Association of physical activity, sedentary behavior, diet quality with adiposity: a longitudinal analysis in children categorized by baseline weight status

Associations of Academic Study- and Non-Study-Related Sedentary Behaviors with Incident Obesity in Children and Adolescents

Objective: To assess the associations between academic study- and non-study-related sedentary behaviors and the risk of overweight/obesity in children and adolescents, as well as their joint association with sugar-sweetened beverage (SSB) consumption. Methods: Sedentary behaviors and SSB consumption were assessed using self-reported questionnaires. Overweight/obesity were defined by age- and sex-specific body mass index cut-off values according to the criteria of "Screening for overweight and obesity among school-age children and adolescents" in China. Poisson regression with robust error variance was used to assess the associations of sedentary behaviors and/or SSB consumption with the risk of overweight/obesity, yielding relative risks (RRs) and 95% confidence intervals (CIs). The Shapley additive explanations (SHAP) method was used to rank the contribution of five specific sedentary behaviors to obesity risk. Results: Among 47,148 participants with a 3-year follow-up, longer durations of screen-related, academic study-related, and total sedentary time were each associated with a higher risk of overweight/obesity (adjusted RR (95% CI) per hour increment: 1.01 (1.00-1.02), 1.03 (1.01-1.06), and 1.02 (1.01-1.03)). After mutual adjustment, the associations of engaging in homework, attending tutorial classes, and using mobile electronic devices remained significantly associated with higher overweight/obesity risk. The SHAP summary plot shows that using mobile electronic devices, attending tutorial classes, and doing homework were the three most important sedentary obesogenic contributors. A significant interaction of age with sedentary time was found (p for interaction < 0.05). No significant interaction was found between SSB consumption and sedentary time. Conclusions: Excessive sedentary behaviors were associated with a higher risk of overweight/obesity, particularly due to mobile electronic device use, attending tutorial classes, and doing homework.

Associations of behavioral, motivational, and socioeconomic factors with BMI among children and adolescents

BACKGROUND

Higher weight represents a significant health concern in youth and may be influenced by socioeconomic and behavioral factors. We investigated the relationship between BMI and parental education, nutritional health, eating culture, organized and non-organized physical activity (PA), motives for PA (weight loss/maintenance, enjoyment), and screen-time in children and adolescents.

METHODS

677 2- to 11-year-olds (young-age-group) and 464 12- to 20-year-olds (old-age-group) from Leipzig, a city in Germany, participated. We applied multivariate linear regression analyses to assess associations.

RESULTS

BMI-SDS was negatively associated with parental education (young-age-group: b = -0.25, p < 0.001, old-age-group: b = -0.27, p = 0.02), non-organized PA (young-age-group: b = -0.23, p = 0.029), and PA enjoyment (young-age-group: b = -0.05, p = 0.01, old-age-group: b = -0.05, p = 0.038), but negatively with media use during dinner (old-age-group: b = 0.53, p < 0.001), PA for weight loss/maintenance (young-age-group: b = 0.15, p < 0.001, old-age-group: b = 0.12, p < 0.001), and screen-time (young-age-group: b = 0.11, p = 0.009, old-age-group: b = 0.09, p = 0.001). Significant interactions with age, sex and parental education were observed.

CONCLUSION

A lower BMI in children is associated with high parental education, screen-free eating, higher participation in non-organized PA and lower screen-time. While measures of motivation were limited and thus findings should be interpreted with caution, intrinsic motivation for PA is associated with lower BMI whereas extrinsic motivation for PA is associated with higher BMI.

IMPACT

In a German cohort of children and adolescents, lower BMI is associated with high parental education, less screen time, more participation in non-organized physical activity and less media use during dinner. Intrinsic and extrinsic motives for physical activity are directly linked to the weight status of children and adolescents. These associations are particularly strong in families with low/medium formal education.

Eating in the Absence of Hunger Is a Stable Predictor of Adiposity Gains in Middle Childhood

BACKGROUND

Eating in the absence of hunger (EAH) is a behavioral phenotype of pediatric obesity characterized by the consumption of palatable foods beyond hunger. Studies in children have identified EAH to be stable over time, but findings are unclear on whether it predicts the development of adiposity, particularly in middle childhood, a period of increased autonomy over food choices.

OBJECTIVES

We hypothesized that EAH would remain stable and be associated with increased adiposity over a ≥1-y prospective study in 7-8-y old children without obesity. Secondary hypotheses tested whether physical activity moderated the impact of EAH on adiposity.

