Abstract
ObjectiveTo examine the association of constipation with exercise, non-exercise physical activity, and sedentary behaviours in Hong Kong adolescents.MethodsIn 2006–2007, 42 secondary schools were randomly selected to participate in the Hong Kong Student Obesity Surveillance (HKSOS) project. A total of 33692 Form 1–7 students (44.9% boys; mean age 14.8, SD 1.9 years) completed an anonymous questionnaire on lifestyle behaviours. Constipation was defined as a frequency of evacuation of less than once every two days. Exercise (moderate-to-vigorous levels) and non-exercise physical activity (NEPA) were each considered insufficient when less than 1 hour per day, and sedentary behaviours were considered excessive when over 4 hours per day. Logistic regression was used to calculate adjusted odds ratio (AOR) for constipation in relation to exercise, NEPA, and sedentary behaviours, adjusting for potential confounders.ResultsConstipation was identified in 15.6% (95% CI 15.2% – 16.0%) of adolescents overall, 14.0% in those with sufficient exercise and 19.6% in those without. Constipation was associated with insufficient exercise (AOR 1.26, 95% CI 1.16 – 1.36), insufficient NEPA 1.21 (1.10 – 1.33) and excessive sedentary behaviours (1.25, 1.17 – 1.34). Compared with having none of the above 3 inactive behaviours, increasing AORs of constipation were observed for having 1 (AOR 1.23), 2 (AOR 1.57) and 3 (AOR 1.88) inactive behaviours (p for trend <0.001).ConclusionsConstipation was associated with insufficient physical activity and excessive sedentary behaviours among Chinese adolescents with a dose-response relation. If the association is causal, constipation could be prevented by promotion of physical activity.
Highlights
Constipation is common worldwide affecting all ages with prevalence rates of 0.7%–29.6% in children and adolescents.[1]
Physical activity can be classified into exercise and non-exercise physical activity (NEPA)
The prevalence of constipation increased with the number of inactive behaviours from none (12.5%), one (15.5%), two (20.7%) to three (23.8%)
Summary
Constipation is common worldwide affecting all ages with prevalence rates of 0.7%–29.6% in children and adolescents.[1] Physical and emotional well-being is affected and treatment could be costly.[2,3] Previously identified risk factors of constipation include female sex, older age, poor socioeconomic status, insufficient fruit and vegetable consumption, psychological problems and insufficient physical activity.[4,5,6,7,8]. Exercise, which generally refers to structured and planned activities of moderate-to-vigorous level, such as jogging, brisk walking and water aerobics, was negatively associated with constipation in adults.[9,10] Daily moderate exercise was associated with a 44% reduction in risk of constipation in women.(10) Regular exercise has been recommended in elderly constipated patients,[2,11,12] the causal role of diminished exercise leading to constipation has not been confirmed.[4] studies focusing on exercise and constipation in children and adolescents were few and results inconsistent. Two studies on children have reported a negative association between physical activity and constipation, [8,13] while another study on adolescents found no association between moderate-to-vigorous exercise and constipation.[14]
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