Association of Sports Practice in Childhood and Adolescence with Cardiac Autonomic Modulation in Adulthood: A Retrospective Epidemiological Study

BACKGROUND

Practicing sports during childhood and adolescence provides benefits to cardiac autonomic modulation (CAM) at these stages of life. However, it is not known whether these benefits to CAM persist into adulthood. Therefore, the objective of this study was to analyze the association of early sports practice (sports practice in childhood and/or adolescence) with CAM in adult life, regardless of habitual moderate-to-vigorous PA.

METHODS

The sample of the present study consisted of 242 adults (141 women and 101 men; age: 41.99 ± 16.24). The assessment of CAM was performed using heart rate variability indices. Sports practice in childhood and adolescence was assessed using a questionnaire. The intensity of physical activity was assessed using accelerometry. To analyze the association between previous sports practice (childhood and/or adolescence) and CAM, the Generalized Linear Model was adopted, considering CAM indices as continuous variables and early sports practice as a 3-fold factor (no sports practice; sports practice in childhood or adolescence; and sports practice in both childhood and adolescence) adjusted by sex, age, socioeconomic condition, and moderate to vigorous PA.

RESULTS

Sports practice in childhood was associated with the average standard deviation of all normal RR intervals expressed in milliseconds (SDNN): β = 5.89; 95%CI: 0.25;11.52, and the standard deviation of the long-term intervals between consecutive heartbeats (SD2): β = 7.63; 95%CI:1.04; 14.23 indices. Sports practice in adolescence was associated in adulthood with the SD2 index: β = 7.37; 95%CI: 0.71;14.04. Sports practice in at least one of the periods (childhood or adolescence) was significantly associated with the square root of the mean square of the differences between adjacent normal RR intervals for a period of time expressed in milliseconds (RMSSD) (β = 8.86; 95%CI = 0.71;17.01), and the standard deviation of the instantaneous beat to beat variability (SD1) (β = 6.21; 95%CI = 0.45;11.97). Sports practice at both stages of life was significantly associated with better SDNN (β = 7.70; 95%CI = 1.16;14.23) and SD2 (β = 10.18; 95%CI = 2.51;17.85).

CONCLUSION

Early sports practice was associated with better CAM in adulthood, independently of the current physical activity level. Based on these findings, sports practice is encouraged from childhood and adolescence, for benefits to CAM in adult life.

Analysis of the association between high workload and musculoskeletal pain in public school teachers according to physical activity level

BACKGROUND

A high workload has been associated with musculoskeletal pain in public school teachers. However, the hypothesis of the present study was that physical activity (PA) practice is able to attenuate this association.

OBJECTIVE

To analyze the associations between high workload with musculoskeletal pain according to PA levels in public school teachers.

METHODS

Teachers (n = 239) from 13 public schools were evaluated. Workload was assessed using a Likert scale in which teachers reported their perception of their work routine as: very low, low, regular, high, and very high. Musculoskeletal pain and PA were assessed using questionnaires. Multivariate logistic regression models were used to investigate the association of high workload with PA levels and musculoskeletal pain in different body regions, compared to participants with normal workload, adjusted by sex, age, and socioeconomic status.

RESULTS

A high workload was associated with higher chances of reporting pain in the wrists and hands (OR = 3.55; 95% CI = 1.27-9.89), knee (OR = 3.09; 95CI%  = 1.09-8.82), and feet and ankles (OR = 3.16; 95% CI = 1.03-9.76) in less active teachers. However, these associations were not observed in teachers considered more active.

CONCLUSION

PA practice is able to act as a good protector against musculoskeletal pain in teachers, even in individuals with a high workload.

High workload is related to lower quality of life in public school teachers: A cross-sectional study

BACKGROUND

People with long work hours, as evidenced by teachers, were more likely to present health problems that impact their quality of life (QoL). The reduced physical activity (PA) level or higher sedentary behavior in public school teachers was related to obesity. Although PA seems to improve the QoL in other professions, assessing whether the PA level could influence the relationship between workload and QoL in public school teachers is necessary.

OBJECTIVE

To analyze whether the high workload was related to worse QoL in teachers considered less active and more active.

METHODS

Two hundred forty-three teachers from public schools participated in this study. The domains of QoL and PA levels were assessed by SF-36 and Baecke questionnaires, respectively. Workload perception was assessed by a Likert scale. Binary logistic regression analyzed the association between high workload and QoL domains in teachers considering the PA level in a model adjusted by confounding factors (i.e., sex, age, and socioeconomic condition).

