Zewditu Demissie

Obesity and Other Correlates of Physical Activity and Sedentary Behaviors among US High School Students

Understanding correlates of physical activity (PA) can help inform and improve programs that promote PA among youth. We analyzed data from the 2010 National Youth Physical Activity and Nutrition Study, a representative sample of US students in grades 9–12. Logistic regression was used to examine associations between PA correlates (obesity, physical education classes, sports team participation, attitude toward PA, adult support for PA, and environmental support for PA) and participation in daily PA (DPA), vigorous PA (VPA), muscle-strengthening activity (MSA), viewing television (TV), and using computers or video games (C/VG). A positive attitude toward PA and adult support for PA were both associated with increased PA and decreased sedentary behavior. However, among students who lived in neighborhoods that were not safe for PA, a positive attitude toward PA was not associated with increased DPA or decreased sedentary behavior and was less strongly associated with VPA and MSA. Efforts to increase PA among youth should promote a positive attitude toward PA among youth and encourage adult family members to support their efforts to be active. Policies that promote safe neighborhoods may work synergistically with a positive attitude toward PA to increase participation in PA and decrease sedentary behaviors.

Associations of Physical Activity and Sedentary Behaviors with Dietary Behaviors among US High School Students

Background. Physical activity (PA), sedentary behaviors, and dietary behaviors are each associated with overweight and obesity among youth. However, the associations of PA and sedentary behaviors with dietary behaviors are complex and not well understood. Purpose. To describe the associations of PA and sedentary behaviors with dietary behaviors among a representative sample of US high school students. Methods. We analyzed data from the 2010 National Youth Physical Activity and Nutrition Study (NYPANS). Using logistic regression models which controlled for sex, race/ethnicity, grade, body weight status, and weight management goals, we compared dietary behaviors among students who did and did not meet national recommendations for PA and sedentary behaviors. Results. Students who participated in recommended levels of daily PA (DPA) and muscle strengthening PA (MSPA) were more likely than those who did not to eat fruits and vegetables. Students who exceeded recommended limits for television (TV) and computer/video game (C/VG) screen time were less likely than those who did not to consume fruits and vegetables and were more likely to consume fast food and sugar-sweetened beverages. Conclusions. Researchers may want to address PA, sedentary behaviors, and dietary behaviors jointly when developing health promotion and obesity prevention programs for youth.

Electronic Media and Beverage Intake Among United States High School Students—2010

OBJECTIVE To describe electronic media exposure and its associations with beverage intake among United States high school students. METHODS School-based survey data from a nationally representative sample of 9th- through 12th-grade students from the National Youth Physical Activity and Nutrition Study were analyzed using chi-square and multivariate logistic analyses. RESULTS On an average school day, 23.5% of students used a computer or played video/computer games ≥ 3 h/d, 28.3% watched television (TV) ≥ 3 h/d, 79.9% had ≥ 3 TVs in the home, 70.2% had a TV in their bedroom, and 41.0% most of the time or always had a TV on while eating dinner at home. Students with high media exposure were more likely to drink sugar-sweetened beverages ≥ 3 times per day and less likely to drink water ≥ 3 times per day and drink ≥ 2 glasses of milk per day. CONCLUSIONS AND IMPLICATIONS Efforts to reduce sugar-sweetened beverage intake among adolescents may include limiting exposure to electronic media.

Associations of School Violence With Physical Activity Among U.S. High School Students

BACKGROUND This study investigated associations of violence-related behaviors with physical activity (PA)-related behaviors among U.S. high school students. METHODS Data from the 2009 national Youth Risk Behavior Survey, a cross-sectional survey of a nationally representative sample of 9th-12th grade students, were analyzed. Sex-stratified, adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated for associations between violence-related behaviors and being physically active for ≥60 minutes daily, sports participation, TV watching for ≥3 hours/day, and video game/computer use for ≥3 hours/day. RESULTS Among male students, at-school bullying victimization was negatively associated with daily PA (aOR: 0.72; 95% CI: 0.58-0.87) and sports participation; skipping school because of safety concerns was positively associated with video game/computer use (1.42; 1.01-2.00); and physical fighting was positively associated with daily PA. Among female students, at-school bullying victimization and skipping school because of safety concerns were both positively associated with video game/computer use (1.46; 1.19-1.79 and 1.60; 1.09-2.34, respectively), and physical fighting at school was negatively associated with sports participation and positively associated with TV watching. CONCLUSIONS Bullying victimization emerged as a potentially important risk factor for insufficient PA. Schools should consider the role of violence in initiatives designed to promote PA.

