Risk factors associated with abdominal obesity in suburban adolescents from a Malaysian district. Dietary intake, physical activity and energy expenditure of Malaysian adolescents. Challenge! Health Promotion/Obesity Prevention Mentorship Model Among Urban, Black Adolescents Physical activity, eating behaviour and body image perception among young adolescents in Kuantan, Pahang, Malaysia. Association of dietary habits with levels of physical activity and screen time among adolescents living in Saudi Arabia. Preventing obesity among Brazilian adolescent girls: Six-month outcomes of the Healthy Habits, Healthy Girls-Brazil school-based randomized controlled trial. A School-Based, Peer-Led, Social Marketing Intervention To Engage Spanish Adolescents in a Healthy Lifestyle ("We Are Cool"-Som la Pera Study): A Parallel-Cluster Randomized Controlled Study. Association between a healthy lifestyle and general obesity and abdominal obesity in an elderly population at high cardiovascular risk. Randomized controlled trial of a good practice approach to treatment of childhood obesity in Malaysia: Malaysian Childhood Obesity Treatment Trial (MASCOT). Increased physical activity and reduced adiposity in overweight Hispanic adolescents. Adolescent obesity in Syria: prevalence and associated factors. Dietary behaviors, physical activity and sedentary lifestyle associated with overweight and obesity, and their socio-demographic correlates, among Pakistani primary school children Promoting healthy eating and physical activity among school children: findings from Health-E-PALS, the first pilot intervention from Lebanon Relative Contribution of Physical Activity, Sedentary Behaviors, and Dietary Habits to the Prevalence of Obesity among Kuwaiti Adolescents Association of physical activity and dietary behaviours in relation to the body mass index in a national sample of Iranian children and adolescents: CASPIAN Study. Associations Between Screen-Based Sedentary Behavior and Cardiovascular Disease Risk Factors in Korean Youth Psychosocial correlates of physical activity and sedentary leisure habits in young adolescents: the Teens Eating for Energy and Nutrition at School study.
INTRODUCTION We aim ed to determine the risk factors associated with abdominal obesity ( AO )  in suburban adolescents . METHODS This cross-sectional study included adolescents aged 15 - 17 years from five r and omly selected secondary schools in the Hulu Langat district of Selangor state , Malaysia .  Waist circumference ( WC ) was measured at the midpoint between the lower margin of the last palpable rib and the top of the iliac crest . Information on sociodemographic data , dietary habits , physical activity levels and duration of sleep was obtained via interviewer-administered question naires . Participants ' habitual food intake was determined using a 73-item Food Frequency Question naire . RESULTS Among 832 participants , 56.0 % were girls ; 48.4 % were Malay , 40.5 % Chinese , 10.2 % Indian and 0.8 % of other ethnic groups . Median age and WC were 16 ( interquartile range [ IQR ] 15 - 16 ) years and 67.9 ( IQR 63.0 - 74.6 ) cm , respectively . Overall prevalence of AO ( > 90th percentile on the WC chart ) was 11.3 % . A higher proportion ( 22.4 % ) of Indian adolescents were found to have AO compared with Malay and Chinese adolescents . Logistic regression analysis showed that female gender ( adjusted odds ratio [ OR ] 7.064 , 95 % confidence interval [ CI ] 2.087 - 23.913 ; p = 0.002 ) , Indian ethnicity ( adjusted OR 10.164 , 95 % CI 2.182 - 47.346 ; p = 0.003 ) , irregular meals ( adjusted OR 3.193 , 95 % CI 1.043 - 9.774 ; p = 0.042 ) and increasing body mass index ( BMI ) ( adjusted OR 2.867 , 95 % CI 2.216 - 3.710 ; p < 0.001 ) were significantly associated with AO . CONCLUSION AO was common among Malaysian adolescents . Female gender , Indian ethnicity , irregular meals and increasing BMI were significant risk factors INTRODUCTION Paediatric obesity is a public health concern worldwide as it can track into adulthood and increase the risk of adult morbidity and mortality . While the aetiology of obesity is multi-factorial , the roles of diet and physical activity are controversial . Thus , the purpose of this study was to report on the differences in  energy intake , diet composition , time spent doing physical activity and energy expenditure  among underweight ( UW ) , normal weight ( NW ) and at-risk of overweight ( OW ) Malaysian adolescents ( 317 females and 301 males ) aged 11 - 15 years . METHODS This was a cross-sectional study with 6,555 adolescents measured for weights and heights for body mass index ( BMI ) categorisation . A total of 618 subjects were r and omly selected from each BMI category according to gender . The subjects '  dietary intake and physical activity  were assessed using self-reported three-day food and activity records , respectively . Dietary intake components included total energy and macronutrient intakes .  