Association of Body Mass Index with Moderate-Intensity Physical Activity, Eating Behavior, and the Use of the Internet or Games among Korean Middle School Students
Abstract
:1. Introduction
2. Materials and Methods
2.1. Design and Study Population
2.2. Measures
2.2.1. Independent Variable
2.2.2. Dependent Variables
2.2.3. Covariate Variables
2.3. Data Analysis
3. Results
3.1. Characteristics of the Study Population
3.2. Differences in the Characteristics of the Study Population Based on BMI
3.3. Association between BMI and the Weekly Frequency of Moderate-Intensity Physical Activity
3.4. Association between BMI and Breakfast Intake
3.5. Association between BMI and the Use of the Internet or Games
4. Discussion
4.1. Interpretation of the Findings
4.2. Practical Implications
4.3. Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Telama, R.; Yang, X.; Viikari, J.; Välimäki, I.; Wanne, O.; Raitakari, O. Physical activity from childhood to adulthood: A 21-year tracking study. Am. J. Prev. Med. 2005, 28, 267–273. [Google Scholar] [CrossRef] [PubMed]
- World Health Organization. WHO Guidelines on Physical Activity and Sedentary Behaviour; World Health Organization: Geneva, Switzerland, 2020. [Google Scholar]
- Farooq, A.; Martin, A.; Janssen, X.; Wilson, M.G.; Gibson, A.M.; Hughes, A.; Reilly, J.J. Longitudinal changes in moderate-to-vigorous-intensity physical activity in children and adolescents: A systematic review and meta-analysis. Obes. Rev. 2020, 21, e12953. [Google Scholar] [CrossRef] [PubMed]
- Janssen, X.; Basterfield, L.; Parkinson, K.N.; Pearce, M.S.; Reilly, J.K.; Adamson, A.J.; Reilly, J.J. Non-linear longitudinal associations between moderate-to-vigorous physical activity and adiposity across the adiposity distribution during childhood and adolescence: Gateshead Millennium Study. Int. J. Obes. 2019, 43, 744–750. [Google Scholar] [CrossRef]
- Gutin, B.; Yin, Z.; Humphries, M.C.; Barbeau, P. Relations of moderate and vigorous physical activity to fitness and fatness in adolescents. Am. J. Clin. Nutr. 2005, 81, 746–750. [Google Scholar] [CrossRef] [PubMed]
- Chmelík, F.; Frömel, K.; Groffik, D.; Šafář, M.; Mitáš, J. Does vigorous physical activity contribute to adolescent life satisfaction? Int. J. Environ. Res. Public Health 2021, 18, 2236. [Google Scholar] [CrossRef] [PubMed]
- Bull, F.C.; Al-Ansari, S.S.; Biddle, S.; Borodulin, K.; Buman, M.P.; Cardon, G.; Carty, C.; Chaput, J.P.; Chastin, S.; Chou, R.; et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Brit. J. Sport Med. 2020, 54, 1451–1462. [Google Scholar] [CrossRef] [PubMed]
- Guthold, R.; Stevens, G.A.; Riley, L.M.; Bull, F.C. Global trends in insufficient physical activity among adolescents: A pooled analysis of 298 population-based surveys with 1· 6 million participants. Lancet Child Adolesc. Health 2020, 4, 23–35. [Google Scholar] [CrossRef]
- Nader, P.R.; Bradley, R.H.; Houts, R.M.; McRitchie, S.L.; O’Brien, M. Moderate-to-vigorous physical activity from ages 9 to 15 years. JAMA 2008, 300, 295–305. [Google Scholar] [CrossRef]
