Adolescent Weight Status Research Articles

Sport participation, weight status, and physical fitness in French adolescents.

The primary objective of this study was to investigate the associations between sport participation and weight status with physical fitness among French adolescents. The secondary aim was to establish sex- and age-specific physical fitness percentiles for French adolescents. The sample comprised 8084 adolescents (4126 boys, 3958 girls), aged 10-14years. Participants were tested on cardiorespiratory fitness and muscular strength using the following tests: 20-m shuttle run test and handgrip strength test. A questionnaire on organized sport participation was completed. Physical fitness levels were better in boys (P < 0.005). Handgrip strength increased with age whereas 20-m shuttle run performance decreased with age. Overweight and obese adolescents had significantly lower cardiorespiratory fitness levels than their normal-weight peers (P < 0.005), whereas normal-weight adolescents had lower cardiorespiratory fitness than thin adolescents (P < 0.005). Sport participation was higher for boys (57.2% boys vs. 52.8% girls) (P < 0.001). Adolescents who participated in at least one organized sport (either through a club or at school) were fitter than those who did not participate in organized sports (P < 0.005). Adolescents who engaged in organized sports were more active and physically fit than those who did not participate. The fitness benefits of club sports are greater than those provided by school-based sports, highlighting the potential of sports clubs as a key setting for promoting health. What is Known: • Physical fitness is a strong marker of health in children and adolescents. • The last French Report Card highlighted the lack of fitness data and the need for nationwide programs, while showing a significant decline in cardiorespiratory fitness among youth in recent decades.. What is New: • This study reveals that adolescents participating in organized sports have better physical fitness compared to their peers who do not, emphasizing the potential advantages of club sports over school-based activities. • We highlight the need for targeted strategies, particularly for overweight or obese adolescents and girls, to increase participation in organized sports and enhance health outcomes. • The study emphasizes the need to develop policies that improve access to organized sports clubs and expand physical education in schools, aiming to improve CRF in adolescents.

Robust identification key predictors of short- and long-term weight status in children and adolescents by machine learning.

Early identification of high-risk individuals for weight problems in children and adolescents is crucial for implementing timely preventive measures. While machine learning (ML) techniques have shown promise in addressing this complex challenge with high-dimensional data, feature selection is vital for identifying the key predictors that can facilitate effective and targeted interventions. This study aims to utilize feature selection process to identify a robust and minimal set of predictors that can aid in the early prediction of short- and long-term weight problems in children and adolescents. We utilized demographic, physical, and psychological wellbeing predictors to model weight status (normal, underweight, overweight, and obese) for 1-, 3-, and 5-year periods. To select the most influential features, we employed four feature selection methods: (1) Chi-Square test; (2) Information Gain; (3) Random Forest; (4) eXtreme Gradient Boosting (XGBoost) with six ML approaches. The stability of the feature selection methods was assessed by Jaccard's index, Spearman's rank correlation and Pearson's correlation. Model evaluation was performed by various accuracy metrics. With 3,862,820 million student-visits were included in this population-based study, the mean age of 11.6 (SD = 3.64) for the training set and 10.8 years (SD = 3.50) for the temporal test set. From the initial set of 38 predictors, we identified 6, 9, and 13 features for 1-, 3-, and 5-year predictions, respectively, by the best performed feature selection method of Chi-Square test in XGBoost models. These feature sets demonstrated excellent stability and achieved prediction accuracies of 0.82, 0.73, and 0.70; macro-AUCs of 0.94, 0.86, and 0.83; micro-AUCs of 0.96, 0.93, and 0.92 for different prediction windows, respectively. Weight, height, sex, total score of self-esteem, and age were consistently the most influential predictors across all prediction windows. Additionally, several psychological and social wellbeing predictors showed relatively high importance in long-term weight status prediction. We demonstrate the potential of ML in identifying key predictors of weight status in children and adolescents. While traditional anthropometric measures remain important, psychological and social wellbeing factors also emerge as crucial predictors, potentially informing targeted interventions to address childhood and adolescence weight problems.

Delay discounting and nucleus accumbens functional connectivity are related to weight status in adolescents from the ABCD study.

