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Smith L, López Sánchez GF, Tully MA, Rahmati M, Oh H, Kostev K, Butler LT, Barnett Y, Keyes H, Shin JI, Koyanagi A. Temporal trends of carbonated soft-drink consumption among adolescents aged 12-15 years from eighteen countries in Africa, Asia and the Americas. Br J Nutr 2024; 131:1633-1640. [PMID: 38225928 DOI: 10.1017/s0007114524000059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2024]
Abstract
Carbonated soft-drink consumption is detrimental to multiple facets of adolescent health. However, little is known about temporal trends in carbonated soft-drink consumption among adolescents, particularly in non-Western countries. Therefore, we aimed to examine this trend in representative samples of school-going adolescents from eighteen countries in Africa, Asia and the Americas. Cross-sectional data from the Global School-based Student Health Survey 2009-2017 were analysed. Carbonated soft-drink consumption referred to drinking carbonated soft-drinks at least once per day in the past 30 d. The prevalence of carbonated soft-drink consumption was calculated for each survey, and crude linear trends were assessed by linear regression models. Data on 74 055 students aged 12-15 years were analysed (mean age 13·9 (sd 1·0) years; 49·2 % boys). The overall mean prevalence of carbonated soft-drink consumption was 42·1 %. Of the eighteen countries included in the study, significant decreasing, increasing and stable trends of carbonated soft-drink consumption were observed in seven, two and nine countries, respectively. The most drastic decrease was observed in Kuwait between 2011 (74·4 %) and 2015 (51·7 %). Even in countries with significant decreasing trends, the decrease was rather modest, while some countries with stable trends had very high prevalence across time (e.g. Suriname 80·5 % in 2009 and 79·4 % in 2016). The prevalence of carbonated soft-drink consumption was high in all countries included in the present analysis, despite decreasing trends being observed in some. Public health initiatives to reduce the consumption of carbonated soft-drink consumption among adolescents are urgently required.
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Affiliation(s)
- Lee Smith
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Guillermo Felipe López Sánchez
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain
| | - Mark A Tully
- School of Medicine, Ulster University, Londonderry, Northern Republic of Ireland, UK
| | - Masoud Rahmati
- Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khorramabad, Iran
- Department of Physical Education and Sport Sciences, Faculty of Literature and Humanities, Vali-E-Asr University of Rafsanjan, Rafsanjan, Iran
| | - Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | | | - Laurie T Butler
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Yvonne Barnett
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Helen Keyes
- School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, UK
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
- Severance Underwood Meta-Research Center, Institute of Convergence Science, Yonsei University, Seoul, Republic of Korea
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Dr. Antoni Pujadas, Sant Boi de Llobregat, Barcelona, Spain
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Li H, Zhang W, Yan J. Physical activity and sedentary behavior among school-going adolescents in low- and middle-income countries: insights from the global school-based health survey. PeerJ 2024; 12:e17097. [PMID: 38680891 PMCID: PMC11055511 DOI: 10.7717/peerj.17097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 02/21/2024] [Indexed: 05/01/2024] Open
Abstract
Background The Global School Student Health Survey (GSHS) is being carried out by students in various countries across the globe to advance improved health programs for youth. However, in comparison to high-income countries, adolescents in low- and middle-income countries (LMICs) are generally at an early stage of understanding regarding physical activity (PA) and sedentary behavior (SB), often exhibiting low levels of PA and high levels of SB. Furthermore, there is limited evidence connecting PA and SB in school-going adolescents from LMICs. Purpose The objective of this review was to synthesize the available evidence regarding PA and sedentary behavior among school-going adolescents in LMICs using data from the GSHS. Method On March 18, 2023, a systematic literature search was performed across four electronic databases, namely Web of Science, PubMed, ScienceDirect, and EBSCO with n odaterestrictions. Studies were eligible if they: (1) utilization of data sourced from the Global Student-based Health Survey; (2) exploration of physical activity; (3) specific focus on adolescents; (4) conducted in low- and middle-income countries; (5) study design encompassing observational; (6) published as English journal articles. Results Among the 29 studies included in the analysis, the majority revealed elevated levels of sedentary behavior and diminished levels of PA in low- and middle-income countries. Furthermore, notable disparities in physical engagement and sedentary behavior were noted between male and female adolescents (p < 0.001). Augmented PA among teenagers was observed to correlate with higher consumption of vegetables and fruits (AOR = 1.30; 95% CI [1.13-1.50]; p < 0.001), decreased alcohol consumption, and a reduced prevalence of loneliness and depression (aOR 1.37, 95% CI [1.18-1.59]). Conclusions The results of this review affirm that in contrast to high-income countries, adolescents in low- and middle-income countries (LMICs) are in the early stages of comprehending physical activity, marked by low levels of PA. Physical activity and sedentary behavior in school-going adolescents from LMICs appear to be influenced by factors such as policies, cultural norms, socioeconomic conditions, as well as gender, and age.
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Affiliation(s)
- Hui Li
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, China
| | - Wenyu Zhang
- Foundation Department of Education, Shandong Communication and Media College, Jinan, China
| | - Jin Yan
- School of Physical Education and Sports Science, Soochow University, Suzhou, China
- Centre for Active Living and Learning, College of Human and Social Futures, University of Newcastle, Newcastle, NSW, Australia
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Zou L, Herold F, Cheval B, Wheeler MJ, Pindus DM, Erickson KI, Raichlen DA, Alexander GE, Müller NG, Dunstan DW, Kramer AF, Hillman CH, Hallgren M, Ekelund U, Maltagliati S, Owen N. Sedentary behavior and lifespan brain health. Trends Cogn Sci 2024; 28:369-382. [PMID: 38431428 DOI: 10.1016/j.tics.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 02/02/2024] [Accepted: 02/06/2024] [Indexed: 03/05/2024]
Abstract
Higher levels of physical activity are known to benefit aspects of brain health across the lifespan. However, the role of sedentary behavior (SB) is less well understood. In this review we summarize and discuss evidence on the role of SB on brain health (including cognitive performance, structural or functional brain measures, and dementia risk) for different age groups, critically compare assessment approaches to capture SB, and offer insights into emerging opportunities to assess SB via digital technologies. Across the lifespan, specific characteristics of SB (particularly whether they are cognitively active or cognitively passive) potentially act as moderators influencing the associations between SB and specific brain health outcomes. We outline challenges and opportunities for future research aiming to provide more robust empirical evidence on these observations.
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Affiliation(s)
- Liye Zou
- Body-Brain-Mind Laboratory, School of Psychology, Shenzhen University, Shenzhen, China.
| | - Fabian Herold
- Body-Brain-Mind Laboratory, School of Psychology, Shenzhen University, Shenzhen, China; Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, 14476 Potsdam, Germany
| | - Boris Cheval
- Department of Sport Sciences and Physical Education, Ecole Normale Supérieure Rennes, Bruz, France; Laboratory VIPS2, University of Rennes, Rennes, France
| | - Michael J Wheeler
- Physical Activity Laboratory, Baker Heart & Diabetes Institute, Melbourne, Victoria, Australia; Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Dominika M Pindus
- Kinesiology and Community Health, University of Illinois at Chicago, Chicago, IL, USA; Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA; Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Kirk I Erickson
- AdventHealth Research Institute, Department of Neuroscience, AdventHealth, Orlando, FL, USA; Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA; Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA, USA
| | - David A Raichlen
- Human and Evolutionary Biology Section, Department of Biological Sciences, University of Southern California, Los Angeles, CA 90089, USA; Department of Anthropology, University of Southern California, Los Angeles, CA 90089, USA
| | - Gene E Alexander
- BIO5 Institute, University of Arizona, Tucson, AZ 85721, USA; Department of Psychology, University of Arizona, Tucson, AZ 85721, USA; Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ 85721, USA; Department of Psychiatry, University of Arizona, Tucson, AZ 85721, USA; Neuroscience Graduate Interdisciplinary Program, University of Arizona, Tucson, AZ 85721, USA; Physiological Sciences Graduate Interdisciplinary Program, University of Arizona, Tucson, AZ85721, USA
| | - Notger G Müller
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, 14476 Potsdam, Germany
| | - David W Dunstan
- Physical Activity Laboratory, Baker Heart & Diabetes Institute, Melbourne, Victoria, Australia; Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Arthur F Kramer
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA; Center for Cognitive and Brain Health, Northeastern University, Boston, MA, USA; Department of Psychology, Northeastern University, Boston, MA, 02115, USA
| | - Charles H Hillman
- Center for Cognitive and Brain Health, Northeastern University, Boston, MA, USA; Department of Psychology, Northeastern University, Boston, MA, 02115, USA; Department of Physical Therapy, Movement, & Rehabilitation Sciences, Northeastern University, Boston, MA, 02115, USA
| | - Mats Hallgren
- Epidemiology of Psychiatric Conditions, Substance Use and Social Environment (EPiCSS), Department of Public Health Sciences, Karolinska Institutet, Solna, Sweden
| | - Ulf Ekelund
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway; Department of Chronic Diseases and Ageing, The Norwegian Institute for Public Health, Oslo, Norway
| | - Silvio Maltagliati
- Human and Evolutionary Biology Section, Department of Biological Sciences, University of Southern California, Los Angeles, CA 90089, USA
| | - Neville Owen
- Physical Activity Laboratory, Baker Heart & Diabetes Institute, Melbourne, Victoria, Australia; Centre for Urban Transitions, Swinburne University of Technology, Melbourne, Victoria, Australia
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Mateo-Orcajada A, Vaquero-Cristóbal R, Abenza-Cano L. Importance of training volume through the use of step trackers apps promoted from the subject of physical education to change body composition, physical fitness and physical activity in adolescents and the influence of gender ✰,✰✰. Physiol Behav 2024; 273:114402. [PMID: 37935300 DOI: 10.1016/j.physbeh.2023.114402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 10/13/2023] [Accepted: 11/03/2023] [Indexed: 11/09/2023]
Abstract
The aim of the present study was to determine the changes in physical activity level (PA), kinanthropometric and derived variables, and physical fitness in adolescents, as a result of an out-of-school intervention with mobile step tracker apps promoted from the field of physical education, according to the volume of training completed and gender. A randomized controlled trial was carried out with 400 adolescents (210 males and 190 females) aged 12 to 16 years old (mean age: 13.96 ± 1.21 years-old). Adolescents were divided into experimental group (EG) (n = 240) and control group (CG) (n = 160). Two measurements were carried out, separated by a 10-week intervention, and PA, kinanthropometric variables and physical condition were measured. During the intervention, EG must use Strava (n = 74); Pokémon Go (n = 59); Pacer (n = 60); and MapMyWalk (n = 47) a minimum of 3 times per week, covering an incremental distance from 7,000 steps per day (week 1) to 12,500 steps per day (week 10). After that, EG were divided in quartile according to the volume of training completed. The results obtained showed a significant increase between pre-and post in PA (p = 0.009-0.044) and curl-up (p < 0.001-0.040) in EG regardless the quartile of compliance, and a reduction in fat variables (p < 0.001) and an increase in CMJ in 75-100 % compliance group (p = 0.005). The introduction of the covariate gender did not introduce changes in the intra-group evolution. On inter-group differences, differences were only found for the post-test values between 0-25 % Vs 25-50 % and between 50-75 % Vs 75-100 % with the group that completed a longer distance being the one that showed the lowest values in the post-test in both cases. When including the covariate gender, no significant differences were found for either the pre-test or the post-test on either variable. To conclude, a higher training volume with mobile apps seems to be relevant in the increase PA and strength and decrease of fat mass. The gender factor is not influential in the intra-group changes, but it is influential in the inter-group differences.
