Association between lifestyle patterns and overweight and obesity in adolescents: a systematic review

The purpose of this systematic review was to summarise the evidence from observational studies regarding the association between lifestyle patterns and overweight and obesity in adolescents. To our knowledge, no review study has analysed this association in this age group. A systematic search was conducted in Latin American and Caribbean Health Sciences Literature (LILACS), Scopus, PubMed Central and Web of Science databases, with no language or time restrictions. Studies that included adolescents (10-19 years old) were selected using data-driven methods that combined the diet domain with at least one of the following behavioural domains: physical activity, sedentary behaviour and sleep. Twenty-one articles met all eligibility criteria. Of these, twelve studies were used for synthesising the results. Studies differed in many aspects, such as sample size, behavioural assessment tools, and lifestyle pattern and weight status indicators. Overall, cross-sectional studies found no association between lifestyle patterns and overweight and obesity, even when the data were stratified by sex. However, when analysing the results stratified by risk of bias, a positive association between predominantly unhealthy and mixed lifestyle patterns with overweight/obesity was identified in cross-sectional studies with moderate risk of bias. A prospective study revealed an increase in BMI over time associated with mixed and predominantly unhealthy lifestyle patterns. Current findings regarding the association between lifestyle patterns and overweight and obesity in adolescents are inconsistent. More studies are needed to clarify possible associations.