Isolated and combined association of excessive screen time and physical inactivity with negative self-rated health in adolescents

OBJECTIVE: The aim of this study was to analyze isolated and combined associations of physical inactivity excessive screen time with negative self-rated health, according to sex, among school adolescents. METHODS: In this cross-sectional study conducted with 2,517 adolescents in Amazonas State, participants were asked about their self-rated health with the following question: How do you rate your health? Responses were dichotomized into positive (excellent and good) and negative (regular, bad, and terrible). Information on sex, age group, family income, physical activity, and screen time (watching TV, using a computer, or playing video games) was collected through a self-administered questionnaire. Adolescents simultaneously classified as physically inactive (<60 min/day) and having excessive screen time (>2 h/day) were considered to have two risk factors. Data was analyzed using binary logistic regression. RESULTS: Out of every 10 adolescents, 2 had a negative self-rated health. After adjusting for age and family income, there were no isolated or combined associations between physical inactivity or excessive screen time and negative self-rated health in girls. In boys, negative self-rated health was associated with insufficient levels of physical activity (odds ratio [OR]: 2.39; 95% confidence interval [CI]: 1.03–5.59) and with the accumulation of two risk factors (OR: 1.61; 95%CI 1.10–2.34). CONCLUSIONS: Being insufficiently active and the combination of physical inactivity and excessive screen time become exposure factors to the negative self-rated health of adolescent boys.