- Di Cesare, M.; Sorić, M.; Bovet, P.; Miranda, J.J.; Bhutta, Z.; Stevens, G.A.; Laxmaiah, A.; Kengne, A.P.; Bentham, J. The epidemiological burden of obesity in childhood: A worldwide epidemic requiring urgent action. BMC Med. 2019, 17, 212. [Google Scholar] [CrossRef]
- Tyson, N.; Frank, M. Childhood and adolescent obesity definitions as related to BMI, evaluation and management options. Best Pract. Res. Clin. Obstet. Gynaecol. 2018, 48, 158–164. [Google Scholar] [CrossRef]
- Kansra, A.R.; Lakkunarajah, S.; Jay, M.S. Childhood and adolescent obesity: A review. Front. Pediatr. 2021, 8, 581461. [Google Scholar] [CrossRef]
- Isganaitis, E.; Lustig, R.H. Fast food, central nervous system insulin resistance, and obesity. Arterioscler. Thromb. Vasc. Biol. 2005, 25, 2451–2462. [Google Scholar] [CrossRef] [PubMed]
- Poorolajal, J.; Sahraei, F.; Mohamdadi, Y.; Doosti-Irani, A.; Moradi, L. Behavioral factors influencing childhood obesity: A systematic review and meta-analysis. Obes. Res. Clin. Pract. 2020, 14, 109–118. [Google Scholar] [CrossRef] [PubMed]
- Pereira, M.A.; Kartashov, A.I.; Ebbeling, C.B.; Van Horn, L.; Slattery, M.L.; Jacobs, D.R.; Ludwig, D.S. Fast-food habits, weight gain, and insulin resistance(the CARDIA study): 15-year prospective analysis. Lancet 2005, 365, 36–42. [Google Scholar] [CrossRef]
- Fleischhacker, S.E.; Evenson, K.R.; Rodriguez, D.A.; Ammerman, A.S. A systematic review of fast food access studies. Obes. Rev. 2011, 12, e460–e471. [Google Scholar] [CrossRef]
- Bahadoran, Z.; Mirmiran, P.; Azizi, F. Fast food pattern and cardiometabolic disorders: A review of current studies. Health Promot. Perspect. 2015, 5, 231. [Google Scholar] [CrossRef] [PubMed]
- Martin, A.J.; Bostwick, K.C.; Burns, E.C.; Munro-Smith, V.; George, T.; Kennett, R.; Pearson, J. A healthy breakfast each and every day is important for students’ motivation and achievement. J. School Psychol. 2024, 104, 101298. [Google Scholar] [CrossRef]
- Horikawa, C.; Kodama, S.; Yachi, Y.; Heianza, Y.; Hirasawa, R.; Ibe, Y.; Saito, K.; Shimano, H.; Yamada, N.; Sone, H. Skipping breakfast and prevalence of overweight and obesity in Asian and Pacific regions: A meta-analysis. Prev. Med. 2011, 53, 260–267. [Google Scholar] [CrossRef]
- Ma, X.; Chen, Q.; Pu, Y.; Guo, M.; Jiang, Z.; Huang, W.; Long, Y.; Xu, Y. Skipping breakfast is associated with overweight and obesity: A systematic review and meta-analysis. Obes. Res. Clin. Pract. 2020, 14, 1–8. [Google Scholar] [CrossRef]
- Blondin, S.A.; Anzman-Frasca, S.; Djang, H.C.; Economos, C.D. Breakfast consumption and adiposity among children and adolescents: An updated review of the literature. Pediatr. Obes. 2016, 11, 333–348. [Google Scholar] [CrossRef] [PubMed]
- Kim, J.Y. The nonlinear association between Internet using time for non-educational purposes and adolescent health. J. Prev. Med. Public. Health 2012, 45, 37. [Google Scholar] [CrossRef] [PubMed]
- Jiang, Q.; Huang, X.; Tao, R. Examining factors influencing internet addiction and adolescent risk behaviors among excessive internet users. Health Commun. 2018, 33, 1434–1444. [Google Scholar] [CrossRef]
