Abstract
BackgroundThe prevalence of overweight in children and adolescents is high and overweight is associated with poor health outcomes over short- and long-term. Lifestyle factors can interact to influence overweight. Comprehensive studies linking overweight concomitantly with several demographic and potentially-modifiable lifestyle factors and health-risk behaviours are limited in adolescents - an age-group characterized by changes in lifestyle behaviours and high prevalence of overweight. Thus, the objective of the current study was to examine the association of overweight with several socio-demographic and lifestyle variables simultaneously in a representative sample of adolescents.MethodsA nationally representative sample of 11-15 year-olds (n = 7154) in France participated as part of the WHO-Collaborative Health Behaviour in School-aged Children (HBSC) study. Students reported data on their age, height, weight, socio-demographic variables, lifestyle factors including nutrition practices, physical activity at two levels of intensity (moderate and vigorous), sedentary behaviours, as well as smoking and alcohol consumption patterns using standardized HBSC protocols. Overweight (including obesity) was defined using the IOTF reference. The multivariate association of overweight with several socio-demographic and lifestyle factors was examined with logistic regression models.ResultsThe adjusted odds ratios for the association with overweight were: 1.80 (95% CI: 1.37-2.36) for low family affluence; 0.73 (0.60-0.88) for eating breakfast daily; 0.69 (0.56-0.84) for moderate to vigorous physical activity (MVPA); and 0.71 (0.59-0.86) for vigorous physical activity (VPA). Significant interactions between age and gender as well as television (TV) viewing and gender were noted: for boys, overweight was not associated with age or TV viewing; in contrast, for girls overweight correlated negatively with age and positively with TV viewing. Fruit and vegetable intake, computer and video-games use, smoking and alcohol consumption were not associated with overweight.ConclusionsIn multivariate model, family affluence, breakfast consumption and moderate to vigorous as well as vigorous physical activity were negatively associated with overweight. These findings extend previous research to a setting where multiple risk and protective factors were simultaneously examined and highlight the importance of multi-faceted approaches promoting physical activity and healthy food choices such as breakfast consumption for overweight prevention in adolescents.
Highlights
The prevalence of overweight in children and adolescents is high and overweight is associated with poor health outcomes over short- and long-term
Few studies have examined the association of health-risk behaviours such as smoking and alcohol consumption practices with overweight in adolescents [5,6,11,17]; most reported a positive association for overweight and smoking [6,11] as well as for overweight and alcohol consumption [5,6,17] but others did not find any relation for Body Mass Index (BMI) and smoking or alcohol [25]
Significant associations between gender and socio-demographic and lifestyle factors were noted with the exception of age, smoking and computer use
Summary
The prevalence of overweight in children and adolescents is high and overweight is associated with poor health outcomes over short- and long-term. The etiology of overweight is complex and involves interplay of genetic predisposition with environmental factors including socio-demographic variables as well as potentially modifiable lifestyle factors The latter can include nutrition practices, physical activity and sedentary behaviours, as well as health-risk behaviours such as smoking and alcohol consumption. Most of the previous literature in children has examined the link of overweight with these factors either singly [2,5,6,7]; or in combination with certain lifestyle or health-risk factors [8,9,10,11,12,13] in a wide age range of participants rather than in adolescents per se [12,14] Such studies generally report an inverse association between socio-economic status (SES) and overweight in developed countries [3,15]. It is important to examine alcohol and smoking practices in relation to overweight because these practices could impact energy metabolism and thereby affect overweight [26,27]
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