The Association Between Physical Activity, Diet, Television/Video Viewing, Computer Use, And Weight Status Among U.S. Adolescents

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Public Health and Policy


Doctor of Public Health

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Overweight among children and adolescents is a significant public health problem in the United States. Epidemiologic studies must scale up efforts to assess risk factors of overweight, by improving measurement and methodological analyses in order to frame and refine overweight prevention policies and programs. The objectives of this study were to determine the relative contribution of physical activity, dietary factors, television/video viewing, and computer use to weight status among adolescents, as well as to determine if the association between physical activity and weight status differs by gender or race. Secondary analyses of the nationally representative NHANES (2003-2006) cross-sectional surveys were conducted among 2, 136 U.S. adolescents. The dependent variable was weight status, categorized as: normal, at-risk for overweight, and overweight; the main independent variables were moderate-to-vigorous physical activity, dietary intake (total energy intake, total fat intake, fiber intake), daily hours of television/video viewing, and daily hours of computer use. Multivariate statistical analyses were conducted using multinomial logistic regression models to obtain odds ratios and 95% confidence intervals. Gender and race were also analyzed as potential effect modifiers on the relationship between physical activity and weight status, by modeling multiplicative interaction terms, testing for departure from homogeneity of the point estimates between categories of the effect modifiers. After controlling for confounders, television/video viewing was significantly associated with both at-risk for overweight (OR=1.57, 95% C.I=0.94, 2.63) and overweight (OR = 1.84, 95% C.I. = 1.24, 2.69), meanwhile television/video viewing (OR = 1.84, 95% C.I. = 1.24, 2.69), physical activity (OR=0.75, 95% C.I = 0.59, 0.95), and fiber intake (OR = 0.96; 95% C.I = 0.92, 1.00), were significantly associated only with overweight. Television/video viewing was found to be an important factor associated with overweight, in addition to physical activity, and fiber intake. The results support previous findings showing television viewing as a determinant of overweight among adolescents. Increased television/video viewing may reduce time spent in physical activity, exposure to high energy dense food advertising, and increased food intake. The findings do not support a multiplicative interaction effect of gender or race, suggesting universal overweight prevention policies and programs should be delivered.