfield NSW Australia

Centre for Active Living and Learning College of Human and Social Futures University of Newcastle Callaghan NSW Australia

CIBER of Epidemiology and Public Health Madrid Spain

Department of Kinesiology and Physical Education McGill University Montreal QC Canada

Department of Preventive Medicine and Public Health School of Medicine Universidad Autonoma de Madrid Madrid Spain

Edge Hill University Ormskirk UK

Faculty of Medicine Health and Sports Department of Sport Sciences Universidad Europea de Madrid Villaviciosa de Odón Madrid Spain

Faculty of Physical Culture Palacký University Olomouc tř Míru 117 771 11 Olomouc Czech Republic

Faculty of Science Palacký University Olomouc 17 listopadu 12 779 00 Olomouc Czech Republic

Faculty of Sport and Health Sciences University of Jyväskylä Jyväskylä Finland

Faculty of Sport Sciences University Isabel 1 09003 Burgos Spain

Hunter Medical Research Institute New Lambton Heights NSW Australia

IMDEA Food Institute CEI UAM CSIC Madrid Spain

La Inmaculada Teacher Training Centre University of Granada 18013 Granada Spain

La Trobe University Melbourne VIC Australia

Navarrabiomed Hospital Universitario de Navarra IdiSNA Navarra Spain

The University of Newcastle Callaghan NSW Australia

The University of Queensland St Lucia QLD Australia

Universidad de Castilla La Mancha Cuenca Spain

Universidad de Sevilla Seville Spain

Universidade Federal de Santa Catarina Florianopolis Brazil

Université Paris Cité Inserm Paris France

Université Paris Cité Inserm U1153 EpiAgeing Paris France

University of Granada Granada Spain

University of Otago Christchurch New Zealand

University of Otago Dunedin New Zealand

University of South Australia Adelaide SA Australia

University of Wollongong Wollongong NSW Australia

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