Associations of adolescent lifestyle behaviors with body mass index within a nationally representative sample of US adolescents: a quantile regression analysis

Abstract

ObjectivesThe purpose of this study was to examine the associations between lifestyle behavior variables such as physical activity, television watching, computer use, and school night sleep duration with body mass index percentile (BMI%) using quantile regression within a representative sample of adolescents who completed the 2017 US National Youth Risk Behavior Survey. Study designThe study design was a cross-sectional study. MethodsA multistage cluster sampling procedure obtained a representative sample of US adolescents. The number of sampled adolescents submitting questionnaires with BMI% data was 13,146. To examine the associations between lifestyle behaviors and BMI%, simultaneous quantile regression was used. ResultsWhen relationships were modeled at every 10th percentile, more precise parameter estimates were observed at higher percentiles. Across the interquartile range, physical activity associated with lower BMI% at the 50th and 75th percentiles (brange = −2.27% to −5.24%, P < 0.05), television watching associated with higher BMI% at the 25th to 75th percentiles (brange = 2.29%–4.16%, P < 0.05), sleep durations less than 8 h per school night associated with higher BMI% at the 25th and 50th percentile (brange = 2.81%–8.26%, P < 0.05), and 10 or more hours of school night sleep associated with higher BMI% at the 50th and 75th percentile (brange = 3.43%–7.53%, P < 0.05). ConclusionsHigher levels of physical activity associated with lower BMI% and longer time watching television, school night sleep durations less than 8 h, and school night sleep durations of 10 h or more at higher quantiles associated with higher BMI% in adolescents. Estimates of association were more precise within higher quantiles.