Association between screen time and dietary patterns and overweight/obesity among adolescents

377 ORIGINAL ORIGINAL https://doi.org/10.1590/1678-98652017000300010 SCREEN TIME, DIETARY PATTERNS AND OVERWEIGHT Association between screen time and dietary patterns and overweight/obesity among adolescents Associação entre tempo de tela e padrões alimentares com sobrepeso/obesidade em adolescentes Maria Gabriela Matias de PINHO1 Fernando ADAMI2 Jucemar BENEDET3 Francisco de Assis Guedes de VASCONCELOS1 ABSTRACT Objective The association between screen time and dietary patterns and overweight/obesity among adolescents was analysed in this study. Methods In this cross-sectional study, 963 Brazilian adolescents, aged between 11 and 14 years were evaluated. Body mass index was used to assess overweight/obesity. Dietary patterns and screen time were assessed using qualitative questionnaires. Principal component analysis was used to obtain dietary patterns. Confounder variables were: type of school (public or private), sexual maturation, mother’s weight and mother’s education. The Chi-square test was used for the crude analysis; for the adjusted analysis was used Poisson regression with sample weighting. Results Overweight/obesity prevalence was 29.8% and statistically higher among boys (34.7%). Higher screen time prevalence was 39.1%. The dietary patterns obtained were: obesogenic; coffee and dairy products; traditional Brazilian meal; fruit and vegetables; bread and chocolate milk. The dietary pattern that more closely represented student food consumption was the obesogenic pattern. Screen time was not significantly associated with overweight/obesity. The obesogenic pattern (in both sexes), the coffee and dairy products pattern, and the 1 Universidade Federal de Santa Catarina, Centro de Ciências da Saúde, Departamento de Nutrição. Campus Universitário, Trindade, 88040-9000, Florianópolis, SC, Brasil. Correspondência para/Correspondence to: FAG VASCONCELOS. E-mail: <>. 2 Faculdade de Medicina do ABC, Departamento de Saúde da Coletividade, Laboratório de Epidemiologia e Análise de Dados. Santo André, SP, Brasil. 3 Universidade Federal de Santa Catarina, Centro de Desportos, Departamento de Educação Física. Florianópolis, SC, Brasil. Article based on the master’s thesis of MGM PINHO, intitled “Associação entre atividade sedentária, consumo, alimentar e sobrepeso/ obesidade em escolares de 11 a 14 anos de idade em Florianópolis, SC”. Universidade Federal da Santa Catarina; 2015. Support: Conselho Nacional de Desenvolvimento Científico e Tecnológico (Process nº 483955/2011-6). Rev. Nutri., Campinas, 30(3):377-389, maio/jun., 2017 Revista de Nutrição 378 MGM PINHO et al. https://doi.org/10.1590/1678-98652017000300010 bread and chocolate milk pattern (only in girls), were inversely associated with overweight/obesity. In this study, dietary patterns influenced overweight/obesity, although in some cases, in an inverse way from what expected. Conclusion A high prevalence of overweight/obesity and a high proportion of screen time activities among the adolescents were observed. Our results indicate a high consumption of unhealthy dietary pattern among adolescents. Keywords: Adolescents. Food behavior. Obesity. Overweight. RESUMO Objetivo Analisar a associação entre tempo de tela e padrões alimentares com sobrepeso/obesidade em adolescentes de Florianópolis, Santa Catarina, Brasil. Métodos Estudo transversal com amostra probabilística de 963 adolescentes de 11 a 14 anos de idade matriculados em escolas públicas e privadas do município. O sobrepeso/obesidade foi avaliado por meio do índice de massa corporal e o consumo alimentar do dia anterior por meio da aplicação de questionário qualitativo. Análise de Componentes Principais foi utilizada para obtenção dos padrões alimentares. Os fatores de confusão considerados foram: tipo de escola, maturação sexual, peso e escolaridade da mãe. Usou-se teste Qui-quadrado e regressão de Poisson nas análises bruta e ajustada, respectivamente. Resultados A prevalência de sobrepeso/obesidade foi de 29,8%, sendo estatisticamente maior nos meninos (34,7%). A prevalência de alto tempo de tela foi de 39,1%. Os padrões alimentares obtidos foram: obesogênico; café e produtos lácteos; refeição tradicional brasileira; frutas e vegetais; pão e achocolatado. O padrão de consumo alimentar que melhor representou o consumo dos adolescentes nessa amostra foi o obesogênico. Não houve associação estatisticamente significativa entre tempo de tela e sobrepeso/obesidade. Foram inversamente associados com sobrepeso/obesidade os padrões: obesogênico; café e produtos lácteos; e pão e achocolatado (apenas em meninas). Padrões de consumo alimentar influenciaram a prevalência de sobrepeso/obesidade, porém, em alguns casos, de maneira contrária ao esperado. Conclusão Observou-se alta prevalência de sobrepeso/obesidade e alta frequência de atividades sedentárias. Os resultados sugerem alto índice de padrão alimentar não saudável pelos adolescentes. Palavras-chave: Adolescentes. Comportamento alimentar. Obesidade. Sobrepeso. INTRODUCTION Despite the reported stabilization in some developed countries, the prevalence of overweight/ obesity among children and adolescents remains high, therefore, representing an important public health issue [1]. However, this stabilization does not appear to be occurring in developing countries. The overweight/obesity prevalence has increased from 8.1% to 12.9% in boys and from 8.4% to 13.4% in girls between 1980 and 2013 in 188 countries [2]. In Brazil, according to data from the Household Budget Survey (HBS), conducted between 2008 and 2009, the Revista de Nutrição prevalence of overweight/obesity among 10 to 19 year-olds was 20.5% [3]. Moreover, the estimated prevalence of overweight/obesity in 2013 was 22.1% for boys and 24.3% for girls [2]. Obesity during adolescence has health repercussions in adulthood, such as type 2 diabetes, hypertension, severe obesity, renal dysfunction and limited mobility [4]. The causes of obesity among adolescents include both biological/genetic factors and social/ environmental factors, the latter are particularly important factors that can lead to obesogenic behaviours among adolescents, such as Rev. Nutri., Campinas, 30(3):377-389, maio/jun., 2017 https://doi.org/10.1590/1678-98652017000300010 SCREEN TIME, DIETARY PATTERNS AND OVERWEIGHT unhealthy dietary practices and sedentary activities (e.g., excessive computer, television and videogame use) [5,6]. In Brazil, the Pesquisa Nacional de Saúde de Escolar, 2012 showed a high consumption of non-healthy foods, with 41.3%, 33.2% and 31.9% of the adolescents eating sweets (i.e., candies, chocolate, ice cream), soft drinks and cookies, respectively, on five or more days per week. In the same survey, 78.0% of Brazilian adolescents watched two or more hours of television per weekday [7]. There is a growing body of literature demonstrating that unhealthy food consumption and sedentary behaviour during childhood and adolescence can promote overweig (...truncated)