RESULTS

Heavy workload was associated with less chances of having better physical limitation domain of both less and more physically active teachers. Less active teachers with heavy workloads were 53%, 61%, and 56% less likely to have better vitality, social functioning, and mental health, respectively. No such associations were observed in the more physically active teachers.

CONCLUSION

Less active teachers with a heavy workload demonstrate lower QoL. Although the PA practice eliminated this relationship, both active and less active teachers with a heavy workload demonstrated lower QoL in physical limitation domain.

Association of Early Sports Participation With Sedentary Behavior in Community-Dwelling Adults-The Role of Sociodemographic Factors in a Retrospective Epidemiological Study

BACKGROUND

The role of sociodemographic factors in the association between early sports participation (ESP) and sedentary behavior is unclear. We analyzed the association of ESP with sedentary behavior and identified the influence of sociodemographic factors in adulthood.

METHODS

A sample of 264 community-dwelling adults was randomly assessed (42.6 [17.0] y old, 57.6% women). Sociodemographic factors (age, gender, and socioeconomic status) and ESP (retrospectively) were assessed by questionnaire. Sedentary behavior was measured by accelerometer and self-reported for domains identification. The association between ESP and sedentary behavior domains and sociodemographic factors was analyzed by Poisson regression and presented in prevalence ratio (PR). Sociodemographic factors were separately included as covariates to identify their role in the main association analysis.

RESULTS

The ESP prevalence was 56.4% (n = 149). ESP participants included a higher proportion of men (59.7% vs 20.0%), had a lower age (36.8 [15.3] vs 50.8 [15.9]), and included a smaller proportion of individuals with low socioeconomic status (24.8% vs 43.5%) compared with those without ESP. The ESP was inversely associated with older age (PR = 0.58, P < .001 for middle aged; PR = 0.34, P < .001 for older participants), female gender (PR = 0.79, P < .001), low socioeconomic status (PR = 0.63, P = .036), and TV watching (PR = 0.67, P = .011). ESP was associated with driving (PR = 1.50, P = .028), office/paper work (PR = 1.63, P = .012), and using a cellphone (PR = 1.60, P = .009). The age was the main confounding factor of association between ESP and sedentary behavior, followed by socioeconomic status. No mediation role was identified.

CONCLUSION

The ESP was associated with mentally active behavior domains and inversely associated with mentally passive sedentary behavior domains, but this association was majorly affected by sociodemographic factors, mainly by age.

Association of Musculoskeletal Pain With Sedentary Behavior in Public School Teachers: The Role of Habitual Physical Activity

BACKGROUND

Sedentary behavior has been associated with musculoskeletal pain in school teachers. However, our hypothesis is that physical activity practice could mitigate this association.

AIM

The aim of this study was to investigate the relationship of musculoskeletal pain with high screen-based sedentary behavior among public school teachers and whether physical activity could mitigate this relationship.

METHOD

A sample of 246 teachers from 13 public schools were assessed (45.0 ± 10.4 years, 76.0% of women). Musculoskeletal pain was assessed using the Nordic Musculoskeletal Questionnaire, screen-based sedentary behavior was measured considering the sum of screen time in television, computer, and smartphone/tablet, and physical activity using the Baecke habitual physical activity questionnaire. Binary logistic regression was used to verify the associations between high screen-based sedentary behavior and musculoskeletal pain in school teachers (Model 1-unadjusted; Model 2-adjusted by age, sex, and socioeconomic status; Model 3-variables of Model 2 + adjusted by physical activity).

RESULTS

High screen-based sedentary behavior was associated with pain in neck (odds ratio = 2.09; 95%confidence interval = 1.08-4.04), upper back (odds ratio = 2.21; 95%confidence interval = 1.07-4.56), and low back (odds ratio = 1.91; 95%confidence interval = 1.00-3.65). However, after inserting the variables, including physical activity, these associations were mitigated.

CONCLUSIONS

High screen-based sedentary behavior was associated with musculoskeletal pain in public school teachers. However, this relationship was mitigated after the inclusion of confounding variables, including physical activity.

