Psychology of Sport & Exercise 47 (2020) 101558

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Psychology of Sport & Exercise

journal homepage: www.elsevier.com/locate/psychsport

Associations between physical activity and sedentary time profiles T

transitions and changes in well-being in youth: The UP&DOWN longitudinal
study
David Sánchez-Olivaa,b,∗, Irene Esteban-Cornejoc,d, Carmen Padilla-Moledoa,b,
Alejandro Pérez-Beya,b, Óscar L. Veigae, Verónica Cabanas-Sáncheze,f, José Castro-Piñeroa,b
a
Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Puerto Real, Spain
b
Biomedical Research and Innovation Institute of Cádiz (INiBICA), Cádiz, Spain
c
Center for Cognitive and Brain Health, Department of Psychology, Northeastern University, Boston, MA, USA
d
PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences,
University of Granada, Granada, Spain
e
Department of Physical Education, Sports and Human Movement, Faculty of Teaching Training and Education, Autonomous University of Madrid, Madrid, Spain
f
Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport. University of Porto, Porto, Portugal

A R T I C LE I N FO A B S T R A C T

Keywords: Objectives: The current study aimed at analyzing the associations between latent transitions based on sedentary
Lifestyle profiles time and physical activity levels and changes in Health-Related Quality of Life (HRQoL), positive affect, and
Transition negative affect over two years in children and adolescents.
Quality of life Design: Longitudinal design.
Affect
Methods: Participants were 1099 children and adolescents (544 girls) aged 8–18 years old (11.72 ± 2.39 years).
Children
Adolescents
Sedentary and physical activity levels were assessed by accelerometry. Well-being was approached through self-
reported HRQoL, positive affect, and negative affect. Latent profile and latent transition analysis were developed
at baseline and 2-year follow-up. Furthermore, we analyzed the cross-sectional relationship between lifestyle
profiles and well-being, as well as the associations between profiles transitions and changes in well-being in-
dicators.
Results: Four profiles were identified at both time-points, respectively: highly sedentary (7.7% and 8.3%), se-
dentary (34.4% and 35.9%), active (46.3% and 44.3%), and highly active (11.6% and 11.5%). Participants
belonging to the highly active profiles showed better HRQL (p < 0.05 at both timepoints) than sedentary
participants, and better positive affect (p < 0.05 at follow-up) than those in sedentary and active profiles.
Lifestyle profiles were unstable to moderate stable, where sedentary and active profiles were the most stable
patter (63.7% and 61.9%, respectively), and highly sedentary and highly active were the least (34.1% and
38.3%, respectively). Changing from an active to a sedentary profile was associated with a significantly greater
decrease on the positive affect than keeping on active or changed from a sedentary to an active profile, whereas
changing to an active profile attenuated the decrease in HRQoL.
Conclusions: This study identified lifestyle profiles transitions among young population, and demonstrates the
importance of these behaviors patterns on well-being indicators. These findings suggest the development of
practical interventions aimed at promoting healthy lifestyles (i.e., increasing PA and reducing ST) in those youth
with sedentary profiles, which will cause an increase on feelings of well-being.

1. Introduction
Physical inactivity has been identified as a major contributing factor
for non-communicable diseases (World Health Organization, 2018).
However, physical activity (PA) has decreased among young people in
the last decades, whereas sedentary time (ST) has dramatically in-
creased since youth are nowadays remarkably exposed to screens be-
haviors (Guthold, Stevens, Riley, & Bull, 2018). Specifically, according
to the report published by the World Health Organization (World
Health Organization, 2013), 81% of adolescents (aged 11–17 years)

∗
Corresponding author.Department of Physical Education, Faculty of Education Sciences, University of Cádiz, 11519, Puerto Real, Spain. Tel.: +34 95601622.
E-mail addresses: david.oliva@uca.es, sandavi15@gmail.com (D. Sánchez-Oliva).

