Correlates of leisure-time sedentary behavior among 181,793 adolescents aged 12-15 years from 66 low- And middle-income countries

Background Sedentary behavior is a growing public health concern in young adolescents from low- and middle-income countries (LMICs). However, a paucity of multinational studies, particularly in LMICs, have investigated correlates of leisure-time sedentary behavior (LTSB) in young adolescents. In the current study, we assessed socio-demographic, socio-economic, sociocultural and health behavior related correlates of LTSB among adolescents aged 12–15 years who participated in the Global school-based Student Health Survey (GSHS). Methods Self-reported LTSB, which was a composite variable assessing time spent sitting and watching television, playing computer games, talking with friends during a typical day excluding the hours spent sitting at school and doing homework, was analyzed in 181,793 adolescents from 66 LMICs [mean (SD) age 13.8 (1.0) years; 49% girls). Multivariable logistic regression was used to assess the potential LTSB correlates. Results The overall prevalence of ≥3 hours/day of LTSB was 26.4% (95%CI = 25.6%-27.2%). Increasing age (OR = 1.14; 95%CI = 1.11–1.17), past 30-day smoking (OR = 1.85; 95%CI = 1.69–2.03), alcohol consumption (OR = 2.01; 95%CI = 1.85–2.18), and bullying victimization (OR = 1.39; 95%CI = 1.31–1.48) were positively associated with increased LTSB across the entire sample of 181,793 adolescents. Food insecurity (OR = 0.93; 95%CI = 0.89–0.97) and low parental support/monitoring (OR = 0.91; 95%CI = 0.85–0.98) were negatively associated with LTSB. There were some variations in the correlates between countries. Conclusions Our data indicate that in adolescents aged 12 to 15 years living in LMICs, LTSB is a complex and multi-dimensional behavior determined by socio-demograhic, sociocultural, socio-economic, and health behavior related factors. Future longitudinal data are required to confirm/ refute these findings, and to inform interventions which aim to reduce sedentary levels in adolescents living in LMICs.