Adherence to sleep guidelines reduces risk of overweight/obesity in addition to 8-5-2-1-0 guidelines among a large sample of adolescents in the United States

To examine whether adherence to US sleep, dietary, screen time, and physical activity (8-5-2-1-0) guidelines is associated with reduced risk of overweight/obesity in adolescents. Multivariable log-binomial regressions were estimated using the 2017 Youth Risk Behavior Surveillance System data. Of the 8194 adolescents aged 13 years and older, only 0.6% (49) met all guidelines. Meeting the recommended 8 hours of sleep per day was associated with reduced risk of overweight/obesity (risk ratio [RR]: 0.90; confidence interval [CI]: 0.81-0.99). Having ≤2 hours of screen time per day was associated with reduced risks of overweight/obesity (RR: 0.85; CI: 0.77-0.95). One hour of daily physical activity was associated with reduced risk of overweight/obesity (RR: 0.80; CI: 0.73-0.87). No significant associations were found between daily consumption of ≥5 fruits and vegetables or consumption of zero sugar-sweetened beverages and overweight/obesity. The 8-5-2-1-0 constitutes an improved prediction model to explain the risk of overweight/obesity among adolescents compared with the 5-2-1-0 model (F1,36 = 4.80; P = .035). Findings from this study suggest that meeting recommendations for sleep, screen time, and physical activity is associated with decreased risk of overweight/obesity in a large sample of adolescents. These are important factors to consider in the prevention and treatment of overweight/obesity in adolescents.