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Affiliation(s)
| | - Raquel Vaquero-Cristóbal
- Department of Physical Activity and Sport, Faculty of Sport Sciences, University of Murcia, Murcia, Spain.
| | - Lucía Abenza-Cano
- Facultad de Deporte, UCAM Universidad Católica de Murcia, Murcia, Spain
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Barros AKC, de Jesus GM, Vieira GO, Dias LA. Use of screens and intake of unhealthy food among children and adolescents: association with physical activity in a cross-sectional study. BMC Nutr 2023; 9:104. [PMID: 37723539 PMCID: PMC10507888 DOI: 10.1186/s40795-023-00763-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 09/05/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND The intake of unhealthy food taken on very regular basis may bring even further negative impact on health if associated with excessive time using of screen-based electronic devices. OBJECTIVE To estimate the association between the use of different types of screen-based devices and the intake of unhealthy foods amongst children and adolescents and to determine whether daily physical activity (DPA) has a moderating effect on the association. METHODS Cross-sectional study carried out with a probabilistic sample of students from second to fifth grade of public elementary schools in Feira de Santana, Bahia (n = 2,477; girls: 53.2%; age: 9.1 ± 1.38 years; BMI z-score 0.37 ± 4.19 Kg/m²). Food intake, screen use, and physical activity were assessed using an online questionnaire based on previous day recall (Web-CAAFE). Prevalence Ratios (PR) and 95% Confidence Intervals (95%CI) were estimated via multiple zero-inflated negative binomial regression, with adjustments for sex, age, and weekly frequency of school meal intake. The moderating effect of DPA was verified by inserting interaction terms with each screen-based device individually and with the daily sum of screen-based device exposure (∑ Screens). RESULTS The majority of students (72.2%) reported using screens. The intake of unhealthy foods was positively associated with the use of cell phones (PR = 1.21; 95%CI = 1.13-1.30), computers (PR = 1.33; 95%CI = 1.22-1.46), and video games (PR = 1.36; 95%CI = 1.22-1.52). TV use was inversely associated with intake of unhealthy foods (PR = 0.92; 95%CI = 0.87-0.99). DPA moderated the effect of video game use on intake of unhealthy foods, that is, among students with DPA ≥ 4 who used video games, the intake of unhealthy foods was 21% lower (PR = 0.79; 95%CI = 0. 65-0.97). Overall, ∑ Screen-based devices were associated with a 20% increase in intake of unhealthy foods. CONCLUSION The intake of unhealthy foods was positively associated with the use of cell phones, computers, and video games. In addition, a frequency of four or more DPA attenuated the effect of video game exposure on intake of unhealthy foods. Upcoming investigations on the use of screen-based devices and the intake of unhealthy foods among schoolchildren should consider the exposure to different types of screen-based devices, as well as the influence of DPA.
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Bagnato M, Roy-Gagnon MH, Vanderlee L, White C, Hammond D, Potvin Kent M. The impact of fast food marketing on brand preferences and fast food intake of youth aged 10-17 across six countries. BMC Public Health 2023; 23:1436. [PMID: 37501119 PMCID: PMC10373354 DOI: 10.1186/s12889-023-16158-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 06/20/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND Consumption of fast food, which is associated with poor diet, weight gain and the development of noncommunicable diseases, is high amongst youth. Fast food marketing, a modifiable determinant of excess weight and obesity, affects youth's food-related behaviours. This study aimed to examine the relationship between exposure to fast food marketing and the fast food brand preferences and intake amongst youth aged 10-17 across six countries. METHODS Data from 9,695 youth respondents living in Australia, Canada, Chile, Mexico, the United Kingdom (UK) and the United States (US) were analyzed from the 2019 International Food Policy Study (IFPS) Youth Survey. Survey measures assessed exposure to fast food marketing and brand-specific marketing, and preference for these brands and fast food intake. Regression models adjusted for age, sex, income adequacy and ethnicity were used to examine the associations. RESULTS Exposure to fast food marketing was positively associated with brand preferences and intake consistently across most countries. Overall, preference for McDonald's (OR:1.97; 95% CI:1.52, 2.56), KFC (OR:1.61; 95% CI:1.24, 2.09) and Subway (OR:1.73; 95% CI:1.34, 2.24) were highest when exposed to general fast food marketing ≥ 2x/week compared to never. Preference for McDonald's (OR:2.32; 95% CI:1.92, 2.79), KFC (OR:2.28; 95% CI:1.95, 2.68) and Subway (OR:2.75; 95% CI:2.32, 3.27) were also higher when exposed to marketing for each brand compared to not. Fast food intake was highest in Chile (IRR:1.90; 95% CI:1.45, 2.48), the UK (IRR:1.40; 95% CI:1.20, 1.63), Canada (IRR:1.32; 95% CI:1.19, 1.48), Mexico (IRR:1.26; 95% CI:1.05, 1.53) and the US (IRR:1.21; 95% CI:1.05, 1.41) when exposed to general fast food marketing ≥ 2x/week compared to never and was higher across most countries when exposed to brand-specific marketing compared to not. Respondents classified as ethnic minorities were more likely to report consuming fast food than ethnic majorities, and females were less likely to report consuming fast food than males. CONCLUSIONS Exposure to fast food marketing is consistently and positively associated with brand preferences and fast food intake in all six countries. Our results highlight the need for strict government regulation to reduce exposure of unhealthy food marketing to youth in all six countries.
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Affiliation(s)
- Mariangela Bagnato
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | | | - Lana Vanderlee
- École de Nutrition, Centre Nutrition, Santé Et Société (Centre NUTRISS), and Institut Sur La Nutrition Et Les Aliments Fonctionnels (INAF), Université Laval, Quebec City, Canada
| | - Christine White
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - David Hammond
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Monique Potvin Kent
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada.
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Vakili M, Mirzadeh M, Mirzaei M, Modarresi M, Raei R, Karimi R, Aghakoochak A, Imani AA. Sex differences in high-risk health behaviors among school-going adolescents in Yazd, Iran; a cross-sectional study. Heliyon 2023; 9:e16404. [PMID: 37303572 PMCID: PMC10250580 DOI: 10.1016/j.heliyon.2023.e16404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 05/14/2023] [Accepted: 05/15/2023] [Indexed: 06/13/2023] Open
Abstract
Objective Adolescents are exposed to a wide range of high-risk health behaviors. This study aimed to investigate the high-risk health behaviors of adolescents in an Iranian adolescent population and gender differences. Method This cross-sectional descriptive study recruited high school students in Yazd city in center of Iran. Schools were randomly selected. In each school, all selected classes were included. Sampling in each class was census. The study investigated self-reported high-risk health behaviors. Students completed the Global School-based Student Health Survey (GSHS), an anonymous, validated questionnaire. Results 2420 students participated in this study (52.5% male). The age range was 12-19 years. Daily consumption of ≥1 serving of fruit and vegetables per day was reported by 77.4% and 49.5% of respondents, respectively. Adequate physical activity was reported by only 18.4% of adolescents, and significantly less frequently by girls than boys (p < 0.001). 11.8% were current smokers (M/F ratio: 2.6), and 20.5% (M/F ratio: 1.5) were ever used hookah. The prevalence of ever alcohol and substance abuse was 15.5% and 8.8%, respectively. The prevalence of tobacco and substance use was significantly higher in participants' boys than in girls (p < 0.001). Males were over twice more likely to report frequent fighting in the past 12 months than girls. Overall, girls reported more parental supervision than boys (82.1% vs. 73.4%) and parental monitoring (90.6% vs. 86.8%), while boys reported higher levels of awareness over leisure activities than girls (65.8% vs. 58.4%). Conclusions High-risk health behaviors are more common in boys than girls. Health policymakers should use these results in prioritizing and designing health interventions to promote youth health. Further studies are recommended to identify the factors influencing the prevalence of these behaviors.
