Leisure-time sedentary behavior and obesity among 116,762 adolescents aged 12-15 years from 41 low- and middle-income countries

Objective: Rates of adolescent obesity are increasing worldwide, with steeper increases being observed in low- and middle-income countries (LMICs). Sedentary behavior (SB), is associated with various physical and mental health conditions. Little is known about the association between SB and obesity among adolescents in LMICs. This cross-sectional study explored the associations between SB and obesity in adolescents from 41 LMICs. Methods: Obesity was measured using BMI; SB was assessed through self-report and considered for all times except when at school or doing homework. Results: Data from the Global school-based Student Health Survey were analyzed in 116,762 adolescents [mean (SD) age 13.8 (1.0) years; 48.6% female]. The overall prevalence of obesity was 4% and the prevalence of ≥3 hours/day of SB was 26%. The prevalence of obesity and SB were lowest in low-income countries and highest in upper middle-income countries. SB for ≥3 hours/day was associated with higher odds for obesity in 32 countries. This relationship was strongest among low-income countries. Conclusions: Being sedentary for ≥3 hours/day is associated with increased odds of obesity in adolescence. Future longitudinal data are required to confirm these findings and to inform interventions targeting SB among adolescents in LMICs, thereby reduce the prevalence of obesity.