- Oliveira, M.P.M.T.D.; Cintra, L.A.D.; Bedoian, G.; Nascimento, R.D.; Ferré, R.R.; Silva, M.T.A. Use of internet and electronic games by adolescents at high social risk. Trends Psychol. 2017, 25, 1167–1183. [Google Scholar] [CrossRef]
- Wei, R. Effects of playing violent videogames on Chinese adolescents’ pro-violence attitudes, attitudes toward others, and aggressive behavior. Cyberpsychol. Behav. 2007, 10, 371–380. [Google Scholar] [CrossRef]
- Purwaningsih, E.; Nurmala, I. The impact of online game addiction on adolescent mental health: A systematic review and meta-analysis. Open Access Maced. J. Med. Sci. 2021, 9, 260–274. [Google Scholar] [CrossRef]
- Felez-Nobrega, M.; Raine, L.B.; Haro, J.M.; Wijndaele, K.; Koyanagi, A. Temporal trends in leisure-time sedentary behavior among adolescents aged 12–15 years from 26 countries in Asia, Africa, and the Americas. Int. J. Behav. Nutr. Phys. Act. 2020, 17, 102. [Google Scholar] [CrossRef]
- Vallenilla, I.; Rousseau-Pierre, T.; Polanco, L.; Rivera, A.; Lopez, T.; Gonzalez, M.P.; Siegel, J.; Parajuli, S. 167. BMI Changes in an Adolescent Population During the COVID-19 Pandemic Lock-Down. J. Adolesc. Health 2022, 70, S87–S88. [Google Scholar] [CrossRef]
- World Health Organization and Regional Office for the Western Pacific. The Asia-Pacific Perspective: Redefining Obesity and Its Treatment; Health Communications Australia: Sydney, Australia, 2000. [Google Scholar]
- Deforche, B.I.; De Bourdeaudhuij, I.M.; Tanghe, A.P. Attitude toward physical activity in normal-weight, overweight and obese adolescents. J. Adolesc. Health 2006, 38, 560–568. [Google Scholar] [CrossRef] [PubMed]
- Hubbard, K.; Economos, C.D.; Bakun, P.; Boulos, R.; Chui, K.; Mueller, M.P.; Smith, K.; Sacheck, J. Disparities in moderate-to-vigorous physical activity among girls and overweight and obese schoolchildren during school-and out-of-school time. Int. J. Behav. Nutr. Phys. Act. 2016, 13, 1–8. [Google Scholar] [CrossRef] [PubMed]
- Heitmann, B.L.; Kaprio, J.; Harris, J.R.; Rissanen, A.; Korkeila, M.; Koskenvuo, M. Are genetic determinants of weight gain modified by leisure-time physical activity? A prospective study of Finnish twins. Am. J. Clin. Nutr. 1997, 66, 672–678. [Google Scholar] [CrossRef] [PubMed]
- Bild, D.E.; Sholinsky, P.; Smith, D.E.; Lewis, C.E.; Hardin, J.M.; Burke, G.L. Correlates and predictors of weight loss in young adults: The CARDIA study. Int. J. Obes. Relat. Metab. Disord. 1996, 20, 47–55. [Google Scholar] [PubMed]
- Rauner, A.; Mess, F.; Woll, A. The relationship between physical activity, physical fitness and overweight in adolescents: A systematic review of studies published in or after 2000. BMC Pediatr. 2013, 13, 19. [Google Scholar] [CrossRef] [PubMed]
- French, S.A.; Jeffery, R.W.; Murray, D. Is dieting good for you? Prevalence, duration and associated weight and behaviour changes for specific weight loss strategies over four years in US adults. Int. J. Obes. 1999, 23, 320–327. [Google Scholar] [CrossRef] [PubMed]
- Melzer, K.; Kayser, B.; Saris, W.H.; Pichard, C. Effects of physical activity on food intake. Clin. Nutr. 2005, 24, 885–895. [Google Scholar] [CrossRef] [PubMed]
