Skip to main content
SpringerLink
Log in

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

  • Original Article
  • Published:
International Journal of Public Health

Abstract

Objectives

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

Methods

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.

Results

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.

Conclusions

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  • Altenburg TM, Chinapaw MJ, van der Knaap ET, Brug J, Manios Y, Singh AS (2013) Longer sleep–slimmer kids: the ENERGY-project. PLoS ONE 8:59522

    Article  Google Scholar 

  • Boone-Heinonen J, Gordon-Larsen P, Adair SA (2008) Obesogenic clusters: multidimensional adolescent obesity-related behaviors in the US. Ann Behav Med 36:217–230

    Article  PubMed  PubMed Central  Google Scholar 

  • Carson V, Tremblay MS, Chaput JP, Chastin SF (2016) Associations between sleep duration, sedentary time, physical activity, and health indicators among Canadian children and youth using compositional analyses. Appl Physiol Nutr Metab 41:S294–S302

    Article  PubMed  Google Scholar 

  • Chaput JP, Gray CE, Poitras VJ, Carson V, Gruber R, Olds T et al (2016) Systematic review of the relationships between sleep duration and health indicators in school-aged children and youth. Appl Physiol Nutr Metab 41:S266–S282

    Article  PubMed  Google Scholar 

  • Cole TJ, Bellizzi MC, Flegal KM, Dietz WH (2000) Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 320:1240

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Craigie AM, Lake AA, Kelly SA, Adamson AJ, Mathers JC (2011) Tracking of obesity-related behaviours from childhood to adulthood: a systematic review. Maturitas 70:266–284

    Article  PubMed  Google Scholar 

  • Cuenca-García M, Huybrechts I, Ruiz JR, Ortega FB, Ottevaere C, González-Gross M et al (2013) Clustering of multiple lifestyle behaviors and health-related fitness in European adolescents. J Nutr Educ Behav 45:549–555

    Article  PubMed  Google Scholar 

  • Dubow EF, Boxer P, Huesmann LR (2009) Long-term effects of parents’ education on children’s educational and occupational success: mediation by family interactions, child aggression, and teenage aspirations. Merrill-Palmer Q 55:224

    Article  Google Scholar 

  • Fernández-Alvira JM, De Bourdeaudhuij I, Singh AS, Vik FN, Manios Y, Kovacs E et al (2013) Clustering of energy balance-related behaviors and parental education in European children: the ENERGY-project. Int J Behav Nutr Phys Act 10:5

    Article  PubMed  PubMed Central  Google Scholar 

  • Garaulet M, Ortega FB, Ruiz JR, Rey-Lopez JP, Beghin L, Manios Y et al (2011) Short sleep duration is associated with increased obesity markers in European adolescents: effect of physical activity and dietary habits. The HELENA study. Int J Obes 35:1308–1317

    Article  CAS  Google Scholar 

  • Griebler R, Molcho M, Samdal O, Incley J, Dür W, Currie C (ed) (2010) Health behaviour in school-aged children: a World Health Organization Cross-National Study. Research protocol for the 2009/2010 survey. Vienna: LBIHPR & Edinburgh: CAHRU

  • Gubbels JS, van Assema P, Kremers SP (2013) Physical activity, sedentary behavior, and dietary patterns among children. Curr Nutr Rep 2:105–112

    Article  PubMed  PubMed Central  Google Scholar 

  • Hirshkowitz M, Whiton K, Albert SM, Alessi C, Bruni O, DonCarlos L et al (2015) National sleep foundation’s sleep time duration recommendations: methodology and results summary. Sleep Health 1:40–43

    Article  Google Scholar 

  • Hitze B, Bosy-Westphal A, Bielfeldt F, Settler U, Plachta-Danielzik S, Pfeuffer M et al (2009) Determinants and impact of sleep duration in children and adolescents: data of the Kiel Obesity Prevention Study. Eur J Clin Nutr 63:739–746

    Article  CAS  PubMed  Google Scholar 

  • Inchley J, Currie D, Young T, Samdal O, Torsheim T, Augustson L et al (ed) (2016) Growing up unequal: gender and socioeconomic differences in young people’s health and well-being. Health behaviour in School-aged Children (HBSC) study: international report from the 2013/2014 survey. Copenhagen, WHO Regional Office for Europe, (Health Policy for Children and Adolescents, No. 7)

  • Jarrin DC, McGrath JJ, Drake CL (2013) Beyond sleep duration: distinct sleep dimensions are associated with obesity in children and adolescents. Int J Obes 37:552–558

    Article  CAS  Google Scholar 

  • Johnson JG, Cohen P, Kasen S, First MB, Brook JS (2004) Association between television viewing and sleep problems during adolescence and early adulthood. Arch Pediatr Adolesc Med 158:562–568

    Article  PubMed  Google Scholar 

  • Leech RM, McNaughton SA, Timperio A (2014a) The clustering of diet, physical activity and sedentary behavior in children and adolescents: a review. Int J Behav Nutr Phys Act 11:4

    Article  PubMed  PubMed Central  Google Scholar 

  • Leech RM, McNaughton SA, Timperio A (2014b) Clustering of children’s obesity-related behaviours: associations with sociodemographic indicators. Eur J Clin Nutr 68:623–628

    Article  CAS  PubMed  Google Scholar 

  • Lobstein T, Baur L, Uauy R (2004) Obesity in children and young people: a crisis in public health. Obes Rev 5(s1):4–85

    Article  PubMed  Google Scholar 

  • McAloney K, Graham H, Law C, Platt L (2013) A scoping review of statistical approaches to the analysis of multiple health-related behaviours. Prev Med 56:365–371

