Elsevier

Journal of Adolescent Health

Volume 51, Issue 3, September 2012, Pages 265-271
Journal of Adolescent Health

Original article
Co-occurrence of Obesogenic Risk Factors Among Adolescents

https://doi.org/10.1016/j.jadohealth.2011.12.017Get rights and content

Abstract

Purpose

The purpose of this study was to determine the prevalence, sociodemographic distribution, and co-occurrence of five potentially obesogenic behavioral risk factors (low physical activity, high screen time, low fruit and vegetable intake, high soft drink consumption, and high snack intake) among adolescents.

Methods

Cross-sectional representative population survey (n = 1,568) of grade 6, 8, and 10 students (49% male) randomly selected from 70 primary and secondary schools in New South Wales, Australia, between February and May 2007. Co-occurrence was assessed using an observed-to-expected ratio (O/E) method.

Results

Only 5% of boys and 9% of girls had none of the five obesogenic behavioral risk factors studied. Overall, 51.4% of boys and 42.9% of girls had three or more risk factors. Prevalence of multiple risk factors (3+) was higher among boys and girls from lower income households and among girls whose mothers had less than grade 12 education. For both boys and girls, the occurrence of all five risk factors was 160% greater than expected (O/E ratio: 2.6).

Conclusions

There was clear evidence of a co-occurrence of obesogenic risk factors among adolescents, especially among those from lower socioeconomic backgrounds, indicating this group would benefit from targeted prevention strategies.

Section snippets

Design and participants

The study used a representative cross-sectional population-based survey of school students in New South Wales (NSW), Australia. Seventy schools (35 primary and 35 high schools) were randomly selected, so that the number of schools selected in each education sector (Government, Catholic, and Independent) was proportional to the number of students enrolled in that sector. Schools that catered for children with special needs (e.g., those with autism or blindness) were excluded from the sampling

Results

Overall, 1,685 students participated in the survey (55% response rate), of which 1,568 (grade 6 = 484; grade 8 = 487; grade 10 = 597) had complete data on all five risk factors. Students with missing data on at least one risk factor (n = 117) were generally comparable with students with complete data, although a greater proportion of girls with missing data were in grade 10 (50.8% vs. 37.9%), and boys with missing data were more likely to be overweight or obese (47.2% vs. 21.6%, p = .011).

Discussion

The findings of this study indicate that behavioral risk factors are prevalent among Australian adolescents and have a tendency to co-occur. The most prevalent risk factor was high screen time among all adolescents, followed by low physical activity among girls and low fruit and vegetable intakes among boys. More than half of boys (51%) and 43% of girls reported three or more risk factors, and the co-occurrence of all five risk factors for both boys and girls was 160% greater than the

Conclusions

The prevalence of multiple behavioral risk factors among adolescents was 160% greater than expected, had the five risk factors occurred independently. Further, the co-occurrence of risk factors was more prevalent among adolescents from lower socioeconomic backgrounds, placing them at higher risk of unhealthy weight gain and ultimately, concomitant chronic diseases. Socially disadvantaged adolescents with multiple risk factor profiles should be an intervention priority.

Acknowledgments

The authors thank the participating students, families, and schools. This study (Good for Kids) was funded by the NSW Department of Health and the Hunter New England Area Health Service, NSW, Australia.

References (40)

  • P. Gordon-Larsen et al.

    Five-year obesity incidence in the transition period between adolescence and adulthood: The national longitudinal study of adolescent health

    Am J Clin Nutr

    (2004)
  • T. Lobstein et al.

    IASO International Obesity Task ForceObesity in children and young people: A crisis in public health

    Obes Rev

    (2004)
  • Foresight tackling obesities: Future choices project

    (2007)
  • T.A. Barnett et al.

    Teens and screens: The influence of screen time on adiposity in adolescents

    Am J Epidemiol

    (2010)
  • J. James et al.

    Preventing childhood obesity by reducing consumption of carbonated drinks: Cluster randomised controlled trial

    BMJ

    (2004)
  • G. Block

    Foods contributing to energy intake in the US: Data from NHANES III and NHANES 1999–2000

    J Food Composit Anal

    (2006)
  • N.J. Wareham et al.

    Physical activity and obesity prevention: A review of the current evidence

    Proc Nutr Soc'Y

    (2005)
  • A.E. Field et al.

    Association between fruit and vegetable intake and change in body mass index among a large sample of children and adolescents in the United States

    Int J Obes Relat Metab Disord

    (2003)
  • V. Mikkilä et al.

    Major dietary patterns and cardiovascular risk factors from childhood to adulthoodThe cardiovascular risk in young Finns study

    Br J Nutr

    (2007)
  • T. Gill et al.

    Best options for promoting healthy weight and preventing weight gain in NSW

    (2010)
  • Cited by (54)

    • Informing theoretical development of salutogenic, asset-based health improvement to reduce syndemics among gay, bisexual and other men who have sex with men: Empirical evidence from secondary analysis of multi-national, online cross-sectional surveys

      2020, SSM - Population Health
      Citation Excerpt :

      Data were analysed with IBM SPSS 23, and Excel. In order to investigate statistical dependence of the three ill-health outcomes, a cluster analysis using the observed/expected (O/E) ratio method was most appropriate, given the small number of outcomes of interest (Hardy et al., 2012). The O/E ratio method provides an indication of the statistical interdependence of the separate outcomes.

    View all citing articles on Scopus
    View full text