Despite the growing epidemic of paediatric obesity, questions remain regarding potential neural mechanisms for individual risk. Delay discounting is a cognitive process of comparison of valuation between immediate and delayed reward, which has been inconsistently linked to weight status. Moreover, central to the brain's reward system is the nucleus accumbens, a region structurally and functionally altered in obesity. This study aimed to examine the relationships between two continuous metrics of weight status, performance on a monetary delay-discounting task and nucleus accumbens functional connectivity in 10-12-year-olds from the Adolescent Brain and Cognitive Development (ABCD) Study. Using multilevel longitudinal linear modelling, we found greater discounting was associated with higher BMI Z-scores (BMIz) and waist-to-height ratio Z-scores (WHtRz) (N = 3819). Moreover, we observed functional connectivity of the nucleus accumbens to the cingulo-opercular, dorsal attention, fronto-parietal, salience and ventral attention networks were predictive of BMIz (N = 1817). Nucleus accumbens functional connectivity was not found to mediate the association between delay-discounting behaviour and BMIz. Delay discounting and nucleus accumbens functional connectivity are independently related to weight status in a large sample of early adolescents. A better understanding of the relationship between reward and overeating behaviours may better inform obesity interventions.

Role of dietary intake and physical activity in reducing weight social inequalities among adolescents: an application of G-formula to PRALIMAP-INÈS trial.

Interventions aiming to reduce social inequalities of weight status in adolescents usually focus on lifestyle behaviours, but their effectiveness is limited. This study analysed the effect of achieving levels of dietary intake (DI) and/or physical activity (PA) guidelines on reducing social inequalities in weight status among adolescents. We included adolescents from the PRomotion de l'ALIMentation et de l'Activité Physique - INÉgalité de Santé (PRALIMAP-INÈS) trial with weight status data available at baseline and 1-year follow-up (n 1130). PA and DI were measured using the International Physical Activity Questionnaire and a validated FFQ, respectively. We estimated the likelihood of a 1-year reduction in BMI z-score (BMIz) and population risk difference (PRD) under hypothetical DI and PA levels and socio-economic status using the parametric G-formula. When advantaged and less advantaged adolescents maintained their baseline DI and PA, we found social inequalities in weight status, with a PRD of a 1-year reduction in BMIz of -1·6 % (-3·0 %, -0·5 %). These inequalities were not observed when less advantaged adolescents increased their proportion of achieving DI guidelines by 30 % (PRD = 2·2 % (-0·5 %, 5·0 %)) unlike the same increase in PA (PRD = -3·9 % (-6·8 %, -1·3 %)). Finally, social inequalities of weight status were not observed when levels of achievement of both PA and DI guidelines increased by 30 % (PRD = 2·2 % (-0·5 %, 4·0 %)). Enhancing DI rather than PA could be effective in reducing social inequalities in weight status among adolescents. Future interventions aiming to reduce these inequalities should mostly target DI to be effective.

High BMI z-Scores from Different Growth References Are Not Comparable: An Example from a Weight Management Trial with an Anti-Obesity Medication in Pubertal Adolescents with Obesity.

Background: The BMI z-score is a standardized measure of weight status and weight change in children and adolescents. BMI z-scores from various growth references are often considered comparable, and differences among them are underappreciated. Methods: This study reanalyzed data from a weight management clinical study of liraglutide in pubertal adolescents with obesity using growth references from CDC 2000, CDC Extended, World Health Organization (WHO), and International Obesity Task Force. Results: BMI z-score treatment differences varied 2-fold from -0.13 (CDC 2000) to -0.26 (WHO) overall and varied almost 4-fold from -0.05 (CDC 2000) to -0.19 (WHO) among adolescents with high baseline BMI z-score. Conclusions: Depending upon the growth reference used, BMI z-score endpoints can produce highly variable treatment estimates and alter interpretations of clinical meaningfulness. BMI z-scores cited without the associated growth reference cannot be accurately interpreted.

Association Between Picky Eating, Weight Status, Vegetable, and Fruit Intake in Children and Adolescents: Systematic Review and Meta-Analysis.

