Patterns of sedentary behavior and compliance with public health recommendations in Spanish adolescents: the AFINOS study Patrones de sedentarismo y cumplimiento de las recomendaciones de salud pública en adolescentes españoles: estudio AFINOS

The aims of the present study were: (i) describe patterns of sedentary behavior in Spanish adolescents; and (ii) determine the proportion of adolescents that do not meet the public health recommendations for sedentary behavior. This study comprised 1,724 Spanish adolescents (882 girls), aged 13 to 16 years. Patterns of sedentary behavior (TV viewing, use of computer games, console games and surfing the Internet) were assessed using the HELENA sedentary behavior questionnaire. The total proportion of adolescents watching TV, using computer and console games, and surfing the internet for more than two hours daily was 24%, 9%, 7%, and 17%, respectively, on weekdays, and 50%, 22%, 16%, and 35%, respectively, on weekends. Over 63% of the adolescents from the study did not meet the recommendation for sedentary behavior (< 2 hours daily screen time) on weekdays and 87% did not comply with this recommendation on weekends. Since sedentary behavior plays a key role in adolescent health, public health interventions in Spain that take these factors into consideration are needed. Sedentary Lifestyle; Adolescent; Health Public Policy Introduction In today’s postmodern society, most people spend the majority of their waking hours engaging in sedentary behavior 1. Emerging evidence shows that prolonged sedentary behavior may have a deleterious effect on health 2. For example, excessive sedentary behavior has been associated with premature all-cause and cardiovascular disease mortality, obesity and an unfavorable cardiometabolic risk factor profile in adults 2. Regarding this behavior in youth, although evidence is more limited, excessive sedentary behavior appears to have a harmful effect on health 3,4. Consequently, educational and public health organizations have focused efforts on promoting a decrease in sedentary behavior from an early age 5. Sedentary behavior includes activities that involve low levels of energy expenditure, consisting mainly of sitting time in different contexts 2. Since several sedentary activities are part of young people’s daily routine (e.g.: classes at school, studying), sedentary activities during leisure time are the target of preventive strategies 4. Among youth, the most common leisure-time sedentary behavior is watching television (TV). Furthermore, new media technologies such as computers and games consoles have provided new opportunities for sedentary activity among this age group and while parents tend to limit the use of different kinds of media during childARTIGO ARTICLE Gómez DM et al. 2238 Cad. Saúde Pública, Rio de Janeiro, 28(12):2237-2244, dez, 2012 hood, adolescents experience greater freedom, and availability of these activities is practically guaranteed 6. Surveillance studies in several countries have described sedentary behavior patterns in adolescents. However, when it comes to large samples of Spanish adolescents, data is limited to TV viewing behavior 9 and little is known about wider sedentary behavior among this age group in this country 7,8. Likewise, the level of compliance with public health recommendations for sedentary behavior is practically unknown 8. From a public health perspective, this study has the following two-fold aim: (i) describe patterns of sedentary behavior in Spanish adolescents; and (ii) determine the proportion of adolescents that do not meet public health recommendations for sedentary behavior.