Rev Cuid. 2024; 15(3): e3942

https://doi.org/10.15649/cuidarte.3942

RESEARCH ARTICLE

Nutritional status and physical activity levels of adolescents in public and private schools

Estado nutricional y niveles de actividad física en adolescentes de instituciones educativas públicas y privadas

Estado nutricional e níveis de atividade física em adolescentes de instituições de ensino públicas e privadas

Faculty of Nursing, Universidad Antonio Nariño, Neiva, Colombia. E-mail: marias10@uan.edu.co María V Arias-Silva
Faculty of Nursing, Universidad Antonio Nariño, Neiva, Colombia. E-mail: vpedreros66@uan.edu.co Valentina Pedreros-Lemuz
Faculty of Nursing, Universidad Antonio Nariño, Neiva, Colombia. E-mail: angierodriguez56@uan.edu.co Angie L Rodríguez-Perdomo
Research Group Innovación y Cuidado, Faculty of Nursing, Universidad Antonio Nariño, Bogotá, Colombia. E-mail: ragonzalez75@uan.edu.co Raúl A González-Lozano
Research Group Innovación y Cuidado, Faculty of Nursing, Universidad Antonio Nariño, Neiva, Colombia. E-mail: joramos98@uan.edu.co Correspondence Author Jorge A Ramos-Castaneda

Highlights

 

How to cite this article: Arias-Silva María V, Pedreros-Lemuz Valentina, Rodríguez-Perdomo Angie L, González-Lozano Raúl A, Ramos-Castaneda Jorge A. Nutritional status and physical activity levels of adolescent in public and private schools. Revista Cuidarte. 2024;15(3):e3942. https://doi.org/10.15649/cuidarte.3942

Received:April 17th 2024
Accepted: August 26th 2024
Published: November 6th 2024

CreativeCommons 

E-ISSN: 2346-3414

Abstract

Introduction: Obesity and physical inactivity in adolescents are associated with some diseases, and poor academic performance. Studies have reported differences in the level of physical activity according to the type of school. Objective: To compare the prevalence of obesity and physical inactivity in adolescents in a public and a private school. Materials and Methods: A cross-sectional study was conducted among adolescents attending a public school and a private school. Ninth, tenth, and eleventh-grade students between 14 and 17 years were included. Physical activity level was assessed using the Physical Activity Questionnaire for Adolescents, and nutritional status using body mass index for age. Results: Information was collected from 343 students, of whom 55.10% (n=189) were from a public school. The 28.28% were overweight. The overall level of physical activity in adolescents was low (mean= 1.97 95% CI 1.92 – 2.01). It was found that public school students were more inactive adjusted (PR= 1.40; 95% CI 1.03 - 1.92) compared to private school students. Discussion: Adolescents do not achieve optimal levels of frequency and duration of physical activity, highlighting the need for educational programs and attractive interventions to promote physical activity. Conclusion: Adolescent students have low levels of physical activity, with more inactive students in the public school compared to the private school. The prevalence of overweight was high in both schools.

Keywords: Exercise; Sedentary Behavior; Adolescent; Obesity; Nutritional Status.

Resumen

Introducción: La obesidad y la inactividad física en adolescentes se asocia con múltiples enfermedades y bajo rendimiento escolar. Algunos estudios han reportado diferencias en nivel de actividad física, práctica deportiva o de clases de educación física según la naturaleza de la institución educativa. Objetivo: Comparar la prevalencia de obesidad e inactividad física en adolescentes de una institución educativa pública y una privada. Materiales y Métodos: Se realizó un estudio de corte transversal en adolescentes escolarizados en una institución educativa pública y una privada. Se incluyeron estudiantes de grado noveno, décimo y once de edades comprendidas entre los 14 y 17. Se evaluó el nivel de actividad física mediante el instrumento Physical Activity Questionnaire para adolescentes, y el estado nutricional mediante el índice de masa corporal para la edad. Resultados: Se recolectó información de 343 estudiantes, donde el 55,10% (n= 189) fueron estudiantes de una institución educativa pública. El 28,28% presentaron exceso de peso. El nivel global de actividad física en los adolescentes fue bajo (media= 1,97 IC95% 1,92 – 2,01). Se identificó que los estudiantes de la institución educativa pública son más inactivos (RP = 1,40; IC95% 1,03 - 1,92) comparado con los de la institución privada. Discusión: Los adolescentes no alcanzan niveles óptimos de frecuencia y duración de la actividad física, por lo que se demuestra la necesidad de diseñar programas educativos e intervenciones atractivas para promover la actividad física. Conclusión: Los estudiantes adolescentes presentan un bajo nivel de actividad física, siendo más inactivos los estudiantes de la institución educativa pública, en comparación con la privada. La prevalencia de exceso de peso fue alta en ambas instituciones educativas.

Palabras Clave: Ejercicio Físico; Conducta Sedentaria; Adolescente; Obesidad; Estado Nutricional.

Resumo

Introdução: A obesidade e a inatividade física em adolescentes estão associadas a múltiplas doenças e ao mau desempenho escolar. Alguns estudos relataram diferenças no nível de atividade física, prática esportiva ou aulas de educação física dependendo da natureza da instituição de ensino. Objetivo: Comparar a prevalência de obesidade e inatividade física em adolescentes de uma instituição de ensino pública e privada. Materiais e Métodos: Foi realizado um estudo transversal entre adolescentes matriculados em uma instituição de ensino pública e privada. Foram incluídos alunos do nono, décimo e décimo primeiro ano entre 14 e 17 anos. O nível de atividade física foi avaliado pelo Questionário de Atividade Física para Adolescentes e o estado nutricional pelo índice de massa corporal para idade. Resultados: Foram coletadas informações de 343 alunos, sendo 55,10% (n= 189) alunos de uma instituição pública de ensino. 28,28% estavam acima do peso. O nível global de atividade física dos adolescentes foi baixo (média = 1,97 IC 95% 1,92 – 2,01). Identificou-se que os alunos da instituição de ensino pública são mais inativos fisicamente (RP = 1,40; IC95% 1,03 - 1,92) em comparação aos da privada. Discussão: Os adolescentes não atingem níveis ótimos de frequência e duração da atividade física, evidenciando a necessidade de programas educacionais e intervenções atrativas para promover a atividade física. Conclusão: Os estudantes adolescentes apresentam baixo nível de atividade física, sendo os estudantes de instituições de ensino públicas mais inativos em comparação aos privados. A prevalência de excesso de peso foi elevada em ambas as instituições de ensino.

