Skipping breakfast, alcohol consumption and physical inactivity as risk factors for overweight and obesity in adolescents:results of the E-MOVO project

Objective/Background: To investigate the association between skipping breakfast, alcohol consumption and physical inactivity with overweight and obesity in adolescents. The design comprises cross-sectional electronic health survey (E-MOVO).Subjects/Methods: Over 35 000 Dutch adolescents in grade 2 (13-14 years of age) and grade 4 (15-16 years of age) of secondary educational schools were recruited by seven community health services. Analyses were performed on 25 176 adolescents. Body mass index was calculated from self-reported body weight and height. Frequency of skipping breakfast per week, amount of alcoholic drinks consumed per occasion, and numbers of physical active days per week were considered as determinants for overweight and obesity.Results: In grade 2, adjusted odds ratios for the association with overweight were 2.17(95% CI: 1.66-2.85) for skipping breakfast, 1.86 (1.36-2.55) for alcohol consumption and 1.73 (1.19-2.51) for physical inactivity. Statistically significant associations with overweight were also found in grade 4. In grade 2, dose-response relations (P for trend <0.05) were present between all risk factors and overweight. In a multivariate model containing all risk factors, breakfast skipping showed the strongest relation with overweight (OR 1.68, 95% CI 1.43-1.97 for grade 2, OR 1.32 95% CI 1.14-1.54 for grade 4) and obesity.Conclusions: Skipping breakfast, alcohol consumption and physical inactivity were associated with overweight in second and fourth grade adolescents. The associations were strongest for younger adolescents. The most important risk factor for overweight and obesity was skipping breakfast.