Aim: Picky eating is a common appetitive trait reported among children and adolescents and may have detrimental effects on their weight, vegetable, and fruit intake, impacting health status. However, an updated systematic review of the literature and summary of effect estimates is required. This study aims to explore the association between picky eating with weight, vegetable and fruit intake, vegetable-only intake, and fruit-only intake. Methods: A systematic literature search of six electronic scientific databases and data extraction was performed between November 2022 and June 2023. Original articles that examined picky eating in association with weight, vegetable and/or fruit intake were included. PRISMA guidelines were followed and meta-analytical and meta-regression analyses were conducted to compute summary effect estimates and explore potential moderators. PROSPERO registration: CRD42022333043. Results: The systematic review included 59 studies of which 45 studies were included in the meta-analysis. Overall, the summarized effect estimates indicated that picky eating was inversely associated with weight [Cohen's dz: -0.27, 95% confidence interval (CI): -0.41 to -0.14, p < 0.0001]; vegetable and fruit intakes (Cohen's dz: -0.35, 95% CI: -0.45, -0.25, p < 0.0001); vegetable-only intake (Cohen's dz: -0.41, 95% CI: -0.56, -0.26, p < 0.0001), and fruit-only intake (Cohen's dz: -0.32, 95% CI: -0.45, -0.20, p < 0.0001). Picky eating was positively associated with underweight (Cohen's dz: 0.46, 95% CI: 0.20, 0.71 p = 0.0008). Conclusion: Although effect sizes were small, picky eating was inversely associated with weight, vegetable, and fruit intakes, and positively associated with underweight in children and adolescents aged birth to 17 years.

Vigorous physical activity and weight status in school-aged children: a cross-sectional study.

To explore the association between VPA and weight status in adolescents. The 2017/2018 Health Behavior in School-aged Children survey (HBSC) targeted children and adolescents aged 11, 13 and 15. A systematic multistage stratified cluster randomized sampling method was used in each participating country. The 2017/2018 survey enrolled over 240,951 adolescents across 45 countries and regions. Frequency of VPA, weight status and confounding factors were collected using a self-reported questionnaire. Compared to daily VPA, less frequent VPA was linked to higher odds of obesity. For example, those who participating in VPA for 4-6 times a week (OR = 1.10, 95% CI = 1.06-1.13), 2-3 times a week (OR = 1.21, 95% CI = 1.17-1.25), or once a week (OR = 1.21, 95% CI = 1.16-1.25) all have higher odds of abnormal weight status. For boys, the frequency of 4-6 times a week (OR = 1.09, 95% CI = 1.04-1.13), 2-3 times a week (OR = 1.22, 95% CI = 1.17-1.27), or once a week (OR = 1.25, 95% CI = 1.19-1.32) were associated with higher odds of abnormal weight status. For girls, those who participating in VPA 4-6 times a week (OR = 1.11, 95% CI = 1.06-1.16), 2-3 times a week (OR = 1.20, 95% CI = 1.14-1.25), or once a week (OR = 1.17, 95% CI = 1.11-1.23) all have higher odds of abnormal weight status (i.e., overweight or obesity). This population-based study suggests that infrequent VPA participation is associated with unhealthy weight status in adolescents compared to their physically active counterparts. Additionally, this association remains consistent in both boys and girls.

Perception of Body Weight and Nutritional Status in Adolescents in Northeastern Mexico

Objetivo: Evaluar la percepción del peso corporal en adolescentes e identificar predictores del estado nutricional. Método: Diseño descriptivo, correlacional. La población estuvo conformada por estudiantes de una institución educativa pública seleccionada de forma aleatoria, ubicada en el noreste de México. La muestra fue de 851 adolescentes que cursaban entre el 7º y 9º grado de educación básica inscritos en la institución educativa seleccionada. Se evalúo la satisfacción con el peso corporal mediante las figuras de Stunkard y Sørensen. Se realizaron mediciones antropométricas (peso y talla) y se calculó el IMC. Resultados: El 18.8 % (n= 160) y 19.1% (n= 163) de los participantes presentaron sobrepeso y obesidad, respectivamente; el 21.6 % (n= 185) pertenecen al sexo masculino y 16.3 % (n= 138) al femenino. Por otro lado, el 67.5 % (n= 574) de los participantes reportó insatisfacción corporal, es decir el 45.2 % (n= 384) desea estar más delegado(a), lo cual es más frecuente en participantes del sexo femenino. La insatisfacción con el peso corporal (?= -2.62, p= .001), edad (?= .29, p= .020) y sexo (?= -.642, p= .005) influyen en el IMC de los adolescentes Conclusiones: La edad, sexo y la percepción del peso corporal son predictores del índice de masa corporal en los adolescentes del estudio.