Trends in Beverage Consumption Among High School Students — United States, 2007–2015

Beverages play an important role in the diets of adolescents because they help to maintain hydration and can provide important nutrients, such as calcium, vitamin D, and vitamin C (1). However, some beverages, such as sugar-sweetened beverages (SSBs) (e.g., soda or pop), provide calories with no beneficial nutrients. Beverage consumption patterns among American youth have changed over time; however, little is known about differences in consumption of various beverages by demographic characteristics such as grade in school, free/reduced price lunch eligibility, and race/ethnicity (2). CDC analyzed data from the 2007-2015 national Youth Risk Behavior Surveys (YRBS) to assess whether the prevalence of drinking non-diet soda or pop (soda), milk, and 100% fruit juice (juice) has significantly changed over time among U.S. high school students. During 2007-2015, daily soda consumption decreased significantly from 33.8% to 20.5%. During 2007-2011, daily milk and juice consumption did not significantly change, but during 2011-2015 daily milk and juice consumption decreased from 44.3% to 37.4% and from 27.2% to 21.6%, respectively. Although a decrease in daily soda consumption is a positive change, soda consumption remains high. Although there is not a specific recommendation for sugar-sweetened beverage consumption, the Dietary Guidelines for Americans 2015-2020 recommend that U.S. residents reduce sugar-sweetened beverage and sweet consumption to reduce intake of added sugars to less than 10% of calories per day. The Dietary Guidelines for Americans 2015-2020 recommend that persons choose beverages with no added sugars, such as water, in place of sugar-sweetened beverages, as one strategy for achieving the added sugars recommendation. Adolescents might need additional support in choosing more healthful beverages, such as low-fat milk, in place of SSBs.

Current and Binge Drinking Among High School Students — United States, 1991–2015

Excessive drinking accounted for approximately 4,300 deaths each year among persons aged <21 years during 2006-2010,* and underage drinking cost the United States

Percentage of Youth Meeting Federal Fruit and Vegetable Intake Recommendations, Youth Risk Behavior Surveillance System, United States and 33 States, 2013

24.3 billion in 2010 (1). CDC analyzed data from the national Youth Risk Behavior Survey (YRBS) for the years 1991-2015 to examine trends in drinking by U.S. high school students, and from the 2015 YRBS to assess the usual source of alcohol consumed† and binge drinking intensity (i.e., the average number of drinks consumed per binge drinking occasion).§ During 1991-2007, the prevalence of current drinking¶ among high school students declined significantly, from 50.8% (1991) to 44.7% (2007), and then significantly declined to 32.8% in 2015. The prevalence of binge drinking** increased from 31.3% in 1991 to 31.5% in 1999, and then significantly declined to 17.7% in 2015. Most high school students who drank were binge drinkers (57.8%), and 43.8% of binge drinkers consumed eight or more drinks in a row. Despite progress, current drinking and binge drinking are common among high school students, and many students who binge drink do so at high intensity (i.e., eight or more drinks in a row). Widespread use of evidence-based strategies for preventing excessive drinking (e.g., increasing alcohol taxes, regulating alcohol outlet density, and having commercial host liability laws) could help reduce underage drinking and related harms.††.

The Association of Meal Practices and Other Dietary Correlates With Dietary Intake Among High School Students in the United States, 2010

