Brazilian Adolescents Research Articles

Nutritional status and temporal trend of coverage of Brazilian adolescents monitored in the Food and Nutritional Surveillance System, 2008 to 2019

Resumo Objetivos: analisar o estado nutricional e a tendência temporal da cobertura de adolescentes brasileiros acompanhados no Sistema de Vigilância Alimentar e Nutricional no período de 2008-2019. Métodos: estudo ecológico de séries temporais com dados do SISVAN coletados no período de 2008 a 2019 com 45.869.266 de registos. Foram coletados dados de índice de massa corporal e calculadas as coberturas dos registros dos adolescentes acompanhados pelo sistema. Estimou-se a percentagem da variação anual da cobertura e estado nutricional pela regressão de Prais-Winsten, com nível de significância de 5%. Resultados: observa-se crescimento da prevalência de obesidade entre 2008 a 2019, nesse período a magreza manteve-se estável no Brasil. A cobertura nacional evoluiu de 9,3% em 2008 para 19,6% em 2019, com variação anual de 9% e tendência de aumento estatisticamente significativa. No Brasil, a obesidade nessa faixa etária apresentou um aumento entre os anos de 2008 e 2019, com uma variação anual de 8,7% (IC95%= 7,8-9,6). Conclusão: modificações observadas no estado nutricional sugerem a ocorrência da transição nutricional na população de adolescentes. O percentual de cobertura disponível no sistema tem potencial de crescimento, entretanto, o atual cenário impacta em possível análise insuficiente para subsidiar a elaboração e reorientação de políticas públicas.

The role of volume and intensity on the association between physical activity and mental health among adolescents: a cross-sectional study.

To analyze the association between volume and intensity of physical activity and mental health among adolescents. Cross-sectional study with 604 Brazilian adolescents. Data were assessed using a self-report questionnaire. The outcomes were suicidal ideation, suspicion of common mental disorders, and negative self-perception of mental health. The independent variables were leisure physical activity at low and moderate-to-vigorous intensities. Volume was analyzed in two ways: any volume (presence vs absence), and volume classified according to amount in minutes of weekly physical activity: inactive (0), low active (1-419), and high active (≥420). Poisson regression was performed to estimate prevalence ratios. Any volume of moderate-to-vigorous physical activity was significantly associated with a lower prevalence ratio of all outcomes (PR 0.67 to 0.77). Compared to inactive adolescents, those who were classified as low active for moderate-to-vigorous intensity, presented a lower likelihood of having suicidal ideation, suspicion of common mental disorders, and negative self-perception of mental health (PR 0.70 to 0.76). Furthermore, high active adolescents in moderate-to-vigorous physical activity presented lower suicidal ideation and negative self-perception of mental health (PR 0.62 and 0.57). The promotion of moderate-to-vigorous intensity physical activity at any volume can benefit the mental health of adolescents, however, no association was evidenced for low intensity physical activity.

Health-promoting domains and lifestyle of a sample of Brazilian adolescents.

Reports indicate that the health habits of adults are strongly linked to the behaviors incorporated in adolescence. Therefore, it is essential to monitor the lifestyle of adolescents to promote their present and future health. This study aimed to identify differences in health-promoting domains according to demographic data and lifestyle behaviors, including physical activity, sedentary behavior, sleep duration, and food intake, in a sample of Brazilian adolescents. Cross-sectional school-based study, with the participation of 306 adolescents aged 14 to 18 years. A questionnaire was applied with structured questions to collect demographic data and lifestyle behaviors. To examine the health-promoting domains the Adolescent Health Promotion Scale (AHPS) was used. Data were analyzed using multivariate analysis. Scores attributed to each of the health-promoting domains showed substantial variations according to sex, age, year of study, parents' schooling, and family economic class. After adjustment for covariables, the adolescent who presented significantly higher scores equivalent to the overall index of health promotion reported being more physically active (F = 4.848; P = 0.009), sleeping 6-8 hours/night (F = 2.328; P = 0.046), consuming fruit/vegetable more frequently (F = 3.168; P = 0.024), while sedentary behavior and intake of sweetened products/soft drinks have not shown any significant effect. The findings confirmed the consistent positive influence of health-promoting domains assessed by AHPS on healthy lifestyle behaviors, suggesting in the intervention programs aimed at adopting healthy lifestyle approaches it is important enough to contemplate actions aimed at all the areas of health promotion with characteristics aimed at nutrition behavior, social support, health responsibility, life appreciation, exercise behavior, and stress management.