Prediction of adolescent weight status by machine learning: a population-based study

BackgroundAdolescent weight problems have become a growing public health concern, making early prediction of non-normal weight status crucial for effective prevention. However, few temporal prediction tools for adolescent four weight status have been developed. This study aimed to predict the short- and long-term weight status of Hong Kong adolescents and assess the importance of predictors.MethodsA population-based retrospective cohort study of adolescents was conducted using data from a territory-wide voluntary annual health assessment service provided by the Department of Health in Hong Kong. Using diet habits, physical activity, psychological well-being, and demographics, we generated six prediction models for successive weight status (normal, overweight, obese and underweight) using multiclass Decision Tree, Random Forest, k-Nearest Neighbor, eXtreme gradient boosting, support vector machine, logistic regression. Model performance was evaluated by multiple standard classifier metrics and the overall accuracy. Predictors’ importance was assessed using Shapley values.Results442,898 Primary 4 (P4, Grade 4 in the US) and 344,186 in Primary 6 (P6, Grade 6 in the US) students, with followed up until their Secondary 6 (Grade 12 in the US) during the academic years 1995/96 to 2014/15 were included. The XG Boosts model consistently outperformed all other model in predicting the long-term weight status at S6 from P4 or P6. It achieved an overall accuracy of 0.72 or 0.74, a micro-averaging AUC of 0.92 or 0.93, and a macro-averaging AUC of 0.83 or 0.86, respectively. XG Boost also demonstrated accurate predictions for each predicted weight status, surpassing the AUC values obtained by other models. Weight, height, sex, age, frequency and hours of aerobic exercise were consistently the most important predictors for both cohorts.ConclusionsThe machine learning approaches accurately predict adolescent weight status in both short- and long-term. The developed multiclass model that utilizing easy-assessed variables enables accurate long-term prediction on weight status, which can be used by adolescents and parents for self-prediction when applied in health care system. The interpretable models may help to provide the early and individualized interventions suggestions for adolescents with weight problems particularly.

Associations between maternal perceptions of social support and adolescent weight status: A longitudinal analysis

Social support is a well-established predictor of improved physical health outcomes among adults. Establishing whether maternal social support may have an inter-generational positive impact on their child's physical health will provide important information for developing potential interventions and policies. Elevated body mass index (BMI) is one indicator of child health that is linked to increased risk for cardiovascular disease and other morbidities later in life. There is some evidence that maternal social support is associated with improved child and adolescent weight status; however, no studies have examined whether specific aspects of social support are more impactful than others or whether support availability is differentially impactful across developmental stages. The present study examined whether maternal perceptions of specific types of social support (i.e., financial support, non-monetary instrumental support, partner emotional support, and having a close supportive contact) were associated with lower adolescent BMI z-scores using longitudinal data collected over a 15-year period from the Future of Families and Child Wellbeing Study (n = 3146), which includes a high proportion of families experiencing socioeconomic disadvantage. Findings from linear regression models using specific types of social support measured across six waves of data collected over a 15-year period indicated that maternal perceptions of greater financial support were associated with lower adolescent BMI z-scores at 15 years (B = −0.05, 95% CI: −0.10, −0.004, P = 0.04), while the other types of support were not. Additional timing analyses demonstrated that perceived financial support during late childhood to adolescence was associated with lower adolescent BMI z-scores (B = −0.06, 95% CI: −0.11, −0.01, P = 0.01), whereas associations between support during infancy and early childhood were not detected. Study findings provide important insights for developing interventions and policies that improve maternal social supports to benefit child health.