- Liang, C.; Lee, P.F.; Yeh, P.C. Relationship between regular leisure-time physical activity and underweight and overweight status in Taiwanese young adults: A cross-sectional study. Int. J. Environ. Res. Public Health 2022, 20, 284. [Google Scholar] [CrossRef]
- Saikia, D.; Ahmed, S.J.; Saikia, H.; Sarma, R. Overweight and obesity in early adolescents and its relation to dietary habit and physical activity: A study in Dibrugarh town. Clin. Epidemiol. Glob. Health 2016, 4, S22–S28. [Google Scholar] [CrossRef]
- Canan, F.; Yildirim, O.; Ustunel, T.Y.; Sinani, G.; Kaleli, A.H.; Gunes, C.; Ataoglu, A. The relationship between internet addiction and body mass index in Turkish adolescents. Cyberpsychol Behav. Soc. Netw. 2014, 17, 40–45. [Google Scholar] [CrossRef] [PubMed]
- Mitchell, J.A.; Rodriguez, D.; Schmitz, K.H.; Audrain-McGovern, J. Greater screen time is associated with adolescent obesity: A longitudinal study of the BMI distribution from ages 14 to 18. Obesity 2013, 21, 572–575. [Google Scholar] [CrossRef] [PubMed]
- Stamatakis, E.; Hirani, V.; Rennie, K. Moderate-to-vigorous physical activity and sedentary behaviours in relation to body mass index-defined and waist circumference-defined obesity. Br. J. Nutr. 2008, 101, 765–773. [Google Scholar] [CrossRef]
- Park, J.H.; Moon, J.H.; Kim, H.J.; Kong, M.H.; Oh, Y.H. Sedentary lifestyle: Overview of updated evidence of potential health risks. Korean J. Fam. Med. 2020, 41, 365–373. [Google Scholar] [CrossRef]
- Kwon, S.; Janz, K.F.; Letuchy, E.M.; Burns, T.L.; Levy, S.M. Active lifestyle in childhood and adolescence prevents obesity development in young adulthood. Obesity 2015, 23, 2462–2469. [Google Scholar] [CrossRef] [PubMed]
- Farooq, M.A.; Parkinson, K.N.; Adamson, A.J.; Pearce, M.S.; Reilly, J.K.; Hughes, A.R.; Janssen, X.; Basterfield, L. and Reilly, J.J. Timing of the decline in physical activity in childhood and adolescence: Gateshead Millennium Cohort Study. Br. J. Sports Med. 2018, 52, 1002–1006. [Google Scholar] [CrossRef]
- Chung, Y.L. New physical education movement and the development of sport in physical education. Korean J. Hist. Phys. Educ. Sport Danc. 1996, 1, 95–107. [Google Scholar]
- Kwon, J.A. Exploring the experiences and implications of the previous teachers who participated in the ‘New Sports Practical and Teaching Methods’ major class using LMS reflective writing. J. Learn.-Centered Curric. Instr. 2024, 24, 115–127. [Google Scholar] [CrossRef]
- Jeon, M.S. Recognition of the necessity and direction of youth activities through youth needs. J. Youth Act. 2022, 8, 111–132. [Google Scholar]
- Down, M.; Picknoll, D.; Piggott, B.; Hoyne, G.; Bulsara, C. “I love being in the outdoors”: A qualitative descriptive study of outdoor adventure education program components for adolescent wellbeing. J. Adolesc. 2023, 95, 1232–1244. [Google Scholar] [CrossRef]
- Cincera, J.; Simonova, P.; Kroufek, R.; Johnson, B. Empowerment in outdoor environmental education: Who shapes the programs? Environ. Educ. Res. 2020, 26, 1690–1706. [Google Scholar] [CrossRef]
