International Journal of Public Health

, Volume 62, Issue 8, pp 929–938 | Cite as

Clustering of energy balance-related behaviours, sleep, and overweight among Finnish adolescents

  • Teija Nuutinen
  • Elviira Lehto
  • Carola Ray
  • Eva Roos
  • Jari Villberg
  • Jorma Tynjälä
Original Article



To examine how clusters of energy balance-related behaviours (EBRBs), including sleep related factors, were associated with overweight among adolescents.


In Finland, 4262 adolescents, aged 13–15, participated in the cross-national Health Behaviour in School-aged Children study. The adolescents completed questionnaires assessing EBRBs [sleep duration, discrepancy and quality, physical activity (PA), screen time, junk food, fruit, and vegetable intake] and height and weight. Clusters were identified with κ-means cluster analysis and their associations with overweight with logistic regression analyses.


Common clusters for boys and girls were labelled “Healthy lifestyle” and “High screen time, unhealthy lifestyle”. In addition, the cluster “Low/moderate screen time, unhealthy lifestyle” was identified among boys, and the cluster “Poor sleep, unhealthy lifestyle” among girls. Only girls in the cluster “High screen time, unhealthy lifestyle” were at increased risk for overweight.


Girls, whose EBRB was characterized by high screen time and low PA, but not with poor sleep, were at increased risk for overweight. Future studies should examine ways to promote PA among adolescent girls with high interest in screen-based activities.


Cluster analysis Adolescent Sleep Screen time Physical activity Diet 



This study was funded by the Juho Vainio Foundation in line with Teija Nuutinen’s personal grant. We also acknowledge Samfundet Folkhälsan i svenska Finland r.f. The Health Behaviour in School-aged Children (HBSC) study is an international study carried out in collaboration with the World Health Organization (WHO). We thank the International Coordinator of the 2009/2010 study, Candace Currie, University of Edinburgh, Scotland.

Compliance with ethical standards

Conflict of interest

Authors declare that they have no conflict of interest.

Informed consent

The adolescents’ participation in the study was voluntary and based on informed consent. In addition, each school’s headmaster independently decided whether to participate in the study.

Ethical approval

Ethics approval came from the National Board of Education and the Trade Union of Education.


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Copyright information

© Swiss School of Public Health (SSPH+) 2017

Authors and Affiliations

  • Teija Nuutinen
    • 1
    • 2
  • Elviira Lehto
    • 1
  • Carola Ray
    • 1
  • Eva Roos
    • 1
    • 2
    • 3
  • Jari Villberg
    • 4
  • Jorma Tynjälä
    • 4
  1. 1.Folkhälsan Research CenterHelsinkiFinland
  2. 2.Department of Public HealthUniversity of HelsinkiHelsinkiFinland
  3. 3.Department of Food and Environmental SciencesUniversity of HelsinkiHelsinkiFinland
  4. 4.Faculty of Sport and Health SciencesUniversity of JyväskyläJyväskyläFinland

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