Palavras-Chave: Exercício Físico; Comportamento Sedentário; Adolescente; Obesidade; Condição Nutricional.

Introduction

Obesity is a chronic, multifactorial disease that is considered a public health problem due to its high prevalence worldwide and its association with chronic diseases1. Obesity is considered a risk factor for the development of cardiovascular diseases, stroke, osteoarticular pathologies, diabetes mellitus, and some cancers (endometrial, breast, ovarian, liver, colon, and others)2-6.

It is estimated that 20% of children and adolescents worldwide are overweight or obese, with some countries such as the United States, Mexico, Canada, Chile, and Argentina having the highest prevalence7. Latin America and the Caribbean have one of the highest prevalence of obesity in the world among people aged 5 to 198. In addition, it has been determined that more than 5 million people die each year as a result of being overweight or obese9. In Colombia, according to the National Survey of the Nutritional Situation of Colombia (ENSIN, for its acronym in Spanish), obesity has increased among children and adolescents compared to previous years10.

A major cause of obesity is the energy imbalance between calories consumed and expended, with diet being an important factor11. Consumption of foods high in saturated fat, salt, and sugar, or ultra-processed foods significantly contributes to obesity11. Another relevant aspect that causes obesity is exogenous determinants such as a sedentary lifestyle and physical inactivity (PI)12.

According to the World Health Organization, people who are insufficiently physically active (PA) have a 30% higher risk of death than those who engage in moderate physical activity13. In addition, several studies have shown that youth who do not engage in PA are at greater risk for mental health problems, poor academic performance, reduced quality of life, and the development of chronic noncommunicable diseases14-18. A recent systematic review found that physically inactive students are at higher risk of anxiety, obesity, depression, and poor diet19. One of the main factors identified for physical inactivity is excessive smartphone use, which leads to greater perceived stress and poor sleep quality in adolescents20.

In Latin America and the Caribbean, about 84% of adolescents do not get enough PA, while in high-income countries, the prevalence drops to 78%21. Some studies have reported differences in PA levels, sports practice, physical education classes, or sedentary behaviors among school-aged adolescents according to social determinants, such as economic income, mother education22, or type of school (Private or public)23. However, a recent study among adolescents in the United States found no difference in PA levels when comparing private and public schools24. Therefore, there is not yet sufficient evidence to demonstrate a difference in the level of PA according to the type of school. This study aimed to compare the prevalence of obesity and physical inactivity (PI) in adolescents aged 14 to 17 years in a public and a private school.

 

Materials and Methods

Study design

A cross-sectional study with an analytical approach was conducted on adolescents attending a public school and a private school. The public school is located in the municipality of Campoalegre (Huila) and has approximately 285 students in secondary grades. The private school is in the municipality of Neiva (Huila), with approximately 210 secondary school students. The data collection process was conducted between May and July 2023.

Participants

The study included ninth, tenth, and eleventh graders between the ages of 14 and 17 enrolled in Campoalegre’s public and Neiva’s private schools for the year 2023. Students with reduced mobility were excluded because the instrument was designed for people without mobility limitations.

Sample size

Considering that the population consisted of 353 students in the ninth, tenth, and eleventh grades in both schools, it was decided to conduct a consecutive sampling25, including all students who met the inclusion criteria, had parental consent, and gave their assent during recruitment period.

Variables

The outcome variable was the level of PA assessed by the PAQ-A. A categorization was made to determine PI, considering the median PA. The students who scored ≤ 1.90 were considered inactive. The independent variables were sex, age, grade level, type of school (private or public), socioeconomic stratification, and anthropometric status. Dataset can be download in Mendeley Data26.

Data source and measurement

A properly calibrated Prestige digital scale and a tape measure were used for anthropometric assessment. Body mass index (BMI)-for-age and height-for-age (H/A) were used to determine the cutoff value for each student according to sex, taking into account the cutoff values of Ministry of Health and Social Protection of Colombia27.

PA was assessed using the Physical Activity Questionnaire for Adolescents (PAQ-A), which assesses adolescents’ activity over the past seven days in various areas of daily life28. The questionnaire consists of 9 closed-ended quantitative questions, each item rated on a Likert scale, commonly used to measure opinions (44). The PAQ A was developed in Spain, demonstrating good reliability with an intraclass correlation coefficient of 0.71, and was shown to have a moderate correlation (rho = 0,39, P <0,001) to classify physical activity levels with respect to the accelerometer 29. Some studies already use this questionnaire in Colombia30,31.

Bias

In order to avoid selection bias, it was decided to use consecutive sampling to include all adolescents who chose to participate in the study; this ensured that the data would be representative of the population of the two educational institutions. To avoid measurement bias, researchers were trained in the use of the PAQ-A, an instrument with validity and reliability used in multiple studies with a similar population29.