Energy expenditure was calculated as a sum of energy expended for basal metabolic rate and physical activity . Time spent ( in minutes ) in low , medium and high intensity activities was also calculated . RESULTS The OW adolescents had the highest crude energy intake and energy expenditure . However , after adjusting for body weight , the OW subjects had the lowest energy intake and energy expenditure ( p-value is less than 0.001 ) . The study groups did not differ significantly in time spent for low , medium and high intensity activities . Macronutrient intakes differed significantly only among the girls where the OW group had the highest intakes compared to UW and NW groups ( p-value is less than 0.05 ) . All study groups had greater than 30 percent and less than 55 percent of energy intake from fat and carbohydrate , respectively . CONCLUSION The data suggested that a combination of low energy expenditure adjusted for body weight and high dietary fat intake may be associated with overweight and obesity among adolescents . To prevent overweight and obesity among children and adolescents , strategies that address eating behaviours and physical activity are required . Various segments of the society must be involved in efforts to promote healthful dietary intakes and active lifestyle in children and adolescents OBJECTIVES : The objective of this study was to evaluate a 12-session home/community-based health promotion/obesity prevention program ( Challenge ! ) on changes in BMI status , body composition , physical activity , and diet . METHODS : A total of 235 black adolescents ( aged 11–16 years ; 38 % overweight/obese ) were recruited from low-income urban communities . Baseline measures included weight , height , body composition , physical activity ( PA ) , and diet . PA was measured by 7-day play-equivalent physical activity ( ≥1800 activity counts per minute ) . Participants were r and omly assigned to health promotion/obesity prevention that is anchored in social cognitive theory and motivational interviewing and was delivered by college-aged black mentors or to control . Postintervention ( 11 months ) and delayed follow-up ( 24 months ) evaluations were conducted . Longitudinal analyses used multilevel models with r and om intercepts and generalized estimating equations , controlling for baseline age/gender . Stratified analyses examined baseline BMI category . RESULTS : Retention was 76 % over 2 years ; overweight/obese status declined 5 % among intervention adolescents and increased 11 % among control adolescents . Among overweight/obese youth , the intervention reduced total percentage of body fat and fat mass and increased fat-free mass at delayed follow-up and increased play-equivalent physical activity at postintervention but not at delayed follow-up . Intervention adolescents declined significantly more in snack/dessert consumption than control adolescents at both follow-up evaluations . CONCLUSIONS : At postintervention , there were intervention effects on diet and PA but not BMI category or body composition . At delayed follow-up , dietary changes were sustained and the intervention prevented an increase in BMI category . Body composition was improved for overweight/obese youth . Changes in body composition follow changes in diet and PA and may not be detected immediately after intervention INTRODUCTION A cross-sectional study was conducted to determine physical activity , eating behaviour , body weight management knowledge , perception of body image and their association with  body weight status of adolescents . METHODS Respondents were 360 adolescents , aged between 13 to 14 years , from six r and omly selected secondary schools in Kuantan , Pahang . Physical  activity , eating behaviour , body weight management knowledge and perception of body image were measured by the  Physical Activity Question naire for Older Children ( PAQ-C ) , Eating Attitude Test-26 ( EAT-26 ) , Weight Management Knowledge Inventory ( WMKI ) and Contour Drawing Rating Scale ( CDRS ) , respectively . RESULTS Almost half of the respondents were categorised as having a normal BMI , while 30.3 % were severely thin and thin and 20.3 % were overweight and obese . Mean physical activity score was 2.06 + /- 0.45 with more males ( 35.0 % ) being physically active than females ( 17.3 % ) . Mean eating behaviour score was 15.41 + /- 10.37 , with 27.8 % of the respondents being at-risk for eating disorders . Mean weight management knowledge score was 5.35 + /- 1.80 , with more females ( 77.7 % ) having higher mean scores than males ( 42.3 % ) . Further , mean discrepancy score for body image perception was 1.24 + /- 0.99 , with 78.1 % of the respondents being dissatisfied with their current body size . Positive associations were found between eating behaviour ( r = 0.28 , p < 0.05 ) and body image ( r = 0.35 , p < 0.05 ) with BMI . Respondents with high eating behaviour scores and body image discrepancy scores were more likely to have greater BMI . CONCLUSION This study shows the need for healthy eating and body image intervention programmes to prevent overweight and obesity problems among adolescents BACKGROUND Underst and ing the inter-relationships between lifestyle factors in youth is important with respect to the development of effective promotional programmes for healthy eating and active living . The present study aim ed to explore the associations of dietary habits ( DH ) with physical activity ( PA ) and screen time ( ST )  among Saudi adolescents aged between 15 and 19 years of age relative to gender . METHODS Data were obtained from the Arab Teens Lifestyle Study , a school-based multicentre lifestyle study conducted in 2009/2010 in three major cities in Saudi Arabia . A multistage stratified cluster r and om sampling technique was used . The number of participants with complete data for  DH  and  PA  was 2886 and the respective number for DH and ST was 2822 . Assessment included weight , height , body mass index , total daily ST ( television viewing , video/computer games and Internet use ) , PA and DH using self-reported question naires . RESULTS Females were significantly more sedentary and less active than males ( P < 0.001 ) . Two-way analysis of covariance , controlling for age , showed significant ( P < 0.05 ) gender by PA and gender by ST interactions for several DH . Logistic regression analyses revealed significant associations of higher PA with a higher consumption of fruit , vegetables , milk , French fries/potato chips and energy drinks , whereas higher ST was significantly associated with a higher consumption of sugar-sweetened drinks , fast foods , cake/doughnuts and energy drinks . CONCLUSIONS Healthful dietary habits were associated mostly with  PA  , whereas sedentary behaviours , independent of PA , negatively impacted upon eating behaviours . The low PA levels and high sedentary levels of Saudi females represent a great concern . The results reported in the present study have important implication s for both youth public health policies and intervention programmes BACKGROUND School-based trials to prevent and reduce prevalence of pediatric obesity in low-income countries are necessary . In Brazil , addressing adolescent obesity is a public health priority . OBJECTIVE To evaluate the impact of a group r and omized controlled trial involving a 6-month multicomponent school-based obesity prevention program  targeting adolescent girls . METHODS The  Healthy Habits , Healthy Girls-Brazil program recruited participants ( n=253 ; 16.05±0.05 years ) from ten eligible public technical schools in São Paulo , Brazil . The program was adapted from an Australian intervention study , which is based on the Social Cognitive Theory . The primary outcome measure was body mass index ( BMI ) , and secondary outcomes included BMI z score , waist circumference , and various sedentary and dietary health-related behaviours . RESULTS Although changes in BMI were not statistically significant , differences favored the intervention group ( adjusted mean difference , -0.26kg/m(2),se SE=0.018 , p=0.076 ) . Statistically significant intervention effects were found for waist circumference ( -2.28 cm ; p= , p=0.01 ) , computer screen time on the weekends ( 0.63h/day , p ; p=0.02 ) , total sedentary activities on the weekends ( -0.92h/day , p<0.01 ) , and vegetable intake ( 1.16servings/day , p=0.01 ) . CONCLUSION These findings provide some evidence for the benefit of a school-based intervention to prevent unhealthy weight gain in adolescent