Association Between Physical Activity, Sedentary Behavior, and Dietary Supplement Use and Obesity Among Adults Using Latent Class Analysis and Matching

Background : Obesity is a growing global health concern influenced by various behavioral factors. While physical activity (PA), sedentary behavior (SB), and dietary supplement (DS) use are known to independently affect obesity, limited research has examined their combined effects. This study aimed to identify latent behavioral subgroups based on these factors and assess their associations with obesity. Methods : Data were drawn from adults aged 18 and older in the 2011–2018 National Health and Nutrition Examination Survey. Individuals with cancer, diabetes, hypertension, or pregnancy were excluded. Latent class analysis was performed using occupational PA (OPA), recreational PA, transportation PA, SB, and DS use. Obesity was defined using percent body fat. Confounders included demographic and lifestyle variables. Propensity score weighting adjusted for confounders, and a quasi-binomial generalized linear model estimated odds ratios (ORs) for obesity across subgroups. Results : Among 13,328 participants, 4 latent classes emerged: OPA, SB/DS, OPA/recreational PA/DS, and SB. Compared with the SB group, the OPA/recreational PA/DS group had significantly lower odds of obesity (OR = 0.87; 95% CI, 0.85–0.89). The SB/DS group also showed reduced odds (OR = 0.96; 95% CI, 0.93–0.98). In contrast, the OPA group had higher odds of obesity than the SB/DS group (OR = 1.04; 95% CI, 1.02–1.06). Conclusion : Distinct patterns of PA, SB, and DS use are differentially associated with obesity risk. These findings highlight the need for targeted public health interventions that consider complex lifestyle behavior profiles.