Statistical methods

Categorical variables were analyzed using absolute and relative frequencies, while quantitative variables were analyzed using means and standard deviations. The variables of age, sex, and socioeconomic stratification were compared by type of school (public or private). The prevalence of nutritional alteration was then determined, considering the BMI-for-age and height-for-age, as well as by the type of school. Later, the global level of PA was calculated by taking the average score of the eight questions of the PAQ-A. Comparison of each questionnaire item by type of school was made using the prevalence ratio (PR) with 95% confidence intervals. In order to identify factors associated with PI, the global score was categorized by the median value as inactive for those students scoring ≤ 1.90 and physically active for those scoring > 1.90. This result was compared by sex, type of school, grade level, socioeconomic stratification, and excess weight (overweight or obesity). A log-binomial regression model was built for explanatory purposes, including type of school as an independent variable and adjusting for covariates such as sex, grade level, and excess weight.

Ethical considerations

The study was submitted to and approved by the Universidad Antonio Nariño research ethics committee (record 44-2023) and participating institutions. The project was socialized to administrators, teachers, students, and parents of each school. The informed consent was completed by the parents of the participants, and each adolescent completed the informed assent.

 

Results

Data were collected from 343 students who volunteered to participate in the study. 55.10% (n=189) were students from the public school, and 44.90% (n=154) from the private school. The 45.20% of students were 9th graders (Figure 1).

 

Figure 1. Study Sample Selection Flowchart.

 

The mean age of the students surveyed was 15.6 (SD=0.727) years, and 52.48% were female. It was observed that 82.80% of the students were from socioeconomic strata 1 and 2, and there were no students from socioeconomic strata 3 in the public school (Table 1).

 

Table 1. Distribution by age, socioeconomic stratification, and sex of the students surveyed.

See More

 

The prevalence of nutritional alteration was 35.78%, slightly higher among adolescents in the private school (40.26%) compared to the public school (31.22%). Among the students in both institutions, 28.28% were overweight, making it the most common alteration (Figure 2).

 

Figure 2. Nutritional status, body mass index for age, and height for age.

 

The overall level of PA in the adolescents had a mean of 1.97 (95% CI 1.92 - 2.01) and was similar in both schools. When comparing each of the PAQ-A questions with school type, it was found that the level of activity in physical education classes PR= 0.67 (95% CI 0.53 - 0.85) and weekly intensity PR= 0.62 (95% CI 0.42 - 0.90) were higher in public school adolescents than in private school adolescents. However, students in the private school were more active before and after lunch PR= 1.94 (95% CI 1.58 - 2.39) than public school students (Table 2). Students engage in high-intensity PA on Thursdays and Fridays, while Saturdays and Sundays are the days when they have the least amount of PA. Public school students are more inactive on Mondays, Wednesdays, and Friday than private school students (Table 2).

 

Table 2. Physical Activity Questionnaire for Adolescents (PAQ-A) by type of school.

See More
X

Table 2. Physical Activity Questionnaire for Adolescents (PAQ-A) by type of school.

Public institution Private institution PR (95%CI) p1
* Active during physical education classes
    Low 70 (37.04) 85 (55.19) Ref
   High 119 (62.96) 69 (44.81) 0.67 (0.53 – 0.85) <0.01
* Active before and after lunchtime
   Low 178 (94.18) 117 (75.97) Ref.
    High 11 (5.82) 37 (24.03) 1.94 (1.58 – 2.39) <0.01
* Active in the afternoon (14 - 18h)
   Low 128 (67.72) 116 (75.32) Ref.
   High 61 (32.38) 38 (24.68) 0.81 (0.61 – 1.07) 0.15
* Active in the evening (18 - 22h)
    Low 153 (80.95) 120 (77.92) Ref.
   High 36 (19.05) 34 (22.08) 1.10 (0.84 – 1.45) 0.50
Active on weekends
   Low 144 (76.19) 119 (77.27) Ref.
   High 45 (23.81) 35 (22.73) 0.97 (0.73 – 1.28) 0.90
Weekly intensity
   Low 140 (74.07) 133 (86.36) Ref.
   High 49 (25.93) 21 (13.64) 0.62 (0.42 – 0.90) <0.01
High intensity per day
   Monday 28 (14.81) 52 (33.78) 1.68 (1.34 – 2.09) <0.01
    Tuesday 35 (18.52) 40 (25.97) 1.25 (0.97 – 1.62) 0.11
   Wednesday 39 (20.63) 60 (38.96) 1.57 (1.26 – 1.97) <0.01
   Thursday 48 (25.40) 54 (35.07) 1.28 (1.00 – 1.62) 0.05
   Friday 46 (24.34) 55 (35.71) 1.33 (1.05 – 1.68) 0.02
   Saturday 39 (20.63) 31 (20.13) 0.98 (0.73 – 1.32) 1,0
   Sunday 25 (13.22) 11 (7.14) 0.66 (0.39 – 1.09) 0.08
Physical activity during leisure time
   Mean (95%CI) 1.47 (1.40 – 1.55) 1.49 (1.42 – 1.55) - 0.782
Physical activity level
   Mean (95%CI) 1.94 (1.88 – 2.00) 2.0 (1.94 – 2.06) - 0.152

* During the last 7 days. PR: Prevalence Ratio; CI: Confidence interval. 1. Fisher exact test. 2. Test Student.

 

It was found that public school students were more inactive (adjusted PR= 1.40; 95% CI 1.03 - 1.92) compared to private school students. It was also observed that tenth and eleventh graders engage in less PA than ninth graders (Table 3).

 

Table 3. Factors associated with physical inactivity among adolescents.

See More
X

Table 3. Factors associated with physical inactivity among adolescents.

