Obesogenic Clusters: Multidimensional Adolescent Obesity-related Behaviors in the U.S.
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ORIGINAL ARTICLE
Obesogenic Clusters: Multidimensional Adolescent Obesity-related Behaviors in the U.S. Janne Boone-Heinonen, M.P.H. & Penny Gordon-Larsen, Ph.D. & Linda S. Adair, Ph.D.
Published online: 6 December 2008 # The Society of Behavioral Medicine 2008
Abstract Background Diet, physical activity, and psychosocial factors are independent and potentially interactive obesity determinants, but few studies have explored complex behavior patterns. Purpose The purpose of this study is to examine obesityrelated behavior patterning and identify high-risk adolescent groups. Methods Cluster analysis identified groups with shared behavior patterns in the National Longitudinal Study of Adolescent Health (1995 and 1996, ages 11–21; N=9,251). Descriptive and multivariate regression analyses compared sociodemographics and prevalent and incident obesity across clusters. Results Seven and six clusters in males and females, respectively, represented behavior patterns such as School Clubs & Sports, Sedentary Behaviors, Dieters, and Junk Food & Low Activity. Sociodemographics varied across clusters. Compared to School Clubs & Sports clusters, adjusted odds of prevalent and incident obesity were higher for most clusters in females but not males. Conclusions Cluster analysis identified several obesogenic behavior patterns, highlighting areas for future research and potential avenues for interventions that target broad lifestyle factors. J. Boone-Heinonen : P. Gordon-Larsen : L. S. Adair Department of Nutrition, Schools of Public Health & Medicine, Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA P. Gordon-Larsen (*) University of North Carolina at Chapel Hill, 123 West Franklin St. Chapel Hill, Chapel Hill, NC 27516-3997, USA e-mail: [email protected]
Keywords Obesity . Physical activity . Diet . Adolescence . Behavior patterning
Introduction As overweight and obesity prevalence has increased in children and adults in the United States [1] and beyond [2, 3], so has the number of identified obesity risk factors. Factors ranging from television viewing [4, 5] to sugarsweetened beverage consumption [6–8] and acculturation [9] are associated with increased obesity risk, while behaviors such as physical activity [10–12] and breakfast consumption [13] appear to be protective. Indeed, obesity etiology is multifactorial, involving myriad determinants under biologic, social, and societal levels of influence [14, 15]. Further, many of these behaviors are inter-related, particularly in adolescents: for example, high-calorie snack food consumption increases with hours of television viewing [16], while many seemingly contrary behaviors such as sedentary and physical activities co-occur [17, 18]. Further, various behaviors may exert combined effects on health, rather than independent effects implied by examination of behaviors in isolation. Pattern analysis, such as cluster analysis, may therefore better address the complexity of obesity-related behavior patterning than single or joint risk
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