title: Lifestyle factors associated with overweight and obesity among Saudi adolescents.
abstract: BACKGROUND
  A better understanding of the relationships between obesity and lifestyle factors is necessary for effective prevention and management of obesity in youth. Therefore, the objective of this study was to evaluate the associations between obesity measures and several lifestyle factors, including physical activity, sedentary behaviors and dietary habits among Saudi adolescents aged 14-19 years.
  
  
  METHODS
  This was a school-based cross-sectional study that was conducted in three cities in Saudi Arabia (Al-Khobar, Jeddah and Riyadh). The participants were 2906 secondary school males (1400) and females (1506) aged 14-19 years, who were randomly selected using a multistage stratified cluster sampling technique. Measurements included weight, height, body mass index (BMI), waist circumference, waist/height ratio (WHtR), screen time (television viewing, video games and computer use), physical activity (determined using a validated questionnaire), and dietary habits (intake frequency per week). Logistic regression was used to examine the associations between obesity and lifestyle factors.
  
  
  RESULTS
  Compared with non-obese, obese males and females were significantly less active, especially in terms of vigorous activity, had less favorable dietary habits (e.g., lower intake of breakfast, fruits and milk), but had lower intake of sugar-sweetened drinks and sweets/chocolates. Logistic regression analysis showed that overweight/obesity (based on BMI categories) or abdominal obesity (based on WHtR categories) were significantly and inversely associated with vigorous physical activity levels (aOR for high level = 0.69, 95% CI 0.41-0.92 for BMI and 0.63, 95% CI 0.45-0.89 for WHtR) and frequency of breakfast (aOR for < 3 days/week = 1.44; 95% CI 1.20-1.71 for BMI and 1.47; 95% CI 1.22-1.76 for WHtR) and vegetable (aOR for < 3 days/week = 1.29; 95% CI 1.03-1.59 for WHtR) intakes, and consumption of sugar-sweetened beverages (aOR for < 3 days/week = 1.32; 95% CI 1.08-1.62 for BMI and 1.42; 95% CI 1.16-1.75 for WHtR).
  
  
  CONCLUSIONS
  The present study identified several lifestyle factors associated with obesity that may represent valid targets for the prevention and management of obesity among Saudi adolescents. Primary prevention of obesity by promoting active lifestyles and healthy diets should be a national public health priority.
authors.affiliation: College of Education, King Saud University, Riyadh, Saudi Arabia. alhazzaa@ksu.edu.sa
authors.forename: Hazzaa M
authors.initials: HM
authors.lastname: Al-Hazzaa
authors.forename: Nada A
authors.initials: NA
authors.lastname: Abahussain
authors.forename: Hana I
authors.initials: HI
authors.lastname: Al-Sobayel
authors.forename: Dina M
authors.initials: DM
authors.lastname: Qahwaji
authors.forename: Abdulrahman O
authors.initials: AO
authors.lastname: Musaiger
mesh_terms: D000293:Adolescent; D003201:Computers / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008297:Male; D009043:Motor Activity; D009765:Obesity / Q000453:epidemiology*; D050177:Overweight / Q000453:epidemiology*; D012307:Risk Factors; D012529:Saudi Arabia / Q000453:epidemiology; D011795:Surveys and Questionnaires; D013690:Television / Q000706:statistics & numerical data*; D018910:Video Games; D055815:Young Adult