Concurrent Associations of Physical Activity and Screen-Based Sedentary Behavior on Obesity Among US Adolescents: A Latent Class Analysis

Background: Independent associations of physical activity (PA) and sedentary behavior (SB) with obesity are well documented. However, little is known about the combined associations of these behaviors with obesity in adolescents. The present study examines the prevalence of concurrent levels of PA and SB, and their associations with obesity among US adolescents. Methods: Data from a total of 12 081 adolescents who participated in the Youth Risk Behaviors Survey during 2012-2013 were analyzed. A latent class analysis was performed to identify latent subgroups with varying combined levels of subjectively measured PA and screen-based SB. Follow-up analysis examined the changes in the likelihood of being obese as determined by the Center for Disease Control and Prevention Growth Chart between latent subgroups. Results: Four latent subgroups with varying combined levels of PA and SB were identified across gender. The likelihood of being obese was significantly greater for the subgroups featuring either or both Low PA or High SB when compared with High PA/Low SB across genders (odds ratio [OR] ranges, 2.1-2.7 for males and 9.6-23.5 for females). Low PA/High SB showed the greater likelihood of being obese compared to subgroups featuring either or both High PA and Low SB (OR ranges, 2.2-23.5) for female adolescents only. Conclusions: The findings imply that promoting sufficient levels of PA while reducing SB should be encouraged in order to reduce obesity risk among adolescents, particularly for males. The risk of obesity for female adolescents can be reduced by engaging in either high levels of PA or low levels of SB.