TV Viewing, Independent of Physical Activity and Obesogenic Foods, Increases Overweight and Obesity in Adolescents

The aim of this study was to estimate the prevalence of overweight and obesity (OAO) and associated risk factors in a representative sample of students aged 11-20 years in Urmia, Iran. In this population-based cross-sectional study, a multistage random cluster-sampling method was used, through which 2,498 students were selected. OAO were defined based on criteria set by the US Center for Health Statistics in collaboration with the US Center for Chronic Disease Prevention and Health Promotion under the Centers for Disease Control and Prevention (CDC). OAO risk factors were assessed using a questionnaire containing questions about TV viewing, nutrition, physical activities (PA), social and economic factors. Contents of the questionnaire were validated by calculating the content validity ratio (CVR) and content validity index (CVI), based on the responses elicited from 15 experts. Reliability of the questionnaire was obtained from a test and re-test of the questionnaire completed by 15 students. To analyze the data, χ²-test, t-test, and multiple logistic regression analysis were conducted. The prevalence of OAO was found to be 14.1% among the 11-20 years old students of junior and senior high schools. The results of multiple logistic regression analysis indicated that the educational level of mothers, type of school, and the time spent on viewing TV were associated with an increased risk of OAO while obesogenic foods and PA had no effect on the frequency of OAO [Odds ratio (OR) for the time spent on watching TV one hour more than usual equals 1.27 at p=0.001]. The direct correlation between TV viewing and OAO, which is independent of PA and obesogenic foods, needs to be carefully investigated through randomized clinical trials and cohort studies.