Socioeconomic Correlates of Sedentary Behavior in Adolescents: Systematic Review and Meta-Analysis

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Abstract

Background

The body of evidence on associations between socioeconomic status (SES) and sedentary behaviors in adolescents is growing.

Objectives

The overall aims of our study were to conduct a systematic review and meta-analysis of this evidence and to assess whether (1) the associations between SES and sedentary behavior are consistent in adolescents from low-middle-income and from high-income countries, (2) the associations vary by domain of sedentary behavior, and (3) the associations vary by SES measure.

Methods

We performed a systematic literature search to identify population-based studies that investigated the association between SES and sedentary behavior in adolescents (aged 10–19 years). Only studies that presented risk estimates were included. We conducted meta-analyses using random effects and univariate meta-regression and calculated pooled effect sizes (ES).

Results

Data from 39 studies were included; this provided 106 independent estimates for meta-analyses. Overall, there was an inverse association between SES and sedentary behavior (ES 0.89; 95 % confidence interval [CI] 0.81–0.98). However, the direction of the association varied: in high-income countries, SES was inversely associated with sedentary behavior (ES 0.67; 95 % CI 0.62–0.73), whereas in low-middle-income countries, there was a positive association between SES and sedentary behavior (ES 1.18; 95 % CI 1.04–1.34). In high-income countries, the associations were strongest for screen time (ES 0.68; 95 % CI 0.62–0.74) and television (TV) time (ES 0.58; 95 % CI 0.49–0.69), whereas in low-middle-income countries, the associations were strongest for ‘other’ screen time (i.e., computer, video, study time, but not including TV time) (ES 1.38; 95 % CI 1.07–1.79). All indicators of SES were negatively associated with sedentary behavior in high-income countries, but only resources (income and assets indexes) showed a significant positive association in low-middle-income countries.

Conclusion

The associations between SES and sedentary behavior are different in high- and low-middle-income countries, and vary by domain of sedentary behavior. These findings suggest that different approaches may be required when developing intervention strategies for reducing sedentary behavior in adolescents in different parts of the world.

Electronic supplementary material

The online version of this article (doi:10.1007/s40279-016-0555-4) contains supplementary material, which is available to authorized users.

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Most cited references 45

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Relationship between body image disturbance and incidence of depression: the SUN prospective cohort

Adriano Pimenta, Almudena Sánchez-Villegas, Maira Bes-Rastrollo … (2009)

Background Body image disturbance is an increasing problem in Western societies and is associated with a number of mental health outcomes including anorexia, bulimia, body dysmorphia, and depression. The aim of this study was to assess the association between body image disturbance and the incidence of depression. Methods This study included 10,286 participants from a dynamic prospective cohort of Spanish university graduates, who were followed-up for a median period of 4.2 years (Seguimiento Universidad de Navarra – the SUN study). The key characteristic of the study is the permanently open recruitment that started in 1999. The baseline questionnaire included information about body mass index (BMI) and the nine figure schemes that were used to assess body size perception. These variables were grouped according to recommended classifications and the difference between BMI and body size perception was considered as a proxy of body image disturbance. A subject was classified as an incident case of depression if he/she was initially free of depression and reported a physician-made diagnosis of depression and/or the use of antidepressant medication in at least one of the follow-up questionnaires. The association between body image disturbance and the incidence of depression was estimated by calculating the multivariable adjusted Odds Ratio (OR) and its 95% Confidence Interval (95% CI), using logistic regression models. Results The cumulative incidence of depression during follow-up in the cohort was 4.8%. Men who underestimated their body size had a high percentage of overweight and obesity (50.1% and 12.6%, respectively), whereas women who overestimated their body size had a high percentage of underweight (87.6%). The underestimation exhibited a negative association with the incidence of depression among women (OR: 0.72, 95% CI: 0.54 – 0.95), but this effect disappeared after adjusting for possible confounding variables. The proportion of participants who correctly perceived their body size was high (53.3%) and gross misperception was seldom found, with most cases selecting only one silhouette below (42.7%) or above (2.6%) their actual BMI. Conclusion We found no association between body image disturbance and subsequent depression in a cohort of university graduates in Spain.

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Sedentary behaviour in youth.

Russell R. Pate, Jonathan Mitchell, Wonwoo Byun … (2011)

The purpose of this review is to describe the amount of time children spend in sedentary behaviour and to determine if there are specific factors that associate with sedentary behaviour in children. The following search terms were used to identify relevant articles: sedentary behaviour, inactivity, television, computer, video games, small screen, sitting, prevalence, patterns, correlates, factors and determinants. The databases used to conduct the search included PubMed, PsycINFO, ERIC (Education Resources Information Center) and Academic Search Premier. The studies reviewed were limited to those that sampled children (2-18 years), were written in English and used a measure of sedentary behaviour as the dependent variable. Several studies reported the time spent watching television or the proportion of children at or above a threshold for television viewing (eg, ≥3 h/day). Among the accelerometer studies included, the National Health and Nutrition Examination Survey is the largest and reported ∼6.1, 7.5 and 8.0 h/day mean sedentary time in children 6-11, 12-15 and 16-19 years old, respectively. Taken together, the existing literature across the world indicates a slightly higher level of sedentary behaviour in older children. Higher levels of sedentary behaviour were also reported in non-white children, children from lower socioeconomic status background and children from households with more access to televisions/computers. Lower levels of sedentary behaviour were reported in children whose parents have rules/limitations on screen time.