Sports Participation from Childhood to Adolescence is Associated with Lower Body Dissatisfaction in Boys-A Sex-Specific Analysis

OBJECTIVES

This study aimed to analyze the association between body dissatisfaction and sports participation from childhood to adolescence in a school-based sample of adolescents, according to sex.

METHODS

A total of 1011 adolescents of 13.1 ± 2.3 years of age were evaluated. Body dissatisfaction was assessed by the Silhouettes Scale and sports participation for at least one consecutive year was retrospectively assessed by closed specific questions related to childhood and adolescence periods. Body mass index (BMI) and abdominal obesity were objectively measured. Habitual practice of physical activity (PA), socioeconomic status (SES), and ethnicity were assessed through questionnaires.

RESULTS

Sports participation from childhood to adolescence was observed in 55.1% of boys and in 41.2% of girls. Boys with body dissatisfaction showed lower habitual PA in leisure time (Baecke score = 4.38 ± 2.27 vs. 5.15 ± 2.25, p < 0.05) and in total (Baecke score = 9.34 ± 2.64 vs. 9.96 ± 2.68, p < 0.05) than those who were satisfied. No differences were observed among girls. Sports participation from childhood to adolescence was associated with 42% less chance of having body dissatisfaction in boys (OR = 0.58 [95%CI = 0.36-0.94]). No significant association was observed among girls.

CONCLUSIONS FOR PRACTICE

Sports participation from childhood to adolescence was negatively associated with body dissatisfaction in boys. The continuity of physical activity during youth may be an important modifiable factor to reduce body dissatisfaction.

Relationship of Cardiac Autonomic Modulation with Cardiovascular Parameters in Adults, According to Body Mass Index and Physical Activity

This study aimed to analyze the relationship between cardiac autonomic modulation (CAM) and cardiovascular parameters (blood pressure and resting heart rate) in a sample of 256 adults, grouped by body mass index and sufficient moderate-to-vigorous physical activity (≥150 min/week). The sample showed different cardiovascular parameters and CAM according to body mass index, but not according to physical activity. Adults who are overweight and physically active presented higher relationship between CAM and blood pressure than those who are insufficiently active, similarly to normal weight groups. Recommended levels of physical activity may play an important role in the relationship of HRV with cardiovascular parameters in overweight adults, regardless of sex, age, socioeconomic level, and central fat. Trial registration: Registered at ClinicalTrials.gov (NCT03986879). Graphical abstract.

Association of musculoskeletal pain with poor sleep quality in public school teachers

BACKGROUND

Teachers perform repetitive movements all day, which can cause pain in body regions. This article analyzes the association of pain with sleep quality in this population.

OBJECTIVE

The objective of the study was to analyze the relationship of musculoskeletal pain and sleep quality in teachers from public schools.

METHODS

The sample consisted of 242 teachers, selected in a random process. Musculoskeletal pain and sleep quality were evaluated by using a questionnaire. The association between sleep quality and musculoskeletal pain was evaluated using the chi-square test. The magnitude of the associations was verified by Binary Logistic Regression, adjusted by sex, age, BMI, and socioeconomic status.

RESULTS

Teachers with poor sleep quality presented higher body mass index (BMI) values when compared to teachers with good sleep quality (27.9 vs 26.0, p = 0.012). Teachers with poor sleep quality were approximately twice as likely to report thoracic pain (OR = 2.16[95% CI = 1.12-4.16]), wrist pain (OR = 3.28[95% CI = 1.18-9.07]), low back pain (OR = 3.09[95% CI = 1.29-7.41]), and ankle/foot pain (OR = 2.83[95% CI = 1.32-6.08]).

CONCLUSIONS

Teachers with poor sleep quality were approximately twice as likely to present pain in several body parts. Our findings revealed that poor sleep quality was significantly associated with musculoskeletal pain in Brazilian teachers of public schools, regardless of confounding factors.