Factors Associated with Suicide Attempts among Adolescents: A Review of the National Literature

Introduction: Suicide among adolescents in Brazil has drawn attention due to the prevalence of the behavior among very young individuals. However, it is still little addressed in society, being little discussed in the school and family environment, which hinders screening strategies for suicide risk and its prevention. Objective: The main objective of this review is to analyze the scientific production on suicide attempts and deaths by suicide among adolescents in Brazil between the years 2011 and 2020. Results and Discussion: It was possible to identify a greater production of cross-sectional articles, in journals of collective/public health and psychiatry or/ and psychology. Of the factors most associated with suicide and suicide attempts, we obtained the use of drugs, presence of other mental disorders, alcohol use, low economic status, dysfunctional relationship with parents, sexual and physical violence. Conclusions: For the interventions, it is clear that there is a need for detection strategies, welcoming and prevention of suicide, programs and financial resources to reduce its indicators, health actions to combat suicide and future studies on the subject. Keywords: Suicide, Suicide Attempt, Adolescents, Brazil.

Hospitalizations and deaths of Brazilian children and adolescents with Severe Acute Respiratory Syndrome caused by COVID-19.

Since the onset of the pandemic, COVID-19 has affected the entire world population, however, data on child morbidity and mortality are scarce. This study aimed to analyze the profile of hospitalizations and factors associated with the deaths of Brazilian children and adolescents with Severe Acute Respiratory Syndrome caused by COVID-19. This cross-sectional study uses public domain data from the Influenza Epidemiological Surveillance System in 2021. The prevalence rates, lethality, and duration of hospitalization of children and adolescents with Severe Acute Respiratory Syndrome caused by COVID-19 were analyzed. Logistic regression and adjusted Odds Ratio were used. A p < 0.05 was considered significant. The prevalence of hospitalization among children and adolescents was 3.6%, and the case lethality rate was 4.0%. Higher lethality rates occurred among adolescents, natives, rural residents, those living in Brazil's northern and northeastern regions, and those who became critically ill and had comorbidities. Hospitalization time was longer for adolescents who became critically ill or had comorbidities. The highest chance of death was associated with: children under one year of age and adolescents, natives, and residents from the North, Northeast, and Southeast regions, who became critically ill and had comorbidities. Despite lower hospitalization and death rates than adults, the prevalence, complications, and mortality from COVID-19 in the pediatric population are relevant. Knowledge of the profile of children and adolescents hospitalized due to COVID-19 and the factors associated with these deaths allows the guidance of response efforts directed to assist this vulnerable population.

Time-use movement behaviors are associated with scores of depression/anxiety among adolescents: A compositional data analysis.