Physical inactivity

≤1.90

Physical activity

>1.90

 PR (95%CI) p1 PR (95% CI)

Adjusted1

Sex
   Female 92 (51.11) 88 (48.89) Ref.
   Male 86 (52.76) 77 (47.24) 0.97 (0.79 – 1.19) 0.76 0.99 (0.80 – 1.24)
Type of school
   Public 109 (57.67) 80 (42.33) Ref.
   Private 69 (44.81) 85 (55.19) 1.29 (1.04 – 1.61) 0.02 1.40 (1.03 – 1.92)
Grade level
   Ninth 63 (40.65) 92 (59.35) 1.0 1.0
   Tenth 46 (58.23) 33 (41.77) 2.64 (1.09 – 1.87) <0.01 1.43 (1.08 – 1.89)
   Eleventh 69 (63.30) 40 (36.70) 3.65 (1.23 – 1.99) <0.01 1.76 (1.38 – 2.26)
Socioeconomic stratification
   1 73 (57.94) 53 (42.06) 1.0 1.0
   2 79 (50.00) 79 (50.00) 0.86 (0.70 – 1.07) 0.18 0.90 (0.70 – 1.13)
   3 26 (44.07) 33 (55.93) 0.76 (0.54 – 1.03) 0.09 0.88 (0.55 – 1.35)
Excess weight
   No 113 (50.90) 109 (49.10) Ref.
   Yes 52 (53.61) 45 (46.39) 0.95 (0.76 – 1.20) 0.65 1.05 (0.86 – 1.30)

PR: Prevalence Ratio; CI: Confidence interval. 1. Log-binomial regression model

 

Discussion

To our knowledge, this is the first study in Colombia to compare nutritional status and PA levels with school type (public and private). The research showed that the level of PA was low in both schools, but students in the public school had higher levels of PI. In addition, a significant prevalence of excess weight was observed in the adolescents.

The study highlights a problem of public health importance as PI among adolescents in Colombia. Studies conducted in adolescents in countries such as Spain or the United States have reported PA levels (>2.6)24,32 higher than those found in this study. This situation is exacerbated when comparing by school type, as public-school students had a higher PI. This difference may be because private school adolescents engage in significantly more high-intensity PA three days a week (Monday, Wednesday, and Friday) than public school adolescents. This result was also found in a study of adolescents in Brazil, where more than 90% of students in a public school were physically inactive23.

In analyzing the differences in PA between public and private schools, it is important to examine the factors that might influence these differences. For example, it could be argued that there is unequal access to PA strategies and spaces in schools. It is plausible that private schools, generally associated with higher economic status, may have more resources to allocate to facilities and programs promoting PA among adolescents16,33. Additionally, studies have shown the influence of socioeconomic factors, such as economic income, educational level, or social class of parents, on sedentary behaviors, including physical inactivity22.

It was also observed that tenth and eleventh graders did less PA than ninth graders. This finding is consistent with data from several studies showing that adolescents’ PA levels decrease with age, possibly due to screen-based leisure activities such as watching television and using mobile devices, video games, and others33,34. The association between age and PA level has also been reported in studies conducted with adolescents in Greece35, the United States36, and Asian countries37. It has even been shown that the levels of PA are significantly reduced in older adults.

PI combined with a sedentary lifestyle is directly linked to an increase in body mass index, leading to overweight and obesity. It has medium- and long-term consequences, particularly an increased risk of chronic noncommunicable diseases2,3,5,6. The increasing prevalence of overweight and obesity can have a negative impact on the quality of life of individuals and the well-being of society and represents a significant burden on countries’ health systems and economies38. Therefore, it is essential to promote physical activity among adolescents in various settings, both in and out of school, to reduce sedentary lifestyles and the risk of obesity in the future.

Given the high prevalence of nutritional excess and the low level of PA among adolescents, it is urgent to develop health promotion strategies, even with a differentiated approach according to the type of educational institution. Despite participation, adolescents do not achieve optimal levels of frequency and duration of PA, highlighting the need for educational programs and attractive interventions to promote PA. The results of this study have important implications for public health, particularly in school environments. We recommend the design and implementation of public policies that contribute to a healthy school environment, offer healthy food, and promote physical activity. Adolescence is an important stage in the development of healthy behaviors and habits39. The type of educational institution (private-public) could reflect the structural determinants of economic income and would generate social inequality in the level of physical activity of adolescents. This should attract attention at a political level.

The limitations of this study are worth noting. First, the lack of representativeness of the population at the national and regional levels (Huila, Colombia). The comparison between only two educational institutions limits the extent to which the study can provide a complete and accurate picture of the situation in a broader context. In addition, the limitation of the questionnaire used lies in its temporal scope, measuring the activity of the last seven days, excluding previous records; this could imply a loss of relevant data. Although validated in Spanish-speaking regions, this approach may have limitations in comprehensively measuring participants’ physical activity32. Additionally, the schools are from two municipalities with different social, demographic, and economic characteristics. This could have affected the comparison of the results, or there may have been variables that confounded the results.

 

Conclusion

It is concluded that adolescent students have low levels of PA and that public school students are more inactive than private school students. The prevalence of excess weight was high in both educational institutions. It is important to conduct future studies with a larger sample size to investigate the social inequality of the level of physical activity by type of school. Qualitative studies that explore the particular circumstances of adolescents regarding healthy lifestyles, especially those with physical activity, are also recommended.

Conflict of Interest: Authors declare no conflict of interest.

Financing: Vicerrectoría de Ciencia, Tecnología e Innovación (VCTI) of the Universidad Antonio Nariño, Project No. 2022212.