https://doi.org/10.1016/j.psychsport.2019.101558
Received 15 November 2018; Received in revised form 24 June 2019; Accepted 24 June 2019
Available online 25 June 2019
1469-0292/ © 2019 Elsevier Ltd. All rights reserved.
D. Sánchez-Oliva, et al.
worldwide do not meet the WHO global recommendations on physical
activity for health.
There is a strong evidence about the positive effects of having
healthy lifestyles on well-being and mental health (Biddle, Ciaccioni,
Thomas, & Vergeer, 2018; Hoare, Milton, Foster, & Allender, 2016;
Lubans et al., 2016; Suchert, Hanewinkel, & Isensee, 2015). However,
few researches included other key issues of well-being states, like
Health-Related Quality of Life (HRQoL) or affect. HRQoL refers to the
“individual’s subjective perception of the impact of health status, including
disease and treatment, on physical, psychologic, and social functioning”
(Leidy, Revicki, & Genesté, 1999, p. 114). Furthermore, positive affect
is characterized by individual experiences of high energy, concentration
and pleasurable engagement (e.g., enthusiasm, active, or alertness),
whereas negative affect represents subjective distress and unpleasur-
able engagement (e.g., distress, fear or nervousness) (Watson & Clark,
1988).
With respect to the antecedents of well-being indicators, a sys-
tematic review developed by Wu et al. (2017) synthetized 31 studies
and concluded that higher levels of PA were associated with better
HRQoL, whereas higher time of ST were negatively associated with
HRQoL. Regarding affectivity, Rodriguez-Ayllon et al. (2019) con-
cluded that there is only evidence for a statistically significant asso-
ciation between PA and negative affect, whereas there is insufficient
evidence for the associations between sedentary behaviors and negative
affect, as well as the relationship between PA or sedentary behaviors
and positive affect. However, all previous studies have analyzed the
effects of ST and PA independently, and no studies have included these
risk factors in tandem. This perspective omits the complex interactions
that occur between ST and PA during a 24-h day, and literature suggest
that “the focus should be on a healthy movement behavior profile rather
than a single healthy movement behavior” (Tremblay et al., 2016, p. 317).
The current study was carried out within the UP&DOWN study
(Castro-Piñero et al., 2014), a 3-year longitudinal and multicenter
project designed to assess the impact of PA and ST over time on health
indicators, as well as to identify the psychoenvironmental and genetic
determinants of physical activity in Spanish children and adolescents
aged 6–18 years. During the last decade, this project has produced
several works aimed at analyzing lifestyle antecedents (i.e., PA and ST)
of academic performance (Esteban-Cornejo et al., 2014, 2015), the role
of fitness components during the childhood and adolescence (Castro-
Piñero et al., 2017; Segura-Jiménez et al., 2016), or lifestyle patterns
among adolescents with Down syndrome (Izquierdo-Gomez et al.,
2014, 2017. Additionally, a recent study also analyzed associations
between lifestyle profiles (based on screen time, ST, PA and diet in-
dicators) and adiposity (Sánchez-Oliva et al., 2018).
However, the current study is the first work within this project that
includes well-being indicators (i.e., HRQoL, positive affect, and nega-
tive affect), and it extends previous researches by analyzing lifestyle
profiles of young people by using Latent Profiles Analysis, that has been
demonstrated superior to the traditional cluster analysis, and also
analyzing transitions of profiles membership over time. The latent
profile approach is used to identify subgroups of people who share a
similar response pattern on the observed variables. Specifically, in the
current study the person-centered approach allows for an evaluation of
complex interactions among ST and PA at the within-person level, since
previous studies found high rates of youth profiles with high levels of
ST and PA (Beck, Chard, Hilzendegen, Hill, & Stroebele-Benschop,
2016; Jago et al., 2018). To date, only Jago et al. (2018) analyzed ST
and PA profiles transitions over time among a sample of children.
Furthermore, to our knowledge, this is the first study aimed to evaluate
associations between lifestyle profiles transitions and changes in well-