BACKGROUND National- and state-level self-reported frequency of fruit and vegetable (F/V) consumption is available for high school students from the Centers for Disease Control and Preventions Youth Risk Behavior Surveillance System (YRBSS). YRBSS monitors priority health-risk behaviors among a nationally representative sample of US high school students and representative samples of students in states and selected large urban school districts. However, YRBSS measures intake in times per day and not the cup equivalents that national goals use, which limits interpretation. OBJECTIVE To help states track youth progress, scoring algorithms were developed from external data and applied to 2013 YRBSS data to estimate the percentages of high school students in the nation and 33 states meeting the US Department of Agricultures Food Patterns F/V intake recommendations. DESIGN Twenty-four-hour dietary recalls were used from the 2007-2010 National Health and Nutrition Examination Survey to fit sex-specific models for 14- to 18-year-olds that estimate probabilities of meeting recommendations as a function of reported frequency of consumption and race/ethnicity, adjusting for day-to-day dietary variation. Model regression parameters were then applied to national cross-sectional YRBSS data (n=12,829) and to data from the 33 states (n=141,006) that had complete F/V data to estimate percentages meeting recommendations. RESULTS Based on the prediction equations, 8.5% of high school students nationwide met fruit recommendations (95% CI 4.9% to 12.1%) and 2.1% met vegetable recommendations (95% CI 0.0% to 8.1%). State estimates ranged from 5.3% in Nebraska and Missouri to 8.9% in Florida for fruit and 1.0% in New Jersey, North Dakota, and South Carolina to 3.3% in New Mexico for vegetables. CONCLUSIONS This method provides a new tool for states to track youth progress toward meeting dietary recommendations and indicates that a high percentage of youth in all states examined have low intakes of F/V.

Prevalence and Correlates of Missing Meals Among High School Students-United States, 2010.

Purpose. To examine behavioral and environmental factors that may be related to dietary behaviors among U.S. high school students. Design. Data were obtained from the 2010 National Youth Physical Activity and Nutrition Study, a cross-sectional study. Setting. The study was school-based. Subjects. Study subjects were a nationally representative sample of students in grades 9 to 12 (n = 11,458). Measures. Variables of interest included meal practices, in-home snack availability, and intakes of healthful foods/beverages (fruits, vegetables, water, and milk) and less healthful foods/beverages (fried potatoes, pizza, and sugar-sweetened beverages). Analysis. Sex-stratified logistic regression models were used to examine associations of meal practices and snack availability with dietary intake. Odds ratios (ORs) were adjusted for race/ethnicity and grade. Results. Eating breakfast daily, frequent family dinners, and bringing lunch from home were associated with higher odds of consuming at least three healthful foods or beverages. High fast-food intake was associated with lower odds of healthful dietary intake and higher odds of sugar-sweetened beverage intake (female OR = 3.73, male OR = 4.60). Students who mostly/always had fruits and vegetables available at home had increased odds of fruits (female OR = 3.04, male OR = 2.24), vegetables (female OR = 2.12, male OR = 1.65), water (female OR = 1.82, male OR = 1.85), and milk intake (female OR = 1.45, male OR = 1.64). Conclusion. Encouraging daily breakfast consumption, frequent family dinners, and fruit and vegetable availability at home may lead to higher intakes of healthful foods among high school students.

Harassment and mental distress among adolescent female students by sexual identity and BMI or perceived weight status

Purpose: To determine the prevalence and correlates of missing meals among adolescents. Design: The 2010 National Youth Physical Activity and Nutrition Study, a cross-sectional study. Setting: School based. Participants: A nationally representative sample of 11 429 high school students. Measures: Breakfast, lunch, and dinner consumption; demographics; measured and perceived weight status; physical activity and sedentary behaviors; and fruit, vegetable, milk, sugar-sweetened beverage, and fast-food intake. Analysis: Prevalence estimates for missing breakfast, lunch, or dinner on ≥1 day during the past 7 days were calculated. Associations between demographics and missing meals were tested. Associations of lifestyle and dietary behaviors with missing meals were examined using logistic regression controlling for sex, race/ethnicity, and grade. Results: In 2010, 63.1% of students missed breakfast, 38.2% missed lunch, and 23.3% missed dinner; the prevalence was highest among female and non-Hispanic black students. Being overweight/obese, perceiving oneself to be overweight, and video game/computer use were associated with increased risk of missing meals. Physical activity behaviors were associated with reduced risk of missing meals. Students who missed breakfast were less likely to eat fruits and vegetables and more likely to consume sugar-sweetened beverages and fast food. Conclusion: Breakfast was the most frequently missed meal, and missing breakfast was associated with the greatest number of less healthy dietary practices. Intervention and education efforts might prioritize breakfast consumption.