Regional study of nutritional status of urban primary schoolchildren. 3. Kuala Lumpur, Malaysia

A total of 5,995 (7.8% of all 7- to 10-year-old primary schoolchildren in Kuala Lumpur), randomly selected from 166 schools (97.6% of all schools), were measured for their weight and height. The analyses of all weight and height data, including the cutoffs used for defining stunting, underweight, and wasting and for thinness and overweight, were carried out as recommended by the World Health Organization (WHO). The prevalances of stunting (height-for-age Z score < -2 SD), underweight (weight-for-age Z score < -2 SD) and wasting (weight-for-height Z score < -2 SD) among all the children studies were 6.7%, 7.1%, and 4.5%, respectively. Undernutrition among boys was more serious than among girls according to all three indicators. Because it was not possible to analyze the weight-for-height data for most of the children above 8.5 years of age, body mass index (BMI)-for-age was used to determine the prevalences of thinness and overweight for all the children. Based on the reference data, the prevalence of overweight (at or above the 95th percentile) was 9.7% and 7.1% for boys and girls, respectively, and 8.4% overall.     

Regional study of nutritional status of urban primary schoolchildren. 1. Manila, Philippines

This multicity study sought to provide baseline information on the nutritional status of urban schoolchildren in order to examine the emerging problem of overweight and obesity in this age group. The study included 1,208 children 8 to 10 years old who were randomly selected from all public and private schools in Manila for weight and height measurements. Nutritional status was assessed by weight-for-age and height-for-age Z scores and BMI percentile cutoff points. On the average, private schoolchildren were taller and heavier and had higher body mass index (BMI) values than public schoolchildren, resulting in a much lower prevalence of undernutrition and a much higher prevalence of overnutrition. These results have important programmatic implications. However, using the World Health Organization (WHO)--recommended cutoff points to define under- and overnutrition gave contrasting results when weight-for-height and BMI were used. There appears to be a need to validate the anthropometric reference standards and cutoff points in children and adolescents to better define nutritional status and ascertain the influence of ethnicity.     

Prevalence of obesity, overweight, and underweight in Qatari adolescents

BACKGROUND: Overweight and obesity have reached epidemic proportions in Arabian oil-rich countries and are threatening to become a global epidemic. Excess weight has a great impact on the health and quality of life of individuals. However, prevalence of underweight in the developing world has shown a decline during the last decade. OBJECTIVE: The aim of this cross-sectional study was to determine the prevalence of underweight, overweight, and obesity, as measured by body-mass index, in a representative sample of adolescents aged 12 to 17 years in the State of Qatar. METHODS: Qatari schoolchildren (n = 3,923) from 30 schools in urban and semiurban districts responded to a sociodemographic questionnaire. Body-mass index was calculated and the prevalence of overweight and obesity was determined on the basis of cutoff points of the International Obesity Task Force (IOTF) values (above the 85th and 95th percentiles, respectively, for overweight and obesity). Underweight was defined on the basis of CDC (Centers for Disease Control and Prevention) less than 5th percentile of BMI for age. RESULTS: The final sample consisted of 1,968 boys and 1,955 girls. The prevalence of underweight, overweight, and obesity was 8.6%, 28.6%, and 7.9%, respectively, among adolescent boys and 5.8%, 18.9%, and 4.7% among girls. The prevalence of underweight was highest at 16 years of age among boys (10.5%) and at 17 years among girls (8.9%). The prevalence of obesity was highest at 12 years of age among boys (11.7%) and at 13 years among girls (6.4%). The 95th percentile curve for boys was above the IOTF standard curve; the 95th percentile curve for girls was below the IOTF curve. CONCLUSIONS: Adolescents living in the State of Qatar are at high risk for overweight and obesity. There is a need to establish a national program for the prevention and treatment of obesity and related complications.     

