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 - 14 Jul 2022

Bibliographical note

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


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

ASJC Scopus subject areas

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


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