    Article  PubMed  Google Scholar 

  • Nedeltcheva AV, Kilkus JM, Imperial J, Kasza K, Schoeller DA, Penev PD (2009) Sleep curtailment is accompanied by increased intake of calories from snacks. J Clin Nutr 89:126–133

    Article  CAS  Google Scholar 

  • Nuutinen T, Ray C, Roos E (2013) Do computer use, TV viewing, and the presence of the media in the bedroom predict school-aged children’s sleep habits in a longitudinal study? BMC Public Health 13:684

    Article  PubMed  PubMed Central  Google Scholar 

  • Nuutinen T, Roos E, Ray C, Villberg J, Välimaa R, Rasmussen M et al (2014) Computer use, sleep duration and health symptoms: a cross-sectional study of 15-year olds in three countries. Int J Public Health 59:619–628

    Article  PubMed  Google Scholar 

  • Ottevaere C, Huybrechts I, Benser J, De Bourdeaudhuij I, Cuenca-Garcia M, Dallongeville J et al (2011) Clustering patterns of physical activity, sedentary and dietary behavior among European adolescents: the HELENA study. BMC Public Health 11:328

    Article  PubMed  PubMed Central  Google Scholar 

  • Parsons MJ, Moffitt TE, Gregory AM, Goldman-Mellor S, Nolan PM, Poulton R et al (2015) Social jetlag, obesity and metabolic disorder: investigation in a cohort study. Int J Obes 39:842–848. doi:10.1038/ijo.2014.201

    Article  CAS  Google Scholar 

  • Pereira S, Katzmarzyk PT, Gomes TN, Borges A, Santos D, Souza M et al (2015) Profiling physical activity, diet, screen and sleep habits in Portuguese children. Nutrients 7:4345–4362

    Article  PubMed  PubMed Central  Google Scholar 

  • Sabbe D, De Bourdeaudhuij I, Legiestand E, Maes L (2008) A cluster-analytical approach towards physical activity and eating habits among 10-year-old children. Health Educ Res 23:753–762

    Article  PubMed  Google Scholar 

  • Sadeh A, Dahl RE, Shahar G, Rosenblat-Stein S (2009) Sleep and the transition to adolescence: a longitudinal study. Sleep 12:1602–1609

    Article  Google Scholar 

  • Sherry B, Jefferds ME, Grummer-Strawn LM (2007) Accuracy of adolescent self-report of height and weight in assessing overweight status: a literature review. Arch Pediatr Adolesc Med 161:1154–1161

    Article  PubMed  Google Scholar 

  • Singh AS, Mulder C, Twisk JW, van Mechelen W, Chinapaw MJ (2008) Tracking of childhood overweight into adulthood: a systematic review of the literature. Obes Rev 9:474–488

    Article  CAS  PubMed  Google Scholar 

  • Strasburger VC, Hogan MJ, Mulligan DA, Ameenuddin N, Christakis DA, Cross C et al (2013) Children, adolescents and the media. Pediatrics 132:958–961

    Article  Google Scholar 

  • Te Velde SJ, De Bourdeaudhuij I, Thorsdottir I, Rasmussen M, Hagströmer M, Klepp KI et al (2007) Patterns in sedentary and exercise behaviors and associations with overweight in 9–14-year-old boys and girls—a cross-sectional study. BMC Public Health 7:16

    Article  Google Scholar 

  • Touitou Y (2013) Adolescent sleep misalignment: a chronic jet lag and a matter of public health. J Physiol Paris 107:323–326

    Article  PubMed  Google Scholar 

  • Tynjälä J (1999) Sleep habits, perceived sleep quality and tiredness among adolescents. A health behavioural approach. Studies in sport, physical education and health 61, University of Jyväskylä: Jyväskylä University Printing House

  • Van den Bulck J, Hofman A (2009) The television-to-exercise ratio is a predictor of overweight in adolescents: results from a prospective cohort study with a two year follow up. Prev Med 48:368–371

    Article  PubMed  Google Scholar 

  • van der Sluis ME, Lien N, Twisk JW, Steenhuis IH, Bere E, Klepp KI et al (2010) Longitudinal associations of energy balance-related behaviours and cross-sectional associations of clusters and body mass index in Norwegian adolescents. Public Health Nutr 13:1716

    Article  PubMed  Google Scholar 

  • Veloso SM, Matos MG, Carvalho M, Diniz JA (2012) Psychosocial factors of different health behaviour patterns in adolescents: association with overweight and weight control behaviours. J Obes. doi:10.1155/2012/852672

    PubMed  PubMed Central  Google Scholar 

  • Yen CF, Ko CH, Yen JY, Cheng CP (2008) The multidimensional correlates associated with short nocturnal sleep duration and subjective insomnia among Taiwanese adolescents. Sleep 31:1515

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

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.

Author information

Authors and Affiliations

  1. Folkhälsan Research Center, Helsinki, Finland

    Teija Nuutinen, Elviira Lehto, Carola Ray & Eva Roos

  2. Department of Public Health, University of Helsinki, Helsinki, Finland

    Teija Nuutinen & Eva Roos

  3. Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland

    Eva Roos

  4. Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland

    Jari Villberg & Jorma Tynjälä

Authors
  1. Teija Nuutinen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Elviira Lehto
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Carola Ray
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Eva Roos
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jari Villberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jorma Tynjälä
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Elviira Lehto.

Ethics declarations

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.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nuutinen, T., Lehto, E., Ray, C. et al. Clustering of energy balance-related behaviours, sleep, and overweight among Finnish adolescents. Int J Public Health 62, 929–938 (2017). https://doi.org/10.1007/s00038-017-0991-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00038-017-0991-4

Keywords

Search

Navigation