The relationship between weight status and food environments, peer influence and dietary intake among high-school students: a case-control study

Purpose The purpose of this study is to evaluate the relationship between weight status and food environments, peer influence and dietary intake among high-school students in Shiraz, Iran. Design/methodology/approach Applying a case-control design, 406 adolescents (n = 203 overweight or obese and n = 203 normal weight) aged 14–18 years were selected using a multistage cluster random sampling method. Demographic information, physical activity level and anthropometric indices were collected. Dietary intake was determined using a 147-item food frequency questionnaire. Food environment (home and out of home) and peer influence were determined by a validated questionnaire. Findings The type of food purchased using pocket money was different between adolescents with overweight or obesity and normal weight adolescents (p &lt; 0.001). The out-of-home food environment score was not different between groups, but the home food environment score (p = 0.004) and the peer influence score (p = 0.001) were higher in normal weight adolescents. Adolescents with overweight or obesity consumed higher amounts of carbohydrate (p = 0.006) and lower amounts of protein (p = 0.01) and more sweet junk foods (p = 0.01), nonstarchy vegetables (p = 0.03) and fruits (p = 0.01) compared to the normal weight group. Originality/value Home food environment, peer influence, differences in macronutrient intake and dietary patterns may be contributing factors to adolescent weight status.

Associations of regular consumption of breakfast, lunch and dinner with Body Mass Index during adolescence: longitudinal findings by weight status among the Eating and Activity over Time 2010-2018 cohort.

To examine how the associations between meal consumption and BMI over 8 years differ by weight status in a sample of adolescents. Longitudinal, population-based study. Breakfast, lunch and dinner consumption and BMI were self-reported. Linear regressions were used to examine how the associations between meal consumption and BMI differed by weight status. Adolescents in the Minneapolis/St. Paul metropolitan area. Adolescents (n 1,471) were surveyed as part of the EAT 2010-2018 in 2009-2010 (Mage = 14·3 years) and 2017-2018 (Mage = 22·0 years). The prevalence of regular breakfast, lunch and dinner consumption (≥ 5 times/week) ranged from 45 to 65 %, 75 to 89 % and 76 to 94 %, respectively, depending on weight status category. Among adolescents with a sex- and age-specific BMI < 15th percentile, regular consumptions of breakfast, lunch and dinner during adolescence were positively associated with BMI in emerging adulthood compared with irregular consumption of breakfast, lunch and dinner (<5 times/week) after adjustment for socio-demographic characteristics (β = 5·43, β = 5·39 and β = 6·46, respectively; all P-values <0·01). Among adolescents in the BMI 15-85th and 85-95th percentiles, regular consumptions of breakfast, lunch and dinner were positively associated with BMI but to a lesser extent (P-values <0·01). For participants with a BMI ≥ 95th percentile, regular consumptions of breakfast, lunch and dinner were positively associated with BMI, but the associations were not statistically significant (P-values > 0·05). The relationship between meal consumption during adolescence and BMI in emerging adulthood differs by adolescent weight status. Future studies should investigate underlying factors related to meal consumption routines and BMI.

Food addiction and its impact on weight status in children and adolescents: The mediating role of responsive eating pattern.

This research explores the relationships between food addiction (FA), eating behaviours, and weight status in school-aged children and adolescents, aiming to understand how FA influences weight. By using a cross-sectional design, 426 healthy children and their parents were enroled in Eastern China. FA was assessed using the Chinese version of the Dimensional Yale Food Addiction Scale for Children 2.0 (dYFAS-C 2.0), while eating patterns were identified using latent profile analysis (LPA) derived from the Children's Eating Behaviour Questionnaire (CEBQ). Weight status was indicated by Body Mass Index Z Score (BMIZ) and waist-to-height ratio (WHtR). The associations among FA, eating patterns, and weight status were explored using structural equation modelling (SEM). Two eating patterns, the Responsive and the Controlled Eating Patterns, were identified. The Responsive Eating Pattern was characterized by high food responsiveness, enjoyment of food, emotional eating, fast eating, low satiety responsiveness, and food fussiness and was associated with FA and weight status (p < 0.001). The SEM results showed the Responsive Eating Pattern partially mediated the relationship between FA and weight status, with a mediation effect of 1.183 (95% CI [0.784, 1.629]) for BMIZ and 0.043 (95% CI [0.025, 0.063]) for WHtR. Increased FA is associated with a higher weight status through a specific eating behaviour pattern characterized by high responsiveness to food, emotional and rapid eating habits, and low satiety. The findings suggest that targeted interventions should take these eating behaviour patterns into account to reduce the impact of FA on weight status among children and adolescents.

Prevalence and risk factors associated with low bone mineral density in Asian adolescents with anorexia nervosa and atypical anorexia nervosa.