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Affiliation(s)
- Mahmood Vakili
- Health Monitoring Research Center, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mahboobahsadat Mirzadeh
- Department of Internal Medicine, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohsen Mirzaei
- Accident Prevention and Crisis Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mozhgan Modarresi
- Yazd Cardiovascular Research Center, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Reihaneh Raei
- Health Monitoring Research Center, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Reihaneh Karimi
- Health Monitoring Research Center, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Arezoo Aghakoochak
- Health Monitoring Research Center, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Kamkuemah M, Gausi B, Oni T, Middelkoop K. Multilevel correlates of abdominal obesity in adolescents and youth living with HIV in peri-urban Cape Town, South Africa. PLoS One 2023; 18:e0266637. [PMID: 36693111 PMCID: PMC9873196 DOI: 10.1371/journal.pone.0266637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 01/11/2023] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Chronic non-communicable disease comorbidities are a major problem faced by people living with HIV (PLHIV). Obesity is an important factor contributing to such comorbidities and PLHIV face an elevated risk of obesity. However, there is data paucity on the intersection of obesity and HIV in adolescents and youth living with HIV (AYLHIV) in sub-Saharan Africa. We therefore aimed to investigate the prevalence of abdominal obesity and associated multilevel factors in AYLHIV in peri-urban Cape Town, South Africa. METHODS We conducted a cross-sectional study enrolling AYLHIV aged 15-24 years attending primary healthcare facilities in peri-urban Cape Town in 2019. All measures, except for physical examination measures, were obtained via self-report using a self-administered electronic form. Our outcome of interest was abdominal obesity (waist-to-height ratio ≥ 0.5). We collected individual-level data and data on community, built and food environment factors. Data was summarized using descriptive statistics, stratified by obesity status. Multilevel logistic regression was conducted to investigate factors associated with abdominal obesity, adjusted for sex and age. FINDINGS A total of 87 participants were interviewed, 76% were female and the median age was 20.7 (IQR 18.9-23.0) years. More than two fifths had abdominal obesity (41%; 95% CI: 31.0-51.7%), compared to published rates for young people in the general population (13.7-22.1%). In multilevel models, skipping breakfast (aOR = 5.42; 95% CI: 1.32-22.25) was associated with higher odds of abdominal obesity, while daily wholegrain consumption (aOR = 0.20; 95% CI: 0.05-0.71) and weekly physical activity (aOR = 0.24; 95% CI: 0.06-0.92) were associated with lower odds of abdominal obesity. Higher anticipated stigma was associated with reduced odds of obesity (aOR = 0.58; 95% CI: 0.33-1.00). Land-use mix diversity (aOR = 0.52; 95% CI: 0.27-0.97), access to recreational places (aOR = 0.37; 95% CI: 0.18-0.74), higher perceived pedestrian and traffic safety (aOR = 0.20; 95% CI: 0.05-0.80) and having a non-fast-food restaurant within walking distance (aOR = 0.30; 95% CI: 0.10-0.93) were associated with reduced odds of abdominal obesity. The main limitations of the study were low statistical power and possible reporting bias from self-report measures. CONCLUSIONS Our findings demonstrate a high prevalence of abdominal obesity and highlight multilevel correlates of obesity in AYLHIV in South Africa. An intersectoral approach to obesity prevention, intervening at multiple levels is necessary to intervene at this critical life stage.
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Affiliation(s)
- Monika Kamkuemah
- Research Initiative for Cities Health and Equity (RICHE), Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- * E-mail:
| | - Blessings Gausi
- Research Initiative for Cities Health and Equity (RICHE), Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Tolu Oni
- Research Initiative for Cities Health and Equity (RICHE), Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Keren Middelkoop
- Desmond Tutu HIV Centre, Institute of Infectious Disease & Molecular Medicine, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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Moradell A, Santaliestra-Pasías AM, Aparicio-Ugarriza R, Huybrechts I, Bertalanné Szommer A, Forsner M, González-Gross M, Kafatos A, Androutsos O, Michels N, Sjöström M, Vanhelst J, Widhalm K, Gutierrez A, Moreno LA. Are Physical Activity and Sedentary Screen Time Levels Associated With Food Consumption in European Adolescents? The HELENA Study. JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2023; 42:55-66. [PMID: 35512776 DOI: 10.1080/07315724.2021.1978900] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 08/06/2021] [Accepted: 09/06/2021] [Indexed: 12/16/2022]
Abstract
One of the current main public health problems is the prevalence of obesity in children. Unhealthy lifestyle behaviors such as poor dietary habits, high sedentary screen time (SST), and low levels of physical activity (PA) have a strong tendency to track from childhood into adulthood. The aim of this manuscript is to assess the association between meeting or not meeting the PA and SST recommendations and the consumption of different food groups. Data were obtained from a sample of European adolescents from the multicenter cross-sectional HELENA study. In all, 1448 adolescents from 8 cities were included. PA was objectively measured by accelerometry and dietary intake by 24-hour dietary records. Adolescents were grouped according to PA and SST recommendations. In both sexes, intake of savory snacks was higher in those groups who did not meet any of the recommendations (p < 0.05). For males, those who met both recommendations were more likely to drink/eat milk, yogurt, and water (p < 0.05). Those not meeting recommendations were more likely to drink sugar-sweetened beverages (p < 0.05). For females, those not meeting recommendations were less likely to eat fruits and vegetables and more likely to have a higher intake of fats and oils (p < 0.05). Those adolescents meeting PA and SST recommendations had a higher intake of healthy foods, like fruit and vegetables and dairy products. However, the negative relationship unhealthier food and SST is stronger in males independently of PA. More studies assessing the combined effect of both PA and SST regarding dietary habits in children and adolescents are needed.
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Affiliation(s)
- Ana Moradell
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, Spain
| | - Alba M Santaliestra-Pasías
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Universidad de Zaragoza, Zaragoza, Spain
| | - Raquel Aparicio-Ugarriza
- ImFine Research Group, Department of Health and Human Performance, Universidad Politécnica de Madrid, Madrid, Spain
| | - Inge Huybrechts
- Department of Public Health, Ghent University, Ghent, Belgium
- International Agency for Research on Cancer, Lyon, France
| | | | - Maria Forsner
- School of Education, Health and Social Sciences, Dalarna University, Falun, Sweden
- Department of Nursing, Umeå University, Umeå, Sweden
| | - Marcela González-Gross
- ImFine Research Group, Department of Health and Human Performance, Universidad Politécnica de Madrid, Madrid, Spain
- Department of Nutrition and Food Sciences-Nutritional Physiology, University of Bonn, Bonn, Germany
- CIBER: CB12/03/30038 Fisiopatología de la Obesidad y la Nutrición, CIBERobn, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Anthony Kafatos
- School of Medicine, University of Crete, Heraklion, Greece
- Ilioupolis, Athens, Greece
| | - Odysseas Androutsos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
- Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala, Greece
| | | | - Michael Sjöström
- Unit for Preventive Nutrition, Department of Biosciences and Nutrition at NOVUM, Karolinska Institutet, Huddinge, Sweden
| | - Jeremy Vanhelst
- CHU Lille, Lille Inflammation Research International Center LIRIC-UMR, University Lille, Lille, France
- CHU Lille, Clinical Investigation Center, CIC-1403-Inserm-CHU, University Lille, Lille, France
| | - Kurt Widhalm
- Department of Pediatrics, Medical University of Vienna, Vienna, Austria
- Department of Pediatrics, Private Medical University, Salzburg, Austria
| | - Angel Gutierrez
- Department of Medical Physiology, School of Medicine, University of Granada, Granada, Spain
| | - Luis A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Universidad de Zaragoza, Zaragoza, Spain
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Jin Z, Li R, Xu H, Rong F, Xiao W, Yu W, Sun Y, Zhang S, Tao F, Wan Y. Interaction effects of screen time and fast-food consumption on suicidal behaviours: Evidence from a nationwide survey among Chinese adolescents. J Affect Disord 2022; 319:164-171. [PMID: 36155233 DOI: 10.1016/j.jad.2022.09.047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 07/29/2022] [Accepted: 09/20/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Although screen time and fast-food consumption have been linked to suicidal behaviours, it is unclear whether their combined effects are associated with suicidal behaviours among adolescents. METHODS A sample of 16,853 Chinese adolescents answered a standard questionnaire on screen time, fast-food consumption, and suicidal behaviours. A binomial logistic regression model was used to analyse the association between the three. An interaction model was used to examine the interaction effects of screen time and fast-food consumption on suicidal behaviours in adolescents. RESULTS There were positive correlations between screen time, fast-food consumption, and suicidal behaviours, even after adjusting for confounding factors. Interaction analyses indicated that increased screen time on weekdays and fast-food consumption were associated with suicidal ideation. The relative excess risk of interaction, attributable proportions, and synergy index of interaction were 0.41, 0.15, and 1.32, respectively. Increased screen time on weekends and fast-food consumption were associated with suicidal ideation. The relative excess risk of interaction, attributable proportions, and synergy index of interaction were 0.37, 0.14, and 1.27, respectively. Similar additive interaction effects were exhibited in increased screen time and fast-food consumption on suicidal planning. Positive additive interaction effects were observed in increased screen time on weekdays and fast-food consumption on suicide attempts. LIMITATIONS A cross-sectional study design was used; therefore, causal associations remain unclear. CONCLUSIONS Screen time and fast-food consumption are cross-sectionally associated with suicidal behaviours among Chinese adolescents. Strategies should be considered to reduce screen time and fast-food consumption among adolescents.