girls living in low-income communities BACKGROUND Encouraging adolescents to adopt healthy lifestyles can be challenging . The aim of the " Som la Pera " study was to engage adolescents by applying new strategies to increase both their fruit and vegetable consumption and their  physical activity ( PA )  while reducing their sedentary behavior . METHODS In disadvantaged neighborhoods of Reus ( Spain ) , two high schools were r and omly assigned to the intervention ( n = 170 adolescents 13- to 16-year-olds ) and two were assigned to the control group ( n = 223 adolescents 13- to 16-year-olds ) . The intervention , which lasted 12 months and spanned 2 academic years ( 2013 - 2015 ) , used social marketing ( SM ) to improve healthy choices . The peer-led strategy involved 5 adolescents who design ed and implemented 10 activities as challenges for their 165 school-aged peers . The control group received no intervention . To assess self-reported lifestyles in both groups , the Health Behavior in School-Aged Children Survey was used at baseline and end of study . RESULTS After 12 months , intervention adolescents showed an increase of 28.9 % in ≥1 fruit/day ( p < 0.01 ) and of 18.5 % in ≥6 hours/week of PA ( p < 0.01 ) compared with controls . Additionally , intervention group males had an increase of 28.8 % in ≥1 vegetable/day ( p < 0.01 ) and of 15.6 % in ≤2 hours/day of sedentary activity ( p = 0.01 ) compared with controls . CONCLUSIONS A school-based , peer-led , SM intervention developed by adolescents attending high schools in low-income neighborhoods effectively improved the healthy choices of their school-aged peers , leading to increased fruit consumption and PA in adolescents of both genders . Furthermore , adolescent males were more sensitive to improvements in healthy choices , showing increased vegetable consumption and decreased sedentary behavior BACKGROUND Diet , smoking and physical activity are important modifiable lifestyle factors that can influence body weight and fat accumulation . We assessed the relationship between lifestyle and obesity risk in a baseline analysis of the PREDIMED study , a r and omized dietary primary prevention trial conducted in Spain . METHODS 7000 subjects at high cardiovascular risk were assessed cross-sectionally . A  healthy lifestyle pattern ( HLP ) was determined using a score including :  adherence to the Mediterranean diet , moderate alcohol consumption , expending ≥200 kcal/day in leisure-time physical activity , and non-smoking . RESULTS Inverse linear trends were observed between the HLP-score and body-mass-index ( BMI ) or waist circumference ( p<0.001 ) . The BMI and waist circumference of participants with a HLP-score=4 were , respectively , 1.3 kg/m(2 ) ( 95 % CI : 0.9 to 1.7 ) and 4.3 cm ( 3.1 to 5.4 ) lower than those of subjects with an HLP≤1 . The odds ratios of general obesity and abdominal obesity for an HLP score of 4 compared to an HPL score≤1 were 0.50 ( 0.42 to 0.60 ) and 0.51 ( 0.41 to 0.62 ) , respectively . CONCLUSION A combination of four healthy lifestyle behaviors was associated with a lower prevalence of general obesity and abdominal obesity in Mediterranean elderly subjects at high cardiovascular risk CONTEXT Few r and omized controlled trials ( RCTs ) of interventions for the treatment of childhood obesity have taken place outside the Western world . AIM To test whether a good practice intervention for the treatment of childhood obesity would have a greater impact on weight status and other outcomes than a control condition in Kuala Lumpur , Malaysia . METHODS Assessor-blinded RCT of a treatment intervention in 107 obese 7- to 11-year olds . The intervention was relatively low intensity ( 8 hours contact over 26 weeks , group based ) , aim ing to change child sedentary behavior , physical activity , and diet using behavior change counselling . Outcomes were measured at baseline and six months after the start of the intervention . Primary outcome was BMI z-score , other outcomes were weight change , health-related quality of life ( Peds QL ) , objective ly measured physical activity and sedentary behavior ( Actigraph accelerometry over 5 days ) . RESULTS The intervention had no significant effect on BMI z score relative to control . Weight gain was reduced significantly in the intervention group compared to the control group ( + 1.5 kg vs. + 3.5 kg , respectively , t-test p < 0.01 ) . Changes in health-related quality of life and objective ly measured physical activity and