Association of dietary habits with levels of physical activity and screen time among adolescents living in Saudi Arabia. Energy balance-related behaviours associated with overweight and obesity in preschool children: a systematic review of prospective studies. Physical activity, sedentary behaviors and dietary habits among Saudi adolescents relative to age, gender and region The association between dietary patterns and mental health in early adolescence. Lifestyle correlates of self-reported sleep duration among Saudi adolescents: a multicentre school-based cross-sectional study. Role of dietary patterns, sedentary behaviour and overweight on the longitudinal development of childhood constipation: the Generation R study. A behaviour change intervention to reduce sedentary time in people with chronic obstructive pulmonary disease: protocol for a randomised controlled trial. Western and Mediterranean dietary patterns among Balearic Islands' adolescents: socio-economic and lifestyle determinants.
BACKGROUND Underst and ing the inter-relationships between lifestyle factors in youth is important with respect to the development of effective promotional programmes for healthy eating and active living . The present study aim ed to explore the associations of dietary habits ( DH ) with physical activity ( PA ) and screen time ( ST )  among Saudi adolescents aged between 15 and 19 years of age relative to gender . METHODS Data were obtained from the Arab Teens Lifestyle Study , a school-based multicentre lifestyle study conducted in 2009/2010 in three major cities in Saudi Arabia . A multistage stratified cluster r and om sampling technique was used . The number of participants with complete data for  DH  and  PA  was 2886 and the respective number for DH and ST was 2822 . Assessment included weight , height , body mass index , total daily ST ( television viewing , video/computer games and Internet use ) , PA and DH using self-reported question naires . RESULTS Females were significantly more sedentary and less active than males ( P < 0.001 ) . Two-way analysis of covariance , controlling for age , showed significant ( P < 0.05 ) gender by PA and gender by ST interactions for several DH . Logistic regression analyses revealed significant associations of higher PA with a higher consumption of fruit , vegetables , milk , French fries/potato chips and energy drinks , whereas higher ST was significantly associated with a higher consumption of sugar-sweetened drinks , fast foods , cake/doughnuts and energy drinks . CONCLUSIONS Healthful dietary habits were associated mostly with  PA  , whereas sedentary behaviours , independent of PA , negatively impacted upon eating behaviours . The low PA levels and high sedentary levels of Saudi females represent a great concern . The results reported in the present study have important implication s for both youth public health policies and intervention programmes The current review aim ed to systematic ally identify dietary , physical activity and sedentary behaviours in preschool children ( 4 - 6 years of age ) that are prospect ively related to overweight or obesity later in childhood . Prospect i ve studies published between January 1990 and June 2010 were selected from search es in PubMed , EMBASE , PsycINFO , CINAHL and Cochrane Library . Studies examining the prospect i ve association between at least one relevant behaviour measured during preschool period ( children aged 4 - 6 years at baseline ) in relation to at least one anthropometric measurement at follow-up ( age < 18 years ) were included . Harvest plots were used to summarize the results and draw conclusions from the evidence . Of the 8,718 retrieved papers , 23 papers reporting on 15 different study sample s were included in this review . Strong evidence was found for an inverse association between total physical activity and overweight . Moderate evidence was observed for a positive association between television viewing and overweight . Because of the heterogeneity in the assessed dietary behaviours , insufficient evidence was found for an association between  dietary intake or specific dietary behaviours and overweight . These results suggest that interventions aim ing to prevent overweight among preschool children should focus on promotion of total physical activity and limitation of screen time and that further research is needed to establish whether and which dietary behaviours are important for obesity prevention in this age group . However , despite the lack of evidence for dietary behaviours from the present review , future interventions may already target specific dietary behaviours that are highly prevalent and for which there a clear rationale as well as preliminary evidence that these behaviours are associated with overweight Background Few lifestyle factors have been simultaneously studied and reported for Saudi adolescents . Therefore , the purpose of the present study was to report on the prevalence of physical activity , sedentary