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Affiliation(s)
- Zhengge Jin
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China; Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui, China
| | - Ruoyu Li
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China; Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui, China
| | - Huiqiong Xu
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China; Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui, China
| | - Fan Rong
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China; Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui, China
| | - Wan Xiao
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China; Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui, China
| | - Weiqiang Yu
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China; Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui, China
| | - Ying Sun
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China; Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui, China
| | - Shichen Zhang
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China; Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui, China
| | - Fangbiao Tao
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China; Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui, China
| | - Yuhui Wan
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China; Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui, China.
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Sugar Content and Warning Criteria Evaluation for Popular Sugar-Sweetened Beverages in Taipei, Taiwan. Nutrients 2022; 14:nu14163339. [PMID: 36014844 PMCID: PMC9415069 DOI: 10.3390/nu14163339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/09/2022] [Accepted: 08/11/2022] [Indexed: 11/20/2022] Open
Abstract
Sugar intake may increase the risk of obesity, cardiovascular disease, diabetes, and dental caries. In Taiwan, people frequently consume sugar-sweetened beverages (SSBs). This study explored the energy and sugar content of Taiwanese SSBs and evaluated them using the Chilean warning label system (>70 kcal/100 mL and >5 g sugar/100 mL) and the World Health Organization (WHO) sugar guideline (≤25 g sugar). A total of 341 SSBs with volumes ≤600 mL were analyzed. No significant differences were observed in sugar per serving among different types of SSBs, but a great variation in portion size (i.e., package size for individual consumption) was noted. The energy and sugar ratios per serving were lower in soft drinks and coffee and tea containing >1 serving than in those containing only one serving. The calorie and sugar ratios per portion were higher in all types of SSBs containing >1 serving per portion than in those containing exactly one serving. Approximately 70.0% of Taiwanese SSBs were classified as high sugar according to the Chilean criteria, and 41.6% of SSBs exceeded the WHO guideline. Moreover, 40.8% of SSBs that were not considered as high sugar according to the Chilean criteria contained >25 g sugar per portion. For individual consumption, it is more clear that nutrition labeling is based on portion rather than serving. Evaluating SSBs on sugar/portion rather than sugar/100 mL will help consumers make better choices.
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Pechtl SML, Kim LP, Jacobsen KH. Physical Inactivity and Sedentariness: Languorous Behavior Among Adolescents in 80 Countries. J Adolesc Health 2022; 70:950-960. [PMID: 35177343 DOI: 10.1016/j.jadohealth.2021.12.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 11/04/2021] [Accepted: 12/06/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE High rates of adolescent physical inactivity and sedentary behavior have been reported worldwide, but the combined prevalence of languorous behavior (physical inactivity and/or sedentary behavior) may more accurately reflect just how few adolescents meet World Health Organization recommendations. METHODS We analyzed nationally representative data from 325,219 students in 80 countries that participated in the Global School-based Student Health Survey between 2009 and 2018. Students were classified as physically inactive if they reported engaging in moderate or vigorous physical activity less than 60 minutes daily. Students were classified as being sedentary if they sat for three or more hours per day outside of school, such as when having screen time not related to studying. Statistics for each country were generated using complex samples analysis, then the results from all countries were synthesized. RESULTS In total, 84% of students were physically inactive, 37% were sedentary, and 91% met the definition for the concept we are calling languorous behavior. DISCUSSION Establishing specific evidence-based guidelines for increasing physical activity and decreasing sitting time will enable progress toward reducing languorous behavior among adolescents.
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Affiliation(s)
- Sarah M L Pechtl
- Natural Science Division, Pepperdine University, Malibu, California
| | - Loan Pham Kim
- Natural Science Division, Pepperdine University, Malibu, California.
| | - Kathryn H Jacobsen
- Department of Health Studies, University of Richmond, Richmond, Virginia
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The Association of Soft Drink Consumption and the 24-Hour Movement Guidelines with Suicidality among Adolescents of the United States. Nutrients 2022; 14:nu14091870. [PMID: 35565838 PMCID: PMC9100874 DOI: 10.3390/nu14091870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 04/19/2022] [Accepted: 04/26/2022] [Indexed: 12/24/2022] Open
Abstract
Background: Evidence is lacking for the association of the behaviors of the 24 h movement guidelines including sleep duration, physical activity, screen time, and soft drink consumption with suicidality among adolescents. Methods: Data were extracted from a national representative sample of Youth Risk Behavior Surveys (YRBS) in the United States from 2011 to 2019. Binary logistic regression models with complex sampling designs were used to explore the association of the recommendations of the 24 h movement guidelines and soft drink consumption with suicidality. Results: The total prevalence of suicidal ideation, suicide plan, suicide attempt, and suicide attempt with medical treatment was higher among adolescents who did not meet all the recommendations in the 24 h movement guidelines and had a higher level of soft drink consumption. Totally, not meeting all the recommendations of the 24 h movement guidelines was significantly associated with an increased risk of suicidal ideation (OR: 1.69, 95% CI: 1.30–2.19) and suicide plan (OR: 1.76, 95% CI: 1.34–2.33) compared with adolescents who meet all the recommendations. Soft drink consumption of ≥3 times/day was associated with an increased risk of suicidality including suicidal ideation, suicide plan, suicide attempt, and suicide attempt with medical treatment, regardless of sex. Soft drink consumption of ≥3 times/day was significantly associated with an increased risk of suicide attempt and suicide attempt with medical treatment, regardless of whether the recommendations of physical activity, screen time, and sleep duration were met. Conclusion: Age-appropriate sleep duration, no more than 2 h of screen time per day, at least 1 h of physical activity per day as contained in the 24 h movement guidelines and less than one soft drink consumption per day are good targets to prevent involvement in suicidality. More actions for intervening in the movement and dietary behaviors among adolescents are needed to maintain physical and mental health.
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14
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Wu H, Gu Z, Zeng L, Guo T. Do Global Adolescents With Food Insecurity Feel Lonely? Front Public Health 2022; 10:820444. [PMID: 35223740 PMCID: PMC8868937 DOI: 10.3389/fpubh.2022.820444] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 01/14/2022] [Indexed: 11/13/2022] Open
Abstract
As a proxy measure of socioeconomic status, food insecurity is understudied in mental health-related research. This study aimed to explore the association between food insecurity and loneliness in adolescents. Using cross-sectional data from the Global Student Health Survey (GSHS), 164,993 adolescent participants were included in this study. Food insecurity, loneliness, and other covariates were assessed by self-reported questionnaire. Multivariable logistics regression considering complex survey was used to explore the association between food insecurity and loneliness. The prevalence of loneliness was 10.8% in adolescents. With higher levels of food insecurity, the prevalence of loneliness in general increased, but “most of the time” was the most frequently reported item in terms of food insecurity. Adolescents who reported severe food insecurity had significantly greater odds for loneliness: (1) being most of the time [odd ratio (OR) = 2.54, 95% CI = 2.13–3.02]; (2) always hungry (OR = 1.97, 95% CI = 1.55–2.51). Of all the 53 countries, adolescents from 39 countries reported significantly higher prevalence of loneliness when exposed to food insecurity. The pooled OR was 1.74 (1.60–1.89) with a negligible heterogeneity (higher I-squared was 34.2%). Adolescents with food insecurity were more likely to be exposed to be lonely. Eliminating socioeconomic disparities in adolescents might be a good approach to promote mental health in adolescents. Future studies are encouraged to utilize longitudinal studies to confirm or negate our study findings.
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Affiliation(s)
- Haowen Wu
- School of Government, Institute of Urban Governance, Shenzhen University, Shenzhen, China
| | - Zhijun Gu
- School of Government, Institute of Urban Governance, Shenzhen University, Shenzhen, China
| | - Linmiao Zeng
- School of Public Administration and Emergency Management, Jinan University, Guangzhou, China
| | - Tianyou Guo
- Exercise Psychophysiology Laboratory, Institute of KEEP Collaborative Innovation, School of Psychology, Shenzhen University, Shenzhen, China
- *Correspondence: Tianyou Guo
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15
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Ma C, Li Z, Tong Y, Zhao M, Magnussen CG, Xi B. Leisure sedentary time and suicide risk among young adolescents: Data from 54 low- and middle-income countries. J Affect Disord 2022; 298:457-463. [PMID: 34780860 DOI: 10.1016/j.jad.2021.11.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 11/06/2021] [Accepted: 11/09/2021] [Indexed: 01/29/2023]
Abstract
BACKGROUND The dose-response association between sedentary time and suicidal ideation and planning among adolescents is unclear. This study examined the association between leisure sedentary time and suicidal ideation, planning and attempts among adolescents in low- and middle-income countries (LMICs). METHODS We used the most recent data (2009-2016) from the Global School-based Student Health Survey (GSHS) in 54 LMICs. Leisure sedentary time and suicidal ideation, planning and attempts were assessed using a standardized questionnaire. A total of 146,345 young adolescents aged 12-15 years were included. RESULTS Among adolescents in the 54 LMICs, the prevalence of suicidal ideation was 14.8%, planning was 14.5%, and attempts was 13.0%. Compared with those who had less than 1 h/day of sedentary time, those who had 3, 4 h/day sedentary time were at higher odds ratio (OR) of suicidal ideation OR=1.21 (95% confidence interval (CI) =1.14-1.29), planning OR=1.15 (95%CI=1.07-1.22) and attempts OR=1.17 (95%CI=1.09-1.26), and those who had more than 8 h/day sedentary time were at OR=1.58 (95%CI=1.44-1.72), OR=1.44 (95%CI=1.31-1.58) and OR=1.27 (95%CI=1.16-1.40), respectively. LIMITATIONS Suicidal behaviors and sedentary time were assessed by a self-reported questionnaire, which might be prone to recall bias. CONCLUSIONS Higher amounts of leisure sedentary time are associated with suicidal ideation, planning and attempts among adolescents. Adolescents should spend less than 2 h/day of their sedentary time to reduce the likelihood of suicide.