Characteristic | Categories | n (%) |
---|---|---|
Sex | Male | 12,126 (51.4%) |
Female | 11,457 (48.6%) | |
Body mass index | Underweight | 5824 (24.7%) |
Normal-weight | 10,520 (44.6%) | |
Overweight | 2613 (11.1%) | |
Obesity | 4626 (19.6%) | |
Weekly frequency of moderate-intensity physical activity | Rarely | 6594 (28.0%) |
1–2 days | 7553 (32.0%) | |
3–4 days | 5304 (22.5%) | |
More than 5 days | 4132 (17.5%) | |
Fast food intake | Never | 3970 (16.8%) |
1–2 days | 17,395 (73.8%) | |
3–5 days | 1943 (8.2%) | |
Every day | 275 (1.2%) | |
Breakfast intake | Always eating | 9775 (41.5%) |
Mostly eating | 5372 (22.8%) | |
Rarely eating | 5219 (22.1%) | |
Mostly not eating | 3217 (13.6%) | |
Use of the Internet or games | Yes | 15,006 (63.6%) |
No | 8577 (36.4%) | |
Amount of sleep | Less than 6 h | 3540 (15.0%) |
6–7 h | 9294 (39.4%) | |
7–8 h | 7830 (33.2%) | |
More than 8 h | 2919 (12.4%) | |
Perceived body shape | Very thin | 1416 (6.0%) |
Somewhat thin | 4292 (18.2%) | |
Average | 9611 (40.8%) | |
Somewhat fat | 6334 (26.8%) | |
Very fat | 1930 (8.2%) | |
Experience of being bullied | Yes | 614 (2.6%) |
No | 22,969 (97.4%) | |
Feelings of unsafety due to violence | Yes | 241 (1.0%) |
No | 23,342 (99.0%) |
Characteristic | Categories | Body Mass Index | χ2 (p) | |||
---|---|---|---|---|---|---|
Underweight | Normal-Weight | Overweight | Obesity | |||
Sex | Male | 2703 (46.4%) | 4901 (46.6%) | 1485 (56.8%) | 3037 (65.7%) | 562.498 (<0.001 ***) |
Female | 3121 (53.6%) | 5619 (53.4%) | 1128 (43.2%) | 1589 (34.3%) | ||
Weekly frequency of moderate-intensity physical activity | Rarely | 1913 (32.8%) | 2884 (27.5%) | 632 (24.2%) | 1165 (25.2%) | 146.525 (<0.001 ***) |
1–2 days | 1887 (32.4%) | 3319 (31.5%) | 852 (32.6%) | 1495 (32.3%) | ||
3–4 days | 1118 (19.2%) | 2372 (22.5%) | 665 (25.4%) | 1149 (24.8%) | ||
More than 5 days | 906 (15.6%) | 1945 (18.5%) | 464 (17.8%) | 817 (17.7%) | ||
Fast food intake | Never | 1010 (17.3%) | 1774 (16.9%) | 429 (16.4%) | 757 (16.4%) | 10.956 (0.279) |
1–2 days | 4237 (72.8%) | 7775 (73.9%) | 1959 (75.0%) | 3424 (74.0%) | ||
3–5 days | 507 (8.7%) | 841 (8.0%) | 194 (7.4%) | 401 (8.7%) | ||
Every day | 70 (1.2%) | 130 (1.2%) | 31 (1.2%) | 44 (0.9%) | ||
Breakfast intake | Always eating | 2649 (45.5%) | 4369 (41.5%) | 1023 (39.2%) | 1734 (37.5%) | 101.071 (<0.001 ***) |
Mostly eating | 1329 (22.8%) | 2380 (22.6%) | 627 (24.0%) | 1036 (22.4%) | ||
Rarely eating | 1132 (19.4%) | 2314 (22.1%) | 617 (23.6%) | 1156 (25.0%) | ||
Mostly not eating | 714 (12.3%) | 1457 (13.8%) | 346 (13.2%) | 700 (15.1%) | ||
Use of the Internet or games | Yes | 3667 (63.0%) | 6518 (62.0%) | 1637 (62.6%) | 3184 (68.8%) | 68.929 (<0.001 ***) |
No | 2157 (37.0%) | 4002 (38.0%) | 976 (37.4%) | 1442 (31.2%) | ||
Amount of sleep | Less than 6 h | 799 (13.7%) | 1663 (15.8%) | 366 (14.0%) | 712 (15.5%) | 43.344 (<0.001 ***) |
6–7 h | 2255 (38.7%) | 4227 (40.2%) | 1043 (39.9%) | 1769 (38.2%) | ||
7–8 h | 1944 (33.4%) | 3431 (32.6%) | 990 (34.1%) | 1565 (33.8%) | ||
