Physical activity, sedentary behavior, and sleep, collectively known as the 24-hour movement behaviors, demonstrate individual and joint benefits on physical and mental health. Examination of these behaviors has expanded beyond guideline adherence to reviews of isotemporal substitution models (ISM) and compositional data analysis (CoDA). This umbrella review sought to review existing systematic reviews to (1) characterize the breadth and scope, (2) examine prevalence estimates for 24-hour movement guideline adherence, and (3) examine the relationship between these behaviors with health outcomes based on various approaches. Eight databases and multiple supplementary strategies were used to identify systematic reviews, meta-analyses and pooled analyses that included two or more of the three 24-hour movement behaviors and a multi-behavior assessment approach. Overall review characteristics, movement behavior definitions, approaches, and health outcomes assessed were extracted, and methodological quality was assessed using the AMSTAR2 tool. Review characteristics (Aim 1), guideline prevalence estimates (Aim 2), and associations with health outcomes (Aim 3) were examined. Thirty-two reviews (20 systematic reviews, 10 meta-analyses, and 2 pooled analyses) were included. Reviews captured the entire lifespan, global regions, and several physical and mental health outcomes. Individual and total guideline adherence waned from preschool to adolescence, but reviews reported similar prevalence estimates and ranges (i.e., within 10%). Common approaches included ISM and CoDA, evaluating 24-hour movement behavior’s interactive associations with health outcomes, guideline adherence, and profile-based analysis. Despite heterogeneous approaches, reviews found consistent evidence for beneficial associations between meeting all three guidelines and high amount of physical activity on physical and mental health outcomes, but varied assessment of sedentary behavior or sleep. Most reviews were rated as low or critically low quality. The breadth and scope of current reviews on 24-hour movement behaviors was wide and varied in this umbrella review, including all ages and across the globe. Prevalence estimates among populations beyond children need to be synthesized. Amongst the variety of definitions and approaches, reviews found benefit from achieving healthy amounts of all three behaviors. Longitudinal multi-behavior original research studies with rigorous assessment of sleep and sedentary behavior may help improve future systematic reviews of these various approaches.

Background: Sleep and dietary intake/quality can contribute to excess weight gain, but food cravings may influence these relationships. This cross-sectional study examined the relationship of adolescents’ sleep characteristics with dietary intake/quality and obesity and whether food cravings mediated these relationships. Methods: Sleep measures were calculated based on 24-h accelerometry, and height and weight were directly measured to calculate body mass index (BMI) z-scores. Food cravings were assessed by the Food Craving Inventory (FCI). Dietary intake and quality were calculated based on dietary recalls. Multivariable linear regression was used to examine the associations among sleep, food cravings, dietary intake/quality, and obesity, adjusting for confounders. Results: In total, 256 adolescents (ages 10–16 years) had complete data; 42% were non-White and 45% were boys. Sleep efficiency was inversely associated with sweet cravings and FCI-28. Sleep duration, meeting the sleep duration guidelines, and fruit/vegetable cravings were each positively associated with dietary quality. Sleep duration was negatively associated with BMI z-score. Mediation models were not performed as no sleep parameter was associated with both cravings and dietary intake/quality or BMI z-score. Conclusions: Associations existed among poor sleep, quantity and quality, with more frequent food cravings and worse dietary quality. Sleep may underlie adolescent obesogenic behaviors.