being over time.
Thus, the objectives of the current study were: (i) identify latent
profiles based on ST and PA at baseline and 2-years follow-up, and the
latent transitions among profiles during the follow-up, (ii) analyze the
cross-sectional associations between latent profiles and HRQoL and
2
Psychology of Sport & Exercise 47 (2020) 101558
affect at two time-points, and (iii) explore the associations between
latent transitions and changes in HRQoL and affect over follow-up in
children and adolescents.
2. Method
2.1. Study design and participants
UP&DOWN project participants included apparently healthy
Spanish children and adolescents from primary and secondary schools
from regions of Cadiz and Madrid (Spain). Baseline data were collected
in 2011–2012 and the 2-year follow-up in 2013–2014, and the study
enrolled a convenience sample of 2225 Spanish youth aged 6–18 years
old. A total of 23 primary school and 22 secondary school centers ac-
cepted the invitation. Hence, the present analysis included 1099 chil-
dren (n = 422) and adolescents (n = 677), of both genders (544 girls),
aged 8–18 years old (11.72 ± 2.39 years). For the current study, six
and seven year-old children were not included, because they did not
complete self-reported measures, due to a possible bias because im-
maturity. Furthermore, those youths who did not meet the accel-
erometry criteria (i.e., less than 3 valid days with at least 10 h of valid
wear time) or with unusual patterns of responses were excluded from
the present study (n = 21; 1.88%).
For the recruitment, an invitation letter to participate in this study
was sent to the headmasters or physical education teachers in each
school. Before participating in the UP&DOWN study, written informed
consents were obtained from parents and participants. Protocols were
approved by the Bioethics Committee of the National Research Council
(Madrid, Spain), the Ethics Committee of the Hospital Puerta de Hierro
(Madrid, Spain), and the Committee for Research Involving Human
Subject at University of Cádiz (Cádiz, Spain).
2.2. Measurements
Sedentary time and physical activity. Objectively-measured ST
and PA were analyzed by the ActiGraph accelerometer models GT1M,
GT3X and GT3X+ (Actigraph™, LLC, Pemsacola, FL, US). The agree-
ment between measures from the three models of ActiGraph™ activity
monitors in children and adolescents has been demonstrated in pre-
vious studies (Grydeland, Hansen, Ried-Larsen, Kolle, & Anderssen,
2014; Robusto & Trost, 2012). The ActiGraph accelerometers have been
widely calibrated for children and adolescents in laboratory and free-
living conditions (Freedson, Pober, & Janz, 2005). Participants wore the
accelerometer at the lower back for 7 consecutive days, removing it
during sleep and water-based activities (e.g., showering, swimming,
etc.). The inclusion criterion was defined as, at least, 3 days of re-
cording (at least, 1 weekend day) with a minimum of 10 h of valid
registrations per day (Cain, Sallis, Conway, Van Dyck, & Calhoon,
2013). Before analyses, we reintegrated data into 10-s epochs. Non-
wear time was defined as a period of 60 min of zero counts and an
allowance of up to two consecutive minutes < 100 counts per minutes
(cpm) with the up/downstream 30 min consecutive of zero counts for
detection of artifactual movements (Choi, Liu, Matthews, & Buchowski,
2011). ST was calculated with activities with less than 100 cpm,
whereas moderate-to-vigorous PA was estimated as intensities greater
than 2000 cpm (Martinez-Gomez et al., 2010; Ruiz et al., 2011). Total
ST and PA (min/day) were used as main indicators.
Health-related quality of life. Health-related quality of life was
evaluated by the KIDSCREEN-10 (Ravens-Sieberer et al., 2010), which
consists of a 10-item scale designed to assess vitality and energy (e.g.,
“Have you felt fit and well?), symptoms of depressed mood (e.g., “Have
you felt sad?), youth’s opportunities to structure his/her leisure time
and enjoying in social activities (e.g., “Have you been able to do the
things that you want to do in your free time?“), or youth’s perception of
his/her cognitive capacity and satisfaction with school performance
(e.g., “Have you got on well at school?). Participants rated each item on
D. Sánchez-Oliva, et al. Psychology of Sport & Exercise 47 (2020) 101558