This retrospective study aimed to evaluate the prevalence and risk factors for low bone mineral density (BMD) at diagnosis in Asian adolescent females with anorexia nervosa (AN) and atypical AN. We analyzed the BMD results for 213 patients between 10 and 18 years of age, with AN and atypical AN receiving care at a pediatric hospital in Singapore. We used linear regression analyses to determine if type of eating disorder, premorbid weight, and duration of amenorrhea were risk factors for low BMD. For a subset of patients with repeat BMD evaluation, we used paired t-tests to assess the impact of weight or menstrual restoration on the change in BMD. The prevalence of BMD height-for-age Z-scores <-2 at presentation was higher in patients with AN (13.0%) than atypical AN (2.3%) (p = .034). In multivariate regression, a diagnosis of atypical AN was protective against low BMD at the lumbar spine (B = 0.394, p = .009) and total body less head (B = 0.774, p = .010). Duration of amenorrhea was not associated with BMD across all sites. For those with repeat BMD measures, there was significantly less deterioration in the BMD Z-scores for patients with weight or menstrual restoration (R = -0.22 ± 0.59, NR = -0.69 ± 0.43, p = .029). Duration of amenorrhea was not associated with BMD in this sample. A diagnosis of AN was correlated with lower BMD than atypical AN. Further research is needed to better understand the relationship between amenorrhea, weight status, and bone health in Asian adolescents with eating disorders. In this sample, 13% of Asian adolescents with AN and 2.3% of Asian adolescents with atypical AN have low BMD. In our study population, duration of amenorrhea was not correlated with BMD. Among adolescents with AN, a history of being underweight at the highest pre-morbid BMI, is correlated with low BMD. It is important for physicians to take a thorough weight history in evaluating bone health in this population.

Associations of Body Mass Index with Self-Rated Health and Weight Perceptions Among Rural Appalachian Adolescent Students.

Adolescents with overweight or obesity are at greater risk of having physical and psychosocial consequences. With increased disparities and inadequate literature on prevalence of adolescent weight status in rural Appalachia, there is potential for further complications. Unfortunately, adolescent obesity treatment options are often limited, especially in medically underserved regions. This cross-sectional study of adolescents at eight rural Appalachian schools examined weight status among and associations between body mass index percentile (BMIp) categories and health-related perceptions and weight-control intentions. Previously validated instruments were utilized. Analyses included independent samples t-tests, ANOVA tests, and chi-squared tests. Of 814 adolescents (ages 11-13; 55.0% girls), BMIp revealed 20.8% overweight, 22.7% obese, and 10.6% severely obese. Adolescents with higher BMIp categories reported poorer self-rated health, inaccurate weight perceptions, and greater weight loss intentions (all p < .05). Findings, including high prevalence of adolescents with overweight and obesity, emphasize the need for more obesity prevention and treatment options. Schools may be an ideal setting to reach at-risk adolescents and provide obesity prevention and treatment options, especially in medically underserved regions such as rural Appalachia. Opportunities and challenges to apply findings, including school-based obesity programs, are discussed.

Lifestyle behaviors clusters in a nationwide sample of Spanish children and adolescents: PASOS study.

Youth is a vulnerable period. To classify lifestyle behaviors and its relationship with health-related outcomes of Spanish children and adolescents. Cross-sectional study including 3261 children aged 7.5-17.5 y (52.8% females). Physical activity (PA), screen-time, sleep time, adherence to Mediterranean diet (MD), weight status (WS) by validated methods. Cluster analysis was run considering chronological age. Six clusters were identified: C1: high screen time, low adherence to MD and sleep time (n = 431,13.20%); C2: high WS, medium adherence to MD,high sleep time, and low screen time (n = 466,14.30%); C3: young group with low screen time and high PA, adherence to MD and sleep (n = 537,16.40%); C4: worst profile regarding adherence to MD, PA, WS and sleep time (n = 609,18.70%); C5: low screen time and PA, high sleep time (n = 804,24.70%); C6: high PA and screen time, low WS (n = 414,12.70%). Mean absolute values were statistically different among PA levels, screen and sleep time, adherence to MD, age, and WS (all p < 0.001). The most prevalent pattern was low levels of PA, MD, and screen time, and high sleep time. The second most prevalent was characterized by very low levels of PA, sleep time, and adherence to MD, and high screen time, and WS in adolescents. The main identified lifestyle behavior was poor physical activity, low adherence to Mediterranean Diet and high screen and sleep time. Children should increase physical activity levels, adherence to Mediterranean diet, decrease screen and sleep the appropriate hours per day. Families, schools, and medical communities must work together to gloss over present and future diseases. Sleep time had not been previously included in cluster analysis with physical activity, sedentary behaviors, obesity, and nutritional status, thus the present data open a new perspective in Spanish population. Health policies should focus on promoting physical activity, Mediterranean diet, adequate sleep and reducing screen time.