Movement behaviors have been associated with mental health. The purposes of this study were to examine the association between movement behaviors and scores of depression/anxiety among adolescents and to determine the difference in depression/anxiety associated with reallocating time between different movement behaviors. This cross-sectional study included 217 Brazilian adolescents (15 to 18 years old, 49.3% female). Adolescents wore an accelerometer for one week to assess the four-movement behaviors which include sleep, sedentary behavior (SB), light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA). The depression/anxiety score was calculated by factor analysis using the 12-item General Health Questionnaire. Compositional data analyses were used to examine the association between movement behavior and the depression/anxiety score. Compositional isotemporal substitution models estimated the change in depression/anxiety score associated with reallocating 10, 30, and 60 min between movement behaviors. The composition of movement behaviors was significantly associated with depression/anxiety scores (p < 0.05). Replacing time from SB to LPA was associated with improvement in the depression/anxiety score, while the inverse was associated with an increase in this score. Replacing time of LPA with MVPA was associated with worsening in the depression/anxiety score. The 24-h time distribution of the day may play a crucial role in mental health. Compositions with more time spent in LPA at the expense of less SB are associated with improvement in the scores of depression/anxiety. The type of MVPA may moderate its effects on depression/anxiety in adolescents. Holistic interventions including the full range of movement behaviors may be a gateway to reduce the levels of depression/anxiety in adolescence.

Adolescent blood pressure classification curves and cardiometabolic risk factors: a comparison of the Brazilian and American references.

The American Academy of Pediatrics (AAP) adolescent blood pressure (BP) percentiles were updated in 2017, and have been used as reference in Brazil since then. However, specific BP percentiles for Brazilian adolescents were recently proposed based on data from the Study of Cardiovascular Risk in Adolescents (ERICA). To compare the prevalence of arterial hypertension according to each reference, as well as to assess the cardiometabolic risk associated with the reclassification by Brazilian BP percentiles. Data from 73 399 adolescents aged 12-17 years who participated in the ERICA study were analyzed. To assess cardiometabolic risk, 6185 adolescents who were reclassified upwards by the Brazilian reference were 1 : 1 matched with adolescents that were normotensive by both references and were of the same age, sex and height percentile. The parameters evaluated were: overweight/obesity, waist circumference, total cholesterol, triglycerides, LDL-c, HDL-c, fasting glucose, HbA1c and HOMA-ir. The classification according to Brazilian BP percentiles resulted in a higher prevalence of arterial hypertension (14%, 95% CI 13.2-14.8), when compared with the AAP percentiles (10.6%, 95% CI 10.0-11.2). The use of the Brazilian reference also resulted in higher prevalence of arterial hypertension in girls, teenagers ranging from 12 to 14 years, and those classified with adequate weight, overweight or obesity. In the case-control analysis, cardiometabolic risk factors were present more often in adolescents reclassified with arterial hypertension by the ERICA reference. The use of the BP percentiles proposed by ERICA is a sensitive method for tracking Brazilian adolescents with hypertension and higher cardiometabolic risk.

Individual and Socioeconomic Contextual Factors Associated with Obesity in Brazilian Adolescents: VigiNUTRI Brasil.

This study investigated the association of socioeconomic contextual factors of the municipality of residence of adolescents, their eating behavior and food consumption with the prevalence of obesity. This was a cross-sectional study, based on individual data regarding anthropometry, eating behavior (eating in front of screens and having at least three main meals a day), and markers of healthy and unhealthy eating of 23,509 adolescents aged 10 to 19 years, participating in the Food and Nutrition Surveillance of the Brazilian Population monitored in Primary Health Care (VigiNUTRI Brasil) assessment in 2018. Based on multilevel Poisson regression, a higher prevalence of obesity was observed among adolescents living in municipalities with per capita income above USD209.68 (PR = 1.22; 95% CI 1.05;1.42) and among those who consumed hamburgers and/or processed meats the previous day (PR = 1.09; 95% CI 1.01;1.17). Adolescents who had the habit of having three main meals a day (PR = 0.81; 95% CI 0.73;0.89 p < 0.05) and who consumed fresh fruit the previous day (PR = 0.91; 95% CI 0.84;0.98 p < 0.001) had lower prevalence of obesity. The results reinforce the influence of the social context and food consumption on obesity rates. The persistence of this situation implies a worsening in the current and future health of adolescents.

Are the laws restricting the sale of food and beverages in school cafeterias associated with obesity in adolescents in Brazilian state capitals?