Table 1
Descriptive and differential analysis among study variables at baseline and follow-up.
Baseline 2-year follow-up Mean Differences

Min Max Mean SD Min Max Mean SD t p

Sedentary time (min/day) 336.97 1118.95 619.22 110.38 416.73 1234.43 652.39 113.37 −9.86 < 0.001
Total PA (cpm) 134.40 1070 434.17 146.32 94.70 1577.70 395.08 161.58 8.93 < 0.001
HRQoL 28.92 83.81 50.45 9.13 25.36 83.81 46.77 8.55 12.26 < 0.001
Positive affect 1.30 3.00 2.44 0.31 1.00 3.00 2.33 0.33 9.35 < 0.001
Negative affect 1.00 2.90 1.74 0.34 1.00 3.00 1.69 0.36 4.33 < 0.001

Note: PA = Physical Activity; cpm = count per minute; HRQoL = Health-Related Quality of Life.

a 5-point Likert scale (ranging from 1 = “nothing” to 5 = “very
much”). Responses were coded so that higher values indicate better
levels of HRQoL. Then, the sum of the items was calculated, and it was
transformed based on the RASCH-Person parameters estimates (Ravens-
Sieberer, 2006). The KIDSCREEN-10 instrument has been highlighted
as a valid and reliably scale to analyze HRQoL among youth population
(Ravens-Sieberer et al., 2010). For the current study, Cronbach’s was
0.76 at baseline and 0.78 at follow-up.
Affect. The Spanish version (Sandín, 2003) of the Positive and
Negative Affect Schedule (PANASN; Watson & Clark, 1988) scale of
positive and negative affect for children and adolescents was used to
assed affectivity. This scale is composed of 20 adjective descriptors of
general mood/affect broken down into two 10-item subscales of posi-
tive affect (e.g., “I am inspired”) and negative affect (e.g., “I am
afraid”), respectively. Participants rated each item on a 3-point Likert
scale (1 = never; 2 = sometimes; 3 = very often). At baseline, Cron-
bach’s were 0.73 and 0.75 for positive and negative affect, respectively,
whereas at follow-up were 0.76 and 0.77 for positive and negative af-
fect, respectively.
2.3. Data analysis
We used Mplus 7.0 (Muthén & Muthén, 1998–2017) with the Robust
Maximum Likelihood (MLR) estimator, in conjunction to the full in-
formation maximum likelihood method to handle missing data re-
sulting from the nature of a longitudinal study (Muthén & Muthén,
1998–2017). Initially, descriptive analysis, mean differences between
time-points, and correlational analysis among the study variables were
estimated. With respect to the main analysis, Latent Profile Analysis
was used to identify lifestyle profiles at baseline and 2-year follow-up,
by using ST and total PA as indicators. Latent Profile Analysis has been
demonstrated to be superior to the traditional cluster analysis (Collins &
Lanza, 2013).
We estimated models from two to five profiles, with the means and
variances of the indicators freely estimated in all profiles, 3000 random
starts, 100 iterations for these random starts, and the 100 best retained
for final stage optimization (Muthén & Muthén, 1998–2017). The op-
timal number of profiles was determined through the examination of a
variety of statistical indicators, the statistical adequacy of the solution,
and the substantive meaning and theoretical conformity of the ex-
tracted profiles. The Akaike Information Criterion (AIC), the Consistent
Akaïke Information Criterion (CAIC), the Bayesian Information Cri-
terion (BIC), and the sample-size adjusted BIC (ABIC) were used as
statistical indicators. A lower value on these indicators suggests a better
fit of the model. In addition, we also used the Bootstrap Likelihood
Ratio Test (BLRT), which compares the fit of a target model (k-profiles)
to a model that specifies one fewer class (k-1 profiles). P-values lower
than 0.05 indicate the superiority of the "higher class" solution, whereas
P-values greater than 0.05 indicate the superiority of the "lower class"
solution. Finally, the entropy criterion was also examined, to determine
the precision with which the cases are classified into their respective
profiles, with higher values (i.e., closer to 1.0) indicating better fit.
After determining the optimal number of classes at each time point,
we performed Latent Transition Analysis to examine changes in profiles
membership from baseline to 2-year follow-up. Lastly, we used SPSS
software version 25.0 to carry out three separate repeated-measures
analysis of covariance (ANCOVA) by including measures of HRQoL,
positive affect, and negative affect as dependent variables, the profile
transition as between-subject factor, the timepoint as within-subject
factor, and gender and age as covariates. Fixed effects of intercept,
profile transition, time, and the interaction profile transition × time
were calculated. Furthermore, since the profile transition is a multi-
categorical variable (i.e., four categories), we also carried out a com-
plementary analysis by splitting the database with the aim to analyze
the transition × time interaction effect in pairs of profile transitions.
3. Results
3.1. Preliminary analysis
Descriptive statistic among the study variables at baseline and
follow-up are presented at Table 1. ST significantly increased over time,
whereas total PA, HRQoL, positive affect, and negative affect decreased
at follow-up (p < 0.01).

Table 2
Model fit indices for latent profile models at baseline and 2-year follow-up.
LL (# parameters) BIC SSABIC Entropy Adj. LMR-LRT (p) BS-LRT (p)

Baseline
2 profiles −2677.90 (11) 5432.82 5397.88 0.72 859.48 (0.00) 877.01 (0.00)
3 profiles −2527.64 (18) 5181.33 5124.15 0.72 294.49 (0.11) 300.50 (0.10)
4 profiles −2432.70 (25) 5040.45 4961.05 0.76 186.09 (0.00) 189.88 (0.00)
5 profiles −2352.18 (32) 4928.43 4826.79 0.73 157.81 (0.06) 161.03 (0.05)

2-year follow-up
2 profiles −2732.29 (11) 5541.61 5506.67 0.65 755.64 (0.00) 771.06 (0.00)
3 profiles −2585.56 (18) 5297.17 5240.00 0.66 287.58 (0.04) 293.45 (0.04)
4 profiles −2500.11 (25) 5175.28 5095.88 0.70 167.48 (0.10) 170.90 (0.10)
5 profiles −2448.70 (32) 5121.48 5019.84 0.69 100.76 (0.09) 102.82 (0.09)

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D. Sánchez-Oliva, et al. Psychology of Sport & Exercise 47 (2020) 101558

Figure 1. Patterns of the lifestyle profiles at baseline and 2-year follow-up (standardized scores). Note: PA = Physical Activity. ST = Sedetentary time.

