Leisure‐Time Sedentary Behavior and Obesity Among 116,762 Adolescents Aged 12‐15 Years from 41 Low‐ and Middle‐Income Countries

Abstract

Objective Rates of adolescent obesity are increasing worldwide, with steeper increases being observed in low‐ and middle‐income countries (LMICs). Sedentary behavior (SB) has been associated with various physical and mental health conditions. Little is known about the association between SB and obesity among adolescents in LMICs. This cross‐sectional study explored the associations between SB and obesity in adolescents from 41 LMICs. Methods Obesity was measured using BMI; SB was assessed through self‐report and was considered for all times except when subjects were at school or doing homework. Results Data from the Global School‐based Student Health Survey were analyzed in 116,762 adolescents (mean [SD] age 13.8 [1.0] years; 48.6% female). The overall prevalence of obesity was 4%, and the prevalence of ≥ 3 h/d of SB was 26%. The prevalence of obesity and SB were lowest in low‐income countries and highest in upper‐middle‐income countries. SB for ≥ 3 h/d was associated with higher odds of obesity in 32 countries. This relationship was strongest among low‐income countries. Conclusions Being sedentary for ≥ 3 h/d is associated with increased odds of obesity in adolescence. Future longitudinal data are required to confirm these findings and to inform interventions targeting SB among adolescents in LMICs, thereby reducing the prevalence of obesity.

Temporal trends in leisure-time sedentary behavior among adolescents aged 12-15 years from 26 countries in Asia, Africa, and the Americas

“…This excluded time at school and when doing homework. In accordance with previous research showing that engaging in sedentary behavior for ≥3 h/day is associated with significant health risks [ 5 , 24 – 28 ], the variable was dichotomized as ≥3 h/day (high LTSB) or not.…”

Parental and Peer Support are Associated with Physical Activity in Adolescents: Evidence from 74 Countries

“…with response options being 'never', 'rarely', 'sometimes', 'most of the time', and 'always'. This food insecurity variable was used as a proxy of socioeconomic status [23,24] as the GSHS did not include any direct measure of socioeconomic status. Trained survey staff measured participants' height and weight [23].…”

“…This food insecurity variable was used as a proxy of socioeconomic status [23,24] as the GSHS did not include any direct measure of socioeconomic status. Trained survey staff measured participants' height and weight [23]. Body mass index (BMI) was categorised as underweight (BMI <−2 Standard Deviation [SD]), overweight (BMI > +1SD), and obese (BMI > +2SD), relative to median BMI, by age and gender based on the WHO Child Growth Standards [21].…”

Correlates of leisure-time sedentary behavior among 181,793 adolescents aged 12-15 years from 66 low- and middle-income countries

“…Multinational studies allow exploration of sedentary behavior correlates irrespective of national policies and available facilities, and at the same time allow comparison between countries in order to investigate the role of these policies and available facilities in different countries. Previous multinational studies in adolescents from LMICs have shown that sedentary behavior is associated with obesity [16], depression [17], loneliness [18], and fast food and carbonated soft drink consumption [19]. However, there is limited information on other important correlates from a global perspective.…”