Public policies that regulate the promotion or sale of unhealthy food and beverages in schools are relevant to prevent obesity in children and adolescents. However, the relationship between food and beverage laws within schools and obesity in Brazilian adolescents needs further study. Thus, this study aims to evaluate the association between laws that restrict the sale of food and beverages in school cafeterias and obesity in adolescents from public and private schools in Brazilian capitals. Data were provided by the ERICA study, which followed a cross-sectional school-based approach. The sample consisted of adolescents aged between 12 and 17 years (n = 19,024) from Brazilian capitals (n = 27) enrolled in schools that sell food and beverages in their dependence (n = 486). The dependent variable was the presence of obesity, and the main effect was the coverage of laws restricting the sale of food and beverages in school cafeterias. Data analysis was carried out using multilevel logistic regression models. Adolescents covered by laws restricting the sale of food and beverages in school cafeterias had an 11 % lower chance of obesity (adjusted OR = 0.89; 95 % CI 0.88 – 0.91). In conclusion, laws restricting the sale of food and beverages inside schools were associated with a decrease in the chance of obesity in adolescents in Brazilian state capitals.

Psychological Aspects, Physical Activity Levels and Overweight Concerns: A Cross-over Study of Brazilian Adolescents.

This study aims to identify levels of anxiety, depression, body weight, and levels of physical activity, as well as to verify possible associations among these variables in Brazilian adolescents. It is a cross-sectional study with a convenience sample of 291 Brazilian adolescents aged 13 to 15 years old (13.75±0.80 years old). Researchers assessed students by filling out questionnaires of anxiety and depression symptoms, as well as the level of physical activity and checking anthropometric measures. Parametric and non-parametric statistics were used to compare groups divided by psychological, physical and overweight factors for boys and girls, adopting a significance level of 95%. Results showed higher waist circumference and physical activity levels for boys (p<0.01) and higher scores for anxiety and depressive symptoms questionnaires for girls (p<0.01). In addition, a low prevalence of depression was observed in boys (0.69%/CI0.03-4.36). For anxiety and depression variables in males and females with and without overweight and physically active and inactive, there were significant differences between groups (p < 0.05), but not within groups. The identification of a higher prevalence of girls with anxiety and depression was observed in this study and reinforced this information already demonstrated in the scientific literature. In general, the prevalence of depression was low in boys, while the prevalence of overweight, sedentary lifestyle, anxiety and depression were higher in girls.

Factors that influence morningness-eveningness and daytime sleepiness: A cross-cultural comparison of Iranian and Brazilian adolescents

ABSTRACT As adolescents get older, they become more evening oriented and, because they are usually expected to wake early to attend school, they often present daytime sleepiness, which is associated with negative outcomes. It is still unclear if this is similar cross-culturally. Here, we studied morningness-eveningness and daytime sleepiness in early adolescence from two different developing nations (Brazil and Iran). A total sample of 697 Iranian and Brazilian early adolescents (9- to 15-year-old; 358 boys) from Tehran, Iran, and São Paulo, Brazil, varying in age and parental schooling (a proxy of socioeconomic status: SES) completed the Morningness–Eveningness Scale for Children (MESC) and the Pediatric Daytime Sleepiness Scale (PDSS) and reported their total sleep time on school nights. They also filled in the Pubertal Developmental Scale to determine their pubertal status. A negligible cross-cultural difference in morningness-eveningness was found, indicating that Brazilians showed a slight circadian-phase delay compared with Iranians throughout all tested ages. There was also seen a very slight increase in phase delay as early adolescents aged, indicative of more eveningness. However, there were no country differences in daytime sleepiness once total sleep time during school nights was controlled for, which was the only factor that affects PDSS scores.

Physical Activity Levels in Brazilian Adolescents: A Secular Trend Study (2007-2017/18).

