Activity-Inactivity Patterns, Screen Time, and Physical Activity: The Association with Overweight, Central Obesity and Muscle Strength in Polish Teenagers. Report from the ABC of Healthy Eating Study.

Today, the time spent actively is increasingly being replaced by screen-based media, although in some teenagers, a high level of physical activity (PA) and longer time spent in front of a screen (screen time, ST) may coexist as a mixed behavioral pattern. This study aimed to examine the association of the pattern created as activity (low/high ST with high PA) and inactivity patterns (low/high ST with low PA) with overweight, central obesity, and muscle strength in Polish teenagers taking into consideration socioeconomic and demographic factors. Cross-sectional data were collected from elementary school children (n = 1567), aged 11-13 years. Height, weight, waist circumference, and handgrip strength were measured. Body mass index (BMI) was calculated as the overweight measure, and the waist-to-height ratio (WHtR) was calculated as the central obesity measure. Data on ST, PA, socioeconomic status, demographics, and nutrition knowledge were collected by a questionnaire. Activity-inactivity patterns were defined by an a priori approach. Multivariate logistic regression modelling was applied. The most active pattern (lowST-highPA) was found in 17% of the total sample. Teenagers with the most inactive pattern (highST-lowPA) had over four times higher chance of general overweight. No association between WHtR ≥0.5 and highST-highPA pattern was found. Higher muscle strength (>1 SD) was associated only with high physical activity. Urban residence or lower socioeconomic status increased adherence to the most inactive pattern. From a public health perspective, implementing interventions promoting active patterns in 11-13-year-old teenagers is important for obesity prevention and enhanced physical fitness, especially in girls, teenagers living in urban areas, and from families with lower socio-economic status.