Research article
Longitudinal Sedentary Behavior Changes in Adolescents in Ho Chi Minh City

https://doi.org/10.1016/j.amepre.2012.10.021Get rights and content

Background

Sedentary behavior is associated with increased risk of chronic disease and sedentary behavior is increasing among adolescents. Data on changes in sedentary behavior in developing countries are limited.

Purpose

To describe 5-year longitudinal changes in nonschool sedentary hours among urban adolescents in Ho Chi Minh City, and to identify correlates with this change.

Methods

This is a 5-year longitudinal cohort with systematic random sampling of 759 students from 18 junior high schools. All measures were taken annually between 2004 and 2009. Sedentary behavior was assessed by self-report and accelerometry. Generalized linear latent and mixed models were used to analyze the data in 2011.

Results

Between 2004 and 2009, self-reported time spent in nonschool sedentary behavior increased from 498 to 603 minutes/day. In the 5th survey year, boys and girls (aged 16 years) were, respectively, 3.6 times (95% CI=2.3, 6.0) and 3.1 times (95% CI= 1.8, 5.0) more likely to spend ≥2 hours/day on screen time compared with baseline (aged 12 years). Accelerometer data adjusted for wearing time revealed that boys and girls aged 16 years had, respectively, 78 minutes/day (95% CI=48, 104) and 69 minutes/day (95% CI=34, 95) more nonschool sedentary time than those at the first accelerometer assessment (at age 13 years). Girls in the highest socioeconomic quartile spent an additional 90 minutes/day in sedentary behavior compared with girls in the lowest quartile (95% CI=52, 128).

Conclusions

Nonschool sedentary behavior increased among Vietnamese adolescents with age. The largest increase was in recreational screen time (28%), which would be the most obvious target for preventive health strategies.

Introduction

Sedentary behaviors increase the risk of obesity1, 2, 3 and the development of a range of chronic diseases.4, 5, 6 In children and adolescents, leisure-time sedentary behaviors, such as TV viewing, have been associated with metabolic risk factors, independent of physical activity levels.4, 7 In recent decades, the opportunities to be sedentary have increased, and young people tend to be more sedentary than those in previous generations.8, 9

Although much is known about correlates of physical activity,10 little is known about correlates of sedentary behaviors among adolescents, despite the belief that the determinants of sedentary behavior are distinct from those of physical activity.11, 12 In addition, sedentary behavior appears to carry over more than physical activity from childhood to adolescence,13 and may even have a greater influence on the development of overweight and obesity than physical activity.14, 15

Data on sedentary behaviors are available for developed countries,16, 17, 18, 19, 20 but they are lacking for developing nations.21 Moreover, current studies are mostly cross-sectional and focused on only screen time (i.e., TV, videos/DVDs, recreational computer use), which has been used widely as a proxy measure of sedentary behavior among youth.7, 22, 23 Few studies have examined a broad range of sedentary behaviors longitudinally among adolescents.24

Identification of the correlates of a full range of sedentary behaviors in adolescents is needed to develop more-efficient preventive action to decrease sedentary behavior and risk of chronic disease including excess adiposity in developing countries, such as Vietnam. The purpose of the current study was to describe the longitudinal changes in sedentary behavior among adolescents in urban Vietnam who participated in the Ho Chi Minh City Youth Cohort study between 2004 and 2009, and to identify individual, family, and environmental factors associated with screen time and sedentary behavior over this 5-year period.

Section snippets

Study Design

The Ho Chi Minh City (Vietnam) Youth Cohort study was a 5-year longitudinal study that began in 2004 from a multistage cluster cross-sectional survey. The study examined the weight status and weight-related behaviors among adolescents in this city. The survey covered 140 junior high schools from which 31 clusters (schools) were selected.

Systematic random sampling was used to select 18 junior high schools, of which 11 were from wealthy districts and seven were from less-wealthy districts for the

Results

At baseline, 759 adolescents consented to participate in the study, and complete data from the 5 survey years were available for 585 (77%) adolescents. At baseline, the mean age of the students was 11.8 years (±0.6). The baseline characteristics of the students (Table 1) showed that 14.2% of students were overweight or obese. The majority of students did not have a TV in their bedroom (92%); had a computer game store nearby (95%); and had parental rules limiting screen time (95%).

Self-reported

Discussion

This is the first study to present longitudinal changes across a broad range of sedentary behaviors and to provide a better understanding of relevant correlates of screen time and sedentary behavior among Vietnamese adolescents. The study findings are important to the design of interventions designed to decrease the sedentary lifestyles that are becoming increasingly common in developing countries such as Vietnam. This study showed an increase in nonschool sedentary time in a representative

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