sedentary behavior favored the intervention group . CONCLUSIONS Treatment was associated with reduced rate of weight gain , and improvements in physical activity and quality of life . More substantial benefits may require longer term and more intensive interventions which aim for more substantive lifestyle changes PURPOSE The objectives of this study were to examine 1 ) whether changes in total physical activity  ( PA ; counts per minute , cpm ) and time spent in moderate to vigorous PA ( MVPA ) are associated with changes in adiposity and 2 ) whether energy intake influences the relationship between changes in PA and changes in adiposity in overweight Hispanic adolescents . METHODS Analysis included 38 overweight ( body mass index , > 85th percentile ) Hispanic adolescents with complete pretest and posttest data on relevant variables after participating in a 16-wk intervention . The intervention treatment did not influence PA , so the sample was combined and the r and omization group was adjusted for in the analysis . Body composition by dual-energy x-ray absorptiometry , 7-d PA by accelerometry , and dietary intake by 3-d diet records were assessed before and after intervention . RESULTS Within individuals , the mean increase of PA ( n = 19 ) and mean decrease of PA ( n = 19 ) was approximately 105 cpm . A 100-cpm increase in total PA was associated with a decrease of 1.3 kg of fat mass and 0.8 % body fat after adjusting for pretest adiposity , PA , age , sex , and treatment ( P < 0.05 ) . Controlling for energy intake modestly strengthened the relationships between total PA and fat mass and percent body fat . Changes in MVPA were not related to changes in adiposity after controlling for total PA ( P > 0.05 ) . CONCLUSIONS Increasing total PA  by 28 % ( 100 cpm ) was associated with a decrease of 1.4 kg of fat mass and 1 % body fat for 16 wk in overweight Hispanic adolescents independent of intervention group assignment . Increases in total PA , compared with MVPA , may be sufficient to improve body composition in overweight Hispanic adolescents Abstract Background Data on the prevalence of overweight and obesity in Eastern Mediterranean countries remain scarce , particularly for children and adolescents . The objective of this study is to estimate the prevalence of obesity and examine associated factors and covariates amongst school adolescents in Syria . Methods A cross-sectional survey of a representative sample of 776 adolescents ( 386 males and 390 females ) , aged 15 - 18 years , was conducted in six r and omly chosen secondary schools in Damascus , the capital city of Syria .  Anthropometric measurements and dietary assessment data  were collected using st and ard methods and techniques . Overweight and obesity were defined according to World Health Organization 2007 child growth st and ards . Results The prevalence rates of overweight and obesity were estimated at 18.9 and 8.6 % , respectively . Carbohydrate and saturated fatty acid intakes were significantly higher amongst overweight and obese ( 250.66 and 32.82 g/day , respectively ) as compared with normal weight adolescents ( 218.12 and 26.10 g/day , respectively ) . Regression analysis showed that the likelihood of obesity was significantly greater amongst adolescent boys than girls ( OR = 2.30 , P < 0.05 ) and amongst subjects reporting family history of obesity ( OR = 2.98 , P < 0.05 ) . The odds of obesity increased consistently with increasing educational attainment of both parents and was higher ( OR = 1.63 ) amongst adolescents reporting lower crowding index than their counterparts . Conclusion Our findings of a positive association between obesity and socio-economic status measured by parental education and crowding index call for intervention strategies for the promotion of healthy dietary practice s not only amongst school adolescents but also parents , targeting families as the unit of intervention . Further studies are needed to examine nutritional habits and food choices amongst families of different socio-economic strata Background There is no data on diet- and activity-related behaviors associated with overweight and obesity among Pakistani school-aged children . The study aim ed to explore  dietary behaviors , physical activity and sedentary lifestyle  associated with overweight and obesity , and their socio-demographic correlates , among Pakistani primary school children . Methods A population -based cross-sectional study was conducted with a representative multistage