PONE-D-24-5050224-hour movement behaviours and mental health in non-clinical populations; a systematic review.PLOS ONE

Dear Dr. Dale,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

 Please submit your revised manuscript by Apr 19 2025 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org . When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

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We look forward to receiving your revised manuscript.

Kind regards,

Heather Macdonald, Ph.D

Academic Editor

PLOS ONE

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3. As required by our policy on Data Availability, please ensure your manuscript or supplementary information includes the following:

A numbered table of all studies identified in the literature search, including those that were excluded from the analyses. 

For every excluded study, the table should list the reason(s) for exclusion. 

If any of the included studies are unpublished, include a link (URL) to the primary source or detailed information about how the content can be accessed.

A table of all data extracted from the primary research sources for the systematic review and/or meta-analysis. The table must include the following information for each study:

Name of data extractors and date of data extraction

Confirmation that the study was eligible to be included in the review. 

All data extracted from each study for the reported systematic review and/or meta-analysis that would be needed to replicate your analyses.

If data or supporting information were obtained from another source (e.g. correspondence with the author of the original research article), please provide the source of data and dates on which the data/information were obtained by your research group.

If applicable for your analysis, a table showing the completed risk of bias and quality/certainty assessments for each study or outcome.  Please ensure this is provided for each domain or parameter assessed. For example, if you used the Cochrane risk-of-bias tool for randomized trials, provide answers to each of the signalling questions for each study. If you used GRADE to assess certainty of evidence, provide judgements about each of the quality of evidence factor. This should be provided for each outcome. 

An explanation of how missing data were handled.

This information can be included in the main text, supplementary information, or relevant data repository. Please note that providing these underlying data is a requirement for publication in this journal, and if these data are not provided your manuscript might be rejected. 

Additional Editor Comments:

Thanks for your patience with the lengthy review time! In addition to the comments from the Reviewers, please consider the following comments. In particular, in light of other reviews I located (e.g., Kracht et al., 2024) it will be important for the authors to highlight the unique contributions of their review.

1. Overall, the manuscript would benefit from thorough copy editing since this is not done by the journal if the manuscript is accepted for publication. I noted punctuation and grammar errors throughout. Specifically, in the results, findings from cited studies should be in the past tense (e.g., “Eleven of 12 studies that assessed meeting the guidelines…”).

2. When referring to results of observational studies, please remove use of “effect” throughout the manuscript since only associations can be determined.

3. The abstract lacks detail. The word limit is 300 for PLOS One so I suggest including additional information such as more detail on the search strategy. In addition, last part of the sentence on lines 30-31 seems like a fragment. Also, the authors mention that this research area is in its infancy but yet there are so many studies – that seems a bit contradictory.

4. Given that this is a narrative review, conclusions regarding age group differences may need to be tempered. While I appreciate the authors’ effort to review the evidence across all ages, perhaps a more focused approach on just one age group is warranted. Related to this, conclusions about the heterogeneity across studies is not surprising given the broad scope of this review. The authors cite the SR by Janssen and colleagues when describing the search strategy. It’s interesting to note that Janssen and colleagues focused just on adults and on studies that use compositional data analysis – so a much more focused approach.

5. Intro, Line 78: Please provide a reference for the opening statement. Similarly, please provide references for the statement on line 85 (“…a number of researchers have now begun to investigate…”)

6. Intro, Lines 98-101: The wording of this sentence could be improved (i.e., Across 10 studies [were they all cross-sectional?] included in the review, better mental health among children and youth was observed among those who met all three recommendations as compared with those who did not meet recommendations. A dose-response gradient was also observed…). Also, please cite the systematic review by Wilhite et al. (https://doi.org/10.1093/aje/kwac212) as they also investigated the relationship between movement behaviours and mental health (among other outcomes). There is also a recent systematic review by Zhao et al. (https://doi.org/10.3389/fpubh.2024.1351972)

7. Line 105: Regarding the statement that no reviews on this topic have included adults, there is a recent umbrella review by Kracht and colleagues (https://doi.org/10.1186/s44167-024-00064-6) that should be cited, and the review by Rollo and colleagues covered the entire lifespan, as did a 2018 review by Grgic et al. (https://doi.org/10.1186/s12966-018-0691-3).

