Adherence to Health Behavior Recommendations among Youth with Obesity Classes I, II, and III.

Overall rates of meeting health behavior recommendations varied widely among youth with obesity.

• Sample included 11,525 youth with obesity from primary care visits between 2013 and 2019, ages 2-17 years.
• Rate of meeting physical activity recommendations was 78.6%.
• Rate of meeting screen time recommendations was 55.0%.
• Rate of meeting fruit/vegetable consumption recommendations was 8.1%.
• Rates of meeting dairy and water consumption recommendations were 29.6% and 54.7%, respectively.

Youth with obesity class II had significantly lower odds of meeting physical activity recommendations compared to youth with obesity class I.

• Adjusted odds ratio for obesity class II vs. class I: OR = 0.63, 95% CI = 0.56, 0.72.
• Youth with obesity class III also had lower odds of meeting PA recommendations compared to class I: OR = 0.60, 95% CI = 0.49, 0.72.
• These findings were from adjusted logistic regression models.
• No significant difference in PA adherence was observed between obesity class II and class III.

Youth with obesity class II and class III had significantly lower odds of meeting screen time recommendations compared to youth with obesity class I.

• Adjusted odds ratio for obesity class II vs. class I for screen time: OR = 0.83, 95% CI = 0.74, 0.92.
• Adjusted odds ratio for obesity class III vs. class I for screen time: OR = 0.78, 95% CI = 0.65, 0.94.
• No significant difference in screen time adherence was observed between obesity class II and class III.

No differences in adherence to fruit/vegetable, dairy, or water consumption recommendations were observed across obesity classes.

• Logistic regression models compared odds of adherence across obesity classes I, II, and III for all five health behaviors.
• Significant differences were only found for physical activity and screen time recommendations.
• Fruit/vegetable adherence was notably low across all groups at 8.1% overall.

Data were collected using a brief survey administered during primary care visits to capture adherence to five different health behaviors.

• Data spanned primary care visits from 2013 to 2019.
• Participants were youth ages 2-17 years with obesity.
• Five health behaviors assessed: physical activity, screen time, fruit/vegetable consumption, dairy consumption, and water consumption.
• Logistic regression was used to compare odds of adherence across obesity classes (class I vs. II/III; class II vs. III).