独立和综合的影响体力活动、屏幕时间和睡眠质量对印度青少年肥胖指标的影响。

Independent and combined influences of physical activity, screen time, and sleep quality on adiposity indicators in Indian adolescents.

机构信息

Department of Food, Nutrition & Dietetics, Sir Vithaldas Thackersey College of Home Science (Autonomous), SNDT Women's University, Santacruz West, Mumbai, Maharashtra, 400049, India.

Department of Special Education, Department of Interdisciplinary Studies, SNDT Women's University, Santacruz West, Mumbai, Maharashtra, 400049, India.

出版信息

BMC Public Health. 2021 Nov 15;21(1):2093. doi: 10.1186/s12889-021-12183-9.

DOI:10.1186/s12889-021-12183-9

PMID:34781921

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8591930/

Abstract

BACKGROUND

Inadequate physical activity (PA), excess screen time (ST), and sub-optimal sleep quality tend to co-occur during adolescence. Yet, little is known about the associations of these behaviors as a cluster with adiposity indicators in Indian adolescents. This study aimed to evaluate the independent and combined influences of PA, ST, and sleep quality on body mass index (BMI) and waist to height ratio (WHtR) in 10-15 years old adolescents in Mumbai, India. A secondary aim was to explore if these influences vary between sexes.

METHODS

Cross-sectional study. Adolescents (n = 772, mean age 13.2 (1.4) years) reported frequency and duration of moderate to vigorous PA (MVPA) and time spent using screens on a previously validated instrument. Sleep quality was estimated using the Pittsburg Sleep Quality Index (PSQI). Weight, height, and waist circumference were measured. Mixed effect logistic regression analyses were performed to explore associations between adiposity indicators (BMI z scores > +1SD and WHtR > 0.5) and unhealthy behaviors (PA < 60 min/d, ST > 120 min/d and PSQI scores > 5), stratified by sex.

RESULTS

The combined prevalence of overweight and obesity was 38.3%. Overall, 62.0 and 85.0% reported MVPA< 60 min/d and ST > 120 min/d respectively. Girls reported higher ST (218.21 (69.01) min/d) as compared to boys (165.3 (101.22) min/d, p < 0.001). Clustering of low PA and excess ST was observed in 69.2% and of all three unhealthy behaviors in 18.8%. Among girls, MVPA < 60 min/d (OR = 1.78, 95% CI 1.54-1.92, p < 0.001) and PSQI scores > 5 (OR = 2.01, 95% CI 1.78-2.25, p < 0.001) predicted increased BMI. The odds of overweight/obesity were 2.10 times higher in boys reporting low PA and 4.13 times higher in those with low PA+ ST > 120 min/d. Clustering of all three unhealthy behaviors increased prevalence of obesity in both sexes.

CONCLUSIONS

The results indicated a co-existence of multiple unhealthy lifestyle factors of obesity and that clustering of these behaviors can further aggravate obesity risk as compared to their independent effects. Integrated interventions that leverage the cumulative benefits of being active, less sedentary and sufficient sleep are warranted to facilitate greater improvements in obesity risk behaviors.

摘要

背景

在青少年时期，身体活动不足（PA）、屏幕时间过长（ST）和睡眠质量不佳往往同时发生。然而，对于这些行为作为一个整体与印度青少年肥胖指标的相关性，人们知之甚少。本研究旨在评估在孟买 10-15 岁青少年中，PA、ST 和睡眠质量对体重指数（BMI）和腰高比（WHtR）的独立和综合影响。次要目的是探讨这些影响是否因性别而异。

方法

横断面研究。青少年（n=772，平均年龄 13.2（1.4）岁）使用先前验证过的仪器报告中等到剧烈 PA（MVPA）的频率和持续时间以及使用屏幕的时间。使用匹兹堡睡眠质量指数（PSQI）估计睡眠质量。测量体重、身高和腰围。采用混合效应逻辑回归分析，按性别分层，探讨肥胖指标（BMI z 分数> +1SD 和 WHtR>0.5）与不健康行为（PA<60min/d、ST>120min/d 和 PSQI 评分>5）之间的关联。

结果

超重和肥胖的综合患病率为 38.3%。总体而言，分别有 62.0%和 85.0%的人报告说 MVPA<60min/d 和 ST>120min/d。与男孩相比，女孩报告的 ST（218.21（69.01）分钟/天）更高（165.3（101.22）分钟/天，p<0.001）。观察到低 PA 和过度 ST 的聚类在 69.2%，所有三种不健康行为的聚类在 18.8%。在女孩中，MVPA<60min/d（OR=1.78，95%CI 1.54-1.92，p<0.001）和 PSQI 评分>5（OR=2.01，95%CI 1.78-2.25，p<0.001）预测 BMI 增加。报告低 PA 的男孩超重/肥胖的几率高 2.10 倍，PA+ST>120min/d 的男孩高 4.13 倍。所有三种不健康行为的聚类增加了两性肥胖的患病率。