The study investigates the evolution of healthy behaviors (healthy eating and regular physical activity) in Brazilian adolescents during 2012 and 2015, and its associations with self-assessment of body weight and adoption of weight control attitudes, in the context of diverse household features, school environments, and regional characteristics.
Two cross-sectional surveys of Brazilian adolescents attending the ninth grade in 2012 and 2015 were gathered comprising a national sample. Data from 209,601 completed surveys were analyzed using robust error estimates of ordinary least squares regressions.
Results showed that there was a decrease in the frequency of healthy foods consumption and recommended physical activity level between 2012 and 2015. The regression analyses revealed that healthy eating and physical activity were significantly higher for adolescents with normal weight perception (i.e., did not perceive themselves to have either low or excess body weight) and for adolescents who were male, were members of middle socioeconomic stratum families, and had mothers with college degrees. In addition, healthy eating was significantly higher for adolescents who did not wish to lose weight, did not watch TV while eating, went to public schools, and lived with both parents. Ethnic differences varied based on region, with healthy eating being significantly higher among black/mulato/indigenous adolescents in the South and Southeast regions, but significantly higher among white/yellow adolescents in the North region.
Ethnic and gender-related differences were identified in health behaviors and attitudes towards weight control of Brazilian adolescents. Findings indicate the relevance of individual characteristics combined with the influence of social networks for the adoption of healthy behaviors among adolescent students.
Level of evidence
Level IV, evidence obtained from multiple time series without intervention.
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World Health Organization (2014) Health for the world’s adolescents: a second chance in the second decade. Geneva, pp 20. https://apps.who.int/adolescent/second-decade/. Accessed 10 Jun 2018
Buscemi S, Marventano S, Castellano S, Nolfo F, Rametta S, Giorgianni G, Matalone M, Marranzano M, Mistretta A (2018) Role of anthropometric factors, self-perception, and diet on weight misperception among young adolescents: a cross-sectional study. Eat Weight Disord 23(1):107–115. https://doi.org/10.1007/s40519-016-0306-4
Balantekin KN, Birch LL, Savage JS (2018) Family, friend, and media factors are associated with patterns of weight-control behavior among adolescent girls. Eat Weight Disord 23(2):215–223. https://doi.org/10.1007/s40519-016-0359-4
Voelker DK, Reel JJ, Greenleaf C (2015) Weight status and body image perceptions in adolescents: current perspectives. Adolesc Health Med Ther 6:149–158. https://doi.org/10.2147/AHMT.S68344
Sampasa-Kanyinga H, Hamilton HA, Willmore J, Chaput JP (2017) Perceptions and attitudes about body weight and adherence to the physical activity recommendation among adolescents: the moderating role of body mass index. Public Health 146:75–83. https://doi.org/10.1016/j.puhe.2017.01.002
Bucchianeri MM, Arikian AJ, Hannan PJ, Eisenberg ME, Neumark-Sztainer D (2013) Body dissatisfaction from adolescence to young adulthood: findings from a 10-year longitudinal study. Body Image 10(1):1–7. https://doi.org/10.1016/j.bodyim.2012.09.001
Caran LG, Santana DD, Monteiro LS, da Veiga GV (2018) Disordered eating behaviors and energy and nutrient intake in a regional sample of Brazilian adolescents from public schools. Eat Weight Disord 23(6):825–832. https://doi.org/10.1007/s40519-018-0519-9
