title: Relationship of milk intake and physical activity to abdominal obesity among adolescents.
abstract: What is already known about this subject Diet and physical activity (PA) are recognized as important factors to prevent abdominal obesity (AO). Studies have found an inverse relationship between milk intake or milk products and body weight and/or body fat in children and adolescents. Evidence suggests that low levels of PA are associated with AO in youth. What this study adds Our study explored the combined association of milk intake and PA on AO in adolescents, which are most often studied in isolation. Our findings suggested that adolescents with high milk intakes, regardless of whether they were active or low active, were less likely to have AO. Our findings could have a great epidemiological interest and bring important evidence in the field of AO management among adolescents.
  
  
  BACKGROUND
  Diet and physical activity (PA) are recognized as important factors to prevent abdominal obesity (AO), which is strongly associated with chronic diseases. Some studies have reported an inverse association between milk consumption and AO.
  
  
  OBJECTIVE
  This study examined the association between milk intake, PA and AO in adolescents.
  
  
  METHODS
  A cross-sectional study was conducted with 1209 adolescents, aged 15-18 from the Azorean Archipelago, Portugal in 2008. AO was defined by a waist circumference at or above the 90th percentile. Adolescent food intake was measured using a semi-quantitative food frequency questionnaire, and milk intake was categorized as 'low milk intake' (<2 servings per day) or 'high milk intake' (≥2 servings per day). PA was assessed via a self-report questionnaire, and participants were divided into active (>10 points) and low-active groups (≤10 points) on the basis of their reported PA. They were then divided into four smaller groups, according to milk intake and PA: (i) low milk intake/low active; (ii) low milk intake/active; (iii) high milk intake/low active and (iv) high milk intake/active. The association between milk intake, PA and AO was evaluated using logistic regression analysis, and the results were adjusted for demographic, body mass index, pubertal stage and dietary confounders.
  
  
  RESULTS
  In this study, the majority of adolescents consumed semi-skimmed or skimmed milk (92.3%). The group of adolescents with high level of milk intake and active had a lower proportion of AO than did other groups (low milk intake/low active: 34.2%; low milk intake/active: 26.9%; high milk intake/low active: 25.7%; high milk intake/active: 21.9%, P = 0.008). After adjusting for confounders, low-active and active adolescents with high levels of milk intake were less likely to have AO, compared with low-active adolescents with low milk intake (high milk intake/low active, odds ratio [OR] = 0.412, 95% confidence intervals [CI]: 0.201-0.845; high milk intake/active adolescents, OR = 0.445, 95% CI: 0.235-0.845).
  
  
  CONCLUSIONS
  High milk intake seems to have a protective effect on AO, regardless of PA level.
authors: Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal.
authors: S
authors: S
authors: Abreu
authors: R
authors: R
authors: Santos
authors: C
authors: C
authors: Moreira
authors: P C
authors: PC
authors: Santos
authors: S
authors: S
authors: Vale
authors: L
authors: L
authors: Soares-Miranda
authors: R
authors: R
authors: Autran
authors: J
authors: J
authors: Mota
authors: P
authors: P
authors: Moreira
mesh_terms: D000293:Adolescent; D000818:Animals; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D002149:Energy Intake; D015444:Exercise; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008297:Male; D008892:Milk; D009043:Motor Activity; D056128:Obesity, Abdominal / Q000453:epidemiology / Q000517:prevention & control*; D016017:Odds Ratio; D011174:Portugal / Q000453:epidemiology; D011795:Surveys and Questionnaires; D055105:Waist Circumference
keywords: Abdominal obesity; adolescents; milk; physical activity