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Determinants of adolescent physical activity and inactivity patterns.

P Gordon-Larsen, R G McMurray, B Popkin (2000)

Despite recognition of the important influence of environmental determinants on physical activity patterns, minimal empirical research has been done to assess the impact of environmental/contextual determinants of physical activity. This article aims to investigate environmental and sociodemographic determinants of physical activity and inactivity patterns among subpopulations of US adolescents. We define environmental determinants as modifiable factors in the physical environment that impose a direct influence on the opportunity to engage in physical activity. The present research examines environmental and sociodemographic determinants of physical activity and inactivity with the implication that these findings can point toward societal-level intervention strategies for increasing physical activity and decreasing inactivity among adolescents. The study population consists of nationally representative data from the 1996 National Longitudinal Study of Adolescent Health on 17 766 US adolescents enrolled in US middle and high schools (including 3933 non-Hispanic blacks, 3148 Hispanics, and 1337 Asians). Hours/week of inactivity (TV/video viewing and video/computer games) and times/week of moderate to vigorous physical activity were collected by questionnaire. Outcome variables were moderate to vigorous physical activity and inactivity, which were broken into categories (physical activity: 0-2 times/week, 3-4 times/week, and >/=5 times/week; inactivity: 0-10 hours/week, 11-24 hours/week, and >/=25 hours/week). Sociodemographic and environmental correlates of physical activity and inactivity were used as exposure and control variables and included sex, age, urban residence, participation in school physical education program, use of community recreation center, total reported incidents of serious crime in neighborhood, socioeconomic status, ethnicity, generation of residence in the United States, presence of mother/father in household, pregnancy status, work status, in-school status, region, and month of interview. Logistic regression models of high versus low and medium physical activity and inactivity were used to investigate sex and ethnic interactions in relation to environmental and sociodemographic factors to examine evidence for the potential impact of physical education and recreation programs and sociodemographic factors on physical activity and inactivity patterns. Moderate to vigorous physical activity was lower and inactivity higher for non-Hispanic black and Hispanic adolescents. Participation in school physical education programs was considerably low for these adolescents and decreased with age. Participation in daily school physical education (PE) program classes (adjusted odds ratio [AOR]: 2.21; confidence interval [CI]: 1.82-2.68) and use of a community recreation center (AOR: 1.75; CI: 1.56-1.96) were associated with an increased likelihood of engaging in high level moderate to vigorous physical activity. Maternal education was inversely associated with high inactivity patterns; for example, having a mother with a graduate or professional degree was associated with an AOR of.61 (CI:.48-.76) for high inactivity. High family income was associated with increased moderate to vigorous physical activity (AOR: 1.43; CI: 1.22-1.67) and decreased inactivity (AOR:.70; CI:.59-.82). High neighborhood serious crime level was associated with a decreased likelihood of falling in the highest category of moderate to vigorous physical activity (AOR:.77; CI:.66-.91). These results show important associations between modifiable environmental factors, such as participation in school PE and community recreation programs, with activity patterns of adolescents. Despite the marked and significant impact of participation in school PE programs on physical activity patterns of US adolescents, few adolescents participated in such school PE programs; only 21.3% of all adolescents

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Author and article information

Contributors

Gregore I. Mielke: 55 (53) 3284 1300 , gregore.mielke@gmail.com

Journal

Journal ID (nlm-ta): Sports Med

Journal ID (iso-abbrev): Sports Med

Title: Sports Medicine (Auckland, N.z.)

Publisher: Springer International Publishing (Cham )

ISSN (Print): 0112-1642

ISSN (Electronic): 1179-2035

Publication date (Electronic): 3 June 2016

Publication date PMC-release: 3 June 2016

Publication date (Print): 2017

Volume: 47

Issue: 1

Pages: 61-75

Affiliations

[1 ]Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro 1160, 3rd floor, Pelotas, 96020-220 Brazil

[2 ]School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, QLD Australia

[3 ]Department of Nursing, Federal University of Pelotas, Pelotas, Brazil

Article

Publisher ID: 555

DOI: 10.1007/s40279-016-0555-4

PMC ID: 5215067

PubMed ID: 27260683

SO-VID: 3ae849e6-a143-4c75-a383-b775561f3039

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

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Socioeconomic Correlates of Sedentary Behavior in Adolescents: Systematic Review and Meta-Analysis

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Abstract

Background

Objectives

Methods

Results

Conclusion

Electronic supplementary material

Related collections

Road 2 Open Meta

Most cited references 45

Relationship between body image disturbance and incidence of depression: the SUN prospective cohort

Sedentary behaviour in youth.

Determinants of adolescent physical activity and inactivity patterns.

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Cited by 49

Most referenced authors 4,313