Dietary and physical activity patterns of 8- to 10-year-old urban schoolchildren in Manila,Philippines

This report is the second part of a study on the nutrition of urban schoolchildren in the city of Manila; the first part was on nutritional status. The primary purpose of the study was to gather data that will assist authorities in planning and implementing nutrition education programs focused on the growing problem of obesity and overweight in children. The study included 1,208 children 8 to 10 years of age, who were randomly selected from all public and private schools in the city of Manila. Data on the children's dietary and physical activity patterns, together with information on nutrition-related knowledge, attitudes, and preferences of the children and their parents, were gathered by interviews and self-administered questionnaires. There were distinct differences in dietary and physical activity patterns between the two groups of children. Children from private schools, who are generally of higher socioeconomic status than those from public schools, tended to consume more total food, more animal foods, fats, and oils, and more beverages, resulting in higher intakes of calories, protein, iron, and vitamin A than public schoolchildren. Moreover, children from private schools were apparently less physically active, were more likely to be driven to school instead of walking, and were more likely to prefer television and computer games over outdoor games. These differences agree with an earlier report on the nutritional status of the children as determined by anthropometry, which showed a higher proportion of overnutrition and a lower proportion of undernutrition among private schoolchildren than among public schoolchildren. Although the emphasis in public schools should be on prevention and control of undernutrition in children, private schools should begin to look at the emerging problem of overnutrition and the role of physical activity programs in the health of children. The information on the knowledge, attitudes, and preferences of the children and their parents showed that parents or guardians, teachers, and television influence the nutritional practices of schoolchildren. These groups should therefore be the major targets for nutrition education programs meant to improve the nutrition and health of schoolchildren.     

Physical activity, aerobic fitness, self-perception, and dietary intake in at risk of overweight and normal weight children.

Differences in physical activity, aerobic fitness, self-perception, and dietary intake were examined in a sample of six- to ten-year-olds at risk of overweight, and in normal weight boys and girls. Participants (n=20 at risk of overweight [BMI > or =85th percentile]; n=115 normal weight [BMI <85th percentile]; n=68 boys; n=67 girls) had anthropometric, physical activity, aerobic fitness, self-perception, and dietary intake measurements at zero, three, six, and 12 months. Over the 12-month period, normal weight children were more physically active (F=4.1, p<0.05) and aerobically fit (F=14.3, p<0.001), and possessed higher self-perceptions of social acceptance (F=7.3, p<0.01) than their at risk of overweight peers. Fitness differences between the sexes were not apparent at baseline, but emerged over the long term (F=7.9, p<0.01). Overall, boys consumed more total energy, fat, carbohydrate, and protein than did girls, while the entire sample consumed diets low in vegetables and fruits and meat and alternatives, and high in "other" foods. These observations highlight key disparities in lifestyle-related behaviours and perceptions between groups of children according to overweight status and sex. The findings underscore the importance of longitudinal studies in youth because cross-sectional studies may reflect transient differences.     

北京市儿童青少年肥胖与副食频次关系探讨

目的:阐明目前经济转型期北京市儿童青少年肥胖高流行与副食摄入频次的关系。方法:资料来源于北京市科技重点项目流行病学调查数据,提取3—18岁组20 867例膳食频次回顾性调查与体检测量指标值,剂量—反应关系采用Logistic多元回归最大似然法,个别副食精细深入分析使用多元方差与复合线图结合显示。结果:各副食搭配频次性别、城乡之间存在差异性,作用既不均衡,又交互影响。多元回归分析显示,正常与超重或肥胖儿童喝汤在各人群、男生肉频次、城区油炸食品、郊区豆制品,以及西式快餐摄入存在统计学差异。具体表现为喝汤对儿童肥胖的保护作用,过多肉类、油炸食品摄入为高BMI危险因子。结论:经济转型期北京儿童青少年肥胖与某些副食高摄入频次有关,这些副食在性别、城乡间存在差异。     

Prevalence of overweight and obesity in school-aged children.