3.2. Latent profile and transition analysis
Table 2 shows the model-fit indices of the latent profile analysis at
baseline and at the 2-year follow-up. The information criteria decreased
when latent profiles were added to each of the alternative models,
whereas the highest entropy was found for the 4-profiles solution at
both timepoints. With respect to the BLRT indicator, at baseline it was
significant for the 4-profiles model (p < 0.05) and not significant for
the 5-profiles model (p > 0.05), whereas at follow-up it was significant
for the 2- and 3-profiles models (p < 0.05) and not significant for the
4- and 5-profiles models (p > 0.05). Thus, based on these statistical
scores (i.e., entropy and BLRT indicator), on theoretical assumptions,
and sample sized of profiles, the 4-profiles model was retained for both
timepoints.
The profiles of ST and PA patterns are graphically described in
Figure 1. At both timepoints, four profiles were identified: 1) a highly
sedentary profile (n = 85; 7.7% at baseline, and n = 92; 8.3% at
follow-up), characterized by very high levels of ST and low levels of PA;
2) a sedentary profile (n = 377; 34.4% at baseline, and n = 394; 35.9%
at follow-up), that had slightly high levels of ST and slightly low levels
of PA; 3) an active profile (n = 509; 46.3% at baseline, and n = 487;
44.3% at follow-up), that displayed slightly low levels of ST and slightly
high levels of PA; and 4) a highly active profile (n = 128; 11.6% at
baseline, and n = 126; 11.5% at follow-up), characterized by low levels
of ST and very high levels of PA.
Table 3 represent differences between resulted profiles on ST,
moderate-to-vigorous PA, total PA, and well-being indicators at base-
line and follow-up. There were significant differences between the
lifestyle profiles at both time-points in ST, moderate-to-vigorous PA,
total PA, since participants belonging to the active profiles scored lower
ST and higher PA levels, whereas participants belonging to the seden-
tary profiles showed lower PA levels and higher ST. Furthermore, at
baseline, participants belonging to the sedentary profile showed sig-
nificantly lower scores on HRQoL than those within the active and
highly active profiles. At follow-up, participants belonging to the highly
active profile showed significantly higher scores on HRQoL than those
belonging to the sedentary profiles, and also significantly higher scores
on positive affect than active and sedentary profiles. Also, highly active
participants showed higher positive affect at follow-up when comparing
to the active and sedentary profiles. No significant differences were
found in negative affect.
Transition probabilities for lifestyle profiles are presented on
Table 4. Sedentary and active profiles displayed the highest stability
over time (63.7% and 61.9%, respectively) whereas highly sedentary
and highly active profiles presented a low stability over time (34.1%cgv
and 38.3%, respectively). The highest transition probabilities were
found for the highly active to active transition (57%) and the highly
sedentary to sedentary transition (45%). Also, it is important to high-
light that 25.5% belonging to the active profile turned to sedentary
profiles, whereas 24.9% belonging to the sedentary profile turned to
active profiles.
3.3. Associations between profile transitions and changes in well-being
indicators
The next objective of the current study was to analyze the incidence
of profile transitions on changes in well-being indicators over time.
Results from the repeated measured ANCOVA are described on Table 5,

Table 3
Mean differences for outcomes across profiles at baseline and two-year follow-up.
1.Highly Sedentary 2.Sedentary 3.Active 4.Highly Active F p η2 Post-hoc (p < .05)

Baseline
Sedentary time (min/day) 876.608 670.042 572.306 485.164 1026.10 < 0.001 0.74 1 > 2,3,4; 2 > 3,4; 3 > 4
Total PA (cpm) 271.04 327.40 475.11 693.34 129.47 < 0.001 0.26 1 > 2,3,4; 2 > 3,4; 3 > 4
MVPA (min/day) 52.11 50.10 69.33 101.21 205.95 < 0.001 0.36 1,2 > 3,4; 3 > 4
HRQoL 49.29 49.12 51.24 52.07 4.51 < 0.001 0.01 2 < 3,4
Positive affect 2.44 2.41 2.45 2.47 1.16 0.32 0.00
Negative affect 1.73 1.77 1.71 1.76 1.66 0.17 0.00

Follow-up
Sedentary time (min/day) 910.16 698.34 601.78 516.07 893.60 < 0.001 0.71 1 > 2,3,4; 2 > 3,4; 3 > 4
Total PA (cpm) 265.65 274.50 439.88 693.15 178.27 < 0.001 0.33 1 > 3,4; 2 > 3,4; 3 > 4
MVPA (min/day) 51.19 42.29 65.70 100.20 263.29 < 0.001 0.42 1 > 2,3,4; 2 > 3,4; 3 > 4
HRQoL 44.91 45.78 47.24 49.48 6.84 < 0.001 0.02 4 > 1,2
Positive affect 2.30 2.31 2.33 2.42 3.33 0.02 0.01 4 > 3,2
Negative affect 1.71 1.69 1.68 1.70 0.22 0.88 0.00

Note: HRQoL = Health-Related Quality of Life. Differences between groups were analyzed with post-hoc analysis based on Bonferroni Test.

