Online Program

Does Healthy BMI Mean Healthy Lifestyle? An Analysis of Adolescent Nutrition and Physical Activity That Challenges Assumptions Underlying Current Primary Care Practices Of Lifestyle Counseling And Obesity Prevention

Tuesday, November 3, 2015

Himabindu Ekanadham, MD, Department of Community & Family Medicine, Columbia University Medical Center, NY, Mohegan lake, NY
Susan X. Lin, DrPH, Center for Family and Community Medicine,College of Physicians & Surgeons, Columbia University, New York, NY
Objective: In the primary care setting, adolescents who are overweight or obese are more likely to receive nutrition and exercise counseling than those who have a normal BMI, suggesting an underlying assumption that adolescents with normal BMI have healthier lifestyles.The primary goal of this study was to assess whether adolescents with normal BMI engage in healthier eating and exercise behaviors in comparison to those who are overweight and obese.

Methods: The 2010 National Youth Physical Activity and Nutrition Study (NYPANS) questionnaire data were used which included a nationally representative sample of US adolescents in grades 9-12 (n=11,429). SPSS software was used to conduct all statstical analyses. 

Results: Normal weight adolescents (NWAs) were significantly more likely than overweight or obese adolescents (OOAs) to engage in ≥5 days of 60 minutes of physical activity per day (OR 1.34, 95% CI 1.15-1.57) and in ≥5 days of 20 minutes of aerobic exercise per day (OR 1.30, 95% CI 1.10-1.54). However, the proportion of NWAs participating in this level of activity was still only about 50%. NWAs did not differ significantly from OOAs in their mean consumption of fruits, vegetables, soda, and sugar-sweetened beverages (p>0.05). NWAs had a higher mean consumption of fried potatoes and pizza than OOAs that was statistically significant (p=.002 and p<0.0001 respectively).

Conclusions: The results of this study are significant in that they refute the assumption that adolescents with normal healthy BMIs engage in healthier lifestyle behaviors in comparison to those who are overweight or obese. This study speaks to the need for intensified primary prevention efforts in fighting the battle against obesity.

Learning Areas:

Advocacy for health and health education
Assessment of individual and community needs for health education
Planning of health education strategies, interventions, and programs
Public health or related education
Public health or related research

Learning Objectives:
Compare physical activity and food consumption behaviors in normal weight adolescents to those in adolescents who are overweight or obese. Explain current US Preventive Services Task Force (USPSTF) guidelines on adolescent screening and counseling and how these are implemented in current primary care practice in the US. Discuss potential changes to approaches within primary care lifestyle counseling and intervention, based on the results of this study, that could be more effectively focused on primary prevention of obesity.

Keyword(s): Children and Adolescents, Obesity

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a postdoctoral fellow at Columbia University in primary care research. During the last 5 years my research has involved the areas of food access in urban underserved areas and, more recently, understanding adolescents' mindsets regarding physical activity, nutrition, and culinary skills so as to make health education to adolescents more effective.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.