Diet and physical activity among adolescents
Consuming a healthy diet and performing regular physical activity when young can be habit forming, promoting a healthy lifestyle in adult life. Daily consumption of fruit and vegetables can help reduce the risk of coronary heart diseases, strokes and certain types of cancer (Hartley et al., 2013[29]; World Cancer Research Fund / American Institute for Cancer Research, 2018[30]). The most common guideline recommends consuming at least five portions of fruit and vegetables daily. During COVD-19 confinements, children and adolescents consumed more fruit and vegetable, since families had more time to cook, although this did not increase the overall quality of diets. Adolescents also exhibited higher consumption of sweet food, probably due to boredom and stress produced by COVID-19 confinement (Ruiz-Roso et al., 2020[31]).
Over 60% of 15-year-olds did not consume any fruit or vegetables daily in 2017-18 in Finland, Hungary, Latvia, Germany, and Lithuania; this proportion was lower than 40% in Belgium and Canada (Figure 4.12). Rates were over 65% for boys in Finland, Germany, Latvia and Hungary, and over 60% for girls in Hungary and Latvia. Rates were under 40% for girls in Belgium, Canada and Denmark, but the rate was only under 40% for boys in Belgium. In the United States, 36% of adolescents aged 12-19 years did not consume any fruit on a given day, and about 8% did not consume any vegetables on a given day, in 2015-18 (Wambogo et al., 2020[32]). Across OECD countries, nearly 55% of 15-year-olds did not consume any fruit or vegetables daily, with girls at 50% and boys at 59%. Girls consumed more fruit and vegetables than boys in all countries. Gender gaps were widest in the Czech Republic, Finland, Germany, Denmark and Italy (a difference of 13-16 percentage points).
More than one in five 15-year-olds consumed sugar-sweetened beverages daily in 2017-18 in Belgium, France, Luxembourg, Switzerland, the Slovak Republic, Hungary and the Netherlands, while fewer than 1 in 15 did so in Estonia, Iceland, Finland, Canada, the Czech Republic, Sweden and Greece (Figure 4.13). Across OECD countries, nearly 13.6% of 15-year-olds consumed sugar-sweetened beverages daily in 2017-18. This is lower than in 2013-14 (17.1%). Between 2014-15 and 2017-18, the sharpest decreases were observed in the Netherlands, the Czech Republic, Hungary and Spain (8-12 percentage points), while small increases were seen in Finland and Lithuania (2-3 percentage points). In the United States, almost two-thirds of youth aged 2-19 years consumed at least one sugar-sweetened beverage on a given day, in 2011-14 (Rosinger et al., 2017[33]).
The WHO recommends 60 minutes of moderate-to-vigorous daily physical activity for the young. The majority of adolescents do not meet this guideline, although physical activity during adolescence improves cardiorespiratory and muscular fitness, bone and cardiometabolic health, and has positive effects on weight and on cognitive development and socialising (Guthold et al., 2019[26]). During the COVID-19-related lockdowns, children’s physical activity decreased (Stockwell et al., 2021[27]).
The proportion of 11-year-olds who achieved the recommended 60 minutes of moderate-to-vigorous physical activity per day exceeded 30% in 2017-18 in Finland, Ireland and Canada, but was lower than 15% in Denmark, Portugal, Italy and France (Figure 4.14). Levels of physical activity declined with age in all countries. Across OECD countries, 13.7% of 15-year-olds met the recommended levels, compared to 22.6% of 11-year-olds. The largest differences (with the youngest more physically active than the oldest) were seen in Finland, Ireland, Austria and Hungary (13-28 percentage points). In the United States, 27.2% of students in grade 9 (ages 14-15) and 20% of those in grade 12 (ages 17-18) were physically active for at least 60 minutes daily in 2019 (U.S. Department of Health and Human Services, n.d.[34]). Rates of moderate-to-vigorous physical activity were higher among boys than girls at both ages. At age 11, 26.1% of boys performed at least 60 minutes of activity daily, compared to 19.5% of girls (at age 15, the rates were 17.7% versus 9.7%). The gender gap – boys being more physically active than girls – increased with age in 17 of 28 countries.
Most, if not all, OECD countries already have – or have had in the past – at least one nationally run mass media campaign to encourage consumption of fruit and vegetables, such as the well-known “5-a-day” target (e.g. in Chile, Germany, Italy, Mexico, New Zealand and Spain), the “6-a-day” target in Denmark or the “2&5” campaign in Western Australia (OECD, 2019[28]). There are also examples of governmental programmes encouraging physical activity, such as the “Manger Bouger” campaign in France, Change4Life campaign in England and Wales, United Kingdom, or Move Your Way in the United States. Recently, WHO Member States endorsed a global action plan on physical activity, with a target of a 15% relative reduction in insufficient physical activity among adolescents by 2030 (WHO, 2018[35]). The plan recommends 20 policy actions built around four areas: creating active societies, active environments, active systems and active people.
Data come from the Health Behaviour in School-aged Children (HBSC) surveys of 2013-14 and 2017-18. Data are drawn from school-based samples of 1 500 in each age group (11-, 13- and 15-year-olds) in most countries.
Dietary habits are measured here in terms of the proportions of young people who report consuming neither fruit nor vegetables (at least once) daily and the proportions of those who report drinking sugar-sweetened beverages (at least once) daily. Young people were asked how often they eat fruit and vegetables and consume sugar-sweetened beverages. Response options ranged from “never” to “every day, more than once”. No reference to excluding juice, soup or potatoes was mentioned in the survey questions. In addition to fruit and vegetables and sugar-sweetened beverages, healthy nutrition also involves other types of food.
Data for physical activity consider the proportion of young people who report at least 60 minutes of moderate-to-vigorous physical activity daily. This refers to exercise that increases the heart rate, and sometimes leaves the child out of breath, undertaken for at least an hour each day.