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Affiliation(s)
- Chuanwei Ma
- Department of Epidemiology, School of Public Health, Qilu Hospital, Cheeloo College of Medicine, Shandong University, 44 Wen Hua Xi Road, Jinan, Shandong 250012, China
| | - Zilin Li
- Department of Epidemiology, School of Public Health, Qilu Hospital, Cheeloo College of Medicine, Shandong University, 44 Wen Hua Xi Road, Jinan, Shandong 250012, China
| | - Yuting Tong
- Centre for Health Management and Policy, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Min Zhao
- Department of Nutrition and Food Hygiene, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Costan G Magnussen
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia; Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Bo Xi
- Department of Epidemiology, School of Public Health, Qilu Hospital, Cheeloo College of Medicine, Shandong University, 44 Wen Hua Xi Road, Jinan, Shandong 250012, China.
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Guo H, Phung D, Chu C. Sociodemographic, lifestyle, behavioral, and parental factors associated with sugar-sweetened beverage consumption in children in China. PLoS One 2021; 16:e0261199. [PMID: 34890424 PMCID: PMC8664181 DOI: 10.1371/journal.pone.0261199] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 11/25/2021] [Indexed: 11/18/2022] Open
Abstract
Objective Evidence shows sugar-sweetened beverage (SSB) consumption is a risk factor for obesity and non-communicable diseases (NCDs) in children. Investigating the influential profiles, which have been examined insufficiently, will help to inform the reduction of SSB consumption. The present research examines the current trend in SSB consumption and associated factors among children in China, in order to inform policy development. Methods Secondary data was extracted from China’s Health and Nutrition Survey (CHNS; 2004, 2006, 2009, and 2011), a repeated cross-sectional research, and a Chi-squared test was applied to compare SSB consumption in the last year, queried by social demographical, `environmental, behavioral, and parental factors. Multilevel mixed-effects logistic regression was employed to examine the trend and effects of the multiple factors. Results A total of 6015 Chinese children aged 6–17 years were investigated. From 2004 to 2011, the percentage of SSB consumption in children increased from 72.6% to 90.3%. The prevalence in urban areas was higher than the prevalence in rural areas, higher in high schools than primary and middle schools, higher in east coast affluent provinces than other provinces, and higher in high-income households than low-income households. Other associated factors include children’s fast food and salty snacks preference, level of physical activity, sedentariness, and parental education. The strongest association with SSB consumption in children was the mother’s SSB consumption (adjusted odds ratio: 5.54, 95% CI: 3.17–9.67). Conclusion Children’s SSB consumption has increased significantly in China, and is associated with socio-economic, demographic, level of physical activity, food preference, and parental factors. Future strategies aimed at reducing SSB consumption among children need to consider these factors.
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Affiliation(s)
- Haijun Guo
- Centre for Environment and Population Health, Griffith University, Nathan, Australia
- * E-mail:
| | - Dung Phung
- Centre for Environment and Population Health, Griffith University, Nathan, Australia
| | - Cordia Chu
- Centre for Environment and Population Health, Griffith University, Nathan, Australia
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Zhu J, Tan Y, Lu W, He Y, Yu Z. Current Assessment of Weight, Dietary and Physical Activity Behaviors among Middle and High School Students in Shanghai, China-A 2019 Cross-Sectional Study. Nutrients 2021; 13:nu13124331. [PMID: 34959883 PMCID: PMC8707717 DOI: 10.3390/nu13124331] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/23/2021] [Accepted: 11/28/2021] [Indexed: 01/22/2023] Open
Abstract
Poor nutrition or insufficient physical activity (PA) are risk factors for obesity and chronic diseases. This 2019 cross-sectional study from the school health survey examined the dietary and PA behaviors of Chinese adolescents. A total of 12,860 adolescents aged 11–18 participated through multistage and stratified cluster random sampling. A questionnaire collected data on weight, PA, sedentary lifestyle, and eating habits. Unhealthy behaviors were identified and summed up for each behavior. Participants were then classified into high and low amounts of risk behaviors. Weight status was defined using Body Mass Index (BMI) cutoff points for Chinese individuals aged 6–18. Multinomial logistic regression was used to assess effects of lifestyle behaviors on weight status. The prevalence of overweight and obesity was 22.3% among all participants (30.6% in boys, 13.2% in girls). Females engaged in more risk physical activities (4.12 vs. 3.80, p < 0.05), while males engaged in more risk dietary activities (2.20 vs. 2.02, p < 0.05). Higher number of risk dietary, PA, and sedentary behaviors were all significantly correlated with higher BMI (dietary: r = 0.064; PA: r = 0.099; sedentary: r = 0.161; p < 0.001 for all) and body weight (dietary: r = 0.124; PA: r = 0.128; sedentary: r = 0.222; p < 0.001 for all). Risk sedentary behaviors was a significant risk factor for overweight/obesity (Adjusted Odds Ratio AOR = 1.30, 95% Confidence Interval CI 1.11–1.52). Obesity and unhealthy lifestyle behaviors remain a concern among Chinese adolescents. These results provide an update on the factors contributing to overweight/obesity among adolescents and call for efforts to address obesity among adolescents.
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Affiliation(s)
- Jingfen Zhu
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China; (J.Z.); (Y.T.); (W.L.); (Y.H.)
| | - Yinliang Tan
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China; (J.Z.); (Y.T.); (W.L.); (Y.H.)
| | - Weiyi Lu
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China; (J.Z.); (Y.T.); (W.L.); (Y.H.)
| | - Yaping He
- School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China; (J.Z.); (Y.T.); (W.L.); (Y.H.)
| | - Zhiping Yu
- Department of Nutrition and Dietetics, University of North Florida, Jacksonville, FL 32224, USA
- Correspondence: ; Tel.: +1-904-6201442
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Chatterjee A, Prinz A, Gerdes M, Martinez S. Digital Interventions on Healthy Lifestyle Management: Systematic Review. J Med Internet Res 2021; 23:e26931. [PMID: 34787575 PMCID: PMC8663673 DOI: 10.2196/26931] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 05/07/2021] [Accepted: 08/10/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Digital interventions have tremendous potential to improve well-being and health care conveyance by improving adequacy, proficiency, availability, and personalization. They have gained acknowledgment in interventions for the management of a healthy lifestyle. Therefore, we are reviewing existing conceptual frameworks, digital intervention approaches, and associated methods to identify the impact of digital intervention on adopting a healthier lifestyle. OBJECTIVE This study aims to evaluate the impact of digital interventions on weight management in maintaining a healthy lifestyle (eg, regular physical activity, healthy habits, and proper dietary patterns). METHODS We conducted a systematic literature review to search the scientific databases (Nature, SpringerLink, Elsevier, IEEE Xplore, and PubMed) that included digital interventions on healthy lifestyle, focusing on preventing obesity and being overweight as a prime objective. Peer-reviewed articles published between 2015 and 2020 were included. We used the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and a framework for an evidence-based systematic review. Furthermore, we improved the review process by adopting the Rayyan tool and the Scale for the Assessment of Narrative Review Articles. RESULTS Our initial searches identified 780 potential studies through electronic and manual searches; however, 107 articles in the final stage were cited following the specified inclusion and exclusion criteria. The identified methods for a successful digital intervention to promote a healthy lifestyle are self-monitoring, self-motivation, goal setting, personalized feedback, participant engagement, psychological empowerment, persuasion, digital literacy, efficacy, and credibility. In this study, we identified existing conceptual frameworks for digital interventions, different approaches to provide digital interventions, associated methods, and execution challenges and their impact on the promotion of healthy lifestyle management. CONCLUSIONS This systematic literature review selected intervention principles (rules), theories, design features, ways to determine efficient interventions, and weaknesses in healthy lifestyle management from established digital intervention approaches. The results help us understand how digital interventions influence lifestyle management and overcome the existing shortcomings. It serves as a basis for further research with a focus on designing, developing, testing, and evaluating the generation of personalized lifestyle recommendations as a part of digital health interventions.
