Diet, Physical Activity, and Sedentary Behaviors as Risk Factors for Overweight in Adolescence

Patrick, Kevin; Norman, Gregory J.; Calfas, Karen J.; Sallis, James F.; Zabinski, Marion F.; Rupp, Joan W.; Cella, John

doi:10.1001/archpedi.158.4.385

Cited by 372 publications

(313 citation statements)

References 37 publications

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“…76 Low levels of physical activity and greater amounts of sedentary pursuits, in particular television viewing (43 h/ days), during childhood and/or adolescence is predictive of greater future adiposity and or overweight. [77][78][79][80][81][82][83][84] Thus, the rationale for prescribing exercise as an adjunct to dietary restriction is compelling given its potential to reduce overweight-related comorbidity and the hazard associated with dietary restriction alone.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of exercise for treating overweight in children and adolescents: a systematic review

2006

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Background: Overweight prevalence among children/adolescents is increasing, while adult obesity may potentially cause a decline in life expectancy. More exercise is uniformly recommended, although treatment efficacy remains unclear. Objective: To determine the efficacy of exercise alone for treating overweight in children/adolescents. Design: A systematic review and meta-analysis of randomized trials published in English were completed following multiple database searches performed on December 10, 2004. Studies of isolated or adjunctive exercise/physical activity treatment in overweight/obese children or adolescents which reported any overweight outcome were included. Literature searches identified 645 papers which were manually searched, of which 45 were considered for inclusion, of which 13 papers which reported 14 studies were included (N ¼ 481 overweight boys and girls, aged B12 years). Two reviewers independently identified relevant papers for potential inclusion and assessed methodological quality. Principal measures of effects included the mean difference (MD) (between treatment and control groups), the weighted MD (WMD), and the standardized MD (SMD). Results: Few studies were of robust design. The pooled SMD was À0.4 (À0.7, À0.1, P ¼ 0.006) for percent body fat, and À0.2 (À0.6, 0.1, P ¼ 0.07) for central obesity outcomes, whereas the pooled WMD was À2.7 kg (À6.1 kg, 0.8 kg, P ¼ 0.07) for body weight, all of which favored exercise. Pooled effects on body weight were significant and larger for studies of higher doses, whereas nonsignificant and smaller effects were seen for studies of lower doses of exercise (155-180 min/weeks vs 120-150 min/ weeks). Conclusions: Based on the small number of short-term randomized trials currently available, an aerobic exercise prescription of 155-180 min/weeks at moderate-to-high intensity is effective for reducing body fat in overweight children/adolescents, but effects on body weight and central obesity are inconclusive. Recommendations for future study designs are discussed.

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Section: Discussionmentioning

confidence: 99%

Efficacy of exercise for treating overweight in children and adolescents: a systematic review

2006

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“…[49][50][51][52] Some of these studies include objective measures of physical activity, such as accelerometer data. [53][54][55] Null findings are not uncommon. 56,57 One study found that obese youth are more active than nonobese youth.…”

Section: Physical Activity and The Development Of Obesitymentioning

confidence: 99%

Physical activity and sedentary behavior: a review of longitudinal studies of weight and adiposity in youth

2005

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AIM:To review the published prospective observational studies of the relationship of physical activity and sedentary behavior with the development of overweight and adiposity, with an emphasis on methodologic issues. METHODS: Sample size, population studied, length of follow-up, assessment of exposure (physical activity, inactivity, or sedentary behavior), assessment of outcome (relative weight, overweight, % body fatness, adiposity), statistical approach, and main findings were extracted, summarized, and key methodological issues highlighted. RESULTS: In total, 17 studies of physical activity and 15 studies of inactivity/sedentary behavior were identified; as these were not mutually exclusive, 20 unique studies were reviewed. Results were mixed, with most studies showing an inverse association of physical activity with weight or fatness outcomes and/or a direct association of inactivity/sedentary behavior with weight or fatness outcomes. The effects identified were generally of small magnitude. Imprecise measurement of activity exposures likely weakens the observed relationships. Most studies used a pre-post design and had limited duration of follow-up (r2 y). Studies with longer and more frequent follow-up did not always use the most advantageous statistical approach. CONCLUSIONS: On balance, the available evidence from prospective observational studies suggests that increased physical activity and decreased sedentary behavior are protective against relative weight and fatness gains over childhood and adolescence. In addition to improved measurement methods, longer and more frequent follow-up as well as truly longitudinal analysis methods would help establish these important prevention and intervention targets, and identify subgroups or development periods where interventions would likely be effective.