Leme ACB, Philippi ST, Thompson D, Nicklas T, Baranowski T (2019) “Healthy Habits, Healthy Girls-Brazil”: an obesity prevention program with added focus on eating disorders. Eat Weight Disord 24(1):107–119. https://doi.org/10.1007/s40519-018-0510-5
Lobstein T, Jackson-Leach R, Moodie ML, Hall KD, Gortmaker SL, Swinburn BA, James WPT, Wang Y, McPherson K (2015) Child and adolescent obesity: part of a bigger picture. Lancet 385(9986):2510–2520. https://doi.org/10.1016/S0140-6736(14)61746-3
Kenney EL, Redman MT, Criss S, Sonneville KR, Austin SB (2017) Are K-12 school environments harming students with obesity? A qualitative study of classroom teachers. Eat Weight Disord 22(1):141–152. https://doi.org/10.1007/s40519-016-0268-6
Sharif Ishak SI, Chin YS, Mohd Taib MN, Mohd Shariff Z (2016) School-based intervention to prevent overweight and disordered eating in secondary school Malaysian adolescents: a study protocol. BMC Public Health 16(1):1101–1112. https://doi.org/10.1186/s12889-016-3773-7
Brazilian Institute for Geography and Statistics (2019) Pesquisa Nacional por Amostra de Domicílios 2018. Rio de Janeiro. https://www.ibge.gov.br/estatisticas/sociais/trabalho/9173-pesquisa-nacional-por-amostra-de-domicilios-continua-trimestral.html?=&t=downloads. Accessed 20 Jul 2019
Brazilian Institute for Geography and Statistics (2013) Pesquisa Nacional de Saúde do Escolar 2012. Rio de Janeiro. https://biblioteca.ibge.gov.br/visualizacao/livros/liv64436.pdf. Accessed 17 Oct 2015
Werneck AO, Oyeyemi AL, Fernandes RA, Romanzini M, Ronque ERV, Cyrino ES, Sardinha LB, Silva DR (2018) Regional socioeconomic inequalities in physical activity and sedentary behavior among Brazilian adolescents. J Phys Act Health 15(5):338–344. https://doi.org/10.1123/jpah.2017-0338
Brazilian Institute for Geography and Statistics (2016) Pesquisa Nacional de Saúde do Escolar 2015. Rio de Janeiro. https://biblioteca.ibge.gov.br/visualizacao/livros/liv97870.pdf. Accessed 27 Aug 2016
Oliveira MM, Campos MO, Andreazzi MAR, Malta DC (2017) Characteristics of the National Adolescent School-based Health Survey—PeNSE. Brazil Epidemiol Serv Saude 26(3):605–616. https://doi.org/10.5123/s1679-49742017000300017
World Cancer Research Fund/American Institute for Cancer Research (2009) Policy and action for cancer prevention—food, nutrition, and physical activity: a global perspective. American Institute for Cancer Research. https://www.wcrf-hk.org/sites/default/files/Policy_Report.pdf. Accessed 20 Dec 2017
Brazil. Ministry of Health. Secretaria de Atenção à Saúde. Departamento de Atenção Básica (2014) Guia alimentar para a população brasileira. 2. ed., 1. reimpr. Ministério da Saúde, Brasília, p 158. https://bvsms.saude.gov.br/bvs/publicacoes/guia_alimentar_populacao_brasileira_2ed.pdf. Accessed 20 Feb 2018
World Health Organization (2010) Global recommendations on physical activity for health. Geneva, p 60. https://apps.who.int/iris/bitstream/handle/10665/44399/9789241599979_eng.pdf?s. Accessed 20 Jun 2017
Zach S, Zeev A, Dunsky A, Goldbourt U, Shimony T, Goldsmith R, Netz Y (2013) Perceived body size versus healthy body size and physical activity among adolescents: results of a national survey. Eur J Sport Sci 13(6):723–731. https://doi.org/10.1080/17461391.2013.771382
Kopcakova J, Veselska ZD, Geckova AM, Dijk JP, Reijneveld SA (2014) Is being a boy and feeling fat a barrier for physical activity? The association between body image, gender and physical activity among adolescents. Int J Environ Res Public Health 11(11):11167–11176. https://doi.org/10.3390/ijerph111111167
Lee J, Sa J, Chaput J-P, Seo D-C, Samuel T (2018) Racial/ethnic differences in body weight perception among US college students. J Am College Health 66(5):429–437. https://doi.org/10.1080/07448481.2018.1446437
Kennedy AK, Schneiderman JU, Winter VR (2019) Association of body weight perception and unhealthy weight control behaviors in adolescence. Child Youth Serv Rev 96:250–254. https://doi.org/10.1016/j.childyouth.2018.11.053