4
D. Sánchez-Oliva, et al. Psychology of Sport & Exercise 47 (2020) 101558

Table 4 they found three, five, and six clusters (Heitzler et al., 2011; Jago, Fox,
Transition probabilities for PA and ST profiles between baseline and 2-years Page, Brockman, & Thompson, 2010). However, although we did not
follow-up. identify the same number of profiles, some of the previous studies share
2-year follow-up several profiles characteristic with the current study. For example, Jago
et al. (2010) also identified our four profiles, and they also found an-
Highly Sedentary Active Highly other profile characterized by slightly high levels of PA and ST, and
Sedentary Active
another profile characterized by average scores in PA and ST. Heitzler
Baseline Highly 34.10% 44.70% 16.50% 4.70% et al. (2011) also identified three profiles similar than the current study
Sedentary (i.e., highly sedentary, active, and highly active profiles), but they did
Sedentary 11.40% 63.70% 22.50% 2.40% not find a patter with moderate levels of PA and low levels of ST.
Active 3.90% 21.60% 61.90% 12.60%
Nevertheless, the number of profiles found is partially influenced by the
Highly Active 0.00% 4.70% 57.00% 38.30%
indicators included in the analysis (e.g., including different PA in-
tensities or including sedentary behaviors modalities instead of total
and graphically represented in Figure 2. The “transition” variable was ST).
categorized as follow: 1) “keep active” (n = 449), participants who kept This study also evaluated differences on ST, PA levels, and well-
in actives profiles; 2) “keep sedentary” (n = 344), participants who being indicators across the lifestyle profiles at both time-points. As
kept in sedentary profiles; 3) “move to active” (n = 107), participants expected, the sedentary profiles showed higher ST than active profiles
who moved from sedentary profiles to actives profiles; and 4) “move to at both time-points. When comparing these results with previous re-
sedentary” (n = 121), participants who moved from actives profiles to ports (Ekelund et al., 2012; Pate, Mitchell, Byun, & Dowda, 2011), we
sedentary profiles. found that all profiles (even the active profiles) were bellow to the
The Transition*Timepoint interaction was significant for positive reference values of daily ST (i.e., around 360 min/day of ST). Fur-
affect, and it indicate that slopes for positive affect were significantly thermore, total PA levels were significantly higher from the highly se-
different depending on the transition group. Specifically, an ad- dentary to the highly active profile. Ekelund et al. (2012), in their study
ditionally test of simple interaction performed by including cluster with a sample of 20,871 youth worldwide aged 4–18 years found that
transition by pairs showed that participants who moved to sedentary boys and girls spent 642 and 540 cpm/min, respectively; so, only par-
profiles showed a significantly higher decrease (p < 0.05) in HRQoL ticipants belonging to the highly active profile reported higher PA le-
than participants who move to active profiles. Furthermore, partici- vels than this reference cutt-points. With respect to the MVPA, youth
pants belonging to the “move to sedentary” group displayed a sig- belonging to the active and highly active profiles met the WHO re-
nificantly higher decrease (p < 0.05) on positive affect compared to commendation (i.e., more than 60 min/day of MVPA), whereas seden-
the “keep active” and “move to active” profiles. tary and highly sedentary profiles did not meet this cut-point. Ad-
ditionally, the four profiles reported higher mean values in MVPA than
the average scores reported by Ekelund et al. (2012) (i.e., 37 and
4. Discussion
24 min/day for boys and girls, respectively).
When comparing lifestyle profiles and well-being indicators, the
The purpose of this study was to identify changes in patterns of ST
inclusion on an active profile was associated with better HRQoL at both
and PA levels in Spanish children and adolescents over 2-year follow-
time-points. Comparing our results with reference values, Petersen-
up, as well as to explore their associations with changes in HRQoL,
Ewert, Erhart, and Ravens-Sieberer (2011) reported the results found in
positive affect, and negative affect. This study allows to interpret in-
the KIDSCREEN survey developed with 82,859 children and adoles-
teractions of ST and PA from a person-centered approach, and the
cents from 13 European countries, where they found an overall score of
findings confirms the positive associations between active lifestyles and
47.45 for the total sample and 48.59 for the Spanish youth. Our results
well-being indicators at the cross-sectional level, and also extend pre-
suggest that, at baseline, the four profiles were above the global and
vious studies by showing the benefits on well-being of moving from
Spanish reference values. However, at follow-up, only highly partici-
sedentary to active lifestyle over time.
pants scored higher than the European and National mean values. These
The 4-clusters solution was retained as the best solution at both
findings are in line with previous studies that also found a positive
timepoints, namely, highly sedentary, sedentary, active, and highly
association between healthy patterns of lifestyle behaviors and HRQoL
active profiles. These findings are not in line with previous studies, as

