Energy Balance-Related Factors Associating with Adolescent Weight Loss Intent: Evidence from the 2017 National Youth Risk Behavior Survey
Abstract Background: The purpose of this study was to examine specific energy balance-related behaviors (sedentary, physical activity, and dietary) associating with adolescent weight loss intent using data from the 2017 US Youth Risk Behavior Survey (YRBS). Methods: A multi-stage cluster sampling procedure was used to obtain a representative sample of US adolescents. The target population consisted of public and private high schoolers from grades 9 through 12. The number of sampled adolescents was 18,324 with 14,765 of the 18,324 sampled students submitting questionnaires with usable data (81% response rate). The outcome was intent to lose weight with specific energy-balance related behaviors examined as predictors. A weighted logistic regression model was employed to examine the associations between sedentary, activity, and dietary-related variables with weight loss intent controlling for age, sex, BMI percentile, and race/ethnicity. Results: Variables associating with adolescent intent to lose weight included 3 or more hours of video game playing (OR=1.15, 95%CI: 1.01-1.31, p = 0.028), achieving 60 minutes of physical activity daily (OR=0.66, 95%CI: 0.59-0.73, p < 0.001), daily breakfast consumption (OR=0.76, 95%CI: 0.67-0.87, p < 0.001) and weekly salad consumption (OR=1.30, 95%CI: 1.12-1.52, p = 0.001). Conclusions: There was an inverse association between physical activity and breakfast consumption with weight loss intent but a direct association between video game playing and salad consumption with weight loss intent in a representative sample of adolescents. Therefore, there is a discordance between adolescent weight loss intent and the engagement in specific energy balance-related health behaviors, particularly physical activity.