Dietary and Physical Activity Behaviors in 2021 and Changes from 2019 to 2021 Among High School Students — Youth Risk Behavior Survey, United States, 2021

Abstract

The fall of 2021 was the first school semester to begin with widespread in-person learning since the COVID-19 pandemic began. Understanding dietary and physical activity behaviors of adolescents during this time can provide insight into potential health equity gaps and programmatic needs in schools and communities. This report uses data from the 2021 national Youth Risk Behavior Survey conducted among a nationally representative sample of U.S. public and private school students in grades 9–12 to update estimates of dietary and physical activity behaviors among U.S. high school students overall and by sex and race and ethnicity. In addition, 2-year comparisons (2019 versus 2021) of these behaviors were examined. In 2021, daily consumption of fruits, vegetables, and breakfast during the past 7 days remained low and decreased overall with specific disparities by sex and race and ethnicity from 2019 to 2021. The overall prevalence of students attending physical education classes daily, exercising to strengthen muscles on ≥3 days/week (i.e., met the guideline for muscle-strengthening activity), and playing on at least one sports team decreased from 2019 to 2021; whereas being physically active for ≥60 minutes/day on all 7 days (i.e., met the guideline for aerobic activity) and meeting both aerobic and muscle-strengthening guidelines remained low but did not change. These findings underscore the need for strategies to increase healthy dietary and physical activity behaviors both in the recovery phase of COVID-19 and longer term.

Association Between Frequency of Muscle-Strengthening Exercise and Depression Symptoms Among Middle and High School Students: Cross-Sectional Survey Study

“…In this study, the overall prevalence of meeting MSE recommendations was 34.6%, much lower than in other studies performed in high-income countries and a previous study conducted in China. For instance, one nationally representative survey conducted in 2021 among 17,232 US students reported that 44.9% of high school students exercised ≥3 days/week to strengthen or tone their muscles [ 10 ]. Another study conducted in 2013 and 2014 of 35,297 grade 9-12 Canadian students reported that 53.7% of students performed MSE ≥3 days per week [ 11 ].…”

“…The frequency of engaging in MSE was evaluated through the question “During the past 7 days, on how many days did you do exercises to strengthen or tone your muscles, such as push-ups, sit-ups, or weight lifting?” Response options included “none,” “1 day,” “2 days,” “3 days,” “4 days,” “5 days,” “6 days,” and “7 days.” This item, with an acceptable reliability for children and adolescents (κ coefficient >0.55) [ 36 ], has been widely used for health behavior surveillance worldwide [ 10 , 11 ]. Meeting MSE recommendations was defined as engaging in MSE at least 3 days in the past 7 days, which is in accordance with World Health Organization (WHO) guidelines [ 6 ].…”

“…Prevalence rates for meeting MSE recommendations (ie, engaging in MSE ≥3 days/week) among adolescents vary across countries and regions, as do secular trends. For instance, the prevalence rate of adhering to MSE guidelines is 44.9% in the United States [ 10 ], 53.7% in Canada [ 11 ], and 39.3% in China [ 12 ]. The prevalence in US adolescents decreased from 55.6% in 2011 to 49.5% in 2019 [ 13 ], while among Korean adolescents it slightly increased from 20.1% in 2009 to 21.9% in 2019 [ 14 ].…”

Intervention to increase physical activity and healthy eating among under-represented adolescents: GOAL trial protocol

“…Open access drink 100% fruit juice <1 time/day and 14.7% drink sugar-sweetened soda/pop ≥1 time/day. 5 Further augmenting the risk among adolescents, pubertal changes occur in the years immediately preceding high school that can contribute to insulin resistance. 6 This information indicates that health-promoting interventions are needed before high school (ie, ages 10-13 years) so that young adolescents can begin to establish healthy behaviours to reduce their risk for adverse outcomes.…”

“…Contributing to the obesity problem and increasing the risk for chronic conditions, 76.1% of high school students do not attain the recommended ≥60 minutes/day of physical activity (PA), 75.0% do not eat breakfast daily, 45.3% eat vegetables <1 time/day, 47.1% eat fruit or drink 100% fruit juice <1 time/day and 14.7% drink sugar-sweetened soda/pop ≥1 time/day. 5 Further augmenting the risk among adolescents, pubertal changes occur in the years immediately preceding high school that can contribute to insulin resistance. 6 This information indicates that health-promoting interventions are needed before high school (ie, ages 10–13 years) so that young adolescents can begin to establish healthy behaviours to reduce their risk for adverse outcomes.…”