Only a small proportion of Brazilian adolescents practice sufficient physical activity (PA). However, it is not clear whether this proportion has been decreasing over time. This study aimed to examine the 10-year trends of sufficient PA in adolescents and to investigate differences by sex and age. Using a standard protocol, we compared two cross-sectional cohorts of adolescents aged 15 to 18 years, recruited in 2007 (n = 1040) and in 2017/18 (n = 978). Using the International Physical Activity Questionnaire-Short Form (IPAQ-SF), the adolescents reported moderate-to-vigorous PA (MVPA) performed in the last seven days. Sufficient PA was defined as engaging in at least 60 min/day of MVPA. In the subgroups, investigated by sex or age, there was an increase in the prevalence of sufficient PA. Overall, sufficient PA declined by 28.1% from 2007 to 2017/18. Boys in 2007 were more active than their 2017/18 peers, and this was equally observed in girls in 2007 compared to those in 2017/18. The findings show decreasing secular trends in sufficient PA in the investigated adolescents. Not only are public health authorities in Brazil witnessing an escalation of insufficient PA, but they are also losing ground with the most active adolescents.

Religious-spiritual coping in family caregivers of Brazilian children and adolescents with cancer

ABSTRACT The aim of this study was to understand how family caregivers of Brazilian children and adolescents with cancer experience and use religious-spiritual coping. This is a qualitative study carried out with 23 participants (being 21 women and two men; age average of 35,9 years old). Semi-structured interviews were virtually conducted, recorded, fully transcribed, organized and analyzed using a thematic-reflective analysis. The results found to allow us to indicate that positive and negative religious-spiritual coping affects the quality of life, physical and emotional health of family members, reverberating in the way they deal with and understand cancer in children and adolescents. The data found demonstrate that paediatric oncology health services and professionals should consider religious-spiritual coping and be prepared to meet the demands of this nature that may arise.

Low- and no-calorie sweetener intakes from beverages – an up-to-date assessment in four regions: Brazil, Canada, Mexico and the United States

The current assessment estimated exposure to four low- and no-calorie sweeteners (LNCS) (aspartame, acesulfame potassium (AceK), steviol glycosides and sucralose) from beverages in Brazil, Canada, Mexico and the United States, using up-to-date nationally representative consumption data and industry reported-use level information. Two modelling scenarios were applied – the probabilistic model was guided by reported use level data, with estimated intake for an individual leveraging market-weighted average use level of a particular LNCS in any given LNCS-sweetened beverage type, while the distributional (brand-loyal) model assumed consumer behaviour-led patterns, namely that an individual will be brand loyal to a pre-determined beverage type. Consumer-only and general population intake estimates were derived for the overall population and individual age categories, and compared to the respective acceptable daily intake (ADI) as established by the Joint FAO/WHO Expert Committee on Food Additives (JECFA) for each LNCS. The mean, 90th percentile and 95th percentile intake estimates were substantially lower than the ADI in both modelling scenarios, regardless of the population group or market. In the probabilistic model, the highest consumer-only intake was observed for AceK in Brazilian adolescents (95th percentile, 12.4% of the ADI), while the highest 95th percentile intakes in the distributional model were observed for sucralose in Canadian adults at 20.9% of the ADI. This study provides the latest insights into current intakes of LNCS from water-based non-alcoholic LNCS-sweetened beverages in these regions, aligning well with those published elsewhere.

Translation and cross-cultural adaptation of the Food Choice Questionnaire for Brazilian Adolescents (FCQ-A-BR)