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Affiliation(s)
- Ayan Chatterjee
- Department for Information and Communication Technologies, Centre for e-Health, University of Agder, Grimstad, Norway
| | - Andreas Prinz
- Department for Information and Communication Technologies, Centre for e-Health, University of Agder, Grimstad, Norway
| | - Martin Gerdes
- Department for Information and Communication Technologies, Centre for e-Health, University of Agder, Grimstad, Norway
| | - Santiago Martinez
- Department of Health and Nursing Science, Centre for e-Health, University of Agder, Grimstad, Norway
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Byun D, Kim R, Oh H. Leisure-time and study-time Internet use and dietary risk factors in Korean adolescents. Am J Clin Nutr 2021; 114:1791-1801. [PMID: 34258617 DOI: 10.1093/ajcn/nqab229] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 06/14/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Prolonged screen time is associated with an increased risk of obesity in adolescents. However, little is known about whether Internet use is also associated with dietary risk factors including consumption of obesogenic foods. OBJECTIVES In this study, we examined the associations of leisure-time and study-time Internet use with dietary risk factors in Korean adolescents using nationally representative survey data. METHODS We conducted a cross-sectional analysis among 54,416 middle and high school students in the Korea Youth Risk Behavior Web-based Survey 2015. Participants were asked to report the average duration of leisure-time and study-time Internet use, days of skipping breakfast, and frequency of fruit, vegetable, instant noodle, fast-food, chip/cracker, and sugar-sweetened beverage (SSB) intakes. We performed multivariable logistic regression to estimate ORs and 95% CIs for the relations between duration of Internet use and dietary risk factors, accounting for complex survey sampling and adjusting for potential confounders. RESULTS Prolonged leisure-time Internet use (≥241 compared with 1-60 min/d) was associated with higher prevalence of frequent skipping breakfast (OR: 1.39; 95% CI: 1.29, 1.49), low intakes of fruits (OR: 1.27; 95% CI: 1.18, 1.36) and vegetables (OR: 1.43; 95% CI: 1.33, 1.55), and high intakes of instant noodles (OR: 1.87; 95% CI: 1.74, 2.02), fast-food (OR: 1.63; 95% CI: 1.49, 1.78), chips/crackers (OR: 1.37; 95% CI: 1.24, 1.52), and SSBs (OR: 1.63; 95% CI: 1.52, 1.75). Prolonged study-time Internet use (≥121 compared with 1-60 min/d) was inversely associated with prevalence of low fruit (OR: 0.94; 95% CI: 0.88, 1.00) and vegetable (OR: 0.91; 95% CI: 0.85, 0.98) intakes but was positively associated with high intakes of instant noodles (OR: 1.10; 95% CI: 1.03, 1.19) and chips/crackers (OR: 1.13; 95% CI: 1.04, 1.23). The overall associations remained consistent in analyses stratified by sex, grade, region, parental co-residence, perceived household income, perceived stress level, physical activity, and obesity status. CONCLUSIONS Our data suggest that prolonged Internet use, particularly during leisure time, is associated with less healthful dietary behaviors in Korean adolescents.
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Affiliation(s)
- Dohyun Byun
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea
| | - Rockli Kim
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea
- Division of Health Policy and Management, College of Health Sciences, Korea University, Seoul, Republic of Korea
| | - Hannah Oh
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea
- Division of Health Policy and Management, College of Health Sciences, Korea University, Seoul, Republic of Korea
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Vancampfort D, Firth J, Smith L, Stubbs B, Rosenbaum S, Hallgren M, Van Damme T, Koyanagi A. Association between physical activity and leisure-time sedentary behavior among 140,808 adolescents aged 12 to 15 from 47 low- and middle-income countries. Public Health 2021; 199:1-9. [PMID: 34509709 DOI: 10.1016/j.puhe.2021.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 07/11/2021] [Accepted: 08/01/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Data from high-income countries (HICs) indicate that sedentary behavior is negatively associated with moderate-to-vigorous physical activity (MVPA) in young people. We examined associations between leisure-time sedentary behavior (LTSB) and MVPA in adolescents from 47 low- and middle-income countries (LMICs). STUDY DESIGN Cross-sectional study. METHODS Data from the Global school-based Student Health Survey were analyzed in 140,808 adolescents (13.8 ± 1.0 years; 49% girls). Time spent in LTSB was a composite variable assessing time spent sitting and playing computer games, watching TV, talking with friends during a typical day. The PACE + Adolescent Physical Activity Measure assessed MVPA levels. The association between ≥3 h/day of LTSB and adequate physical activity levels (every day last week 60 min MVPA) was explored with multivariable logistic regression analyses. RESULTS The prevalence of ≥3 h/day of LTSB and 60 min of MVPA/day last week were 26.3% (girls 26.2%; boys 26.5%) and 15.3% (girls 12.1%; boys 18.4%), respectively. LTSB of ≥3 h/day versus <3 h/day was associated with a 35% increased odds for adequate levels of MVPA in boys [OR = 1.35 (95%CI = 1.23-1.48)] and 22% in girls [1.22 (95%CI = 1.10-1.36)]. CONCLUSIONS Our data indicate that being physically active 60 min per day every day and at moderate-to-vigorous intensity and being sedentary ≥3 h/day during leisure-time might co-exist in adolescents in some LMICs.
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Affiliation(s)
- D Vancampfort
- KU Leuven, Department of Rehabilitation Sciences, Leuven, Belgium; KU Leuven, University Psychiatric Center KU Leuven, Kortenberg, Belgium.
| | - J Firth
- NICM Health Research Institute, School of Science and Health, University of Western Sydney, Australia; Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, United Kingdom; Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - L Smith
- Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, United Kingdom
| | - B Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, United Kingdom; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, United Kingdom
| | - S Rosenbaum
- School of Psychiatry, University of New South Wales, Sydney, Australia; Black Dog Institute, Prince of Wales Hospital, Sydney, Australia
| | - M Hallgren
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - T Van Damme
- KU Leuven, Department of Rehabilitation Sciences, Leuven, Belgium
| | - A Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, CIBERSAM, Barcelona, Spain; ICREA, Pg. Lluis Companys 23, Barcelona, Spain
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Substance use and psychological distress among school-going adolescents in 41 low-income and middle-income countries. J Affect Disord 2021; 291:254-260. [PMID: 34052748 DOI: 10.1016/j.jad.2021.05.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 05/08/2021] [Accepted: 05/14/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Substance use remains a public health problem worldwide, and it is particularly concerning among adolescents because of its harmful effects. There is a need to better understand the factors associated with adolescents' substance use to inform policies for effective prevention. METHODS We used data from the Global School-based Student Health Surveys. Data were collected by anonymous self-report questionnaires. This study is based on three questions assessing substance use and four questions assessing psychological distress. Logistic regression models were used to analyse associations between substance use and psychological distress. We calculated the pooled overall and regional estimates by random-effects meta-analysis. RESULTS We included 126,763 adolescents (boys, 44.7%; girls, 55.3%). Substance users tended to be older, male, physically attacked, in physical fighting, bullied; to experience psychological distress; and to have a higher socio-economic status. Alcohol use was consistently associated with medium and high psychological distress. In terms of four aspects of psychological distress, only suicidal ideation was consistently associated with the substance use components and all specific combinations of substance use. Additionally, the prevalence of alcohol use was higher than that of cigarette use and drug use. Region-wise analysis showed that substance use was associated with psychological distress in the African region, American region, South-East region and Western Pacific region. LIMITATIONS The cross-sectional data could not infer causality. CONCLUSIONS This study indicated that high levels of substance use were significantly associated with an increased likelihood of psychological distress among adolescents. In addition, age also had an effect on substance use.
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Aguilo A, Lozano L, Tauler P, Nafría M, Colom M, Martínez S. Nutritional Status and Implementation of a Nutritional Education Program in Young Female Artistic Gymnasts. Nutrients 2021; 13:nu13051399. [PMID: 33919356 PMCID: PMC8143314 DOI: 10.3390/nu13051399] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/16/2021] [Accepted: 04/19/2021] [Indexed: 12/31/2022] Open
Abstract
Adolescent high-performance gymnasts are considered to be at risk for low energy intake. The aim of the present study was to determine the effects of implementing a nutritional education program during the sports season on the nutritional status and nutrition knowledge of the female artistic gymnasts from the Technification Center of the Balearic Islands (n = 24; age, 14.1 ± 2.3 years). A quasi-experimental intervention design was applied, which consisted of implementing a nutritional education program of seven sessions given during eight months. Measurements of nutritional intake, nutrition knowledge, and anthropometric parameters, as well as hematological and biochemical blood parameters, were performed. Gymnasts reported low energy and carbohydrate intakes, with significant increases during the study (energy, 28.3 ± 1.4 vs. 32.8 ± 1.4 kcal kg−1, p = 0.015, carbohydrate 3.2 ± 0.2 vs. 3.9 ± 0.2 g kg−1, p = 0.004). The average values for parameters such as hemoglobin, ferritin, lipoprotein, and vitamin C and E levels in the plasma were within normal ranges. Low intakes of most of the food groups were observed during the study, with similar initial and final values. Nutrition knowledge did not change as a result of the study (28.0 ± 1.7 vs. 31.1 ± 1.3, p = 0.185). In conclusion, gymnasts reported low energy intakes. However, blood markers and most of the anthropometrical parameters measured were within normal ranges. The nutrition education program implemented did not produce significant improvements in the dietary habits or nutritional knowledge of gymnasts.
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Affiliation(s)
- Antoni Aguilo
- Research Group on Evidence, Lifestyles and Health, Department of Nursing and Physiotherapy, Research Institute of Health Sciences (IUNICS), University of the Balearic Islands, 07122 Palma, Spain; (A.A.); (L.L.); (M.N.); (M.C.); (S.M.)
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
| | - Leticia Lozano
- Research Group on Evidence, Lifestyles and Health, Department of Nursing and Physiotherapy, Research Institute of Health Sciences (IUNICS), University of the Balearic Islands, 07122 Palma, Spain; (A.A.); (L.L.); (M.N.); (M.C.); (S.M.)
| | - Pedro Tauler
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
- Research Group on Evidence, Lifestyles and Health, Department of Fundamental Biology and Health Sciences, Research Institute of Health Sciences (IUNICS), University of the Balearic Islands, 07122 Palma, Spain
- Correspondence: ; Tel.: +34-971-172858
| | - Mar Nafría
- Research Group on Evidence, Lifestyles and Health, Department of Nursing and Physiotherapy, Research Institute of Health Sciences (IUNICS), University of the Balearic Islands, 07122 Palma, Spain; (A.A.); (L.L.); (M.N.); (M.C.); (S.M.)
| | - Miquel Colom
- Research Group on Evidence, Lifestyles and Health, Department of Nursing and Physiotherapy, Research Institute of Health Sciences (IUNICS), University of the Balearic Islands, 07122 Palma, Spain; (A.A.); (L.L.); (M.N.); (M.C.); (S.M.)
| | - Sonia Martínez
- Research Group on Evidence, Lifestyles and Health, Department of Nursing and Physiotherapy, Research Institute of Health Sciences (IUNICS), University of the Balearic Islands, 07122 Palma, Spain; (A.A.); (L.L.); (M.N.); (M.C.); (S.M.)
