An Exploratory Analysis Investigating Correlates of Fidgeting Among Hong Kong Adolescents

This dissertation, "An Exploratory Analysis Investigating Correlates of Fidgeting Among Hong Kong Adolescents" by Hoi-yi, Donna, Yung, 容凱怡, was obtained from The University of Hong Kong (Pokfulam, Hong Kong) and is being sold pursuant to Creative Commons: Attribution 3.0 Hong Kong License. The content of this dissertation has not been altered in any way. We have altered the formatting in order to facilitate the ease of printing and reading of the dissertation. All rights not granted by the above license are retained by the author. Abstract: Background: As modern nations undergo demographical and epidemiological transitions, infectious diseases are replaced by non-communicable and chronic illnesses as the main source of ill-health. In particular, the obesity epidemic is of important public health concern as the prevalence of overweight and obesity continues to increase at an alarming rate globally. The trend in childhood and adolescent obesity is also escalating rapidly as people are gaining excess weight at younger ages, representing a growing threat as obesity is linked to a myriad of detrimental psychosocial and physical health consequences which may persist through adulthood. The fundamental cause of obesity is energy imbalance with energy intake exceeding energy expenditure within the human body. Total daily energy expenditures can vary substantially among individuals due to non-exercise activity thermogenesis (NEAT), which accounts for the energy expended from activities we do in daily living, including spontaneous behaviours such as fidgeting. Cumulatively, trivial activities such as fidgeting may accrue to have a significant impact on total daily energy expenditure. Studies have shown that NEAT levels increase or decrease in response to over- and under-feeding, respectively, to counterbalance changes in energy homeostasis. Therefore, fidgeting and NEAT may be an important component in maintaining weight. Decreased levels of fidgeting and NEAT has been hypothesized to be more common among obese individuals as the body fails to activate NEAT in response to over-eating, leading to weight gain. Understanding the correlates of fidgeting and non-exercise physical activity will be helpful in supplementing the design and implementation of effective strategies against obesity. Objective: To investigate the correlates of fidgeting among Hong Kong adolescents, including the association between fidgeting and weight status. Methods: Post hoc statistical analysis was conducted using secondary data from the Hong Kong Student Obesity Surveillance (HKSOS) Project from 2006-2007, which surveyed 34 678 students across 42 secondary schools in Hong Kong. Multivariate logistic regression analyses yielded crude and adjusted odds ratios for the associations of background characteristics, lifestyle characteristics, and dietary intake on fidgeting. Multinomial logistic regression analyses estimated crude and adjusted odds ratios to evaluate the associations between weight status and fidgeting/non-exercise physical activity. Results: Among the sample of Hong Kong adolescents, subjects who were male, older, born outside of Hong Kong, and had daily consumption of fresh fruits, fresh vegetables, and protein were associated with having lower odds of fidgeting. In contrast, high paternal control, high maternal control, smoking, alcohol consumption, elevated levels of daily screen time, exercise time, non-exercise physical activity time, and increased intake in deep fried/fatty foods, snacks/fizzy drinks, coffee, and tea were all associated with having higher odds of fidgeting. Fidgeting did not appear to have any significant relationships with weight status. However, non-exercise physical activity was associated with increased odds of being both underweight and overweight. Conclusions: The results from this study indicate that there are meaningful associations between fidgeting and various correlates, incl