PURPOSE: Childhood obesity is a public health concern in Canada. Few published anthropometric data are available to indicate obesity prevalence in Canadian children. Obesity prevalence is reported for school-aged children in 11 London, Ontario, schools. METHODS: Data on body weight and height were obtained using standardized procedures. United States Centers for Disease Control and Prevention (CDC) body mass index (BMI)-for-age references and Cole's international BMI reference were used to classify the children's weight categories. RESULTS: The study included 1,570 pupils aged six to 13. The CDC BMI references categorized 16.6% and 11.8% of children as overweight and obese, respectively. In comparison, when the Cole BMI reference and cut-off points were used, 17.5% and 7.6% of children were classified as overweight and obese, respectively. CONCLUSION: Overweight is prevalent in the study population. Public health interventions are warranted to curb the obesity epidemic in school-aged children.     

Prevalence of challenging nutritional problems among adolescents in Sri Lanka

BACKGROUND: Although 21% of the population of Sri Lanka consists of adolescents, studies of nutritional status among this group are limited. OBJECTIVE: To assess nutritional problems and dietary and activity patterns among adolescents in Sri Lanka. METHODS: A nationally representative cross-sectional study was conducted on 6,264 adolescents 10 to 15 years of age. All subjects were clinically examined for Bitot's spots, and their weights and heights were measured. The subjects were interviewed during regular class time. Hemoglobin concentration and dietary and activity patterns were assessed among a subsample (n = 787) of 1,521 adolescents. The World Health Organization age- and sex-specific references for body-mass index and height-for-age were used to estimate the prevalence of underweight and stunting, respectively. The International Obesity Task Force age- and sex-specific reference for body-mass index was used to estimate the prevalence of overweight. Age-specific WHO-defined cut off points were used to estimate the prevalence of anemia. RESULTS: The prevalence rates of underweight, stunting, and overweight were 47.2%, 28.5%, and 2.2%, respectively. The prevalence rates of anemia and vitamin A deficiency were 11.1% and 0.4%, respectively. During the previous 6 months, 10.4% of the subjects had usually not eaten breakfast before going to school. During the week before the interview, 24.4% of the children had not consumed green leafy vegetables, 26.6% had not consumed fruit, 19.0% had not participated in physical activities, and 27.5% had watched television for more than 2 hours per day. CONCLUSIONS: The nutritional problems of adolescents aged 10 to 15 years should be addressed through the schools. Specific policies should be developed in collaboration with the Ministry of Health and Education to control nutritional problems among adolescents.     

Assessment of nutritional status of children under five years of age, pregnant women, and lactating women living in relief camps after the tsunami in Sri Lanka

BACKGROUND: A strong earthquake that hit Aceh on December 26, 2004, triggered a powerful tsunami, resulting in an unprecedented catastrophe in Sri Lanka. The initial phase of the disaster was marked by limited access to food coupled with an inadequate supply of safe water and poor environmental hygiene and sanitation, all of which placed children at increased risk for undernutrition. OBJECTIVE: To assess the nutritional status of children under five years of age, pregnant women, and lactating women residing in 40 relief camps after the tsunami. METHODS: A cross-sectional, 30-cluster study was performed. Thirty children under five from each cluster (camp) and all pregnant and lactating women in selected camps were studied. Data were collected by interviews with the primary caregivers of the children, interviews with key informants in the camps, direct observation, and focus group discussions with mothers. Weight, height, or length was measured on children and pregnant women. Mid-upper-arm circumference of lactating women was measured. RESULTS: A total of 878 children were assessed, of whom 16.1%, 20.2%, and 34.7% were wasted, stunted, and underweight, respectively. The prevalence of each indicator was higher in boys than in girls. During the 2 weeks before the survey, 69.5% of the children had acute respiratory tract infections and 17.9% had diarrhea. Although the general food distribution was well in place, the food supply lacked diversity, and 70.9% of the children did not get appropriate supplementary food. The prevalence of undernutrition among pregnant women (n = 168) was 37%. Thirty-one percent of lactating women (n = 97) were underweight, and 20% were overweight. CONCLUSIONS: The prevalence of both acute and chronic undernutrition among children in the camps is significantly higher than the national Sri Lankan average. There is a need to establish nutritional surveillance systems to monitor the nutritional status of displaced and nondisplaced children and mothers.     