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
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Khan A, Rosenbaum S. Relationship between sedentary behaviours and loneliness: Mediating role of fast food and soft drink consumption. Acta Paediatr 2021; 110:907-908. [PMID: 33156524 DOI: 10.1111/apa.15657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Asaduzzaman Khan
- School of Health and Rehabilitation Sciences The University of Queensland Brisbane QLD Australia
| | - Simon Rosenbaum
- School of School of Psychiatry University of New South Wales Sydney NSW Australia
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Do TV viewing and frequency of ultra-processed food consumption share mediators in relation to adolescent anxiety-induced sleep disturbance? Public Health Nutr 2021; 24:5491-5497. [PMID: 33500011 DOI: 10.1017/s1368980021000379] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To investigate the role of potential shared mediators in the association of TV viewing and frequency of ultra-processed food consumption with anxiety-induced sleep disturbance. DESIGN Cross-sectional study. SETTING Data from the Adolescent School-Based Health Survey, a Brazilian nationally representative survey of ninth-grade adolescents conducted in 2015, were used. PARTICIPANTS 99 791 adolescents (52 015 girls) with a mean age of 14·3 years (range 11-19) participated. All variables were collected through a self-reported questionnaire based on the Global School-Based Student Health Survey. Anxiety-induced sleep disturbance was the outcome. Over 4 h/d of TV viewing and daily consumption of ultra-processed foods were the exposures. Body satisfaction, loneliness, self-rated health and eating while watching TV or studying were mediators. Age, ethnicity, food insecurity, type of city (capital or interior), country region and physical activity were covariates. Logistic regression and mediation models (Karlsson-Holm-Breen method) assessed associations. RESULTS Both daily ultra-processed food consumption (boys: OR 1·48, 95 % CI 1·30, 1·70; girls: OR 1·46, 95 % CI 1·34, 1·60) and TV viewing (boys: OR 1 24, 95 % CI 1·08, 1·43; girls: OR 1·09, 95 % CI 1·00, 1·19) were associated with higher odds for anxiety-induced sleep disturbance. Loneliness and eating while watching TV or studying (only among girls) consistently mediated the association of both daily ultra-processed food consumption (loneliness: boys 17·4 %, girls 23·4 %; eat while watching TV or studying: girls 6·8 %) and TV viewing (loneliness: boys 22·9 %, girls 45·8 %; eat while watching TV or studying: boys 6·7 %, girls 17·9 %) with anxiety-induced sleep disturbance. CONCLUSIONS Daily ultra-processed food consumption and TV viewing share mediators and can act in synergic mechanisms in the association with anxiety-induced sleep disturbance. Therefore, future interventions should focus in the reduction of both behaviours in combination.
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Li L, Sun N, Zhang L, Xu G, Liu J, Hu J, Zhang Z, Lou J, Deng H, Shen Z, Han L. Fast food consumption among young adolescents aged 12-15 years in 54 low- and middle-income countries. Glob Health Action 2020; 13:1795438. [PMID: 32762333 PMCID: PMC7480506 DOI: 10.1080/16549716.2020.1795438] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND Most countries worldwide, especially low- and middle-income countries (LMICs), are facing an increasing prevalence of fast-food consumption and multiple burdens of malnutrition among young adolescents. OBJECTIVE To compare the prevalence of fast-food consumption among young adolescents in LMICs. METHODS We used data from the most recent Global School-Based Student Health Survey (2009-2015), which had been collected using a standardized questionnaire. The weighted prevalence and 95% confidential intervals of fast-food consumption were calculated overall and in subgroups stratified by age, sex, and nutritional status. The pooled overall and regional estimates were obtained using a random-effects model. Heterogeneity was assessed using the I2 statistic. The associated risk factors for fast-food consumption were explored using logistic regression analysis. RESULTS Our study comprised 153,496 young adolescents (46.90% boys) from 54 LMICs. Overall, approximately 55.2% (51.3-59.1%) of the adolescents consumed fast food at least 1 day per week, and 10.3% (8.3-12.4%) did so 4-7 days per week. The prevalence of fast-food consumption 4-7 days per week was lowest in the Americas (8.3%; 6.7-9.9%) and highest in Southeast Asia (17.7%; 2.3-33.2%). At a country level, the prevalence was lowest in Pakistan (1.5%; 1.0-2.0%) and highest in Thailand (43.3%; 40.4-46.1%). Furthermore, in subgroups stratified by nutritional status, the prevalence was lowest in the obesity group (6.6%; 4.5-8.7%). Factors such as age, sex, BMI, food insecurity, fruit consumption, vegetable consumption, soft-drink consumption, smoking, physical activity level, and sedentary behavior level were found to be correlated with fast-food consumption. CONCLUSIONS The identified high prevalence of fast-food consumption among young adolescents in LMICs indicates the urgent need to prioritize the implementation of healthy-diet promotion programs to improve adolescent health in these countries.
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Affiliation(s)
- Lian Li
- Department of Epidemiology, Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University , Ningbo, China
| | - Ning Sun
- School of Nursing, Ningbo College of Health Sciences , Ningbo, Zhejiang, PR China
| | - Lina Zhang
- Department of Epidemiology, Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University , Ningbo, China
| | - Guodong Xu
- Department of Epidemiology, Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University , Ningbo, China
| | - Jingjing Liu
- Department of Social Medicine, School of Public Health, Harbin Medical University , Harbin, China
| | - Jingcen Hu
- Department of Epidemiology, Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University , Ningbo, China
| | - Zhiying Zhang
- Teaching and Research Department, Affiliated Hospital of Weifang Medical University , Weifang, China
| | - Jianjun Lou
- Nutrition Department, Yuyao People's Hospital , Yuyao, Zhejiang, PR China
| | - Hongxia Deng
- Department of Otorhinolaryngology Head and Neck Surgery, Ningbo Medical Center Lihuili Hospital , Ningbo, Zhejiang, PR China
| | - Zhisen Shen
- Department of Otorhinolaryngology Head and Neck Surgery, Ningbo Medical Center Lihuili Hospital , Ningbo, Zhejiang, PR China
| | - Liyuan Han
- Hwa Mei Hospital, University of Chinese Academy of Sciences , Ningbo, Zhejiang, PR China.,Department of Global Health, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences , Ningbo, Zhejiang, PR China
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26
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Felez-Nobrega M, Raine LB, Haro JM, Wijndaele K, Koyanagi A. Temporal trends in leisure-time sedentary behavior among adolescents aged 12-15 years from 26 countries in Asia, Africa, and the Americas. Int J Behav Nutr Phys Act 2020; 17:102. [PMID: 32787874 PMCID: PMC7424676 DOI: 10.1186/s12966-020-01010-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 08/03/2020] [Indexed: 12/31/2022] Open
Abstract
Background Multi-country studies examining trends in sedentary behaviors among adolescents have mainly focused on high-income or Western countries, and almost no data exists for the rest of the world. Thus, this study aims to examine temporal trends in adolescents’ leisure time sedentary behavior (LTSB) employing nationally representative datasets from 26 countries from five WHO-defined geographical regions. Methods Data from the Global School-based Student Health Survey 2003–2017 were analyzed in 17,734 adolescents [mean (SD) age: 13.7 (1.0) years; 49.0% boys]. LTSB was self-reported and included all types of sedentary behaviors, excluding time spent at school or doing homework. The prevalence and 95%CI of high LTSB (i.e., ≥3 h/day) was calculated for the overall sample and by sex for each survey. Crude linear trends in high LTSB were assessed by linear regression models. Interaction analyses were conducted to examine differing trends among boys and girls. Results Temporal variations in LTSB substantially diverged across countries, with results showing increasing (6/26 countries), decreasing (4/26) and stable trends. The sharpest increases in LTSB occurred in United Arab Emirates, Kuwait, and Thailand. Some countries did not show an increase in LTSB prevalence over time but had very high levels of LTSB (i.e., > 40%) across multiple years. Most countries showed no differences in LTSB trends between boys and girls. Conclusions Data from our study may serve as an important platform for policymakers, as well as local and national stakeholders, to establish country-specific and tailored strategies for reducing LTSB.
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Affiliation(s)
- Mireia Felez-Nobrega
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, C/ Dr. Antoni Pujadas 42, 08830 Sant Boi de Llobregat, Barcelona, Spain.
| | - Lauren B Raine
- Department of Psychology, Northeastern University, 125 NI, 360 Huntington Ave, Boston, MA, 02115, USA
| | - Josep Maria Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, C/ Dr. Antoni Pujadas 42, 08830 Sant Boi de Llobregat, Barcelona, Spain.,Centre for Biomedical Research on Mental Health (CIBERSAM), Madrid, Spain
| | | | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, C/ Dr. Antoni Pujadas 42, 08830 Sant Boi de Llobregat, Barcelona, Spain.,Centre for Biomedical Research on Mental Health (CIBERSAM), Madrid, Spain.,ICREA, Pg. Lluis Companys 23, Barcelona, Spain
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Violence and obesogenic behavior among adolescents aged 12-15 years from 62 countries: A global perspective. Prev Med 2020; 137:106123. [PMID: 32389676 DOI: 10.1016/j.ypmed.2020.106123] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 04/23/2020] [Accepted: 05/03/2020] [Indexed: 11/20/2022]
Abstract
Exposure to violence may be associated with increased risk for obesogenic behavior among adolescents but studies providing a global perspective are lacking. The aim of this work was to assess the relationship between violence and obesogenic behaviors among young adolescents from 62 countries. Cross-sectional data from the Global School-based Student Health Survey 2009-2016 were analyzed. Information on violence (intentional injury, physical attack, physical fight) and obesogenic behavior (anxiety-induced sleep problems, low physical activity, sedentary behavior, fast-food consumption, carbonated soft-drink consumption) were self-reported. Associations were analyzed using meta-analysis based on country-wise multivariable logistic regression analyses. A total of 165,380 adolescents aged 12-15 years [mean (SD) age 13.8 (1.0) years; 50.9% boys] were included in the analysis. All types of violence were positively associated with higher odds for all types of obesogenic behavior with the exception of low physical activity. Associations were particularly pronounced for anxiety-induced insomnia. In contrast, intentional injury (OR = 0.72; 95%CI = 0.64-0.81) and physical fight (OR = 0.90; 95%CI = 0.86-0.95) were associated with lower odds for low physical activity. In this large global sample of adolescents, exposure to violence was associated with all obesogenic behaviors apart from low physical activity. Multidimensional government programs and policies addressing exposure to violence among young adolescents may lead to reduction in obesogenic behavior and hence curtail the global obesity epidemic.