r and om cluster sample of 1860 children aged five to twelve years in Lahore , Pakistan . Overweight ( > + 1 SD ) and obesity ( > + 2 SD ) were defined using the World Health Organization reference 2007 . Chi-square test was used as the test of trend . Linear regression was used to examine the predictive power of independent variables in relation to body mass index ( BMI ) . Logistic regression was used to quantify the independent predictors and adjusted odds ratios ( aOR ) with 95 % confidence intervals ( CI ) were obtained . Statistical significance was considered at P < 0.05 . Results Children skipping breakfast ( 8 % ) , eating fast food and snacks ≥ once a week ( 43 % ) and being involved in sedentary lifestyle > one hour a day ( 49 % ) were significantly more likely to be overweight and obese while those participating in physical activity > twice a week ( 53 % ) were significantly less likely to be overweight and obese ( all P < 0.01 ) . Skipping breakfast ( P < 0.001 ) , eating fast food and snacks ( P = 0.001 ) and sedentary lifestyle ( P < 0.001 ) showed an independent positive association with BMI while physical activity showed an independent inverse association ( P = 0.001 ) . Skipping breakfast ( aOR 1.82 , 95 % CI 1.22 - 2.71 ) , eating fast food and snacks ≥ once a week ( OR 1.41 , 95 % CI 1.07 - 1.86 ) , physical activity > twice a week ( aOR 0.49 , 95 % CI 0.34 - 0.70 ) and sedentary lifestyle > one hour a day ( aOR 1.56 , 95 % CI 1.19 - 2.03 ) were independent predictors of being overweight . Skipping breakfast had independent inverse association with physical activity ( aOR 0.63 , 95 % CI 0.45 - 0.89 ) and eating fast food and snacks had independent positive association with sedentary lifestyle ( aOR 1.79 , 95 % CI 1.49 - 2.16 ) . Female gender was independently associated with skipping breakfast ( aOR 1.50 , 95 % CI 1.04 - 2.16 ) . Male gender ( aOR 1.64 , 95 % CI 1.33 - 2.02 ) , urban area with high SES ( aOR 5.09 , 95 % CI 3.02 - 8.60 ) and higher parental education ( aOR 1.74 , 95 % CI 1.12 - 2.68 ) were significant independent predictors of eating fast food and snacks ≥ once a week . Living in the rural area was independently associated ( aOR 2.51 , 95 % CI 1.71 - 3.68 ) with physical activity > twice a week . Male gender ( aOR 1.60 , 95 % CI 1.31 - 1.95 ) , urban area with low SES ( aOR 1.46 , 95 % CI 1.02 - 2.09 ) , high-income neighborhoods ( aOR 1.52 , 95 % CI 1.02 - 2.25 ) , higher parental education ( aOR 1.55 , 95 % CI 1.03 - 2.34 ) and fewer siblings ( aOR 1.38 , 95 % CI 1.10 - 1.73 ) were independent predictors of sedentary lifestyle > one hour a day . Conclusions Dietary behaviors , physical activity and sedentary lifestyle are independent predictors of overweight  and higher BMI among Pakistani primary school children , and are significantly affected by the child 's socio-demographic characteristics . These findings support the urgent need to develop a National strategy for diet and physical activity and to implement culturally relevant behavioral interventions in the re source -poor developing country setting Background In Lebanon , childhood obesity doubled during the past decade . Preventive measures should start early in life and Schools are considered an important environment to promote energy balance health behaviours . School-based programmes promoting healthy lifestyles are lacking . The purpose of this study was to evaluate the feasibility and effectiveness of a multicomponent school-based intervention to promote healthy eating and physical activity ( and prevent obesity ) with school children aged 9–11 years in Lebanon . Methods The intervention was developed based on the constructs of the Social Cognitive Theory and adapted to the culture of Lebanese and Arab population s. It consisted of three components : class curriculum , family involvement and food service .  