8. Intro, Line 107: Please use the same order for the populations as in the rest of the paper.

9. Methods – Eligibility criteria – the subheading numbers for each PICOS item should be at the next level heading (e.g., 2.2.1 for Population, 2.2.2 for Intervention/exposure etc.)

10. Please provide the age range for each population.

11. Methods – study designs: I am unclear what the authors mean by “…accounting for different combinations of recommendations met by participants in the analyses” – perhaps an example would help here?

12. The publication year information on Lines 168-69 can be removed since it is already in the results.

13. Line 180: Regarding percentage of each “gender” – I assume that most studies reported biological sex and not the social construct of gender, so please update accordingly.

14. For the longitudinal studies, it would help to know the duration of follow-up. On a related note, while intervention studies/RCTs will be helpful, it seems that more longitudinal studies are needed. This was also highlighted as an area of future research in the umbrella review by Kracht and colleagues.

15. The discussion repeats the results in some sections (e.g., lines 435-443).

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: N/A

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Thank you for the opportunity to review this submission. Some suggestions as follows:

- I recommend updating the keywords as they appear too similar to the title. Keywords should facilitate additional insights to the paper and expand its visibility

- pg 3 line 42: not just the amount but the type/quality/frequency impact someone's health

- pg 3, line 50: what are you trying to get across? Yes we have finite time during the day but are you indicating "finite time to complete all work/life/health expectations"? it's an incomplete thought

- pg 5, line 90-94: references needed to support your claims

- pg 6, line 128 is redundant (MVPA is already explained as an acronym on pg 3, line 55)

- pg 7, line 133: this is not a sentence. please rewrite.

- pg 7, line 137: why are these phrases underlined?

- why was the search frame limited to 10 years?

- since you exported to excel, how were duplicates removed? was this an automatic process?

- page 12 "emotional problems" needs to be rephrased. this isn't accurate and is negatively framing symptoms affiliated with mental health. suggest using "emotional disruptions" or something akin

- your subheadings are confusing. "emotional problems" shows up on page 12, line 244 and then again on page 14, line 277. what are the differences? can they not be consolidated?

- page 26, line 546. you need to rephrase this sentence because there are plenty of research studies on movement and mental health in adults - yours is focused on 24-hour movement in particular. additionally, the sentence written as-is, it's a runon sentence

- pg 26, line 554: you say you wanted to capture as much as possible, but you've limited the search to the last 10 years. why?

Reviewer #2: Dear Authors,

I would like to thank you for the opportunity to review your manuscript. Your study addresses an important and timely topic, examining the relationship between movement behaviors and mental health across different age groups. The paper provides a comprehensive review of existing literature and presents valuable findings that contribute to the growing body of research in this field.

Below, I provide detailed comments and suggestions that I believe will help enhance the clarity, methodological rigor, and impact of your manuscript. I hope these recommendations will be useful in refining your work.

Major Comments

The introduction should more precisely formulate the research problem so that the reader clearly understands the main hypothesis or research question. Currently, the rationale for the study is somewhat broad and could be more explicitly defined.

Some topics in the introduction change abruptly and without clear transitions. For example, after discussing physical health (lines 41–60), the text suddenly shifts to methodological analysis methods (lines 61–76) and then to mental health (lines 77–88).

The description of movement behavior analysis methods (CoDA, ISM, lines 61–76) is overly detailed.

The introduction presents data from studies on children and adolescents (lines 97–105), but their connection to adult mental health is not clearly established.

Since the article aims to examine associations across all age groups, it would be beneficial to balance the analysis of studies from different age groups and explicitly highlight their interconnections.

Although the literature search was conducted in PubMed, Scopus, and Embase (lines 156–169), there is no explanation for why other important databases, such as Web of Science, were not included.