 

References

X

Referencias

Tiwari A, Balasundaram P. Public Health Considerations Regarding Obesity. In: StatPearls. StatPearls Publishing, Treasure Island (FL); 2023. Disponible en: http://www.ncbi.nlm.nih.gov/books/NBK572122/

X

Referencias

Bryce-Moncloa A, Alegría-Valdivia E, San Martin-San Martin MG. Obesidad y riesgo de enfermedad cardiovascular. An Fac Med. 2017;78(2):202-6. https://doi.org/10.15381/anales.v78i2.13218

X

Referencias

Pajuelo Ramírez J, Bernui Leo I, Sánchez González J, Arbañil Huamán H, Miranda Cuadros M, Cochachin Henostroza O, et al. Obesidad, resistencia a la insulina y diabetes mellitus tipo 2 en adolescentes. An Fac Med. 2018;79(3):200-5. https://doi.org/10.15381/anales.v79i3.15311

X

Referencias

Herrera-Covarrubias D, Coria-Avila GA, Fernández-Pomares C, Aranda-Abreu GE, Manzo Denes J, Hernández ME. La obesidad como factor de riesgo en el desarrollo de cáncer. Rev Peru Med Exp Salud Publica. 2015;32:766–76. https://www.scielosp.org/article/ssm/content/raw/?resource_ssm_path=/media/assets/rpmesp/v32n4/a21v32n4.pdf

X

Referencias

Azizi N, Zangiabadian M, Seifi G, Davari A, Yekekhani E, Safavi-Naini SAA, et al. Gastric Cancer Risk in Association with Underweight, Overweight, and Obesity: A Systematic Review and Meta-Analysis. Cancers.2023;15(10):2778. https://doi.org/10.3390/cancers15102778

X

Referencias

Bautista-Florez N, Vega-González KM, Figueroa-Cabrera AN, Ramos-Castaneda JA. Asociación entre obesidad y tasa de filtración glomerular en población con hipertensión arterial. Enferm Nefrológica. 2021;24(1):47–54. https://doi.org/10.37551/s2254-28842021005

X

Referencias

Abarca-Gómez L, Abdeen ZA, Hamid ZA, Abu-Rmeileh NM, Acosta-Cazares B, Acuin C, et al. Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. The Lancet 2017;390(10113):2627–42. https://doi.org/10.1016/S0140-6736(17)32129-3

X

Referencias

Di Cesare M, Sorić M, Bovet P, Miranda JJ, Bhutta Z, Stevens GA, et al. The epidemiological burden of obesity in childhood: a worldwide epidemic requiring urgent action. BMC Med 2019;17:1–20. https://doi.org/10.1186/s12916-019-1449-8

X

Referencias

Dai H, Alsalhe TA, Chalghaf N, Riccò M, Bragazzi NL, Wu J. The global burden of disease attributable to high body mass index in 195 countries and territories, 1990–2017: An analysis of the Global Burden of Disease Study. PLoS Med 2020;17(7):e1003198. https://doi.org/10.1371/journal.pmed.1003198

X

Referencias

Encuesta Nacional de la Situación Nutricional 2015. Infografía población en edad escolar y adolescentes 5 a 12 años. Consulta: Noviembre 10, 2023. Disponible en https://www.icbf.gov.co/sites/default/files/infografia_situacion_nutricional_5_a_12_y_13_a_17_anos.pdf

X

Referencias

De Amicis R, Mambrini SP, Pellizzari M, Foppiani A, Bertoli S, Battezzati A, et al. Ultra-processed foods and obesity and adiposity parameters among children and adolescents: a systematic review. Eur J Nutr 2022;61:2297–311. https://doi.org/10.1007%2Fs00394-022-02873-4

X

Referencias

Malicevic S, Mirkov DM, Milanovic I, Janic SR, Batez M, Mazic S. Is the physical fitness of schoolchildren dependent on their physical activity levels and nutritional status? The experience from Serbia. Nutr Hosp Organo Of Soc Esp Nutr Parenter Enter 2022;39(3):506–12. https://doi.org/10.20960/nh.03861

X

Referencias

Organización Mundial de la Salud. Indicator Metadata Registry Details n.d. Accesed: September 14, 2023. Available from: https://www.who.int/data/gho/indicator-metadata-registry/imr-details/3416

X

Referencias

Davison J, Bunting B, Stewart-Knox B. The mediating effect of food choice upon associations between adolescent health-related quality of life and physical activity, social media use and abstinence from alcohol. Health Qual Life Outcomes 2023;21:46. https://doi.org/10.1186/s12955-023-02129-7

X

Referencias

Zenic N, Lipowska M, Maric D, Versic S, Vlahovic H, Gilic B. Exploring the association between alcohol drinking and physical activity in adolescence; two-year prospective study in younger adolescents from Bosnia and Herzegovina. Int J Environ Res Public Health 2021;18(22):11899. https://doi.org/10.3390/ijerph182211899

X

Referencias

Silva DAS, de Andrade Gonçalves EC, Coelho EF, Cerqueira MS, Werneck FZ. Cardiorespiratory Fitness and Physical Activity among Children and Adolescents: 3-Year Longitudinal Study in Brazil. Int J Environ Res Public Health 2022;19(18):11431. https://doi.org/10.3390/ijerph191811431

X

Referencias

Hassan MA, Zhou W, Ye M, He H, Gao Z. The effectiveness of physical activity interventions on blood pressure in children and adolescents: A systematic review and network meta-analysis. J Sport Health Sci 2024;13(5):399-708. https://doi.org/10.1016/j.jshs.2024.01.004

X

Referencias

Cristi-Montero C, Courel-Ibáñez J, Ortega FB, Castro-Piñero J, Santaliestra-Pasias A, Polito A, et al. Mediation role of cardiorespiratory fitness on the association between fatness and cardiometabolic risk in European adolescents: The HELENA study. J Sport Health Sci 2021;10(3):360–7. https://doi.org/10.1016/j.jshs.2019.08.003

X

Referencias

Medeiros AV, Bueno GR, Antunes MD. Uso do smartphone e sua relação com o sedentarismo em estudantes: uma revisão sistemática. Rev Interdiscip Promoção Saúde 2022;5;3-18. https://doi.org/10.17058/rips.v5i3.17872

X

Referencias

Zhai X, Ye M, Wang C, Gu Q, Huang T, Wang K et al. Associations among physical activity and smartphone use with perceived stress and sleep quality of Chinese college students. Ment Health Phys Act 2020;18:100323. https://doi.org/10.1016/j.mhpa.2020.100323