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28
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Jacob L, Stubbs B, Firth J, Smith L, Haro JM, Koyanagi A. Fast food consumption and suicide attempts among adolescents aged 12-15 years from 32 countries. J Affect Disord 2020; 266:63-70. [PMID: 32056938 DOI: 10.1016/j.jad.2020.01.130] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 11/19/2019] [Accepted: 01/21/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND We examined the fast food consumption-suicide attempt relationship among 105,061 adolescents aged 12-15 years from 32 countries. METHODS This study was based on cross-sectional data from the Global School-based Student Health Survey (GSHS), and included 4 low-income, 13 lower middle-income, 9 upper middle-income, and 6 high-income countries. Data on past 7-day fast food consumption and 12-month suicide attempts were collected. The association between fast food consumption and suicide attempts was investigated with multivariable logistic regression and meta-analysis while adjusting for sex, age, food insecurity (proxy of socioeconomic status), alcohol consumption, smoking, physical activity, obesity, carbonated soft drink consumption, and fruit and vegetable consumption. RESULTS Overall, the prevalence of fast food consumption was high (53.5%) and the proportion of suicide attempts was higher among consumers of fast food compared to non-consumers (11.8% vs. 8.3%). Of the 32 countries included in the study, a positive association between fast food consumption and suicide attempts was found in 26 countries although this was not statistically significant in all countries. The pooled OR (95% CI) based on a meta-analysis was 1.31 (1.17-1.46). LIMITATIONS Since this was a cross-sectional study, it is not possible to draw any conclusions about causality or temporality in the associations assessed. CONCLUSIONS Fast food consumption is positively associated with suicide attempts in adolescents. Further research of longitudinal design is needed to confirm/refute our findings and explore the potential underlying mechanisms.
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Affiliation(s)
- Louis Jacob
- Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France; Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain.
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, United Kingdom; Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Positive Ageing Research Institute, Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, United Kingdom
| | - Joseph Firth
- Division of Psychology and Mental Health, University of Manchester, Manchester, United Kingdom; NICM Health Research Institute, Western Sydney University, Westmead, Australia; Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Lee Smith
- Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, United Kingdom
| | - Josep Maria Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain; ICREA, Pg. Lluis Companys 23, Barcelona, Spain
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Temporal Trends and Recent Correlates in Sedentary Behaviors among Chinese Adults from 2002 to 2010-2012. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:ijerph17010158. [PMID: 31878308 PMCID: PMC6982214 DOI: 10.3390/ijerph17010158] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 12/15/2019] [Accepted: 12/23/2019] [Indexed: 12/31/2022]
Abstract
Evidence suggests that more time spent in sedentary behaviors (SB) increases health risk independent of physical activities. Trends in SB among adults have not been fully described in China, and the sociodemographic correlates of SB have not been systematically evaluated either. This study examined the temporal trends of SB among 184,257 adults (2002: n = 52,697, 2010-2012: n = 131,560) using data from the China National Nutrition and Health Survey in 2002 and 2010-2012, and analyzed the recent correlates of SB in Chinese adults. Overall, an increase (+0.29 h/d) was seen in total SB across the survey years, and there was a slight increase (+0.14 h/d) in leisure time SB and a decrease (-0.39 h/d) in occupational SB. From 2002 to 2012, the proportion of Chinese adults whose total SB time over 4 h/d increased from 35.4% to 43.0%, and the proportion of leisure SB time over 3 h/d increased from 42.0% to 48.0%, and the proportion of occupational SB time over 4 h/d decreased from 63.4% to 53.0%. Male, urban areas, employed, unmarried, and with higher educational and family economic level were all positively associated with high sedentary time (HST) in 2010-2012. These trends and correlates are important for health policy in China and other countries that are facing similar challenges.
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Vancampfort D, Firth J, Smith L, Stubbs B, Rosenbaum S, Van Damme T, Christiaansen L, Ashdown-Franks G, Koyanagi A. Cannabis use and leisure-time sedentary behavior among 94,035 adolescents aged 12-15 years from 24 low- and middle-income countries. Addict Behav 2019; 99:106104. [PMID: 31470242 DOI: 10.1016/j.addbeh.2019.106104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 07/21/2019] [Accepted: 08/16/2019] [Indexed: 12/15/2022]
Abstract
Adolescents spend a high proportion of their leisure time in sedentary behavior, which is associated with adverse physical and mental health outcomes. Exploring factors associated with leisure-time sedentary behavior (LTSB) is important for the development of targeted interventions. The aim of this study was to explore associations between cannabis use and LTSB in adolescents from 24 low- and middle-income countries. Data from the Global School-based Student Health Survey were analyzed. Data on past month cannabis use and LTSB during a typical day were collected. Multivariable logistic regressions were conducted to assess the associations. Among 94,035 adolescents aged 12-15 years [age = 13.7 ± SD 0.9 years; 49.2% female], the prevalence of high LTSB (≥3 h/day) was 26.6%, while 2.8% used cannabis at least once in the past 30 days. In adjusted analyses, compared to those who did not consume cannabis in the past 30 days, the OR (99%CI) for high LTSB among those who used cannabis 1-2 times, 3-9 times, 10-19 times, and ≥20 times were 0.89 (0.58-1.35), 1.96 (1.26-3.07), 1.97 (0.71-5.47), and 2.34 (0.95-5.78), respectively (test for trend p < 0.01). Our data suggest that frequent cannabis use is associated with increased odds for being more sedentary in adolescence. Future longitudinal data are required to confirm/refute the findings to inform public health campaigns.
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Vancampfort D, Van Damme T, Firth J, Hallgren M, Smith L, Stubbs B, Rosenbaum S, Koyanagi A. Correlates of leisure-time sedentary behavior among 181,793 adolescents aged 12-15 years from 66 low- and middle-income countries. PLoS One 2019; 14:e0224339. [PMID: 31725744 PMCID: PMC6855478 DOI: 10.1371/journal.pone.0224339] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 10/10/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Sedentary behavior is a growing public health concern in young adolescents from low- and middle-income countries (LMICs). However, a paucity of multinational studies, particularly in LMICs, have investigated correlates of leisure-time sedentary behavior (LTSB) in young adolescents. In the current study, we assessed socio-demographic, socio-economic, socio-cultural and health behavior related correlates of LTSB among adolescents aged 12-15 years who participated in the Global school-based Student Health Survey (GSHS). METHODS Self-reported LTSB, which was a composite variable assessing time spent sitting and watching television, playing computer games, talking with friends during a typical day excluding the hours spent sitting at school and doing homework, was analyzed in 181,793 adolescents from 66 LMICs [mean (SD) age 13.8 (1.0) years; 49% girls). Multivariable logistic regression was used to assess the potential LTSB correlates. RESULTS The overall prevalence of ≥3 hours/day of LTSB was 26.4% (95%CI = 25.6%-27.2%). Increasing age (OR = 1.14; 95%CI = 1.11-1.17), past 30-day smoking (OR = 1.85; 95%CI = 1.69-2.03), alcohol consumption (OR = 2.01; 95%CI = 1.85-2.18), and bullying victimization (OR = 1.39; 95%CI = 1.31-1.48) were positively associated with increased LTSB across the entire sample of 181,793 adolescents. Food insecurity (OR = 0.93; 95%CI = 0.89-0.97) and low parental support/monitoring (OR = 0.91; 95%CI = 0.85-0.98) were negatively associated with LTSB. There were some variations in the correlates between countries. CONCLUSIONS Our data indicate that in adolescents aged 12 to 15 years living in LMICs, LTSB is a complex and multi-dimensional behavior determined by socio-demograhic, sociocultural, socio-economic, and health behavior related factors. Future longitudinal data are required to confirm/refute these findings, and to inform interventions which aim to reduce sedentary levels in adolescents living in LMICs.
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Affiliation(s)
- Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium
- KU Leuven, University Psychiatric Center KU Leuven, Kortenberg, Belgium
| | - Tine Van Damme
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium
| | - Joseph Firth
- NICM Health Research Institute, Western Sydney University, Sydney, Australia
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia Department of Public Health Sciences, Melbourne, Australia
| | | | - Lee Smith
- Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, United Kingdom
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, United Kingdom
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, United Kingdom
| | - Simon Rosenbaum
- School of Psychiatry, University of New South Wales, Sydney, Australia
- Black Dog Institute, Prince of Wales Hospital, Sydney, Australia
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, CIBERSAM, Barcelona, Spain
- ICREA, Pg. Lluis Companys 23, Barcelona, Spain
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