Consumption of Hidden Sugars, Sleep Deprivation, and Physical Activity- Determinants of Obesity among Adolescents.

Background: The availability of ultra-processed foods (UPFs) and sugar-sweetened beverages (SSBs), together with declining physical activity and inadequate sleep, has contributed to an alarming rise in adolescent overweight and obesity. India is now seeing a shift in dietary patterns. Home cooked wholesome meals are increasingly replaced by ultra processed foods which are rich in hidden sugars, unhealthy fats, and sodium. The dietary changes and limited physical activity are placing adolescents at an increased risk of obesity. Objectives: The study aimed to observe the association between consumption of hidden sugars, physical activity and sleep duration and BMI of adolescents. Methods: A cross-sectional study was conducted among 160 adolescents aged 12-17 years using snowball sampling. A structured, pre-tested questionnaire was used to collect information on socio-demographic characteristics, food frequency, physical activity, sleep behaviour. Anthropometric measurements including body mass index (BMI), waist circumference (WC), and mid-upper arm circumference (MUAC) were measured. Data was analysed using appropriate statistical tests. Results: Overall, 62.5% children had normal BMI, 16.3% were thin and 21.2% were overweight/obese. Nearly half of the adolescents reported sleeping less than seven hours per night, while only about half participated in regular physical activity. Being overweight/obese was significantly associated with frequent consumption of instant noodles, breads, flavoured chips, energy drinks, instant soups, mayonnaise and ice cream products (p < 0.05). These findings suggest that frequent consumption of ultra processed foods is associated with increased BMI. Conclusion: Hidden sugars present in ultra-processed foods, combined with poor sleep habits and inadequate physical activity, contribute to obesity risk among Indian adolescents. School-based nutrition education and improved awareness regarding hidden sugars, and promotion of healthy lifestyle behaviours will help to have healthier adolescents.