Relationship between domains of physical activity and cardiac autonomic modulation in adults: a cross-sectional study

This study aimed to analyze the relationship of physical activity in different domains with cardiac autonomic modulation in adults. A sample of 252 adults was randomly selected, with mean age of 42.1 (± 16.5) years, being 58% of women. Cardiac autonomic modulation was assessed through indexes of heart rate variability in time (SDNN, RMSSD) and frequency (LF, HF) domains for linear method, and by Poincaré plot for non-linear method (SD1, SD2 components). Domains of PA (occupation, sport, leisure time/commuting, and total) were assessed by Baecke's questionnaire. Variables of age, gender, socioeconomic status (questionnaire) and body mass index (objectively measures) were covariates. Occupational PA was positively related to LF (β = 2.39, 95% CI 0.24; 4.54), sports PA was positively related to SDNN (β = 3.26, 95% CI 0.18; 7.05), RMSSD (β = 4.07, 95% CI 0.31; 7.85), and SD1 (β = 2.85, 95% CI 0.11; 5.81), and leisure time/commuting PA was positively related to SDNN (β = 3.36, 95% CI 0.28; 6.70) and RMSSD (β = 3.53, 95% CI 0.46; 7.52) indexes. Total PA was related to RMSSD (β = 1.70, 95% CI 0.04; 3.72). Sports, leisure time/commuting, and total PA were related to higher parasympathetic modulation, while occupational PA was related to higher sympathetic modulation to the heart in adults.

Sedentary behavior is more related with cardiovascular parameters in normal weight than overweight adolescents

This study analyzed the relationship between sedentary behavior and cardiovascular parameters in normal weight and overweight adolescents. The sample included 449 boys and 555 girls with mean age of 13 years from public schools, which were divided into five geographical regions, with data collections performed in one selected school from each region. Sedentary behavior was assessed by screen time on TV, computer, videogame and cell phone/tablet, with good reliability in adolescents. Physical activity was assessed by Baecke's questionnaire, validated for adolescents. Measures of body weight, height and waist circumference were collected. Adolescents were classified as overweight or normal weight by cut-off points of body mass index for age and sex. Cardiovascular parameters were evaluated by oscillometric device and heart rate by specific monitor. Computer use was positively related to systolic blood pressure (SBP) (β = 0.35; 95%CI = 0.07-0.62) and diastolic blood pressure (DBP) (β = 0.25; 95%CI = 0.05-0.44) in normal weight but not in overweight adolescents. Similar results were observed for cell phone/tablet in SBP (β = 0.46; 95%CI = 0.20-0.72) and DBP (β = 0.36; 95%CI = 0.18-0.54), only for normal weight. The cluster of screen time was related to SBP in normal weight (β = 0.44; 95%CI = 0.03-0.84) and overweight (β = 0.60; 95%CI = 0.01-1.19). Screen time in computer and cell phone/tablet was more related to cardiovascular parameters in normal weight than overweight adolescents.

Gender Analyses of Brazilian Parental Eating and Activity With Their Adolescents' Eating Habits

OBJECTIVE

To explore the associations between the eating habits of sons and daughters and the eating habits, sedentary behavior, and physical activity of their fathers and mothers.

DESIGN

A cross-sectional survey of adolescents.

SETTING

The 6 largest schools in Londrina, Brazil.

PARTICIPANTS

A total of 842 adolescents, 842 mothers, and 842 fathers participated in this study.

MAIN OUTCOMES MEASURES

Eating habits of adolescents and sedentary behavior, physical activity, and eating habits of their fathers and mothers, measured by questionnaire.

ANALYSIS

The associations were identified by binary logistic regression, adjusted by adolescent's age, family's socioeconomic status, parents' educational level, and the other parental behavior.

RESULTS

Independent of educational level and socioeconomic condition, mothers' eating behaviors seem to be more closely related to their adolescent children's eating behavior (vegetables, fruits, fried foods, soft drinks, and sweets [P = .001]) than fathers' behaviors (fried foods and sweets [P = .01], soft drinks [P = .001]). In addition, the behaviors of mothers were more associated to the behaviors of daughters than to the behaviors of sons (7 vs 5 associated behaviors), while behaviors of fathers were more associated with the behaviors of sons than to the behaviors of daughters (4 vs 2 associated behaviors). No associations were noted for sedentary and physical activity behavior and eating behaviors between adolescents and their parents.

CONCLUSIONS AND IMPLICATIONS

Many eating habits of adolescents were associated with eating habits of both fathers and mothers, emphasizing the importance of family-focused health promotion actions. Future research is needed incorporating into the analyses, among others, the nutritional statuses and the clustering of healthy and unhealthy behaviors of parents and their children.

Is physical activity associated with resting heart rate in boys and girls? A representative study controlled for confounders

OBJECTIVE

Investigate the relationship between different domains of physical activity and resting heart rate (RHR) in boys and girls.