X

Referencias

Guthold R, Stevens GA, Riley LM, Bull FC. Global trends in insufficient physical activity among adolescents: a pooled analysis of 298 population-based surveys with 1·6 million participants. Lancet Child Adolesc Health 2020;4(1):23–35. https://doi.org/10.1016/S2352-4642(19)30323-2

X

Referencias

Silva RMA, Andrade AC de S, Caiaffa WT, de Medeiros DS, Bezerra VM. National Adolescent School-based Health Survey - PeNSE 2015: Sedentary behavior and its correlates. PLoS ONE 2020;15(1):e0228373. https://doi.org/10.1371/journal.pone.0228373

X

Referencias

Alves Junior CAS, Silva AFD, Pereira EV, Farias JMD, Silva DAS. Characteristics associated with sport practice among adolescents from a city in Southern Brazil. J Hum Growth Dev 2022;32(1):155–64. https://doi.org/10.36311/jhgd.v32.10262

X

Referencias

Tribby CP, Oh A, Perna F, Berrigan D. Adolescent Physical Activity at Public Schools, Private Schools, and Homeschools, United States, 2014. Prev Chronic Dis 2020;17:E85. https://doi.org/10.5888/pcd17.190450

X

Referencias

Arrogante O. Sampling techniques and sample size calculation: How and how many participants should I select for my research? Enferm Intensiva Engl Ed. 2022;33(1):44-47. https://doi.org/10.1016/j.enfie.2021.03.004

X

Referencias

Arias-Silva MV, Pedreros-Lemuz V, Rodríguez-Perdomo AL, González-Lozano RA, Ramos-Castaneda JA. Nutritional status and physical activity. Mendeley Data V1. 2024. https://doi.org/10.17632/pwxnc3hszy.1

X

Referencias

Ministerio de Salud y Protección Social. Resolución 2465 de 2016. Consulta: Agosto 12, 2023. Disponible en https://www.icbf.gov.co/sites/default/files/resolucion_no._2465_del_14_de_junio_de_2016.pdf

X

Referencias

Kowalski KC, Crocker PRE, Kowalski NP. Convergent Validity of the Physical Activity Questionnaire for Adolescents. Pediatr Exerc Sci 1997;9(4):342–52. https://doi.org/10.1123/pes.9.4.342

X

Referencias

Lema-Gómez L, Arango-Paternina CM, Eusse-López C, Petro J, Petro-Petro J, López-Sánchez M, et al. Family aspects, physical fitness, and physical activity associated with mental-health indicators in adolescents. BMC Public Health 2021;21(1):2324. https://doi.org/10.1186/s12889-021-12403-2

X

Referencias

Castellanos EJR, Rojas IAS, Herrera ADR, Hernández NDS, Romero DM, Rueda SL. Niveles de actividad física en adolescentes de Colombia. Rev Iberoam Cienc Act Física El Deporte 2021;10(3):78–98. https://doi.org/10.24310/riccafd.2021.v10i3.12533

X

Referencias

Zapata Lopez JS, Calvo Paz M, Carrillo HA. Acoso escolar y su relación con la actividad física en adolescentes escolarizados de Cali, Colombia. Retos Nuevas Tend En Educ Física Deporte Recreación 2024;(52):639-646. https://dialnet.unirioja.es/servlet/articulo?codigo=9273871

X

Referencias

Martínez-Gómez D, Martínez-de-Haro V, Pozo T, Welk GJ, Villagra A, Calle ME, et al. Fiabilidad y validez del cuestionario de actividad física PAQ-A en adolescentes españoles. Rev Esp Salud Pública 2009;83(3):427–39. https://www.redalyc.org/articulo.oa?id=17011592008

X

Referencias

Torres PA. Educación Física y Salud. Evaluación de la aptitud muscular y la adiposidad corporal en adolescentes escolares. Rev Cienc Act Física 2021;22(2):1–12. https://doi.org/10.29035/rcaf.22.2.5

X

Referencias

Silva D, Monteiro Teixeira D, de Oliveira G, Petroski E, Marcio de Farias JM. Aerobic fitness in adolescents in southern Brazil: Association with sociodemographic aspects, lifestyle and nutritional status. Rev Andal Med Deporte 2016;9(1):17–22. https://www.redalyc.org/articulo.oa?id=323344442005

X

Referencias

Loucaides CA, Jago R, Theophanous M. Physical activity and sedentary behaviours in Greek-Cypriot children and adolescents: a cross-sectional study. Int J Behav Nutr Phys Act 2011;8(1):90. https://doi.org/10.1186/1479-5868-8-90

X

Referencias

Nelson MC, Neumark-Stzainer D, Hannan PJ, Sirard JR, Story M. Longitudinal and secular trends in physical activity and sedentary behavior during adolescence. Pediatrics 2006;118(6):e1627-e1634. https://doi.org/10.1542/peds.2006-0926

X

Referencias

Müller AM, Khoo S, Lambert R. Review of physical activity prevalence of Asian school-age children and adolescents. Asia Pac J Public Health 2013;25(3):227-238. https://doi.org/10.1177/1010539513481494

X

Referencias

Machado K, Gil P, Ramos I, Pírez C. Sobrepeso/obesidad en niños en edad escolar y sus factores de riesgo. Arch Pediatría Urug 2018;89:16–25. http://www.scielo.edu.uy/scielo.php?pid=S1688-12492018000400016&script=sci_arttext

X

Referencias

McGovern CM, Militello LK, Arcoleo KJ, Melnyk BM. Factors Associated With Healthy Lifestyle Behaviors Among Adolescents. J Pediatr Health Care. 2018;32(5):473–80. https://doi.org/10.1016/j.pedhc.2018.04.002

X

Referencias

n#

  1. Tiwari A, Balasundaram P. Public Health Considerations Regarding Obesity. In: StatPearls. StatPearls Publishing, Treasure Island (FL); 2023. Disponible en: http://www.ncbi.nlm.nih.gov/books/NBK572122/

