Research article
Patterns and Correlates of Physical Activity and Nutrition Behaviors in Adolescents

https://doi.org/10.1016/j.amepre.2006.10.012Get rights and content

Background

Knowledge of the prevalence, clustering, and correlates of multiple adolescent health behaviors can inform the design of health promotion interventions.

Methods

A cross-sectional design was used to assess 878 adolescents aged 11 to 15 years (53.6% girls, 58% non-Hispanic white) recruited in primary care clinics in 2001–2002. Adolescent physical activity (assessed with accelerometers), television viewing time (reported), percent calories from fat, and servings of fruits and vegetables (assessed with multiple 24-hour recalls) were dichotomized into meeting or not meeting national guidelines. Parent health behaviors were assessed with self-reported measures. Analyses were conducted in 2006.

Results

Fifty-five percent of adolescents did not meet the physical activity guideline, and 30% exceeded 2 hours daily of television viewing time, with boys more active and less sedentary than girls (p <0.01). The majority of the adolescents did not meet dietary guidelines. Nearly 80% had multiple risk behaviors and only 2% met all four guidelines. The number of risk behaviors was associated with being older and being at risk for overweight or being overweight, for boys and girls (p <0.05). Two parent health behaviors—history of smoking and failure to meet the fruits and vegetables guideline—were significantly associated with a higher number of risk behaviors for girls (p <0.05).

Conclusions

Eight of ten adolescents in this sample failed to meet guidelines for two or more diet, physical activity, and sedentary risk behaviors. Some parent health behaviors, along with the adolescent’s weight status and age, were associated with a higher number of adolescent health risk behaviors.

Introduction

Modifiable physical activity and sedentary and diet behaviors are associated with morbidity and mortality, and improving these behaviors in all populations, including among adolescents, is a national health priority. Expert groups have recommended 60 minutes per day of moderate to vigorous physical activity for youth,1, 2 yet data based on objective measures suggest that only 30% of teenagers meet this guideline.3 Television watching is the dominant sedentary behavior in adolescents,4 and it is estimated that 57% adolescents view television for less than 2 hours a day.5

The Centers for Disease Control and Prevention (CDC) estimates that only 15% of adolescents aged 12 to 19 years meet the recommendation for total fat intake (less than 30% of total energy), and 7% of adolescents meet the recommendation for saturated fat intake (less than 10% of total energy).3, 5 Data from the CDC’s 2003 Youth Risk Behavior Survey indicated that fewer than 22% of high school students consumed the recommended five or more servings per day of fruits and vegetables.6 Meeting public health recommendations for these four health risk behaviors is expected to improve quality of life and to reduce considerably the incidence of obesity and several chronic diseases.2, 7, 8, 9

Despite extensive evidence about the high prevalence of risk behaviors, little is known about the relationship among these behaviors, such as their clustering patterns, especially in adolescents.10 There is some evidence that diet and physical activity behaviors tend to cluster in individuals.10, 11, 12 Improved understanding of behavioral clustering could inform strategies for multiple risk factor interventions. Identifying characteristics of adolescents most likely to have multiple risk behaviors could lead to more targeted intervention strategies.

The aims of the present study were to (1) describe the prevalence and clustering patterns of four adolescent health behaviors (physical activity, TV viewing time, fruit and vegetable consumption, dietary fat intake); and (2) examine the sociodemographic, behavioral, and parent health behavior correlates of the number of health risk behaviors. These aims were considered exploratory and primarily hypothesis generating, with the goal of identifying patterns and relationships that can inform further research and suggest possible intervention strategies.

Section snippets

Participants

Adolescents aged 11 to 15 years were recruited through their primary care providers as part of a health promotion intervention trial.13 A total of 45 primary care providers from six clinic sites in San Diego County agreed to participate in the study. The goal was to recruit an ethnically representative sample of adolescents seeing primary care providers in San Diego County. All study procedures were approved by university and clinic institutional review boards. Recruitment occurred between May

Demographic Characteristics by Gender

Table 1 displays the demographic, behavioral, and anthropometric characteristics of the participants. The mean age of the sample was 12.7 (SD=1.3) years, with 42% of the participants from racial/ethnic minority backgrounds. Although not fully representative of the San Diego community (see San Diego Association of Governments, www.sandag.org, March 7, 2003), in which those aged 10 to 17 are 35% Hispanic (13% in the study sample), 7% African American, 12% Asian or other (3% in the study sample),

Discussion

Nearly 80% of sampled adolescents had multiple physical activity and dietary risk behaviors, and almost half had at least three risk behaviors. Only 2% met all four of the health guidelines. These findings clearly demonstrate the need for effective interventions to help adolescents improve multiple risk behaviors.

Of the individual risk behaviors, adolescents were least likely to meet the fruit and vegetable guidelines; only 12% met this guideline, which is 10 percentage points lower than what

References (31)

  • N. Cavill et al.

    Health enhancing physical activity for young people: Statement of the United Kingdom expert consensus conference

    Pediatr Exerc Sci

    (2001)
  • Youth risk behavior surveillance—United States, 1999

    Morb Mortal Wkly Rep

    (2000)
  • Generation M: media in the lives of 8–18-year-olds

    (2005)
  • Healthy people 2010: understanding and improving health

    (2000)
  • J.A. Grunbaum et al.

    Youth risk behavior surveillance—United States, 2003

    MMWR Morb Mortal Wkly Rep

    (2004)
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    1

    AS was a fellow at the University of California-San Diego, affiliated with the Basque Country Health Department, Vitoria, Spain.

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