Behavioral Factors For Adolescents' Obesity And Overweight: Physical Activity, Sleep, Sedentary Behavior, And Diet

Abstract

PURPOSE: To investigate the risk factors in weight status among adolescents regarding dietary habits and movement behavior. METHODS: Primary data were derived from the CDC Youth Risk Behavior Survey (YRBS), a nationally representative sample of 40,130 grade 9-12 students (N=20,340 boys and 19,790 girls) from 2011 to 2017. The prevalence of overweight and obesity was examined using by BMI percentile and then compared based on various demographics (i.e., sex, age, race) and behavioral factors (i.e., physical activity, sedentary time, sleep, soda consumption). Logistic regression analysis was conducted to illustrate the differences in weight status within each group of physical activity levels after control the behavioral and demographic factors. RESULTS: Overall, African-American adolescents had the highest prevalence of overweight or obesity (36%), followed by Hispanics (35%), others (29%), and White (27%). Female students had significantly lower obesity rate than male students (-6.4 ± 0.2%), but also spend less time for behavioral activities (e.g., sedentary time: -0.372 ± 0.015 hours, MVPA -20.4 ± 0.4%, and strength training -20.9 ± 0.3%). The self-diagnosis was relatively accurate, with 69% of true positive and 13% of true negative in comparison to actual overweight and obesity status. For the PA group, students who satisfied both PA recommendations had less likely to be obese compared to non-PA group: Odds Ratio (OR) for PA = 0.89, 95% CI [0.825, 0.961], p = 0.003; OR for strength training = 0.92, 95% CI [0.865, 0.996], p = 0.039). Students who consumed soda on more than one day were more likely to be obese (OR = 1.13, 95% CI [1.049, 1.223]), and students who had more sedentary time tended to be obese (OR=1.03, 95% CI [1.011, 1.041]). CONCLUSIONS: Students who were meeting PA recommendations were less likely to be obese, while students who had more sedentary time and higher levels of soda consumption were more likely to be obese. In addition, African American and Hispanic students were more likely to be overweight and obese.