behaviors and dietary habits among Saudi adolescents and to examine the interrelationships among these factors using representative sample s drawn from three major cities in Saudi Arabia . Methods This school-based cross-sectional study was conducted during the years 2009 - 2010 in three cities : Al-Khobar , Jeddah and Riyadh . The participants were 2908 secondary -school males ( 1401 ) and females ( 1507 ) aged 14 - 19 years , r and omly selected using a multistage stratified sampling technique . Measurements included weight , height , sedentary behaviors (  TV viewing  , playing video games and computer use ) , physical activity using a vali date d question naire and dietary habits . Results A very high proportion ( 84 % for males and 91.2 % for females ) of Saudi adolescents spent more than 2 hours on screen time daily and almost half of the males and three-quarters of the females did not meet daily physical activity guidelines . The majority of adolescents did not have a daily intake of breakfast , fruit , vegetables and milk . Females were significantly ( p < 0.05 ) more sedentary , much less physically active , especially with vigorous physical activity , and there were fewer days per week when they consumed breakfast , fruit , milk and diary products , sugar-sweetened drinks , fast foods and energy drinks than did males . However , the females ' intake of  French fries and potato chips , cakes and donuts , and c and y and chocolate was significantly ( p < 0.05 ) higher than the males ' . Screen time was significantly ( p < 0.05 ) correlated inversely with the intake of breakfast , vegetables and fruit .  Physical activity had a significant ( p < 0.05 ) positive relationship with fruit and vegetable intake but not with sedentary behaviors . Conclusions The high prevalence of sedentary behaviors , physical inactivity and unhealthy dietary habits among Saudi adolescents is a major public health concern . There is an urgent need for national policy promoting active living and healthy eating and reducing sedentary behaviors among children and adolescents in Saudi Arabia OBJECTIVE To investigate the associations between dietary patterns and mental health in early adolescence . METHOD The Western Australian Pregnancy Cohort ( Raine ) Study is a prospect i ve study of 2900 pregnancies recruited from 1989 - 1992 . At 14 years of age ( 2003 - 2006 ; n=1324 ) , the Child Behaviour Checklist ( CBCL ) was used to assess behaviour ( characterising mental health status ) , with higher scores representing poorer behaviour . Two dietary patterns ( Western and Healthy ) were identified using factor analysis and food group intakes estimated by a 212-item food frequency question naire . Relationships between dietary patterns , food group intakes and behaviour were examined using general linear modelling following adjustment for potential confounding factors at age 14 : total energy intake , body mass index , physical activity , screen use , family structure , income and functioning , gender and maternal education at pregnancy . RESULTS Higher total ( b=2.20 , 95 % CI=1.06 , 3.35 ) , internalizing ( withdrawn/depressed ) ( b=1.25 , 95 % CI=0.15 , 2.35 ) and externalizing ( delinquent/aggressive ) ( b=2.60 , 95 % CI=1.51 , 3.68 ) CBCL scores were significantly associated with the Western dietary pattern , with increased intakes of takeaway foods , confectionary and red meat . Improved behavioural scores were significantly associated with higher intakes of leafy green vegetables and fresh fruit ( components of the Healthy pattern ) . CONCLUSION These findings implicate a Western dietary pattern in poorer behavioural outcomes for adolescents . Better behavioural outcomes were associated with a higher intake of fresh fruit and leafy green vegetables BACKGROUND Lifestyle factors are important determinants of adequate sleep among adolescents . However , findings on sleep duration relative to lifestyle factors are conflicting . Therefore , this study examined the association of self-reported sleep duration with physical activity , sedentary behaviours and dietary habits among Saudi adolescents . METHODS A multicentre school-based cross-sectional study was conducted in three major cities in Saudi Arabia . The sample included 2868 secondary -school students ( 51.9 % girls ) aged 15 - 19 years , r and omly selected using a multistage stratified cluster sampling technique . In addition to  anthropometric measurements , sleep duration , physical activity , sedentary behaviours and dietary habits were assessed using self-reported question naire . RESULTS Several lifestyle factors were associated with sleep duration in adolescents . While controlling for some potential confounders , the findings showed that high screen time [ > 5 h/day ; adjusted odds ratio ( aOR ) = 1.505 , 95 % confidence interval ( CI ) = 1.180 - 1.920 , P = 0.001 ] and low ( aOR = 1.290 , 95 % CI = 1.064 - 1.566 , P = 0.010 ) to medium ( aOR = 1.316 , 95 % CI = 1.075 - 1.611 , P = 0.008 ) physical