Violence exposure and adolescents' same-day obesogenic behaviors: New findings and a replication

Objective To test whether exposure to violence is associated with same-day increases in obesogenic behaviors among young adolescents, including unhealthy food and beverage consumption, poor quality sleep, and lack of physical activity. Methods Young at-risk adolescents between 12 and 15 years of age were recruited via telephone screening from low-income neighborhoods. Adolescents and their parents completed in-person assessments, followed by Ecological Momentary Assessment (EMA) delivered to 151 adolescents' mobile phones three times a day for 30 days (4329 person days). Three obesogenic behaviors – unhealthy food consumption, poor sleep quality, and lack of physical activity – and violence exposure were assessed daily. Adolescents’ body mass index (BMI) was assessed prior to the EMA and 18 months later. A replication was performed among 395 adolescents from a population-representative sample (with 5276 EMA person days). Results On days that at-risk adolescents were exposed versus not exposed to violence, they were more likely to consume unhealthy foods and beverages (b = 0.12, p = 0.01), report feeling tired the next morning (OR = 1.58, p < 0.01), and to be active (OR = 1.61, p < 0.01). At-risk adolescents who reported higher consumption of soda and caffeinated beverages during the 30-day EMA were more likely to experience increases in BMI in later adolescence. Findings related to sleep and activity were supported in the population-based replication sample; however, no significant same-day associations were found between violence exposure and unhealthy dietary consumption. Conclusions This study provides evidence that exposure to violence is associated with same-day unhealthy dietary consumption among at-risk adolescents and next-day tiredness related to sleep quality among adolescents from both at-risk and normative populations. Findings also point to unhealthy soda consumption during early adolescence as an important predictor of weight gain among at-risk adolescents.