Combinations of physical activity and screen time recommendations and their association with overweight/obesity in adolescents.

Objectives

To examine the four possible combinations of adherence to physical activity and screen time recommendations in adolescents and how the combinations relate to overweight and obesity.

Methods

A total of 9913 students in grades 7–12 were included in the present cross-sectional analyses. Moderate-to-vigorous physical activity (MVPA), screen time, and body mass index were self-reported. Multivariate logistic regression analysis was used to test the associations between combinations of MVPA (≥ 60 min/day [active] or < 60 min/day [inactive]) and screen time (≤ 2 h/day [not sedentary] or > 2 h/day [sedentary]) recommendations with overweight/obesity.

Results

We found that 53.1% of students in Ontario were considered “inactive+sedentary”, 23.7% were considered “inactive+not sedentary”, 12.1% were considered “active+sedentary”, and 11.1% were considered “active+not sedentary”. Some characteristics of “active+not sedentary” students (optimal category) included younger age, male gender, white ethnicity, higher socio-economic status, optimal sleep duration, and lower prevalence of cannabis use. After adjusting for relevant covariates, the “inactive+sedentary” group was more likely to report overweight/obesity than the “active+not sedentary” group (odds ratio [OR] = 1.71, 95% confidence interval [CI] = 1.26–2.32). The “inactive+not sedentary” group was also more likely to report overweight/obesity (OR = 1.54, 95% CI 1.20–1.97) while the “active+sedentary” group was not significantly associated with overweight/obesity (OR = 1.27, 95% CI 0.88–1.83).

Conclusion

Children meeting both the physical activity and screen time recommendations are less likely to be classified as overweight/obese compared with any other combination. Future efforts are needed to target both MVPA and sedentary behaviour to address public health concerns such as excess weight.