ANALYSIS OF THE MOVEMENT BEHAVIOR OF BRAZILIAN ADOLESCENTS AND ITS ASSOCIATION WITH HEALTH INEQUITIES, VULNERABILITIES, AND VIOLENCE
Movement behaviors; Intersectionality; Intrafamily Violence; Adolescence; National School Health Survey.
Introduction: Adolescence is a critical stage for the consolidation of movement behaviors that influence health and lifestyle throughout the life course. Sedentary behavior and physical inactivity are distinct constructs, and their overlap forms movement behavior patterns that vary according to social determinants. Objective: To investigate movement behavior patterns among Brazilian adolescents, as well as their associations with lifestyle habits, health status, and social markers of difference. Methods: 1) A cross-sectional study using data from the 2019 National School Health Survey (PeNSE), which analyzed the association between movement behavior profiles (physical activity or physical inactivity combined with high or low television or screen time) and lifestyle, dietary intake, and health status variables; 2) A cross-sectional and time-trend study using data from the 2012, 2015, and 2019 PeNSE surveys, which analyzed the association between the intersectionality of race, sex, and maternal education and sedentary behavior (assessed through screen time or television viewing) and physical inactivity among adolescents exposed to violence; 3) A bibliometric study of publications addressing adolescent movement behaviors and social and health inequalities. Results: In the study based on the 2019 PeNSE data, profiles were constructed by combining accumulated physical activity with different forms of sedentary behavior (television viewing time and screen time). Physically inactive adolescents with low screen time had a lower prevalence of consumption of foods considered healthy (aPR=0.97) and unhealthy (aPR=0.96), a lower prevalence of purchasing food from the school canteen (aPR=0.94), alcohol use (aPR=0.94), and smoking (aPR=0.92), but a higher prevalence of eating meals in front of screens (aPR=1.11). Physically active adolescents with low screen time had a lower prevalence of purchasing food from the school canteen (aPR=0.96), but also a higher prevalence of eating meals in front of screens (aPR=1.09), suggesting that even with lower screen exposure, other dimensions of eating behavior remain affected. In the study based on the 2012, 2015, and 2019 PeNSE data, patterns combining physical inactivity with high television viewing time decreased between 2012 and 2019, whereas physical inactivity combined with high screen time initially declined and subsequently increased, indicating transitions in sedentary behaviors. The intersection of gender, race, and maternal education defined distinct profiles: Black girls with low maternal education showed different patterns of sedentary behavior and physical inactivity, reflecting structural pressures and inequalities in access to different electronic devices. Differences according to screen type and intersectional group suggest that the experience of sedentary behavior is shaped by overlapping vulnerabilities and social contexts. The bibliometric analysis identified 250 PubMed articles addressing adolescent movement behaviors and social and health inequalities. English was the predominant publication language (97.4%). Canada showed the greatest scientific impact and the highest number of citations and included the leading institutions researching the topic, while Brazil emerged as an important contributor to the field, particularly within South America. Conclusion: Taken together, the findings indicate that among Brazilian adolescents, both sedentary behavior and physical inactivity are complexly associated with dietary habits, health status, and social inequalities. Reducing screen time appears to be important but insufficient to eliminate adverse effects on dietary behaviors. Intersectional analyses demonstrate that policies and interventions should consider the matrix of inequalities and ongoing transitions in patterns of screen exposure so that health promotion strategies can be more equitable and effective.