Table 5
Results of repeated-measures ANCOVA of dependent variables.
HRQoL Positive Affect Negative Affect

F p η2 F p η2 F p η2

Fixed Effects
Intercept 1235.59 < 0.001 0.55 1341.19 < 0.001 0.57 501.81 < 0.001 0.33
Sex 1.67 0.20 0.00 11.10 < 0.001 0.01 19.21 < 0.001 0.02
Age 50.49 < 0.001 0.05 3.94 0.05 0.00 0.01 0.95 0.00
Transition 4.77 < 0.001 0.01 1.25 0.29 0.00 1.65 0.18 0.01
Time 3.65 0.06 0.00 9.52 < 0.001 0.01 23.93 < 0.001 0.02
Transition*Time 1.62 0.18 0.01 3.28 0.02 0.01 0.47 0.71 0.00

Baseline Follow-up p Baseline Follow-up p Baseline Follow-up p

Mean changes over time

Keep active 51.14 47.68 < 0.001 2.44 2.36 0.003 1.74 1.68 < 0.001
Keep sedentary 48.91 45.25 < 0.001 2.43 2.31 0.223 1.75 1.72 < 0.001
Move to active 49.55 47.11 0.039 2.38 2.31 0.08 1.76 1.69 0.01
Move to sedentary 51.41 46.24 < 0.001 2.49 2.29 0.364 1.68 1.65 < 0.001

Note: HRQoL = Health-Related Quality of Life; I-J = follow-up score - baseline score.