It is mentioned that most studies were observational ("Due to the observational nature of most studies, the quality was rather low", line 218), but there is no detailed analysis of the main quality shortcomings (e.g., selection bias, differences in measurement methods, or lack of control variables).

The results indicate that certain movement behaviors are associated with better mental health, but there is no discussion of the potential mechanisms that could explain these associations.

The discussion section focuses more on data from adolescents and adults, while the findings from the children’s group are discussed only briefly, despite the fact that their results were more contradictory.

It is noted that the findings may not be generalizable to African populations, but there is a lack of a broader discussion on how cultural and social factors might influence the association between movement behaviors and mental health.

Although the studies vary significantly in methodology, a more in-depth discussion of how this heterogeneity may influence the findings is needed.

It would be beneficial to expand the discussion on the potential mechanisms explaining the relationship between movement behaviors and mental health.

Recent studies (e.g., Skurvydas et al., 2024, in BMC Public Health and PLOS ONE) highlight that leisure-time physical activity has a stronger impact on mood and well-being compared to work-related physical activity.

Overall, this study presents valuable insights into the relationship between movement behaviors and mental health, making a meaningful contribution to the field. However, addressing the aforementioned methodological and interpretative issues will significantly improve the manuscript’s clarity, coherence, and scientific rigor.

I hope these suggestions will be helpful in enhancing your paper. I appreciate your work and look forward to seeing the revised version.

Best regards,

**********

6. PLOS authors have the option to publish the peer review history of their article (what does this mean? ). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy .

Reviewer #1: No

Reviewer #2: No

**********

[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/ . PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org . Please note that Supporting Information files do not need this step.

PONE-D-24-50502R124-hour movement behaviours and mental health in non-clinical populations; a systematic review.PLOS ONE

Dear Dr. Dale,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

Thank you for addressing my comments and those of the 2 reviewers. My only remaining comment is that although the authors modified use of "effects" when referring to their own findings (except on line 36 in the abstract - "effects" needs to be changed), the same needs to be done when citing results of previous observational studies. For example, for the statement on lines 49-51 - were the cited reviews able to confirm evidence of "reciprocal effects" or just associations? Please check use of effect throughout the manuscript.

Please submit your revised manuscript by Jun 13 2025 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org . When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

• A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
• A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
• An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols . Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols .

We look forward to receiving your revised manuscript.

Kind regards,

Heather Macdonald, Ph.D

Academic Editor

PLOS ONE

Journal Requirements:

Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

Additional Editor Comments:

Thank you for addressing my comments and those of the 2 reviewers. My only remaining comment is that although the authors modified use of "effects" when referring to their own findings (except on line 36 in the abstract - "effects" needs to be changed), the same needs to be done when citing results of previous observational studies. For example, for the statement on lines 49-51 - were the cited reviews able to confirm evidence of "reciprocal effects" or just associations? Please check use of effect throughout the manuscript.

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #2: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #2: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #2: N/A

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #2: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #2: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #2: Thank you for the opportunity to review the revised version of this manuscript. The authors have significantly improved the paper, presenting a well-structured, clearly written systematic review that adheres to PRISMA guidelines. The manuscript covers a broad and up-to-date range of literature.

The thorough and thoughtful discussion section addresses consistent and contradictory findings across different age groups.

**********

7. PLOS authors have the option to publish the peer review history of their article (what does this mean? ). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy .

Reviewer #2: No

**********

[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/ . PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org . Please note that Supporting Information files do not need this step.

24-hour movement behaviours and mental health in non-clinical populations; a systematic review.

PONE-D-24-50502R2

Dear Dr. Dale,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

An invoice will be generated when your article is formally accepted. Please note, if your institution has a publishing partnership with PLOS and your article meets the relevant criteria, all or part of your publication costs will be covered. Please make sure your user information is up-to-date by logging into Editorial Manager at Editorial Manager®  and clicking the ‘Update My Information' link at the top of the page. If you have any questions relating to publication charges, please contact our Author Billing department directly at authorbilling@plos.org.

If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org.

Kind regards,

Heather Macdonald, Ph.D

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments: