Clustering of obesogenic behaviours amongst 140 052 South American adolescents: a harmonized meta-analysis of national health surveys

Background Physical activity, sedentary behaviour, and diet synergically coexist (in different ways) within adolescents' lifestyles. Thus, understanding obesogenic behaviour patterns within populations is critical to promoting adolescents' health. This study investigates clustering patterns of adolescents' obesogenic behaviours across South American countries. Methods The present work is a harmonized analysis of 10 national representative cross-sectional health surveys investigating adolescents' risk and protective factors for non-communicable diseases. The surveys used questionnaires, and three obesogenic behaviours were analyzed for cluster formation (physical activity, sitting time, and diet). Sociodemographic variables were sex, age, and food insecurity. The Two-step cluster, the Rao-Scott chi-square test, and a meta-analysis were performed for data analysis. Results Three to four cluster solutions were identified in each country, and most clusters are unhealthy. The All-day sitters-very poor diet cluster was observed in Paraguay, Peru, Suriname, Chile, Guyana, Argentina, Brazil, Colombia, and Ecuador, with a pooled prevalence of 17.8% (95% CI:15.0; 20.7) amongst South American countries, with the highest prevalence observed in Argentina [26.8% (95% CI: 26.7; 26.9)]. Girls were more likely to belong to the unhealthiest clusters. Conclusions The lifestyle behaviours of South American adolescents coexist negatively, and there is a severe obesogenic risk for this population. The synergy between physical inactivity and poor/very poor diet was clustered together in all countries, and our analysis did not reveal any natural healthy clusters. Furthermore, girls are at a disadvantage, given that they are the majority in clusters with unhealthy profiles in South America.