  2. Bryce-Moncloa A, Alegría-Valdivia E, San Martin-San Martin MG. Obesidad y riesgo de enfermedad cardiovascular. An Fac Med. 2017;78(2):202-6. https://doi.org/10.15381/anales.v78i2.13218

  3. Pajuelo Ramírez J, Bernui Leo I, Sánchez González J, Arbañil Huamán H, Miranda Cuadros M, Cochachin Henostroza O, et al. Obesidad, resistencia a la insulina y diabetes mellitus tipo 2 en adolescentes. An Fac Med. 2018;79(3):200-5. https://doi.org/10.15381/anales.v79i3.15311

  4. Herrera-Covarrubias D, Coria-Avila GA, Fernández-Pomares C, Aranda-Abreu GE, Manzo Denes J, Hernández ME. La obesidad como factor de riesgo en el desarrollo de cáncer. Rev Peru Med Exp Salud Publica. 2015;32:766–76. https://www.scielosp.org/article/ssm/content/raw/?resource_ssm_path=/media/assets/rpmesp/v32n4/a21v32n4.pdf

  5. Azizi N, Zangiabadian M, Seifi G, Davari A, Yekekhani E, Safavi-Naini SAA, et al. Gastric Cancer Risk in Association with Underweight, Overweight, and Obesity: A Systematic Review and Meta-Analysis. Cancers.2023;15(10):2778. https://doi.org/10.3390/cancers15102778

  6. Bautista-Florez N, Vega-González KM, Figueroa-Cabrera AN, Ramos-Castaneda JA. Asociación entre obesidad y tasa de filtración glomerular en población con hipertensión arterial. Enferm Nefrológica. 2021;24(1):47–54. https://doi.org/10.37551/s2254-28842021005

  7. Abarca-Gómez L, Abdeen ZA, Hamid ZA, Abu-Rmeileh NM, Acosta-Cazares B, Acuin C, et al. Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. The Lancet 2017;390(10113):2627–42. https://doi.org/10.1016/S0140-6736(17)32129-3

  8. Di Cesare M, Sorić M, Bovet P, Miranda JJ, Bhutta Z, Stevens GA, et al. The epidemiological burden of obesity in childhood: a worldwide epidemic requiring urgent action. BMC Med 2019;17:1–20. https://doi.org/10.1186/s12916-019-1449-8

  9. Dai H, Alsalhe TA, Chalghaf N, Riccò M, Bragazzi NL, Wu J. The global burden of disease attributable to high body mass index in 195 countries and territories, 1990–2017: An analysis of the Global Burden of Disease Study. PLoS Med 2020;17(7):e1003198. https://doi.org/10.1371/journal.pmed.1003198

  10. Encuesta Nacional de la Situación Nutricional 2015. Infografía población en edad escolar y adolescentes 5 a 12 años. Consulta: Noviembre 10, 2023. Disponible en https://www.icbf.gov.co/sites/default/files/infografia_situacion_nutricional_5_a_12_y_13_a_17_anos.pdf

  11. De Amicis R, Mambrini SP, Pellizzari M, Foppiani A, Bertoli S, Battezzati A, et al. Ultra-processed foods and obesity and adiposity parameters among children and adolescents: a systematic review. Eur J Nutr 2022;61:2297–311. https://doi.org/10.1007%2Fs00394-022-02873-4

  12. Malicevic S, Mirkov DM, Milanovic I, Janic SR, Batez M, Mazic S. Is the physical fitness of schoolchildren dependent on their physical activity levels and nutritional status? The experience from Serbia. Nutr Hosp Organo Of Soc Esp Nutr Parenter Enter 2022;39(3):506–12. https://doi.org/10.20960/nh.03861

  13. Organización Mundial de la Salud. Indicator Metadata Registry Details n.d. Accesed: September 14, 2023. Available from: https://www.who.int/data/gho/indicator-metadata-registry/imr-details/3416

  14. Davison J, Bunting B, Stewart-Knox B. The mediating effect of food choice upon associations between adolescent health-related quality of life and physical activity, social media use and abstinence from alcohol. Health Qual Life Outcomes 2023;21:46. https://doi.org/10.1186/s12955-023-02129-7

  15. Zenic N, Lipowska M, Maric D, Versic S, Vlahovic H, Gilic B. Exploring the association between alcohol drinking and physical activity in adolescence; two-year prospective study in younger adolescents from Bosnia and Herzegovina. Int J Environ Res Public Health 2021;18(22):11899. https://doi.org/10.3390/ijerph182211899

  16. Silva DAS, de Andrade Gonçalves EC, Coelho EF, Cerqueira MS, Werneck FZ. Cardiorespiratory Fitness and Physical Activity among Children and Adolescents: 3-Year Longitudinal Study in Brazil. Int J Environ Res Public Health 2022;19(18):11431. https://doi.org/10.3390/ijerph191811431

  17. Hassan MA, Zhou W, Ye M, He H, Gao Z. The effectiveness of physical activity interventions on blood pressure in children and adolescents: A systematic review and network meta-analysis. J Sport Health Sci 2024;13(5):399-708. https://doi.org/10.1016/j.jshs.2024.01.004

  18. Cristi-Montero C, Courel-Ibáñez J, Ortega FB, Castro-Piñero J, Santaliestra-Pasias A, Polito A, et al. Mediation role of cardiorespiratory fitness on the association between fatness and cardiometabolic risk in European adolescents: The HELENA study. J Sport Health Sci 2021;10(3):360–7. https://doi.org/10.1016/j.jshs.2019.08.003

  19. Medeiros AV, Bueno GR, Antunes MD. Uso do smartphone e sua relação com o sedentarismo em estudantes: uma revisão sistemática. Rev Interdiscip Promoção Saúde 2022;5;3-18. https://doi.org/10.17058/rips.v5i3.17872