Resumo Introdução Instrumentos que busquem conhecer os motivos que propiciam as escolhas alimentares em adolescentes são inexistentes no Brasil até o momento. O Food Choice Questionnaire (FCQ) para adolescentes é um questionário de fácil aplicação e que pode ser utilizado não somente em pesquisas, mas também nos serviços de atenção à saúde. Objetivo Descrever as etapas iniciais - validade de face e de conteúdo - do processo de tradução e adaptação transcultural do FCQ para adolescentes da versão em espanhol para o português do Brasil. Método Trata-se de um estudo metodológico de tradução e adaptação transcultural, em conformidade com as normas internacionais para tradução de instrumentos para validação. Foram seguidas quatro etapas: tradução, retradução, avaliação por comitê de especialistas e dois pré-testes, que foram realizados com adolescentes com idades entre 14 e 19 anos. Resultados Os itens e o título do instrumento foram traduzidos para o português. Alguns itens necessitaram de ajustes para melhor compreensão do público-alvo. O tempo médio de aplicação foi de sete minutos. Um item foi eliminado do questionário e modificou-se a escala de resposta para melhor adequação do instrumento. Conclusão O processo inicial de tradução e adaptação transcultural do Questionário de Escolhas Alimentares para Adolescentes Brasileiros (FCQ-A-BR) atestou as validades de face e conteúdo. No entanto, faz-se necessária a complementação das análises psicométricas, para utilização do instrumento, caso elas se mostrem satisfatórias.

The COVID-19 pandemic and changes in eating habits of Brazilian adolescents.

The social distancing imposed by the COVID-19 pandemic influenced lifestyle and modified dietary patterns. Our objective was to evaluate the consumption of fruits and vegetables (FV), and ultra-processed foods (UPF), before and after the COVID-19 pandemic, as well as to identify the sociodemographic factors associated. This study used data from the "Convid Adolescents", a survey on health behaviors that were collected through an online questionnaire self-completed by 9.470 adolescents between 12 and 17 years of age during the pandemic in Brazil in 2020. Individuals were invited to participate through a chain-sampling procedure called "virtual snowballing". Information about FV, and UPF consumption before and during the pandemic period were reported. The independent variables used were sex, age group, race/color of skin, kind of school, education level of the mother, region of Brazil, financial difficulties during the pandemic, food insecurity, and social restrictions. Logistic regression models were used. There was a reduction in the low consumption of FV (83.5% to 80.3%) and there was no significant difference in the high consumption of UPF (38.9% to 38.1%) before and during the pandemic. The incidence of low consumption of FV and high consumption of UPF during the pandemic was 20% and 13.8%, respectively. Girls, private school adolescents, who reported having food insecurity and financial difficulties during the pandemic were the most affected subgroups. Despite little change in the prevalence of FV and UPF consumption before and during the pandemic, the incidence of high consumption of UPF and low FV consumption was high, and it identified in specific population subgroups.

Inequalities and participation in the digital society: online experiences among children and adolescents in Brazil and Chile

Inequalities and participation in the digital society: online experiences among children and adolescents in Brazil and Chile

Screen time and its association with adolescents' lifestyles in a city in the Brazilian Northeast

Objective: To associate screen time with food, physical activity, sleep and sociodemographic variables in Brazilian adolescents, students of urban public institutions. Methods: Observational, cross-sectional, quantitative, analytical study approved by the Ethics Committee in Research on Human Beings of the Federal University of Sergipe (CAAE 38981320.2.0000.5546) with students from 10 to 18 years of age at a public school in a municipality in the Brazilian Northeast. A descriptive analysis of screen time, sociodemographic, economic variables, academic year, physical activity, sleep duration and daytime sleepiness was performed. Fisher's exact test and Pearson's chi-square test were used to analyze the independence hypothesis and the Mann-Whitney test to assess the hypothesis of equality of the median of two samples, in addition to simple and multiple logistic regression. Results: 364 students participated in the study. The eighth and ninth year of elementary school; the first and second years of high school made more excessive use of electronic devices. There is a greater chance of screen time higher than recommended in those with a higher socioeconomic level. High screen time was associated with the presence of daytime sleepiness, with a higher prevalence of excessive screen time in students who considered they rarely and often had sleepiness. Conclusions: The prevalence of excessive screen time was higher in adolescents considered older, when compared to younger ones and in those with better socioeconomic conditions. It is possible that screen time influences shorter sleep duration and the presence of daytime sleepiness.