Cuevas AG, Ortiz K, Ransome Y (2019) The moderating role of race/ethnicity and nativity in the relationship between perceived discrimination and overweight and obesity: results from the National Epidemiologic Survey on Alcohol and Related Conditions. BMC Public Health 19:1458. https://doi.org/10.1186/s12889-019-7811-0
Haddad MR, Sarti FM (2020) Sociodemographic determinants of health behaviors among Brazilian adolescents: trends in physical activity and food consumption, 2009–2015. Appetite 144:104454. https://doi.org/10.1016/j.appet.2019.104454
Groth MV, Sorensen MR, Matthiessen J, Fagt S, Landvad N, Knudsen VK (2014) Disparities in dietary habits and physical activity in Denmark and trends from 1995 to 2008. Scand J Public Health 42(7):611–620. https://doi.org/10.1177/1403494814547668
Monge-Rojas R, Fuster-Baraona T, Garita C, Sánchez M, Smith-Castro V, Valverde-Cerros Ó, Cólon-Ramos L (2015) The influence of gender stereotypes on eating habits among Costa Rican adolescents. Am J Health Promot 29(5):303–310. https://doi.org/10.4278/ajhp.130904-QUAL-462
Musaiger AO, Al-Mufty BA, Al-Hazzaa HM (2014) Eating habits, inactivity, and sedentary behavior among adolescents in Iraq: sex differences in the hidden risks of noncommunicable diseases. Food Nutr Bull 35(1):12–19. https://doi.org/10.1177/156482651403500102
Cooke LJ, Wardle J (2005) Age and gender differences in children’s food preferences. Br J Nutr 93(5):741–746. https://doi.org/10.1079/BJN20051389
Fernandes RA, Christofaro DGD, Casonatto J, Kawaguti SS, Ronque ERV, Cardoso JR, Freitas Júnior IF, Oliveira AR (2011) Cross-sectional association between healthy and unhealthy food habits and leisure physical activity in adolescentes. J Pediatr 87(3):252–256. https://doi.org/10.2223/JPED.2093
Cureau FV, Silva TLN, Bloch KV, Fujimori E, Belfort DR, Carvalho KMB, Leon EB, Vasconcellos MTL, Ekelund U, Schaan BD (2016) ERICA: leisure-time physical inactivity in Brazilian adolescents. Rev Saude Publica 50(suppl. 1):1s–11s. https://doi.org/10.1590/s01518-8787.2016050006683
Dias DF, Loch MR, Ronque VER (2015) Perceived barriers to leisure-time physical activity and associated factors in adolescents. Cienc Saude Coletiva 20(11):3339–3350. https://doi.org/10.1590/1413-812320152011.00592014
Farias Júnior JC, Lopes AS, Mota J, Hallal PC (2012) Physical activity practice and associated factors in adolescents in Northeastern Brazil. Rev Saude Publica 46(3):505–515. https://doi.org/10.1590/S0034-89102012005000031
Gonçalves H, Hallal PC, Amorim TC, Araujo CL, Menezes AM (2007) Sociocultural factors and physical activity level in early adolescence. Rev Panam Salud Publica 22(4):246–253. https://doi.org/10.1590/s1020-49892007000900004
Wilson-Frederick SM, Thorpe RJ Jr, Bell CN, Ford JG, LaVeist TA (2014) Examination of race disparities in physical inactivity among adults of similar social context. Ethn Dis 24(3):363–369
Barufaldi LA, Abreu GA, Oliveira JS, Santos DF, Fujimori E, Vasconcelos SML, Vasconcelos FAG, Tavares BM (2016) ERICA: prevalence of healthy eating habits among Brazilian adolescents. Rev Saude Publica 50(suppl. 1):1s–9s. https://doi.org/10.1590/s01518-8787.2016050006678
D’Avila GL, Muller RL, Gonsalez PS, Vasconcelos FAG (2015) The association between nutritional status of the mother and the frequency and location of and company during meals and overweight/obesity among adolescents in the city of Florianópolis. Brazil Rev Bras Saude Mater Infantil 15(3):289–299. https://doi.org/10.1590/S1519-38292015000300004
Hammons AJ, Fiese BH (2011) Is frequency of shared family meals related to the nutritional health of children and adolescents? Pediatrics 127(6):e1565–e1574. https://doi.org/10.1542/peds.2010-1440