  20. Zhai X, Ye M, Wang C, Gu Q, Huang T, Wang K et al. Associations among physical activity and smartphone use with perceived stress and sleep quality of Chinese college students. Ment Health Phys Act 2020;18:100323. https://doi.org/10.1016/j.mhpa.2020.100323

  21. Guthold R, Stevens GA, Riley LM, Bull FC. Global trends in insufficient physical activity among adolescents: a pooled analysis of 298 population-based surveys with 1·6 million participants. Lancet Child Adolesc Health 2020;4(1):23–35. https://doi.org/10.1016/S2352-4642(19)30323-2

  22. Silva RMA, Andrade AC de S, Caiaffa WT, de Medeiros DS, Bezerra VM. National Adolescent School-based Health Survey - PeNSE 2015: Sedentary behavior and its correlates. PLoS ONE 2020;15(1):e0228373. https://doi.org/10.1371/journal.pone.0228373

  23. Alves Junior CAS, Silva AFD, Pereira EV, Farias JMD, Silva DAS. Characteristics associated with sport practice among adolescents from a city in Southern Brazil. J Hum Growth Dev 2022;32(1):155–64. https://doi.org/10.36311/jhgd.v32.10262

  24. Tribby CP, Oh A, Perna F, Berrigan D. Adolescent Physical Activity at Public Schools, Private Schools, and Homeschools, United States, 2014. Prev Chronic Dis 2020;17:E85. https://doi.org/10.5888/pcd17.190450

  25. Arrogante O. Sampling techniques and sample size calculation: How and how many participants should I select for my research? Enferm Intensiva Engl Ed. 2022;33(1):44-47. https://doi.org/10.1016/j.enfie.2021.03.004

  26. Arias-Silva MV, Pedreros-Lemuz V, Rodríguez-Perdomo AL, González-Lozano RA, Ramos-Castaneda JA. Nutritional status and physical activity. Mendeley Data V1. 2024. https://doi.org/10.17632/pwxnc3hszy.1

  27. Ministerio de Salud y Protección Social. Resolución 2465 de 2016. Consulta: Agosto 12, 2023. Disponible en https://www.icbf.gov.co/sites/default/files/resolucion_no._2465_del_14_de_junio_de_2016.pdf

  28. Kowalski KC, Crocker PRE, Kowalski NP. Convergent Validity of the Physical Activity Questionnaire for Adolescents. Pediatr Exerc Sci 1997;9(4):342–52. https://doi.org/10.1123/pes.9.4.342

  29. Lema-Gómez L, Arango-Paternina CM, Eusse-López C, Petro J, Petro-Petro J, López-Sánchez M, et al. Family aspects, physical fitness, and physical activity associated with mental-health indicators in adolescents. BMC Public Health 2021;21(1):2324. https://doi.org/10.1186/s12889-021-12403-2

  30. Castellanos EJR, Rojas IAS, Herrera ADR, Hernández NDS, Romero DM, Rueda SL. Niveles de actividad física en adolescentes de Colombia. Rev Iberoam Cienc Act Física El Deporte 2021;10(3):78–98. https://doi.org/10.24310/riccafd.2021.v10i3.12533

  31. Zapata Lopez JS, Calvo Paz M, Carrillo HA. Acoso escolar y su relación con la actividad física en adolescentes escolarizados de Cali, Colombia. Retos Nuevas Tend En Educ Física Deporte Recreación 2024;(52):639-646. https://dialnet.unirioja.es/servlet/articulo?codigo=9273871

  32. Martínez-Gómez D, Martínez-de-Haro V, Pozo T, Welk GJ, Villagra A, Calle ME, et al. Fiabilidad y validez del cuestionario de actividad física PAQ-A en adolescentes españoles. Rev Esp Salud Pública 2009;83(3):427–39. https://www.redalyc.org/articulo.oa?id=17011592008

  33. Torres PA. Educación Física y Salud. Evaluación de la aptitud muscular y la adiposidad corporal en adolescentes escolares. Rev Cienc Act Física 2021;22(2):1–12. https://doi.org/10.29035/rcaf.22.2.5

  34. Silva D, Monteiro Teixeira D, de Oliveira G, Petroski E, Marcio de Farias JM. Aerobic fitness in adolescents in southern Brazil: Association with sociodemographic aspects, lifestyle and nutritional status. Rev Andal Med Deporte 2016;9(1):17–22. https://www.redalyc.org/articulo.oa?id=323344442005

  35. Loucaides CA, Jago R, Theophanous M. Physical activity and sedentary behaviours in Greek-Cypriot children and adolescents: a cross-sectional study. Int J Behav Nutr Phys Act 2011;8(1):90. https://doi.org/10.1186/1479-5868-8-90

  36. Nelson MC, Neumark-Stzainer D, Hannan PJ, Sirard JR, Story M. Longitudinal and secular trends in physical activity and sedentary behavior during adolescence. Pediatrics 2006;118(6):e1627-e1634. https://doi.org/10.1542/peds.2006-0926

  37. Müller AM, Khoo S, Lambert R. Review of physical activity prevalence of Asian school-age children and adolescents. Asia Pac J Public Health 2013;25(3):227-238. https://doi.org/10.1177/1010539513481494

  38. Machado K, Gil P, Ramos I, Pírez C. Sobrepeso/obesidad en niños en edad escolar y sus factores de riesgo. Arch Pediatría Urug 2018;89:16–25. http://www.scielo.edu.uy/scielo.php?pid=S1688-12492018000400016&script=sci_arttext

  39. McGovern CM, Militello LK, Arcoleo KJ, Melnyk BM. Factors Associated With Healthy Lifestyle Behaviors Among Adolescents. J Pediatr Health Care. 2018;32(5):473–80. https://doi.org/10.1016/j.pedhc.2018.04.002