Incidence of retinoblastoma in children and adolescents in Brazil: A population-based study.

To estimate the incidence of retinoblastoma in children and adolescents in Brazil based on Population-Based Cancer Registry (PBCR), describing temporal trends and some quality indicators of this registry. Based on secondary data from the PBCR of the National Institute of Cancer (INCA) (2000-2018), by selecting the morphological code of retinoblastoma, the annual incidences per million (0-19 years of age) in each local PBCR were estimated by sex and age group, global combined and by region, in addition to the percentage of diagnosis only by death certificate (DC) or not informed (NI), and the male/female ratio (M/F). An annual incidence trend in the five Brazilian geographic regions was also analyzed using the inflection point regression technique. 675 patients were identified in 28 PBCR, 91% between 0 and 4 years of age. The overall combined incidence per million by age group was: 7.02 (0-4 years old), ranging from 5.25 in the Midwest to 11.26 in the Northeast; 0.46 (5-9 years old); 0.05 (10-14 years old) and 0.03 (15-19 years old). The combined incidence per million, adjusted for the world population, was 2.23 (0-14 years old) and 2.24 (0-19 years old). The DC and NI percentages were 13% and 18%, respectively; the M/F ratio was 1.3. The incidence remained stable throughout the study period, except for the city of São Paulo, where there was a significant reduction of 3.4% per year. In Brazil, except for the Northeast region, the incidences of retinoblastoma were lower than those reported in several countries worldwide, suggesting possible underreporting, and the time series analysis showed a stable trend. Although this pioneering study brings a recent panel of available data on retinoblastoma in Brazil, more precise estimates are needed and welcome for better planning of onco-ophthalmologic care in the country.

Clustering of Obesogenic Behaviors Associated With Bullying Roles Among 100,794 Adolescents.

Obesogenic behaviors have been individually associated with bullying during adolescence. However, physical activity, sedentary behavior, and diet manifest themselves in synergy and even behavioral profiles in which positive and negative behaviors coexist can be more positively associated with psychosocial outcomes. The present study aimed to analyze the association between clusters of obesogenic behaviors and different bullying roles in Brazilian adolescents. This cross-sectional study used data from the Brazilian School-based Health Survey-PENSE, 2015. A total of 100,794 male and female adolescents of the ninth-grade elementary school participated in the study. Students responded to an electronic questionnaire. Clusters of obesogenic behavior consisted of physical activity, exposure to sedentary behavior, and diet, and the different roles in bullying were: participant, victim, bully, and bully-victim. Binary logistic regression with 95% confidence intervals (CI) was used for data analysis (p < .05). Multiple adjustments and complex sampling procedures were employed. Adolescents in the cluster "Health-promoting sedentary behavior and Diet" had reduced chances of participating in bullying (odds ration [OR] = 0.70; 95% CI [0.64, 0.76]), of being a victim (OR = 0.87; 95% CI = 0.76-0.99), and being the bully (OR = 0.65; 95% CI [0.59, 0.71]); and those from the cluster "Health-promoting physical activity and Diet" had reduced chances of participating (OR = 0.81; 95% CI [0.76, 0.87]), being a victim of bullying (OR = 0.86; 95% CI [0.76, 0.98]), being the bully (OR = 0.79; 95% CI [0.72, 0.85]), and being a bully-victim (OR = 0.74; 95% CI [0.61, 0.90]), when compared to those from the "health-risk" cluster in the adjusted analysis. Clusters of obesogenic behavior may reduce adolescent bullying: victim, bully, and bully-victim benefit when exposed to healthier behavioral profiles. The school setting must recognize bullying as a problem and therefore simultaneously promote multi-component interventions to tackle physical activity, sedentary behavior, and eating behavior. Outcomes other than obesity should be acknowledged when promoting obesogenic behaviors.