Correlates of leisure-time sedentary behavior among 181,793 adolescents aged 12-15 years from 66 low- and middle-income countries

Background: Sedentary behavior is a growing public health concern in young adolescents from low- and middle-income countries (LMICs). However, a paucity of multinational studies, particularly in LMICs, have investigated correlates of leisure-time sedentary behavior (LTSB) in young adolescents. In the current study, we assessed socio-demographic, socio-economic, socio-cultural and health behavior related correlates of LTSB among adolescents aged 12-15 years who participated in the Global school-based Student Health Survey (GSHS). Methods: Self-reported LTSB, which was a composite variable assessing time spent sitting and watching television, playing computer games, talking with friends during a typical day excluding the hours spent sitting at school and doing homework, was analyzed in 181,793 adolescents from 66 LMICs [mean (SD) age 13.8 (1.0) years; 49% girls). Multivariable logistic regression was used to assess the potential LTSB correlates. Results: The overall prevalence of ≥3 hours/day of LTSB was 26.4% (95%CI=25.6%-27.2%). Increasing age (OR=1.14; 95%CI=1.11-1.17), past 30-day smoking (OR=1.85; 95%CI=1.69-2.03), alcohol consumption (OR=2.01; 95%CI=1.85-2.18), and bullying victimization (OR=1.39; 95%CI=1.31-1.48) were positively associated with increased LTSB across the entire sample of 181,793 adolescents. Food insecurity (OR=0.93; 95%CI=0.89-0.97) and low parental support/monitoring (OR=0.91; 95%CI=0.85-0.98) were negatively associated with LTSB. There were some variations in the correlates between countries. Conclusions: Our data indicate that in adolescents aged 12 to 15 years living in LMICs, LTSB is a complex and multi-dimensional behavior determined by socio-demograhic, sociocultural, socio-economic, and health behavior related factors. Future longitudinal data are required to confirm/refute these findings, and to inform interventions which aim to reduce sedentary levels in adolescents living in LMICs.