Public Health Nutrition

Research paper

Longitudinal associations of energy balance-related behaviours and cross-sectional associations of clusters and body mass index in Norwegian adolescents

Maria E van der Sluisa1, Nanna Liena2 c1, Jos WR Twiska1a3, Ingrid HM Steenhuisa1, Elling Berea4, Knut-Inge Kleppa2 and Marianne Winda2

a1 Department of Health Science, Institute of Health Sciences, VU University Amsterdam De Boelelaan, Amsterdam, The Netherlands

a2 Faculty of Medicine, Department of Nutrition, University of Oslo, PO Box 1046, Blindern NO-0316 Oslo, Norway

a3 Department of Clinical Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands

a4 Faculty of Health and Sport, University of Agder, Kristiansand, Norway


Background Insight into the role of energy balance-related behaviours (EBRB) is of great importance when it comes to prevention of weight gain and design of interventions tailored to target these behaviours.

Objectives First, the present study examines the longitudinal association of four EBRB in Norwegian adolescents. Second, it aims to examine whether clusters of EBRB are cross-sectionally associated with being overweight.

Design The present study is part of the ‘Fruits and Vegetables Make the Marks’ project. The study sample consists of twenty control schools in two Norwegian counties.

Methods Survey questionnaires were completed by 884 pupils with an average age at baseline, September 2001, of 11·8 years. In the follow-up surveys in May 2002 and May 2005, a total of 809 and 724 adolescents participated, respectively. Four EBRB were measured: habitual fruit and vegetable intake, snacking and soda consumption, television and computer use and physical activity.

Results Results of the associations between EBRB were similar for boys and girls. The odds, ranging from 1·14 to 12·06, were mostly significant. One out of four clusters, the unhealthy cluster, was significantly and cross-sectionally associated with overweight and obesity.

Conclusions Longitudinal associations of EBRB show that it is important to start early with interventions that aim to prevent unhealthy behaviours becoming habitual. These behaviours should be targeted at the same time as they tend to co-occur. More research, preferably longitudinal and more objective, is needed to investigate associations between health behaviours and body weight among adolescents.

(Received February 2009)

(Accepted May 2010)


c1 Corresponding author: Email