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“…8 Previous research on physical activity in paediatric obesity has focused on non-clinical samples, comparing habitual physical activity or energy expenditure in obese and nonobese children and adolescents. [9][10][11][12][13][14][15][16] Most of these studies found lower levels of physical activity and *PAL (TEE/REE) in obese children and adolescents relative to their lean counterparts. [9][10][11][12][14][15][16] The few studies that have compared objec-tively measured sedentary behaviour in non-clinical samples of obese and lean children have reported inconsistent results.…”

Section: Introductionmentioning

confidence: 99%

“…[9][10][11][12][13][14][15][16] Most of these studies found lower levels of physical activity and *PAL (TEE/REE) in obese children and adolescents relative to their lean counterparts. [9][10][11][12][14][15][16] The few studies that have compared objec-tively measured sedentary behaviour in non-clinical samples of obese and lean children have reported inconsistent results. 10,14,15 The aims of this study were therefore to use accelerometry to (1) measure habitual physical activity and sedentary behaviour objectively in a clinical sample of obese children aged 5-11 years; (2) compare the results with a sample of ageand sex-matched non-obese control children.…”

Section: Introductionmentioning

confidence: 99%

Habitual physical activity and sedentary behaviour in a clinical sample of obese children

et al. 2006

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Objective: To objectively measure habitual physical activity and sedentary behaviour in a clinical sample of obese children and to compare with age-and sex-matched non-obese controls. Design: Pairwise comparison of obese children matched for age and gender with non-obese controls. Subjects: A total of 116 obese children (body mass index (BMI)X98th centile) and 53 non-obese control children (BMIo85th centile). Controls were matched with 53 of the obese children (mean age 8.6, s.d. 2.0 years; 25 M and 28 F). Measurement: Habitual physical activity and sedentary behaviour were measured over a 7-day period using CSA accelerometers. Total physical activity (mean accelerometry count per minute (c.p.m.)), percentage of monitored time in sedentary behaviour, light and moderate to vigorous intensity physical activity (MVPA) were compared. Results: Obese children (n ¼ 116) spent on average 80.4% of their monitored time in sedentary behaviour and 2.5% of their monitored time in MVPA. Total activity (mean c.p.m.) was significantly higher in the non-obese group (n ¼ 53) than the obese group (n ¼ 53), 729 vs 648 c.p.m.; 95% confidence interval (CI) 7, 155. Time spent in sedentary behaviour averaged 80.9% (s.d. 6.6) in the obese group and 79.3% (s.d. 6.2) in the non-obese group, with no significant between-group difference (95% CI À3.9, 0.6). Light intensity activity was similar in the obese and non-obese groups (15.9 vs 17.3%; 95% CI À0.3, 3.0). Participation in MVPA was significantly higher in the non-obese vs obese group (3.9 vs 2.4%; 95% CI 0.6, 2.0). Conclusion: This study supports the hypothesis that a clinical sample of obese children is less physically active than non-obese children, although the difference in total activity and MVPA between the groups was small.

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Diet, Physical Activity, and Sedentary Behaviors as Risk Factors for Overweight in Adolescence

Cited by 372 publications

References 37 publications

Efficacy of exercise for treating overweight in children and adolescents: a systematic review

Efficacy of exercise for treating overweight in children and adolescents: a systematic review

Physical activity and sedentary behavior: a review of longitudinal studies of weight and adiposity in youth

Habitual physical activity and sedentary behaviour in a clinical sample of obese children

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