Associations of outdoor activity and screen time with adiposity: findings from rural Chinese adolescents with relatively low adiposity risks

Youjie Zhang,Hua Zhong,Chen-Wei Pan,Xiaofan Zhang,Jun Li

doi:10.1186/s12889-020-09897-7

Abstract

BackgroundWhether and to what extent outdoor activity and screen time are relevant to adiposity among rural adolescents remain largely unknown as most of relevant evidence was generated from high-income countries and urban areas. This study aimed to investigate associations of outdoor activity and screen time with adiposity among early adolescents living in rural southwest China.MethodsIn this cross-sectional study, seventh graders (n = 2264) were recruited from 10 middle schools of a rural county. Overweight and obesity was assessed using adolescents’ body mass index and waist circumference. Adolescents’ outdoor activity and screen time were measured using self-reported daily time spending on outdoor activity, watching TV, playing video games, and computers on weekdays and weekends, respectively.ResultsThe prevalence of overweight/obesity and high waist circumferences were 8.0 and 4.9% and were higher among those from one-child families and with parents having high school or higher education and whose fathers were not farmers. Adolescents who did not have ≥1 h outdoor activity on weekdays were more likely to be overweight/obese (OR: 1.86, 95% CI: 1.30, 2.66) and have high waist circumferences (OR: 2.22, 95%CI: 1.39, 3.57). Adolescents who had > 2 h screen time on weekends were more likely to have high waist circumferences (OR: 2.08, 95% CI: 1.14, 3.80). Lack of outdoor activity and excessive screen time also showed synergistic effects on overweight/obesity (OR: 1.93. 95% CI: 1.15, 3.24) and high waist circumferences (OR: 3.02, 95% CI: 1.54, 5.94).ConclusionsLack of outdoor activity and excessive screen time were relevant to adiposity among rural Chinese adolescents even when the obesity prevalence was low. Efforts to promote active lifestyles may help prevent rural adolescents from losing their advantage in the era of the global obesity epidemic.

Highlights

Whether and to what extent outdoor activity and screen time are relevant to adiposity among rural adolescents remain largely unknown as most of relevant evidence was generated from high-income countries and urban areas
Unlike previous research of childhood obesity that primarily conducted in economically developed countries and areas, this study exclusively focused on an underrepresented sample of early adolescents who were predominantly ethnic minorities living in rural southwest China
The study findings characterized the prevalence of overweight and obesity and high waist circumferences by key socio-demographic characteristics and demonstrated that not meeting the activity guidelines were associated with greater risks of childhood obesity

Summary

Introduction

Whether and to what extent outdoor activity and screen time are relevant to adiposity among rural adolescents remain largely unknown as most of relevant evidence was generated from high-income countries and urban areas. Different from high-income countries, the prevalence of childhood obesity has been higher in urban areas than rural areas in low- and middle-income countries [2]. In 2015, the urban-rural gap was no longer statistically significant at the national level [4]. This alarms the disappearing advantage in rural areas and calls for urgent efforts on preventing unhealthy weight gain among rural pediatric populations

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