Behavioral classes related to physical activity and sedentary behavior on the evaluation of health and mental outcomes among Brazilian adolescents

Abstract

Latent Class Analysis can assist researchers interested in a better understanding of behavioral patterns and their association with health outcomes. This study aimed to identify lifestyle latent classes related to distinct domains of physical activity (PA) and sedentary behavior (SB) among adolescents and their association with health outcomes. This crosssectional study included 217 Brazilian adolescents (15 to 18 years old, 49.3% female). The classes were based on moderate-to-vigorous physical activity (MVPA), light physical activity (LPA), number of steps, sedentary behavior (SB), and screen time (ST). To assess these behaviors, participants wore an accelerometer for one week. ST, demographic characteristics, socioeconomic status, and signs of common mental disorders (CMD) were evaluated through questionnaires. Latent Class Analysis was used to identify lifestyle classes. Three classes were recognized: "Active-Non-sedentary" (class 1) with 28.1% of adolescents; "Inactive-Non-sedentary" (class 2), 48.85%; and "Inactive-Sedentary" (class 3), 23.04%. Sex and signs of CMD were associated with the prevalence of the classes. Female adolescents presented 4.48 (95% CI 2.04-9.77) times more chance of belonging to the "Inactive-Sedentary" (class 3). Adolescents who presented CMD had 11.35 (95% CI 3.45-101.1) times more chance of belonging to the "Inactive-Non-sedentary" (class 2). The interaction between sex and signs of CMD showed that girls with signs of CMD were 9.20 (95% CI 1.17-71.52) more likely to belong to the Inactive-Sedentary class than the "Active-Nonsedentary". Results indicate that sex and signs of CMD can affect the prevalence of the classes. Our findings highlight that physical inactivity and SB can be associated with signs of CMD, especially in female adolescents.

Use of latent class analysis as a method of assessing the physical activity level, sedentary behavior and nutritional habit in the adolescents’ lifestyle: A scoping review

“…Until 2019, only one study was conducted in a middle-income country (Brazil) [ 20 ]. from 2020 onwards, 4 more articles used the LCA to assess the adolescents’ lifestyle [ 9 – 11 , 13 ]. The other 25 articles were conducted in high-income countries.…”

“…Some studies [ 13 , 27 , 43 ] have shown that female adolescents who were considered physically inactive showed a greater association with some health risk behavior. In contrast, the LCs that grouped female adolescents who performed dance and aerobic exercises, such as walking and running, showed an association with good health.…”

“…In addition, it was found that psychosocial diseases can also be associated with the behavior of adolescents. As an example, inactive adolescents with high BS showed greater dissatisfaction with body image [ 11 ] and with signs of depression and anxiety [ 13 ]. However, Xiao et al [ 36 ] showed that adolescents in the classes with adequate PAL, SB and nutritional habits, when compared to those in classes with lowest engagement in health-promoting behaviors, showed an increase in suicidal behaviors.…”

“…Currently, adolescents’ lifestyle is commonly characterized by physical inactivity, sedentary behavior, and inappropriate eating habits in general [ 1 ]. Scientific studies have increasingly shown that adolescents do not practice the minimum recommendation of 60 minutes of moderate-to-vigorous physical activity (MVPA) daily [ 2 ].…”

“…These unhealthy behaviors and habits can decrease the cardiorespiratory fitness and as consequence to result in pediatric obesity [ 9 ], body fat accumulation and clinical manifestations of cardiometabolic diseases, inflammatory status [ 10 ]. Besides that, psychosocial consequences, such as low self-esteem, body image disturbance [ 11 ], eating disorder risk [ 12 ] and signs of depression and anxiety [ 13 ].…”