METHOD

The sample included 1011 adolescents, aged between 10 and 17 years. RHR was measured by a heart rate monitor and physical activity was assessed in total and in three different domains (school, occupational, and sports practice) by a questionnaire. Anthropometry was directly obtained for body mass index and central fat. Ethnicity, sedentary behavior, and smoking habits were self-reported and used to adjust the analysis, through hierarchical linear regression.

RESULTS

Total physical activity was associated with low RHR in boys (β=-0.52; 95% CI: -0.92, -0.12) and girls (β=-0.67; 95% CI: -1.07, -0.28). Although sporting physical activities were associated with low RHR in both boys (β=-0.58; 95% CI: -1.05, -0.11) and girls (β=-0.87; 95% CI: -1.34, -0.39), occupational physical activity was related to low RHR only in boys (β=-1.56; 95% CI: -2.99, -0.14).

CONCLUSION

The practice of physical activity in the sport practice domain and total physical activity were related to low RHR in both sexes, while occupational physical activities were associated with RHR only in boys.

The relationship between physical activity intensity and domains with cardiac autonomic modulation in adults: An observational protocol study

INTRODUCTION

Cardiac autonomic modulation is an important marker of cardiovascular health and the practice of physical activity is a fundamental tool for good maintenance or increments in this marker. However, it is not clear in the literature whether different intensities and different domains of physical activity are related in the same way to cardiac autonomic modulation.

OBJECTIVES

This randomized epidemiologic study will examine the relationship between cardiac autonomic modulation and different intensities and domains of physical activity in a representative sample of adults.

METHODS

The sample of study will consist of 252 subjects aged from 18 years and above. The sample will be randomized through census sectors in which the neighborhoods, streets, and houses will also be randomized. Cardiac autonomic modulation will be assessed by heart rate variability and the intensity (mild, moderate, intense) of physical activity will be evaluated by means of accelerometers, while the different domains of physical activity (physical activity at work, occupational activities) will be evaluated through a questionnaire. The relationship between cardiac autonomic modulation and different physical activity intensities, as well as the different domains will be analyzed by linear regression, considering a statistical significance of 5% and a 95% confidence interval. This research protocol is registered in ClinicalTrials.gov at number NCT03986879.

Effects of active video games on children and adolescents: A systematic review with meta-analysis

OBJECTIVE

To investigate the effectiveness of active video games (AVGs) on obesity-related outcomes and physical activity levels in children and adolescents.

DESIGN

Systematic review with meta-analysis.

METHODS

Literature search was performed in five electronic databases and the main clinical trials registries. Randomized controlled trials investigating the effect of AVGs compared with no/minimal intervention on obesity-related outcomes (body mass index [BMI], body weight, body fat, and waist circumference) and physical activity levels of children and adolescents were eligible. Two independent reviewers extracted the data of each included study. PEDro scale was used to assess risk of bias and GRADE approach to evaluate overall quality of evidence. Pooled estimates were obtained using random effect models.

RESULTS

Twelve studies were considered eligible for this review. Included studies mostly reported outcome data at short-term (less or equal than three months) and intermediate-term follow-up (more than 3 months, but <12 months). AVGs were more effective than no/minimal intervention in reducing BMI/zBMI at short-term (SMD = -0.34; 95% CI: -0.62 to -0.05) and intermediate-term follow-up (SMD = -0.36; 95% CI: -0.01 to -0.71). In addition, AVGs were more effective in reducing body weight compared with no/minimal intervention at intermediate-term follow-up (SMD = -0.25; 95% CI: -0.46 to -0.04). Regarding physical activity levels, AVGs were not more effective compared with minimal intervention at short-term and intermediate-term follow-up.

CONCLUSIONS

Our review identified that AVGs were better than minimal intervention in reducing BMI and body weight, but not for increasing physical activity in young people.

