Elsevier

Public Health

Volume 119, Issue 6, June 2005, Pages 518-524
Public Health

Sedentary behaviour, physical activity and weight problems in adolescents in Wales

https://doi.org/10.1016/j.puhe.2004.10.011Get rights and content

Summary

Objective

We studied the prevalence and stability of overweight and obesity in a cohort of adolescents, and the effects of sedentary behaviour and physical activity on changes in body mass. The study also examined the extent to which physical activity mediated the relationship between sedentary behaviour and body mass.

Design

Four-year cohort study.

Methods

The study was part of the Health Behaviour of School-aged Children Study that took place in Wales between 1994 and 1998. Body height and weight measurements and self-report data on sedentary behaviour, physical activity and psychosocial adjustment were collected from 355 adolescents on two occasions 4 years apart. The mean age of the sample at baseline was 12.30 (SD=6.30) years.

Results

Weight conditions (underweight, overweight and obesity) and body mass were moderately stable over the interval. Regression analyses showed that sedentary behaviour at Time 1 predicted body mass at Time 2, while physical activity predicted a change in body mass over time. The influence of sedentary behaviour on body mass was not found to be mediated by physical activity. However, weight problems in Year 7 coincided with getting bullied, bullying others, and feeling left out of things. Obesity was also related to snacking and skipping breakfast.

Conclusions

Sedentary behaviour and physical activity in early adolescence both influenced body mass in late adolescence. Results indicated that promoting healthy diets and physical activities may have long-term health benefits for young people.

Introduction

Increasing rates of overweight and obesity among children is a global public health concern.1 In a number of developed countries, the proportion of children in the general population who are overweight has doubled over the past two decades.2, 3 Childhood obesity increases the risk of adult obesity as well as chronic health problems such as type II diabetes, hypertension and cardiovascular disease.4, 5 Additionally, obese children tend to complete fewer years of education and earn a lower household income as adults, independent of their families' socio-economic status.6 Understanding the social and behavioural contributors to weight problems in adolescents is an ongoing research priority.

Diet and lifestyle are ostensibly major contributors to weight problems.7 Irregular food intake, particularly breakfast skipping, tends to be more common among overweight and obese adolescents than among normal-weight adolescents.8 Popular sedentary activities, such as watching television, have also been implicated in childhood obesity because they reduce resting metabolism, displace physical activity and expose children to food advertisements.9, 10 Several studies have shown that watching television is negatively correlated with physical activity and positively correlated with body mass.11, 12, 13 For example, a study in China found that the prevalence rates of obesity among children who watch television for less than 1, 1–2, and 2–3 h and more than 3 h/day were 10.9, 11.8, 13.2 and 15.1%, respectively.14

While it seems intuitive that the influence of sedentary behaviour on weight problems can be attributed to a reduction of physical activity, the cross-sectional nature of previous research precludes a strong conclusion about this mediation.13 As physical activities for young people are often structured group activities, the negative social consequences of weight problems may perpetuate a transactional influence on sedentary activities and gains in body mass. Indeed, childhood obesity relates to bullying,15 exclusion from peer groups,16 and feelings of low self-esteem, negative body image and difficult social mobility.17, 18, 19 One study found that teasing about body weight contributed to adolescents' body dissatisfaction, low self-esteem, depressive symptoms and suicidal ideation even after controlling for actual body weight.15 Therefore, changes in sedentary behaviour and physical activity could be both antecedents and consequences of weight problems.

Using data from a 4-year community cohort, the present study had four objectives: (1) to describe the prevalence and stability of weight conditions from early to late adolescence; (2) to identify behavioural and social factors that co-occur with weight problems; (3) to study whether sedentary behaviour and physical activity are predictive of body mass and change in body mass from early to late adolescence; and (4) to determine the extent to which physical activity mediates a relationship between sedentary behaviour in early adolescence and body size in late adolescence.

Section snippets

Participants

Data were obtained from a cohort of Welsh adolescents who participated in the 1994 and 1998 Health Behaviour of School-aged Children (HBSC) study, a multinational study that was conducted with the collaboration of the World Health Organization. Participants were part of a cluster sample of 57 schools that, in 1994, reflected a representative distribution of schools in Wales.20 Twenty-three of these 57 schools were randomly selected to participate in a longitudinal study in which measured height

Results

Participants' height, weight and BMI are shown in Table 1. In Year 7, females were slightly taller, F(1, 637)=6.35, P=0.012, and heavier, F(1, 636)=8.44, P=0.004, than males. By Year 11, males were taller, F(1, 348)=222.28, P<0.001, and heavier, F(1, 342)=24.57, P<0.001, than females.

Table 2 shows rates of underweight, overweight and obesity in Year 7 and Year 11. No sex or age differences were found in the prevalence rates of weight conditions and there were no significant changes in the

Discussion

The first and second objectives of the study were to study the prevalence and stability of weight problems from early to late adolescence and to identify behavioural and social factors that co-occur with weight problems. The prevalence of overweight and obesity were within the expected range for British adolescents,2 and social and behavioural differences between underweight, normal-weight, overweight and obese adolescents were also consistent with previous studies.15 In Year 7, obese

Acknowledgements

L. Moore was supported by a Public Health Career Scientist Award funded by the Welsh Assembly Government.

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