5
D. Sánchez-Oliva, et al.
Figure 2. Graphical representation of changes in well-being indicators across transition groups. Note: HRQoL = Health-Related Quality of Life.
(Mitchell & Steele, 2018). On the other hand, participants belonging to
the highly active profile also showed greater positive affect than the
active and sedentary profiles, in line with previous studies who also
found positive associations between PA levels and positive affect (Reid,
Maccormack, Cousins, & Freeman, 2015; White, Olson, Parker, Astell-
Burt, & Lonsdale, 2018). Globally, these results suggests that the fact of
having a healthy lifestyle characterized by acceptable-high levels of PA
and low-moderate levels of ST cause better feelings of quality of life
(i.e., feel fit and well, with energy, with enough time, and not sad or
6
Psychology of Sport & Exercise 47 (2020) 101558
lonely), as well as greater feeling of positive affect (i.e., interested in
people, getting excited, proud or satisfied of something).
Another goal of the current study was to evaluate the transition
between the profiles during the follow-up. Lifestyle profiles were found
to be unstable to moderately stable. Sedentary and active profiles were
the most stable pattern of behaviors (63.7% and 61.9%, respectively).
Although comparisons with the study from Jago et al. (2018) are pro-
blematic given that they found five profiles at baseline and six profiles
at follow-up, their results are in the line with our study, since they
D. Sánchez-Oliva, et al.
found similar stability rates in their highly active (39%) and sedentary
profiles (48%). Change to the active profile was the most commonly
observed transition for youth belonging to the sedentary profile at
baseline (22.5%), and it represent an adaptive change in participants
who start to include PA and reduce ST in their lifestyle during the two
year of follow-up. Nevertheless, youth belonging to the active profile
showed the highest transition probability in the change to the sedentary
profile (21.6%). This transition represents a dangerous change, as it
represents participants who had a healthy lifestyle at baseline in terms
of moderate levels of PA and low ST, and they changed to a sedentary
lifestyle during the two years of follow-up by increasing ST and redu-
cing PA. Given the important percentage of participants belonging to
this transition, these findings suggest that school-based interventions
aimed to promote extra-curricular PA level should be focus not only on
sedentary population, but also should pay special attention on pro-
moting the stabilization of a healthy lifestyle in order to avoid this
maladaptive change.
On the other hand, 95.3% of the highly active youth at baseline kept
a healthy lifestyle (38.3% kept in the highly active profile and 57%
turned to the Active profile). These results are promising, since only
4.7% changed to a sedentary profile, and it demonstrated that the
healthy lifestyle patterns of behaviors have a greater stability than the
sedentary patterns. This idea is justified given that 21.2% of highly
sedentary and 24.9% of Sedentary participants at baseline turned to
active profiles at follow-up, respectively. These findings are contrary to
the results found by Jago et al. (2018), since they found a greater sta-
bility on sedentary profiles when comparing to the active profiles, and
it demonstrated that this particular sample of Spanish children and
adolescents showed a better stability on healthy lifestyles than Britain
children.
In addition, the main objective of the current study was to analyze
associations between lifestyle profiles transitions and changes in well-
being indicators over time. With respect to the positive affect, all
transition groups decreased their scores over time; however, partici-
pants who changed from an active to a sedentary profile showed sig-
nificantly higher decreases in positive affect when comparing with
participants who kept active or changed from a sedentary to an active
profile. In other words, the fact of turning from an active lifestyle to a
sedentary lifestyle had a negative impact on the positive affect. These
results are in line with those showed by Babic et al. (2017), who found
how adolescents who decreased recreational screen-time and computer
use were associated with better psychological well-being.
Furthermore, all transition groups decreased both HRQoL and ne-
gative affect over time, and non-significant effects on the transi-
tion*time interaction were found. However, in the case of HRQoL, the
analysis of interaction effect by pairs showed that participants who
changed to a sedentary lifestyle displayed a greater decrease on HRQoL
than participants who moved to an active lifestyle. By analyzing mean
scores at baseline and follow-up, only participants who kept an active
profile scored values HRQoL above the international reference of pro-
vided by Petersen-Ewert et al. (2011). Furthermore, the current study
showed that participants who changed from an active to a sedentary
lifestyle displayed a stronger decrease on positive affect compared to
those participants who kept an active lifestyle or change from a se-
dentary to an active lifestyle. From a practical point of view, taking into
account that well-being indicators decreased over time among all
transition groups, this study demonstrates that moving to a healthier
lifestyle by increasing PA levels and reducing ST attenuated the de-
crease of positive affect feelings (e.g., energy, vitality, lively, inspira-
tion, or getting excited) and HRQoL. This is an important adding to the
field, since the current study demonstrated not only cross-sectional
associations between a healthy lifestyle and indicators of well-being,
but also highlights the longitudinal impact of moving from a sedentary
lifestyle to an active profile.
The main strength of this study included the longitudinal design, the
relatively large sample of children and adolescents, the use of
7
Psychology of Sport & Exercise 47 (2020) 101558
innovative statistical analysis (i.e., latent profiles and latent transition
analysis), and the use of accelerometers to assess PA and ST.
Furthermore, this study was the first that analyzed ST and PA profiles
transition among children and adolescents, and the first study that
evaluated the impact of these profile changes on well-being indicators.
However, the current study is not without limitations. Firstly, we in-
cluded total PA as a profile indicator, and we did not distingue different
intensities (i.e., light, moderate, and vigorous PA), in order to simplify
the profile solutions and the interpretation of results. Furthermore, al-
though the PANAS scale has been demonstrated as a valid and reliable
scale to analyze affectivity worldwide, it is not without limitations.
Positive and negative affect are conceptually defined as independent
factors, previous studies have demonstrated that these factors are not
bipolar, given the small observed correlations (Tellegen, Watson, &
Clark, 1999). Furthermore, some researches argue that PANAS scale do
not measure all pleasant and unpleasant affective states, but rather
measure only high-activation states (Barrett & Russell, 1999). Also, data
for HRQoL and affect were derived from subjective methods, which are
associated with some disadvantages, such as social desirability bias.
Lastly, some confounding variables that may influence the findings
were not available (e.g., family socioeconomic status, body mass index,
birth weight).
In conclusion, the current study extends previous researches by
identifying lifestyle profiles among Spanish children and adolescents, as
well as at analyzing associations between profile transitions and
changes in well-being indicator over time. Our findings demonstrate the
associations of a healthy lifestyle and HRQoL and positive affect at a
cross-section level, and also the positive benefits of moving to active
profiles in well-being. These findings confirmed the positive con-
sequences of having healthy lifestyles on well-being during childhood
and adolescence, and they are useful to develop intervention strategies
in order to increase PA and reducing ST among youth population.
Interventions should aim to increase PA levels and reduce ST of ado-
lescents with sedentary profiles, through practical strategies developed
both at the curricular time (i.e., increasing % of moderate-to-vigorous
PA within PE lessons, proposing physical activities at the recess, and
promoting active commuting to/from the school) and at the extra-
curricular time (e.g., promoting different alternatives for organized
extracurricular activities or proposing tools for doing exercise by self).
Acknowledgement
This work was supported by the National Plan for Research:
Development and Innovation (R+D+i) MICINN of Spain: DEP 2010-
21662-C04-00 (DEP 2010-21662-C04-01: DEP 2010-21662-C04-02:
DEP 2010-21662-C04-03: DEP 2010-21662-C04-04). DSO is supported
by an ‘Juan de la Cierva’ Postdoctoral Research Fellowship (FJCI-2015-
25867).
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