Physical activity levels are associated with regional bone mineral density in boys

Background: Youth is a crucial period for bone gain, and physical activity (PA) has shown to increase bone mineral density (BMD) in this period. However, whether PA affects regional BMD is unclear. Thus, the aim of this study was to analyze the relationship between PA levels and regional BMD in youths. Methods: The sample included 110 children and adolescents aged 6-14 years. Body mass, height, sitting trunk length, and leg length were obtained for body mass index and maturity offset calculation. The arms, pelvis, spine, trunk, and legs BMD were measured by double energy X-ray absorptiometry. The PA was evaluated by questionnaire, and youths were classified as low, moderately, or highly physically active. Results: The sample included 63.7% boys and 36.3% girls with mean age of sample 9.5 (±1.6) yrs. Age, body mass index, and maturity offset were similar between sexes (p > 0.05). Boys with low PA levels had lower BMD Z-score for arms (-0.20 ± 0.71 vs. 0.30 ± 1.19, p = 0.006) and legs (-0.14 ± 1.00 vs. 0.35 ± 1.06, p = 0.026) compared to highly physically active youths. Multiple linear regression showed a positive linear relationship between legs BMD and PA in boys (β = 0.72 [95% CI = 0.09; 1.36]). Conclusion: In boys, low PA levels are associated with lower BMD in arms and legs.

Analysis of different anthropometric indicators in the detection of high blood pressure in school adolescents: a cross-sectional study with 8295 adolescents

•

Overweight adolescents classified in any of three anthropometric indices have more HBP.

•

The sensitivity of the indicators was low and the specificity was high in detecting HBP.

•

Parents must be aware that high BMI, WC or WTHR are highly associated with HBP.

Background

High blood pressure is strongly associated with obesity in different populations. However, it is unclear whether different anthropometric indicators of obesity can satisfactorily predict high blood pressure in the school setting.

Objectives

This study evaluated the sensitivity and specificity of body mass index, waist circumference, and waist to height ratio in the detection of high blood pressure in adolescents.

Methods

The sample consisted of 8295 adolescents aged 10–17 years. Weight was measured using a digital scale, height with a stadiometer, and waist circumference using a tape measure. Blood pressure was measured by an automatic blood pressure measuring device. ROC curves were used for the analysis of sensitivity and specificity of the three anthropometric indices in identifying high blood pressure. Binary Logistic Regression was used to assess the association of body mass index, waist circumference, and waist to height ratio with high blood pressure.

Results

Low values of sensitivity were observed for body mass index (0.35), waist circumference (0.37), and waist to height ratio (0.31) and high values of specificity for body mass index (0.86), waist circumference (0.82), and waist to height ratio (0.83) in the detection of high blood pressure. An association was observed between adolescents classified with high body mass index (OR = 3.57 [95% CI = 3.10–4.10]), waist cirumference (OR = 3.24 [95% CI = 2.83–3.72]), and waist to height ratio (OR = 2.94 [95% CI = 2.54–3.40]) with high blood pressure.

Conclusions

Body mass index, waist circumference, and waist to height ratio presented low sensitivity to identify adolescents with high blood pressure. However, adolescents classified with high body mass index, waist circumference, and waist to height ratio demonstrated a high association of presenting high blood pressure.

Screen time by different devices in adolescents: association with physical inactivity domains and eating habits

BACKGROUND

Sedentary behaviors in adolescents are associated with using screen devices, analyzed as the total daily time in television viewing, using the computer and video game. However, an independent and clustered analysis of devices allows greater understanding of associations with physical inactivity domains and eating habits in adolescents.

METHODS

Sample of adolescents aged 10-17 years (N.=1011) from public and private schools, randomly selected. The use of screen devices was measured by hours per week spent in each device: TV, computer, videogames and mobile phone/tablet. Physical inactivity domains (school, leisure and sports), eating habits (weekly food consumption frequency) and socioeconomic status were assessed by questionnaire.

RESULTS

The prevalence of high use of mobile phone/tablet was 70% among adolescents, 63% showed high use of TV or computer and 24% reported high use of videogames. High use of videogames was greater among boys and high use of mobile phone/tablet was higher among girls. Significant associations of high use of TV (OR=1.43, 95% CI: 1.04-1.99), computer (OR=1.44, 95% CI: 1.03-2.02), videogames (OR=1.65, 95% CI: 1.13-2.69) and consumption of snacks were observed. High use of computer was associated with fried foods consumption (OR=1.32, 95% CI: 1.01-1.75) and physical inactivity (OR=1.41, 95% CI: 1.03-1.95). Mobile phone was associated with consumption of sweets (OR=1.33, 95% CI: 1.00-1.80). Cluster using screen devices showed associations with high consumption of snacks, fried foods and sweets, even after controlling for confounding variables.

CONCLUSIONS

The high use of screen devices was associated with high consumption of snacks, fried foods, sweets and physical inactivity in adolescents.