Associations among metabolic health, weight status, and various physical fitness components in Japanese adolescents: a cross-sectional study (NICE EVIDENCE study- Agano 3)

ABSTRACT Aim was to examine associations among metabolic health, weight status, and various physical fitness (PF) components in 1744 Japanese adolescents aged 13–14. Anthropometric measurements and PF tests (20 m shuttle run test [20mSRT], handgrip strength/body mass [HG], standing long jump [SLJ], and sit ups [SU]) were administered. The bottom sex-specific quintile of PF indicated “low fit”. Participants were classified as non-overweight (non-OW) or overweight/obese (OW) according to the International Obesity Task Force. Clustered metabolic risk was defined as the sum of Z scores for mean arterial pressure, non-high-density lipoprotein cholesterol, and HbA1c, divided by three, and ≥ 1 SD. Combination of weight status and scores for HG or SU were additively associated with clustered metabolic risk. Compared with the non-OW-moderate-high fit group, the OW-low HG group was 3.05 (95%CI: 1.88–4.97) times more likely to have clustered metabolic risk although risk was not significantly elevated in the OW-moderate-high HG group (1.52 [95%CI: 0.88–2.62]). A similar association was observed between OW and low SU scores but not between OW and low 20mSRT or SLJ scores. Adolescents with OW and moderate-high HG or SU scores had a lower prevalence of an unfavourable metabolic state than those with OW and low HG or SU results.

Weight status and weight-control exercise in adolescents: A longitudinal population-based study

ObjectiveExercise is a transdiagnostic clinical feature of eating disorders, but consensus is lacking as to what constitutes, and gives rise to, excessive exercise motivated by weight control. Using a longitudinal cohort study, we aimed to describe population-level prevalence rates of varying levels of weight-control exercise and examine gender and weight status (overweight or obesity; OVOB) as cross-sectional determinants of weight-control exercise in 14–15-year-old adolescents. We then evaluated the association of OVOB at 10–11 years with weight-control exercise at 14–15 years. MethodsThe sample comprised 6329 adolescents from the Longitudinal Study of Australian Children (LSAC). Weight and height were measured in early adolescence (aged 10–11) and in mid-adolescence (aged 14–15). Participants reported weight-control exercise using the Branched Eating Disorders Test at 14–15 years. ResultsIn mid-adolescence, the estimated population prevalence for any weight-control exercise was 49 % (55 % in females). For girls, moderate levels of exercise were most prevalent, and low levels for boys. For all levels except for the very lowest, boys with (vs. without) OVOB history (10–11 years) had about twice the odds of endorsing every level of weight-control exercise. Patterns among girls were similar, though lower in magnitude (∼1.5 times). ConclusionsFor both girls and boys, across most exercise levels, rates of weight-control exercise were greatest for those with OVOB; for the highest exercise level, effects were strongest for boys with OVOB. To accurately identify at-risk adolescents, our results provide preliminary support for a fluid definition of excessive weight-control exercise, dependent on gender and weight status.

Abstract P269: Associations Between Neighborhood Socioeconomic Deprivation During Pregnancy and Offspring Early Anthropometric Outcomes