activity levels were significantly related to daily sleep of 8 h or longer . Furthermore , having low intake of breakfast ( <3 day/week compared with 5 days or more per week ) decreased the odd of having adequate sleep duration by a factor of 0.795 ( 95 % CI = 0.667 - 0.947 , P < 0.010 ) . CONCLUSIONS Short sleep duration ( < 8 h/day ) among Saudi adolescents 15 - 19 year olds was significantly associated with several lifestyle factors . Intervention programs aim ing for improving sleeping habits among adolescents need to consider such potential association of lifestyle variables with sleep duration The influence of childhood nutrition on the development of constipation beyond the period of weaning and breastfeeding is relatively understudied . In addition , eating patterns in childhood can be highly correlated with overweight and sedentary behaviour , which may also have an influence on constipation . The aim of this study was to assess whether common dietary patterns , sedentary behaviour and childhood overweight are associated with  constipation in childhood . The study was embedded in a population -based prospect i ve birth cohort . Information on dietary intake was obtained by a food frequency question naire  at the child 's age of 14 months ( n = 2420 ) . The adherence scores on a ' Health conscious ' and ' Western-like ' diet were extracted from principal component analysis . At the age of 24 , 36 and 48 months , information on constipation and sedentary behaviour , and weight and height was obtained by parental-derived question naires and from the child health centres , respectively . Adherence to a ' Western-like ' dietary pattern was associated with a higher prevalence of constipation up to 48 months [ adjusted odds ratio ( aOR ) ; 95 % confidence interval ( CI ) : 1.39 ; 1.02 - 1.87 ] , which was not mediated by overweight or sedentary behaviour . Adherence to a ' Health Conscious ' dietary pattern was only associated at short term , with a lower prevalence of constipation at 24 months ( aOR ; 95%CI : 0.65 ; 0.44 - 0.96 ) . No association was found between overweight , sedentary behaviour and constipation . Our results suggest that specific dietary patterns in early childhood could be associated with higher or lower risks for constipation , but these effects are time-dependent . Overweight and sedentary behaviour seem to not have a major role on constipation in childhood INTRODUCTION Replacing sedentary behaviour with light intensity physical activity ( ie , activities classified as less than three metabolic equivalents , such as slow-paced walking ) may be a more realistic strategy for reducing cardiometabolic risk in people with chronic obstructive pulmonary disease than only aim ing to increase levels of moderate-vigorous intensity physical activity . Behaviour change interventions to reduce sedentary behaviour in people with chronic obstructive pulmonary disease have not yet been developed or tested . RESEARCH QUESTIONS Is a 6-week behaviour change intervention effective and feasible in reducing sedentary time in people with chronic obstructive pulmonary disease ? DESIGN This study will be a multi-centre , r and omised , controlled trial with concealed allocation , assessor blinding , and intention-to-treat analysis , comparing a 6-week behaviour change intervention aim ed at reducing sedentary time with a sham intervention in people with chronic obstructive pulmonary disease . PARTICIPANTS AND SETTING Seventy participants will be recruited from the waiting lists for pulmonary rehabilitation programs at Royal Prince Alfred Hospital and Prince of Wales Hospital , Sydney , Australia . INTERVENTION The behaviour change intervention aims to reduce sedentary time through a process of guided goal setting with participants to achieve two target behaviours : ( 1 ) replace sitting and lying down with light-intensity physical activity where possible , and ( 2 ) st and up and move for 2minutes after 30minutes of continuous sedentary time . Three face-to-face sessions and three phone sessions will be held with a physiotherapist over the 6-week intervention period . The ' capability ' , ' opportunity ' , ' motivation ' and ' behaviour ' ( COM-B ) model will be applied to each participant to determine which components of behaviour ( capability , opportunity or motivation ) need to change in order to reduce sedentary time . Based on this ' behavioural diagnosis ' , the Behaviour Change Wheel will be used to systematic ally select appropriate behaviour change techniques to assist participants in achieving their weekly goals . Behaviour change techniques will include providing information about the health consequences of sedentary behaviour , self-monitoring and review of weekly goals , problem-solving of barriers to achieving weekly goals , and providing feedback on sedentary time using the Jawbone UP3 activity monitor . CONTROL The sham intervention will consist of weekly phone calls for 6 weeks , to enquire whether the participants ' health