Associations of accelerometer measured school- and non-school based physical activity and sedentary time with body mass index: IPEN Adolescent study

Delfien Van Dyck, Anthony Barnett, Ester Cerin, Terry L. Conway, Irene Esteban-Cornejo, Erica Hinckson, Lukáš Rubín, Elaine Rush, Orna Baron-Epel, Kelli L. Cain, Lars Breum Christiansen, Mohammed Zakiul Islam, Josef Mitáš, Javier Molina-García, Adewale Oyeyemi, Harish Ranjani, Rodrigo Reis, Maria Paula Santos, Cindy Sit, Anna TimperioWan Abdul Manan Wan Muda, James F. Sallis

Research output: Contribution to journalArticlepeer-review


Background: This study examined the strength, shape and direction of associations of accelerometer-assessed overall, school- and non-school-based moderate-to-vigorous physical activity (MVPA) and sedentary time (ST) with BMI among adolescents across the world. Second, we examined whether these associations differed by study site and sex. Methods: Cross-sectional data from the IPEN Adolescent study, an observational multi-country study, were used. Participants wore an accelerometer for seven days, reported height and weight, and completed a socio-demographic survey. In total, 4852 adolescents (46.6% boys), aged 11–19 years (mean age = 14.6, SD = 1.7 years) were included in the analyses, using generalized additive mixed models. Results: Adolescents accumulated on average 41.3 (SD = 22.6) min/day of MVPA and 531.8 (SD = 81.1) min/day of ST, and the prevalence of overweight and obesity was 17.2% (IOTF), but these mean values differed by country. Linear negative associations of accelerometer-based MVPA and ST with standardized BMI scores and the likelihood of being overweight/obese were found. School-based ST and non-school-based MVPA were more strongly negatively associated to the outcomes than non-school based ST and school-based MVPA. Study site moderated the associations; adolescent sex did not. No curvilinear associations were found. Conclusions: This multi-country study confirmed the importance of MVPA as a potential protective factor against overweight/obesity in adolescents. Non-school-based MVPA seemed to be the main driver of these associations. Unexpected results were found for ST, calling for further examination in methodologically sound international studies but using inclinometers or pressure sensors to provide more precise ST measures.

Original languageEnglish
Article number85
JournalInternational Journal of Behavioral Nutrition and Physical Activity
Issue number1
StatePublished - Dec 2022

Bibliographical note

Funding Information:
Funding for the International Physical Activity and Environment Network Adolescent study was made possible by a grant from the National Institutes of Health (NIH) grant: R01 HL111378. Data collection in Belgium was supported partially by the Research Foundation Flanders (FWO) grant: FWO12/ASP/102. Data collection in Brazil was supported partially by the Brazilian National Council for Scientific and Technological Development grant: 306836/2011–4. Data collection in the Czech Republic was funded by the Czech Science Foundation grants: GA14-26896S and GA17-24378S. Data collection in Denmark was supported partially by the University of Southern Denmark. The Hong Kong study (iHealt(H) was supported by the Health and Medical Research Fund (Food and Health Bureau, Government of the Hong Kong SAR, PR of China) grant: 10111501. Data collection in India (BE ACTIV India! study) was supported by an in-house grant from Madras Diabetes Research Foundation (MDRF), Chennai. The Israeli study was supported by a grant from the Israel Science Foundation – ISF grant: 916/12. Data collection in Malaysia was supported partially by a Universiti Sains Malaysia International Research Collaboration Grant. Data collection in New Zealand (BEANZ study) was funded by the Health Research Council (HRC) of New Zealand grant: HRC12/329. Data collection in Portugal was supported by the Portuguese Foundation for Science and Technology. Data collection in Spain was supported partially by Generalitat Valenciana, Spain grant: GV-2013–087. Data collection in the USA (TEAN) was supported by NIH grant: R01 HL083454. AT was supported by a Future Leader Fellowship from the National Health Foundation of Australia (grant: ID100046) during the conduct of this study. EC was supported by an Australian Research Council Future Fellowship grant: FT140100085. JS is supported by a Leadership Level 2 Fellowship, National Health and Medical Research Council Australia (APP 1176885). None of the funding bodies had a role in the design of the study, analysis or writing of this paper. National Institutes of Health,R01 HL111378,James F Sallis

Publisher Copyright:
© 2022, The Author(s).


  • Adolescents
  • Body weight
  • Exercise
  • Physical activity
  • Public health

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Physical Therapy, Sports Therapy and Rehabilitation
  • Nutrition and Dietetics


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