METHODS

Children (n =72, age 7.8 ± 0.6 y; BMI% <90th), in a 7-visit longitudinal study, had EAH, adiposity, and physical activity assessed at baseline (time 1 - T1) and follow-up (time 2 - T2). EAH was determined by measuring children's intake from 9 energy-dense (>3.9 kcal/g) sweet and savory foods during a 10-min access period after intake of a standard meal eaten to satiation. Adiposity was measured by dual-energy X-ray absorptiometry (DXA), with an outcome of fat mass index (FMI; fat mass/height in m2). Seven days of wrist-worn Actigraphy quantified moderate-to-vigorous-physical activity (MVPA) and sedentary time.

RESULTS

EAH had moderate stability across time points (ICC = 0.54). ICCs were stronger for sweet (ICC = 0.53) than savory (ICC = 0.38) foods. Linear regression predicting 1-y change in FMI (adjusted for income, parent education, sex, time to follow-up, T2 Tanner stage, maternal weight status, and baseline adiposity) found that both total and sweet food EAH at baseline predicted increases in adiposity (P < 0.05 for both). EAH and adiposity were negatively correlated among children with high MVPA and low sedentary time.

CONCLUSIONS

These findings show that EAH is a stable predictive phenotype of increases in adiposity over 1 y among youth in middle childhood, although activity-related behaviors may moderate this effect. If replicated, targeting EAH as part of interventions may prevent excess adiposity gain.

TRIAL REGISTRATION NUMBER

The data was obtained from the Food and Brain study with registration number: NCT03341247.

Nuts and seeds consumption impact on adolescent obesity: sex-specific associations from 2003 to 2018 National Health and Nutrition Examination Survey

The nutritional benefits and immunological advantages of consuming nuts and seeds are well-established. However, the link between nuts and seeds consumption and the susceptibility of being overweight or obese among adolescents is not clear. This study aims to explore this relationship in adolescents aged 12-19. Using a weighted multiple logistic regression model, we analysed data of the Food Patterns Equivalents Database and the U.S. National Health and Nutrition Examination Survey (NHANES) from 2003 to 2018. We found a significant association between nuts and seeds consumption and a reduced odds of being overweight or obese in females. Specifically, females who habitually consumed nuts and seeds had lower odds of being overweight or obese (OR = 0.55, 95% CI: 0.32-0.94). Additionally, we found an L-shaped relationship between nuts and seeds consumption and appropriate waist-to-height ratio in males. The findings suggest that nuts and seeds consumption may contribute to healthier physical development in adolescents.

Mediating role of physical activity levels on physical fitness in overweight and obese children when Body Mass Index is not a determining factor

Background and Study Aim. Physical fitness is a crucial health indicator in children and adolescents. Despite the global rise in overweight and obesity, the impact of Body Mass Index (BMI) on physical fitness remains unclear. This cross-sectional study aims to investigate: (R1) the differences in physical fitness components and physical activity levels among children according to gender and BMI, and (R2) the mediating role of physical activity in the relationship between BMI and physical fitness components. Material and Methods. The sample was made of 180 students aged 11-14 years (n=90 – male; n=90 - female) divided according to BMI cutoff in normal weight, overweight and obese. Physical fitness components were assessed with several tests: Standing Long Jump (SLJ), Medicine Ball Throw 2Kg (MBT), Shuttle Run 10x5m (10x5), and One Mile Walk Test. Physical activity levels were evaluated with a self-reported questionnaire. A two-way factorial MANOVA was conducted to assess the effects of gender and BMI on physical fitness. Additionally, a mediation analysis was performed to explore the effect of physical activity on the relationship between BMI and physical fitness. Results. Results revealed significant differences in the Standing Long Jump (SLJ), 10x5 Shuttle Run, One Mile Walk Test, and physical activity levels, with moderate to large effect sizes observed. Males demonstrated higher levels of physical fitness and physical activity levels (PAL) compared to females. Individuals of normal weight were generally more active and stronger than their overweight and obese peers. Mediation analysis revealed that physical activity completely mediates the relationship between BMI and physical fitness components. Conclusions. Results from the present study suggest that the development of physical fitness is not solely determined by BMI, but also depends on the daily practice of physical activity. Future research is needed to assess the effect of physical activity in mediating and moderating the relationship between obesity and physical fitness.