Eight schools were purposively selected from two communities of different socioeconomic status ( SES ) in Beirut and , within each school type , were matched on SES , religious sect profile , and then r and omly assigned to either the intervention or control group . Anthropometric measurements and question naires on determinants of behavioural change , eating and physical activity habits were completed by the students in both groups at baseline and post intervention . Focus group interviews were conducted in intervention schools at the end of the study . Challenges encountered during the programme implementation were also identified , since Lebanon is considered a country with political unrest and no similar research projects were conducted in the area . Results Students in the intervention group reported purchasing and consuming less chips and sweetened drinks post-intervention compared with controls ( 86 % & 88 % less respectively p < 0.001 ) . Knowledge and self-efficacy scores increased for the intervention ( + 2.8 & + 1.7 points respectively p < 0.001 ) but not for the control group . There was no difference in physical activity and screen time habits and no changes in BMI between groups at post intervention . Interview data from focus groups showed that the programme was generally well accepted . Limitations for better outcomes include the length of the programme and the school environment . Conclusion “ Health-E-PALS ” intervention is a promising innovative , theory-based , culturally sensitive intervention to promote healthy eating habits and physical activity in Lebanese school children with a potential to be scaled up , replicated and sustained Background The increasing rate of obesity among Kuwaiti adolescents is associated with immediate and long term-risks to their health and well-being . Objective To up date data on the prevalence of overweight and obesity among Kuwaiti adolescents and to examine the relative contribution of selected lifestyle factors to overweight and obesity in this population . Methods The present study is part of the Arab Teens Lifestyle Study ( ATLS ) . A total of 906 adolescents ( 463 boys and 443 girls ) aged between 14 and 19 years were selected from Kuwaiti schools by a multistage stratified r and omization process . A vali date d question naire was used to collect data on  physical activity , sedentary lifestyle , and eating habits . The International Obesity Task Force ( IOTF ) cutoff values for adolescents under 18 years of age were used to define overweight and obesity . Total energy expenditure was calculated using metabolic equivalent-minutes per week . A general linear model was used to establish the proportion of the variance ( expressed in partial eta squared ) in excess weight attributable to differences in eating habits and physical activity . Results The prevalence of overweight and obesity was 50.5 % in boys and 46.5 % in girls . Among boys , moderate and vigorous activities were found to be significantly negatively associated with overweight and obesity ( p < .05 ) , whereas in girls , only those with not less than moderate activities were negatively associated with overweight and obesity ( p < .05 ) . Sedentary behaviors , time spent watching television , and time spent working on the computer were not significantly associated with obesity in either sex . Consumption of breakfast , vegetables , and fast foods ( boys and girls ) and potatoes , cakes and doughnuts , and sweets ( girls only ) was significantly associated with overweight and obesity ( p < .05 ) . In general , the partial eta square explained by physical activity was less than 3.6 % in boys compared with less than 1.0 % in girls , and eating habits explained less than 1.8 % in boys compared with 2.5 % in girls . Conclusions Physical activity explains a greater proportion of variation in body mass index than do eating habits , particularly in boys . Eating habits explain a greater proportion of variation in body mass index than does physical activity in girls . Prospect i ve studies are needed to clarify the relative effects of sedentary behaviors on overweight in adolescents OBJECTIVE To examine the relation of dietary and physical activity ( PA ) patterns with the body mass index ( BMI ) , and the associations between these patterns among children . METHODS A representative sample of 21 111 school students aged 6 - 18 years was selected by multistage r and om cluster sampling from 23 provinces in the Islamic Republic of Iran .  