Dataset Information

Clustering of diet, physical activity and sedentary behavior among Brazilian adolescents in the national school - based health survey (PeNSE 2015).

ABSTRACT:

Background

There is a lack of evidence regarding clusters of health-related behaviors among adolescents from low, lower-middle, and upper-middle income countries. This study aimed to identify clustering patterns of health-related behaviors (diet, physical activity [PA] and sedentary behavior [SB]) and association with sociodemographic variables among a population-based sample of Brazilian adolescents.

Methods

Cross-sectional data from the 2015 National School-Based Health Survey (PeNSE). A total of 102,072 (females: 51.7%) students in ninth-grade (age: 14.3 ± 1.1 years-old) enrolled in public and private schools were investigated in this study. Healthy and unhealthy diet, PA and SB were measured using a validated questionnaire. Two-step cluster analysis was conducted to identify lifestyle patterns. The methodology for complex analysis and weighting was used to inferential statistical procedures. Multinomial logistic regression assessed associations between sociodemographic factors and the clusters.

Results

Three reliable and meaningful clusters were identified and labelled as follows: (1) health-promoting SB and diet (32.6%); (2) health-promoting PA and diet (44.9%), and (3) health-risk (22.5%). Compared to boys, girls were less likely to be in clusters 1 (OR = 0.85; 95% CI = 0.78-0.93, p < 0.001) and 2 (OR = 0.43; 95% CI = 0.40-0.46, p < 0.001) than the health-risk cluster. Higher socioeconomic status was positively associated with health-promoting PA and diet, and negatively related to health-promoting SB and diet. Older adolescents were more likely to be in cluster 1 than in cluster 3, compared to younger adolescents.

Conclusion

Approximately one-quarter of the population (health-risk cluster) reported engaging in multiple risk behaviors. Interventions may need to be tailored to specific adolescent groups, especially considering sociodemographic differences.

SUBMITTER: Matias TS

PROVIDER: S-EPMC6249930 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:Diet, physical activity (PA) and sedentary behavior are important, yet modifiable, determinants of obesity. Recent research into the clustering of these behaviors suggests that children and adolescents have multiple obesogenic risk factors. This paper reviews studies using empirical, data-driven methodologies, such as cluster analysis (CA) and latent class analysis (LCA), to identify clustering patterns of diet, PA and sedentary behavior among children or adolescents and their associations with socio-demographic indicators, and overweight and obesity. A literature search of electronic databases was undertaken to identify studies which have used data-driven methodologies to investigate the clustering of diet, PA and sedentary behavior among children and adolescents aged 5-18 years old. Eighteen studies (62% of potential studies) were identified that met the inclusion criteria, of which eight examined the clustering of PA and sedentary behavior and eight examined diet, PA and sedentary behavior. Studies were mostly cross-sectional and conducted in older children and adolescents (? 9 years). Findings from the review suggest that obesogenic cluster patterns are complex with a mixed PA/sedentary behavior cluster observed most frequently, but healthy and unhealthy patterning of all three behaviors was also reported. Cluster membership was found to differ according to age, gender and socio-economic status (SES). The tendency for older children/adolescents, particularly females, to comprise clusters defined by low PA was the most robust finding. Findings to support an association between obesogenic cluster patterns and overweight and obesity were inconclusive, with longitudinal research in this area limited. Diet, PA and sedentary behavior cluster together in complex ways that are not well understood. Further research, particularly in younger children, is needed to understand how cluster membership differs according to socio-demographic profile. Longitudinal research is also essential to establish how different cluster patterns track over time and their influence on the development of overweight and obesity.

Project description:BackgroundA better understanding of how multicomponent school-based interventions work and their effects on health and education outcomes are needed. This paper described the methods of the Movimente Program, a school-based intervention that aims to increase physical activity (PA) and decrease sedentary behavior (SB) among Brazilian students.MethodsThis is a cluster randomized controlled trial with adolescents from 7th to 9th grade in public schools from Florianopolis, Southern Brazil. After agreement, 6 schools were randomly selected to intervention or control groups (3 schools each), and all eligible students were invited to the study. The Movimente intervention program was performed during a school year and included 3 main components: Teacher training (including face-to-face meeting, social media platform, and handbook with lesson plans); improvements in the PA environment in school; and educational strategies. Control schools continued with their traditional schedule. Baseline (March/April 2017), postintervention (November/December 2017), and maintenance (June/July 2018) evaluations included PA and SB as primary outcomes (assessed by self-report and accelerometry). Secondary outcomes included psychosocial factors related to PA and SB (e.g., social support and self-efficacy), as well as health (e.g., quality of life and nutritional status) and education (e.g., academic achievement) outcomes. A program evaluation was performed based on the RE-AIM framework. Participants, intervention staffs, and evaluators were not blinded to group assignment, but a standardized evaluation protocol was applied independently of the trial allocation.ResultsStatistical analyses will include a multilevel approach for repeated measurements and mediation analysis. Any side effects of the intervention will be recorded. The sample size close to that expected (n = 1090) was reached (n = 999). The results of this trial will involve valuable information about the effect and the evaluation of a multicomponent intervention carried out in a middle-income country.ConclusionBy creating opportunities for adolescents to be active at school using multicomponent strategies, the Movimente program has the potential to enhance students health and academic performance which may encourage the school community (e.g., teachers, principals) to adopt the program. Also, this trial will provide evidence for practitioners, policy makers, and researchers on how multicomponent program may be implemented in a school setting.Trial registrationThe trial is registered at the Clinical Trial Registry (Trial ID: NCT02944318; date of registration: 18 October 2016).