More than 8 h | 826 (14.2%) | 1199 (11.4%) | 314 (12.0%) | 580 (12.5%) | ||
Perceived body shape | Very thin | 1018 (17.5%) | 293 (2.8%) | 46 (1.7%) | 59 (1.3%) | 12,439.26 (<0.001 ***) |
Somewhat thin | 2511 (43.1%) | 1554 (14.8%) | 93 (3.6%) | 134 (2.8%) | ||
Average | 1920 (33.0%) | 6077 (57.8%) | 866 (33.1%) | 748 (16.2%) | ||
Somewhat fat | 300 (5.2%) | 2323 (22.1%) | 1423 (54.5%) | 2288 (49.5%) | ||
Very fat | 75 (1.2%) | 273 (2.5%) | 185 (7.1%) | 1397 (30.2%) | ||
Experience of being bullied | Yes | 125 (2.1%) | 249 (2.4%) | 86 (3.3%) | 154 (3.3%) | 21.599 (<0.001 ***) |
No | 5699 (97.9%) | 10,271 (97.6%) | 2527 (96.7%) | 4472 (96.7%) | ||
Feelings of unsafety due to violence | Yes | 53 (0.9%) | 114 (1.1%) | 24 (0.9%) | 50 (1.1%) | 1.552 (0.670) |
No | 5771 (99.1%) | 10,406 (98.9%) | 2589 (99.1%) | 4576 (98.9%) |
Variable | Weekly Frequency of Moderate-Intensity Physical Activity Compared to Rare Participation, OR (95% CI) | |||
---|---|---|---|---|
1–2 Days | 3–4 Days | More Than 5 Days | ||
Body mass index | Underweight | 0.929 (0.819–1.054) p = 0.252 | 0.764 (0.664–0.880) p < 0.001 *** | 0.883 (0.756–1.032) p = 0.118 |
Normal-weight | 1.020 (0.921–1.130) p = 0.698 | 1.046 (0.936–1.170) p = 0.426 | 1.279 (1.131–1.446) p < 0.001 *** | |
Overweight | 1.107 (0.971–1.260) p = 0.127 | 1.172 (1.019–1.348) p = 0.026 * | 1.181 (1.011–1.380) p = 0.036 * | |
Obesity | 1.000 | 1.000 | 1.000 |
Variable | Breakfast Intake Compared to Mostly Not Eating Breakfast, OR (95% CI) | |||
---|---|---|---|---|
Always Eating | Mostly Eating | Rarely Eating | ||
Body mass index | Underweight | 1.299 (1.114–1.515) p < 0.001 *** | 1.236 (1.045–1.461) p = 0.013 * | 1.073 (0.907–1.270) p = 0.409 |
Normal-weight | 1.157 (1.026–1.305) p = 0.018 * | 1.102 (0.967–1.256) p = 0.147 | 1.043 (0.916–1.188) p = 0.526 | |
Overweight | 1.151 (0.987–1.342) p = 0.073 | 1.215 (1.030–1.433)p = 0.021 * | 1.131 (0.960–1.333) p = 0.142 | |
Obesity | 1.000 | 1.000 | 1.000 |
Variable | Use of the Internet or Games Compared to No Use, OR (95% CI) | |
---|---|---|
Body mass index | Underweight | 1.005 (0.906–1.115), p = 0.923 |
Normal-weight | 0.876 (0.806–0.952), p = 0.002 ** | |
Overweight | 0.824 (0.743–0.913), p < 0.001 *** | |
Obesity | 1.000 |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Kwon, J.; Roh, S.-Y.; Kwon, D. Association of Body Mass Index with Moderate-Intensity Physical Activity, Eating Behavior, and the Use of the Internet or Games among Korean Middle School Students. Children 2024, 11, 1000. https://doi.org/10.3390/children11081000
Kwon J, Roh S-Y, Kwon D. Association of Body Mass Index with Moderate-Intensity Physical Activity, Eating Behavior, and the Use of the Internet or Games among Korean Middle School Students. Children. 2024; 11(8):1000. https://doi.org/10.3390/children11081000
Chicago/Turabian StyleKwon, Jeonga, Su-Yeon Roh, and Daekeun Kwon. 2024. "Association of Body Mass Index with Moderate-Intensity Physical Activity, Eating Behavior, and the Use of the Internet or Games among Korean Middle School Students" Children 11, no. 8: 1000. https://doi.org/10.3390/children11081000