Tosatti AM, Ribeiro LW, Machado RHV, Maximino P, Bozzini AB, Ramos CC, Fisberg M (2017) Does family mealtime have a protective effect on obesity and good eating habits in young people? A 2000–2016 review. Rev Bras Saude Mater Infantil 17(3):425–434. https://doi.org/10.1590/1806-93042017000300002
Costa ALF, Duarte DE, Kuschnir MCC (2010) Family and eating behavior in adolescence. Adolesc Saude 7(3):52–58. https://www.adolescenciaesaude.com/detalhe_artigo.asp?id=236. Accessed 12 Jan 2017
Askovic B, Kirchengast S (2012) Gender differences in nutritional behavior and weight status during early and late adolescence. Anthropol Anz 69(3):289–304. https://doi.org/10.1127/0003-5548/2012/0212
Al-Hazzaa HM, Al-Sobayel HI, Abahussain NA, Qahwaji DM, Alahmadi MA, Musaiger AO (2014) Association of dietary habits with levels of physical activity and screen time among adolescents living in Saudi Arabia. J Hum Nutr Diet 27(Suppl 2):204–213. https://doi.org/10.1111/jhn.12147
Santaliestra-Pasías AM, Mouratidou T, Huybrechts I, Beghin L, Cuenca-Gracia M, Castillo MJ, Galfo M, Hallstrom L, Kafatos A, Manios Y et al (2014) Increased sedentary behaviour is associated with unhealthy dietary patterns in European adolescents participating in the HELENA study. Eur J Clin Nutr 68(3):300–308. https://doi.org/10.1038/ejcn.2013.170
Chapman CD, Benedict C, Brooks SJ, Schioth HB (2012) Lifestyle determinants of the drive to eat: a meta-analysis. Am J Clin Nutr 96:492–497. https://doi.org/10.3945/ajcn.112.039750
Cesar JT, Valentim EA, Almeida CCB, Schieferdecker MEM, Schimidt ST (2018) School feeding in Brazil and United States: an integrative review. Cienc Saude Coletiva 23(3):991–1007. https://doi.org/10.1590/1413-81232018233.01582016
Seabra AF, Mendonça DM, Thomis MA, Anjos LA, Maia JÁ (2008) Biological and socio-cultural determinants of physical activity in adolescents. Cad Saude Publica 24(4):721–736. https://doi.org/10.1590/S0102-311X2008000400002
Nascente FMN, Jardim T, Peixoto MD, Carneiro CS, Mendonça KL, Povoa TI, Sousa AL, Barroso WK, Jardim PC (2016) Sedentary lifestyle and its associated factors among adolescents from public and private schools of a Brazilian state capital. BMC Public Health 16(1):1177–1185. https://doi.org/10.1186/s12889-016-3836-9
Oliveira TC, Silva AAM, Santos CJN, Silva JS, Conceição SIO (2010) Physical activity and sedentary lifestyle among children from private and public schools in Northern Brazil. Rev Saude Publica 44(6):996–1004. https://doi.org/10.1590/S0034-89102010000600003
Conflict of interest
All authors declare that they have no conflict of interest.
Students interviewed in the surveys performed by the Brazilian Institute for Geography and Statistics (IBGE) were presented and signed informed consent to previous to participation in the study, and the surveys were approved by the National Committee of Ethics in Research (CONEP), opinion nos. 16805/2012 and 1006467/2015.
Informed consent was presented to students interviewed in the surveys by the Brazilian Institute for Geography and Statistics (opinion nos. 16805/2012 and 1006467/2015) and data without individual identification was made publicly available (https://www.ibge.gov.br/estatisticas/sociais/educacao/9134-pesquisa-nacional-de-saude-do-escolar.html?=&t=microdados) for research purposes without requirement for further informed consent. Regarding authors participating in the coauthorship of the manuscript, all authors read and agreed with the final version of the manuscript.
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Haddad, M.R., Sarti, F.M. & Nishijima, M. Association between selected individual and environmental characteristics in relation to health behavior of Brazilian adolescents. Eat Weight Disord 26, 331–343 (2021). https://doi.org/10.1007/s40519-020-00856-0
- Eating habits
- Physical activity
- Health behavior
- Body weight