Introduction: Residing in areas with lower neighborhood socioeconomic position (NSEP) is associated with adverse birth outcomes like small for gestational age and low birthweight. Lower NSEP is also associated with higher weight status and blood pressure in adolescence. However, few studies have assessed NSEP and indicators of cardiometabolic health in early childhood. We examined associations between NSEP during gestation and changes in early childhood weight in a North Carolina (NC) birth cohort. Hypothesis: We hypothesized that lower gestational NSEP would associate with rapid infant weight gain and increased odds of having overweight in early childhood. Methods: The sample was from the Newborn Epigenetics STudy (NEST) cohort. 2,681 gestational parent-offspring pairs were recruited from prenatal visits at obstetrics care facilities in Durham County, NC and enrolled between 2005-2011. For this study, offspring were assessed at birth (N=1,058), 6 months (N=1,268), 1 year (N=1,268), 2 years (N=1,033), and 3 years (N=1,038). NSEP was measured as Neighborhood Deprivation Index (NDI) tertiles at the 2010 US census block group level in NC using parent residential address at enrollment (high NDI=low NSEP). Offspring anthropometric outcomes included: (1) having vs not having overweight (weight for length or body mass index percentiles ≥85 th ) at each study visit; and (2) having rapid vs non-rapid infant weight gain from birth to 6 months and birth to 1 year. Multilevel logistic regression models estimated odds ratios (OR) and 95% confidence intervals (CI) for the relationship between NDI (ref=low) and weight, adjusting for gestational parent age, race, marital status, and education. Results: On average, gestational parents were 28 years old with college degrees (35%), followed by high school or equivalent (22%), and identifying as non-Hispanic (NH) Black (43%), followed by NH White (34%). Prior to covariate adjustment, children residing in neighborhoods with high vs low NDI had greater odds of having overweight at 6 months (OR=1.57, 95% CI=1.10-2.25), 1 year (OR=2.01, 95% CI=1.49-2.71), 2 years (OR=1.78, 95% CI=1.25-2.49), and 3 years (OR=1.35, 95% CI=0.96-1.89) and of experiencing rapid infant weight gain from birth to 6 months (OR=1.03, 95% CI=0.79-1.33) and to 1 year (OR=1.62, 95% CI=1.25-2.09). Associations were attenuated after adjustment, but children residing in neighborhoods with high vs low NDI had greater odds of having overweight at 1 year (OR=1.53, 95% CI=1.09-2.15). Conclusions: Low NSEP may associate with higher early childhood weight. This has important implications for later developmental milestones and health outcomes in childhood. Several potential mechanisms could explain this association, including biological programming and limited neighborhood opportunities for movement and healthy eating. Future work exploring these and other mechanisms is warranted.

Shorter sleep among adolescents is associated with lower fruit and vegetable consumption the following day

BackgroundInsufficient sleep has been associated with weight gain and metabolic dysregulation, with one suggested mechanism being through reduction in diet quality. Experimental evidence supports a causal effect of sleep timings on diet but this may not be applicable to a free-living adolescent population. In this analysis we use daily measures of sleep timings and diet quality, to examine the effect of sleep duration and timing on diet quality the following day among free-living adolescents.MethodsThe ROOTS study is a prospective cohort recruited from secondary schools in Cambridgeshire and Suffolk (UK). Participants (n = 815) at mean age 15.0y (SD 0.3y) completed a diet diary and wore a combined heart rate and accelerometer device over 4 consecutive days. Sleep duration and timing (midpoint) were derived from acceleration and heart rate traces, while daily energy density and fruit and vegetable intake were calculated from dietary data. Analyses were performed at day-level (1815 person-days). Multilevel random effects models were used to test associations between sleep each night and subsequent day diet, with daily sleep and diet measures nested within individuals and schools, and adjusted for day-level and individual-level confounding variables.ResultsAdolescents slept a mean of 7.88 hrs (SD 1.10) per night, reporting a mean energy density of 2.12 kcal/g (SD 0.48) and median energy-adjusted daily fruit and vegetable intake of 137.3 g (IQR 130.4). One hour shorter sleep duration was associated with lower intake of fruit and vegetables (-6.42 g, 95%CI -1.84, -10.99) the following day. An association with higher dietary energy density (0.016 kcal/g, 95%CI 0.034, -0.002) the following day was observed but did not reach statistical significance. Sleep timing was not associated with either fruit and vegetable intake (-2.52 g/d, 95%CI -7.66, 2.62) or dietary energy density (-0.001 kcal/g, 95%CI -0.022, 0.020).ConclusionsOur observational findings from a free-living adolescent population support the experimental evidence for a causal role of sleep on diet, with shorter sleep duration at night leading to a small decrease in diet quality the following day. These findings support experimental evidence to suggest inclusion of sleep duration as one component of interventions designed to improve diet quality and weight status in adolescents.