Background and Objective: China has experienced a rapid increase in the number of obese and overweight
children, and sedentary behavior has been recognized as an important factor. The purpose of this review is
to summarize studies on the relationship between sedentary behavior and obesity in school-age children in China.
Methods: A systematic search was conducted to identify studies that investigate the relationship between sedentary
behavior and obesity in children between the ages of 6 and 18 years in China. Two researchers independently
screened studies, assessed their methodological quality, and extracted relevant data. Findings on the relationship
between sedentary behavior and obesity in children were synthesized and analyzed.
Results: A total of 17 studies were included in the review. Fifteen out of 17 studies indicated that spending too
much time engaged in sedentary behavior, especially screen-based sedentary behavior, was associated with obesity
in children and adolescents in China. Possible reasons for this association are less energy expenditure, increased
energy intake, and insufficient sleep owing to overtime sedentary behavior. Moreover, seven, six, and
three studies justified children’s physical activity, dietary intake, or sleep, and most of the studies (five, three, and
two) indicated that association between sedentary behavior and obesity is independent of these justified variables.
Although differences in gender and area of residence in the association between sedentary behavior and obesity
were examined in five studies, definite conclusions could not be drawn because of inconsistent findings or limited
Conclusion: Future research is necessary to enhance understanding of demographic differences in the association
between sedentary behavior and obesity in children as well as on the contributions of different types of sedentary
behavior to child obesity in China.