PA and dietary pattern  were assessed by self-administered vali date d question naires . FINDINGS Fruit and vegetables , dairy products and snacks ( salty , fatty or sweet ) had a similar consumption frequency of approximately twice a day . The type of fat most frequently consumed was hydrogenated solid fat ( consumed by 73.8 % of families ) . The  PA level was significantly higher among boys than girls , in rural than in urban residents , and in intermediate students than high-school students . Among boys , the frequency of consumption of vegetables and plant proteins  ( R(2 ) = 0.46 ) ; and among girls , the frequency of consumption of dairy products and fruits  , as well as  high PA level had a significant inverse association with BMI ( R(2 ) = 0.57 ) . Among boys , the low frequency of consumption of fruits , the time spent on PA and the energy expenditure ; and among girls , the time spent on PA and the energy expenditure , had significant relationships with overweight . When controlling for covariates ,  PA levels had significant relationships with the frequency of consumption of all food groups . CONCLUSION Unhealthy lifestyles make Iranian young people prone to chronic diseases later in life . When examining their health benefits , the interrelationship of dietary and PA behaviours should be considered The purpose s of this study were to : 1 ) describe the patterns of screen-based sedentary behaviors  , and 2 ) examine the association between  screen-based sedentary behavior and cardiovascular disease ( CVD ) risk factors in representative Korean children and adolescents , aged 12 to 18 yr , in the Korean National Health and Nutrition Examination Survey .  Screen-based sedentary behavior  was measured using self-report question naires that included items for time spent watching TV and playing PC/video games . Physical activity  was measured using items for frequency and duration of moderate-to-vigorous physical activity ( MVPA )  . CVD risk factors such as body mass index ( BMI ) , waist circumference , LDL cholesterol , HDL cholesterol , total cholesterol , triglycerides , glucose , systolic blood pressure , and diastolic blood pressure were measured . Boys spent more time playing PC/video games , and girls spent more time watching TV . After adjusting for age , gender , annual household income , and MVPA , an additional hour of watching TV was significantly associated with the risk of overweight ( OR 1.17 [ 95 % CI 1.03 - 1.33 ] ) , high abdominal adiposity ( OR 1.27 [ 1.06 - 1.51 ] ) , and low HDL cholesterol ( OR 1.27 [ 1.10 - 1.47 ] ) . An additional hour spent playing PC/video games  also increased the risk of high abdominal adiposity ( OR 1.20 [ 1.03 - 1.40 ] ) . Prospect i ve observations and interventions are needed to determine causal relationships between  screen-based sedentary behavior  and CVD risk profiles in Korean youth BACKGROUND Low levels of physical activity ( PA ) and highly sedentary leisure habits ( SLH ) in youth may establish behavioral patterns that will predispose youth to increased chronic disease risk in adulthood . The purpose of this paper was to examine associations of demographic and psychosocial factors with self-reported PA and SLH in young adolescents . METHODS A general linear mixed model predicted self-reported PA and SLH in the spring from demographic and psychosocial variables measured the previous fall in 3798 seventh grade students . RESULTS  PA and SLH differed by race , with Caucasian students reporting among the highest PA and lowest SLH . Perceptions of higher academic rank or expectations predicted higher  PA  and lower SLH . Depressive symptomatology predicted higher SLH scores but not PA .  Higher self-reported value of health , appearance , and achievement predicted higher PA  and lower SLH in girls . Girls who reported that their mothers had an authoritative parenting style also reported higher PA  and lower SLH . CONCLUSIONS Determinants of  PA  and SLH appear to differ from each other , particularly in boys . Development of effective programs to increase  PA  and /or decrease SLH in young adolescents should be based on a clear underst and ing of the determinants of these behaviors
The studies showed that obese and overweight adolescents consume significantly more energy and macronutrients .
They are also more likely to skip their daily meals compared to their normal weight peers .
In most studies , the direction of the PA effect on body weight was unclear .
Some studies found that higher PA is associated with a lower risk of overweight and obesity .
Conclusions This review identified a lack of evidence and well-conducted prospect i ve studies on the effect of diet and PA on cardio-metabolic health of Malaysian adolescents
Background A sedentary lifestyle and an unhealthy diet are major factors in the increasing prevalence of obesity among Malaysian adolescents .
The purpose of this systematic review is to compile the evidence from observational and intervention studies among Malaysian adolescents to evaluate the associations between diet and physical activity ( PA ) as determinants of cardio-metabolic risk factors .