Adolescents with at-risk eating and lifestyle behaviors are affected by after school schedules across the clinical weight spectrum.

Objective: Evaluate adolescent lifestyle patterns to develop more effective health promotion programs.

Methods: An interview approach was employed to gain in-depth understanding of eating and activity behaviors. Adolescents aged 13-18 years (n=43) from clinically normal and obese weight categories were enrolled. Nutrient intake and food group servings were obtained from a food frequency questionnaire.

Results: Four participant subgroups were identified and labeled: "Idle, Engaged, Balanced and Working." "Idle" adolescents were sedentary, sometimes napped, and often snacked after dinner. "Engaged" adolescents participated in extra-curricular activities for the majority of their after school hours. "Balanced" adolescents participated in a single after-school activity followed by sedentary time; they consumed meals consistently and often snacked after dinner. "Working" adolescents were the least sedentary with limited sleep duration and inconsistent meals; they often substituted a meal with a snack. Weight status did not differentiate subgroups effectively.

Conclusions: Each group demonstrated at-risk behaviors for obesity. Future programs should consider after-school schedules and use activity and meal pattern assessments, not simply weight status, for program tailoring.

Practice Implications: Pediatric health care providers could identify at-risk behaviors through routine assessment of diet and activity patterns in combination with weight monitoring.