Abstract
BackgroundRates of sedentary behavior (SB), fast food and carbonated soft drink consumption are increasing worldwide, with steeper increases being observed in low- and middle-income countries (LMICs) in recent years. Given that these behaviors have been linked to adverse health outcomes among adolescents, this presents a new but rapidly growing challenge to human health in these under-resourced nations. However, very little is known about the associations between SB and fast food or soft drink consumption among adolescents in LMICs.MethodsThus, data from the Global school-based Student Health Survey (GSHS) were cross-sectionally analyzed in 133,555 adolescents aged 12–15 years from 44 LMICs [mean (SD) age 13.8 (1.0) years; 49% females]. The data were collected in the form of self-report questionnaires. Associations were assessed with multivariable logistic regression analysis and meta-analysis.ResultsThe overall prevalence of fast food consumption (at least once in previous 7 days) and carbonated soft drink consumption (at least once per day during past 30 days) were 49.3 and 43.8%, respectively. The overall pooled estimates based on a meta-analysis with random effects for the association of ≥3 h/day of SB with fast food consumption and soft drink consumption using country-wise estimates were OR = 1.35 (95% CI = 1.27–1.43, I2 = 62.1%).) and OR = 1.26 (95% CI = 1.19–1.34; I2 = 54.3%), respectively. Spending > 8 h/day of SB compared to < 1 h/day in females was associated with significantly higher odds for fast food (OR = 1.61, 95% CI = 1.38–1.88) and soft drink consumption (OR = 1.91, 95% CI = 1.60–2.28).ConclusionsFuture interventions to address unhealthy behaviors in adolescents should take into account the interrelated nature of SB and unhealthy dietary habits, and seek to further understand the mechanisms linking these behaviors in the LMIC context.
Highlights
Rates of sedentary behavior (SB), fast food and carbonated soft drink consumption are increasing worldwide, with steeper increases being observed in low- and middle-income countries (LMICs) in recent years
There is increasing evidence that Sedentary behavior (SB) is associated with various negative health outcomes such as obesity, non-communicable diseases (NCDs) and premature mortality [4, 29]
The survey Publicly available data from the Global School-Based Student Health Survey (GSHS) were analyzed. Details on this survey and the questionnaires can be found at http://www.who.int/chp/gshs and http://www.cdc.gov/ gshs
Summary
Rates of sedentary behavior (SB), fast food and carbonated soft drink consumption are increasing worldwide, with steeper increases being observed in low- and middle-income countries (LMICs) in recent years. Given that these behaviors have been linked to adverse health outcomes among adolescents, this presents a new but rapidly growing challenge to human health in these under-resourced nations. There is increasing evidence that SB is associated with various negative health outcomes such as obesity, non-communicable diseases (NCDs) (e.g., diabetes, cardiovascular diseases, cancer) and premature mortality [4, 29]. Previous studies from high-income countries have found that SB is associated with higher intake of snacks, sugar-sweetened beverages and fast foods [14], which are known risk factors for obesity and other negative health outcomes such as type-2 diabetes, hypertension and hypercholesterolemia and dental disease in adolescents [8, 26, 30]
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