title: Clustering of risk-related modifiable behaviours and their association with overweight and obesity among a large sample of youth in the COMPASS study.
abstract: Canadian youth exhibit a number of risky behaviours, some of which are associated with overweight and obesity. The purpose of this study was to examine the prevalence of 15 modifiable risk behaviours in a large sample of Canadian youth, to identify underlying subgroups based on patterns of health behaviours, and to examine the association between identified subgroups and overweight/obesity.
  
  
  
  Data from 18,587 grades 9-12 students in Year 1 (2012-13) of the COMPASS study and latent class analysis were used to identify patterns and clustering among 15 health behaviours (e.g., physical inactivity, sedentary behaviour, unhealthy eating, substance use). A logistic regression model examined the associations between these clusters and overweight/obesity status.
  
  
  
  Four distinct classes were identified: traditional school athletes, inactive screenagers, health conscious, and moderately active substance users. Each behavioural cluster demonstrated a distinct pattern of behaviours, some with a greater number of risk factors than others. Traditional school athletes (odds ratio (OR) 1.15, 95% CI 1.03-1.29), inactive screenagers (OR 1.33; 1.19-1.48), and moderately active substance users (OR 1.27; 1.14-1.43) were all significantly more likely to be overweight/obese compared to the health conscious group.
  
  
  
  Four distinct subpopulations of youth were identified based on their patterns of health and risk behaviours. The three clusters demonstrating poorer health behaviour were all at an increased risk of being overweight/obese compared to their somewhat healthier peers. Obesity-related public health interventions and health promotion efforts might be more effective if consideration is given to population segments with certain behavioural patterns, targeting subgroups at greatest risk of overweight or obesity.
authors.affiliation: School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L3G1, Canada. rlaxer@uwaterloo.ca.
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Laxer
authors.affiliation: Brown School and School of Medicine, Washington University in St. Louis, Campus Box 1196, One Brookings Drive, St. Louis, MO, 63130-4899, USA.
authors.forename: Ross C
authors.initials: RC
authors.lastname: Brownson
authors.affiliation: School of Public Health and Health Systems, Department of Statistics and Actuarial Science, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L3G1, Canada.
authors.forename: Joel A
authors.initials: JA
authors.lastname: Dubin
authors.affiliation: School of Public Health and Health Systems, Department of Sociology & Legal Studies, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L3G1, Canada.
authors.forename: Martin
authors.initials: M
authors.lastname: Cooke
authors.affiliation: School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L3G1, Canada.
authors.forename: Ashok
authors.initials: A
authors.lastname: Chaurasia
authors.affiliation: School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L3G1, Canada.
authors.forename: Scott T
authors.initials: ST
authors.lastname: Leatherdale
mesh_terms: D000293:Adolescent; D002170:Canada / Q000453:epidemiology; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D005247:Feeding Behavior; D005260:Female; D015438:Health Behavior; D006801:Humans; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D050177:Overweight / Q000453:epidemiology / Q000209:etiology*; D063766:Pediatric Obesity / Q000453:epidemiology / Q000209:etiology*; D015995:Prevalence; D012307:Risk Factors; D012309:Risk-Taking; D057185:Sedentary Behavior
keywords: Adolescent; Behaviour patterns; Diet; Health promotion; Latent class analysis; Obesity; Physical activity; Risk-taking