How do energy balance-related behaviors cluster in adolescents?

Int J Public Health. 2019 Mar;64(2):195-208. doi: 10.1007/s00038-018-1178-3. Epub 2018 Dec 4.


Objectives: To delineate the clustering of energy balance-related behaviors in adolescents and investigate whether these behaviors are associated with the household socioeconomic status and parental education level.

Methods: Two cross-sectional studies assessed information on sedentary behavior, physical activity, sugar-sweetened beverages and fruit and vegetable consumption, and sleep duration by self-reported questionnaires in adolescents (12.5-17.5 years old) from Maringá/Brazil (BRACAH Study; n = 682) and ten European cities (HELENA Study; n = 1252) from nine different countries. Gender-specific cluster analyses were performed separately for each study, applying a combination of hierarchical and non-hierarchical methods.

Results: Girls showed equivalent behaviors: Sedentary; Active; Unhealthy Eating; Healthy Eating; while boys differed (Brazilian: Sedentary; Active; Healthy Eating; European: Sedentary; Healthy; Unhealthy Eating). In Brazil, we found no association between socioeconomic status and parental education. In European girls, the high socioeconomic status and both parents' university degree were associated with Healthy Eating. In European boys, the high socioeconomic status was associated with Unhealthy Eating, and the mothers' university degree was associated with the Healthy cluster.

Conclusions: Adolescents show Sedentary behavior, regardless of their sex, country of origin, or socioeconomic condition.

Keywords: Adolescents; Cluster analysis; Energy balance-related behaviors; Parental education; Socioeconomic status.

MeSH terms

  • Adolescent
  • Adolescent Behavior*
  • Brazil
  • Cluster Analysis
  • Cross-Sectional Studies
  • Energy Metabolism*
  • Exercise / physiology*
  • Feeding Behavior / psychology*
  • Female
  • Humans
  • Male
  • Sedentary Behavior*
  • Social Class
  • Surveys and Questionnaires