Association of physical activity, screen time, and sleep recommendations with excess weight in adolescents

Objective: This study aims to analyze the prevalence of adherence to physical activity, screen time, and sleep recommendations and their association with excess weight in high school adolescents from the state public network of Pernambuco, Brazil. Methods: A cross-sectional study was conducted with 4,203 adolescents aged 14 to 19 years. Data were collected using a translated and validated version of the Global School-Based Student Health Survey (GSHS). The study assessed adherence to recommendations for Moderate to Vigorous Physical Activity (MVPA), screen time (ST), and sleep duration. Logistic regression analysis was used to examine the associations between these behaviors and excess weight, adjusting for age, race, and maternal education. Results: Only 2.68% of adolescents met the combined recommendations for MVPA, ST, and sleep. The total proportion of obese adolescents was 12.3%, with a higher prevalence among girls (13.4%) compared to boys (10.9%). Male adolescents who did not meet the MVPA recommendation had a 1.53 times higher chance of being obese (95% CI: 1.11; 2.12), and those who did not meet the ST recommendation had a 1.60 times higher chance of being obese (95% CI: 1.11; 2.31). Conclusions: Low adherence to physical activity, screen time, and sleep recommendations is associated to higher excess weight rates among adolescents in Pernambuco, Brazil, particularly in boys. Public health strategies promoting these behaviors are essential to combat obesity, with a focus on gender-specific interventions.