status has changed over the intervention period ( eg , hospitalised for an acute exacerbation ) . No instructions regarding physical activity or exercise will be given . MEASUREMENTS Outcomes will be assessed at baseline , at the end of the 6-week intervention period , and at the 3-month follow-up . Primary outcome measures will be : ( 1 ) total sedentary time , including the pattern of accumulation of sedentary time , assessed by the activPAL3 activity monitor , and ( 2 ) feasibility of the intervention assessed by uptake and retention of participants , participant compliance , self-reported achievement of weekly goals , and adverse events . Secondary outcome measures will include functional exercise capacity , health-related quality of life , domain-specific and behaviour-specific sedentary time , patient activation , and anxiety and depression .  Semi-structured interviews will be conducted with participants who receive the behaviour change intervention to explore acceptability and satisfaction with the different components of the intervention . ANALYSIS Analysis of covariance ( ANCOVA ) will be used to calculate between-group comparisons of total sedentary time and the number of bouts of sedentary time>30minutes after adjusting baseline values . Uncertainty about the size of the mean between-group differences will be quantified with 95 % CI . Within-group comparisons will be examined using paired t-tests and described as mean differences with 95 % CIs . Secondary outcome measures will be analysed similarly . The feasibility measures will be analysed descriptively . Semi-structured interviews will be conducted until data saturation is achieved and there are no new emerging themes . De-identified interview transcripts will be coded independently by two research ers and analysed alongside data collection using the COM-B model as a thematic framework . DISCUSSION / SIGNIFICANCE If behaviour change interventions are found to be an effective and feasible method for reducing sedentary time , such interventions may be used to reduce cardiometabolic risk in people with chronic obstructive pulmonary disease . An approach that emphasises participation in light-intensity physical activity may increase the confidence and willingness of people with chronic obstructive pulmonary disease to engage in more intense physical activity , and may serve as an intermediate goal to increase uptake of pulmonary rehabilitation OBJECTIVE To assess prevailing food patterns among Balearic Isl and s ' adolescents , and socio-economic and lifestyle determinants . DESIGN Cross-sectional nutritional survey carried out ( 2007 - 2008 ) in the Balearic Isl and s , a Mediterranean region . Dietary assessment was based on a 145-item semi-quantitative FFQ and two non-consecutive 24 h recalls .  Anthropometric measurements and questions related to socio-economic , lifestyle , physical activity and body image were assessed . SETTING Data obtained from a representative sample of all inhabitants living in the Balearic Isl and s aged 12 - 17 years . SUBJECTS A r and om sample ( n 1231 ) of the adolescent population ( 12 - 17 years old ) was interviewed . RESULTS Factor analysis identified two major dietary food patterns : ' Western ' and ' Mediterranean ' . The ' Western ' dietary pattern was higher among boys than girls , associated with spending ≥4 h/d on media screen time , but less prevalent among those adolescents who desired a thinner body and those girls who desired to remain the same weight . The ' Mediterranean ' dietary pattern was mainly followed by girls , and also boys who spent < 2 h/d on media screen time and girls with high parental socio-economic status . CONCLUSIONS The present study shows the existence of two major dietary patterns among Balearic Isl and s ' adolescents : ' Western ' and ' Mediterranean ' , but girls are more ' Mediterranean ' than boys . This evidence supports that the food pattern of Balearic Isl and s ' adolescents is in a transitional state characterised by the loss of the traditional Mediterranean dietary pattern towards a Western dietary pattern . Low parental socio-economic status , much leisure-time on sedentary behaviours such as media screen time and body image are factors associated with the ' Western ' dietary pattern
No significant associations between screen time with blood pressure and cholesterol were reported .
Sedentary behaviour appears to be associated with  adiposity in adolescents , irrespective of dietary intake .
Screen time , but not overall sedentary behaviour , is consistently related to cardiometabolic health in adolescents .
Because of the associations screen time has with dietary intake , diet may be an important factor in the screen time and health relationship ; however , evidence has not previously been synthesized .
Thus , the aim of this systematic review was to explore whether the associations between various sedentary behaviours and cardiometabolic risk markers are independent of dietary intake in adolescents .