北京市儿童青少年副食摄入现况评估

目的：对北京市儿童青少年副食摄入现况进行评估,阐述营养转型期儿童发展与副食关系内在规律性,为决策提供依据。方法：资料来自北京市儿童青少年代谢综合征分层随机整群抽样调查样本,截取3-18岁儿童青少年20867人,约男女各半。儿童青少年超重（含肥胖）、肥胖以国际肥胖专家组（IOTF）之BMI界值进行界定。副食为10类,即：肉类、豆制品、海产品、奶类、蔬菜、水果、油炸食品、洋快餐、汤、软饮料;每类按5等级,由家长填写;将问卷中5等级均归为射周重置,进行加权评估与Z评估。结果：副食加权评分年龄别构成比变化趋势显示,肉和水果频次构成相似,呈“较多-渐少-再渐多”过程,蔬菜递增、奶类递减;男生肉频次较高,而女生水果频次较高;城市肉、奶频次较高,而农村蔬菜、汤频次较高;正常儿童较超重与肥胖者肉频次略低,且蔬菜频次略高;重要副食搭配Z值图形呈对称交叉蝶状,负性相关多于正性相关。对体格类型影响显示多项Z值互逆。结论：副食频次研究能够反映营养转型期不同群体儿童青少年摄入状况,众多类副食搭配Z评分负相关,不同体格儿童之副食谱存在显著性差异。     

Insulin resistance and impaired glucose tolerance in overweight and obese Costa Rican schoolchildren

BACKGROUND: Worldwide obesity has become an unprecedented public health challenge. In addition, a notable increase in the risk of insulin resistance and type 2 diabetes mellitus has emerged. In Costa Rica, there are no epidemiological data to establish the prevalence of type 2 diabetes in the pediatric population. However, information from the Endocrinology Department of the Children's National Hospital indicates an increased number of cases in the last 2 to 3 years. OBJECTIVE: To determine the prevalence of insulin resistance and impaired glucose tolerance in overweight and obese schoolchildren. METHODS: This cross-sectional study was conducted among 214 healthy 8- to 10-year-old children from urban schools of San José, Costa Rica. Anthropometric measurements and blood determinations of glucose, insulin, proinsulin, glycosylated hemoglobin, C-peptide, and leptin were performed. Indexes were calculated to assess insulin resistance. Information on social and lifestyle variables was obtained from questionnaires, and acanthosis nigricans was certified by a physician. Statistical analysis was performed with SPSS software for Windows, version 10.0. RESULTS: The prevalence of type 2 diabetes mellitus was very low (0.5%) in the studied population. However, hyperinsulinemia and impaired glucose tolerance were present in 20.6% and 6.5% of the subjects, respectively. On the basis of the Fasting Glucose-to-Insulin Resistance Ratio (FGIR), 46.7% of the children showed insulin resistance. Girls and obese children (body mass index > or = 95th percentile) were more likely to have higher serum insulin levels and insulin resistance than boys and overweight children (BMI > or = 85th percentile). Compared with the lowest quintile, children in the highest quintile of body-fat tissue had higher insulin resistance but had similar serum concentrations of glucose, C-peptide, and proinsulin. Positive family histories of type 2 diabetes mellitus and sedentarism (73.7% and 40.7%, respectively) were highly prevalent among overweight and obese children. CONCLUSIONS: The prevalence of impaired glucose tolerance and insulin resistance in obese children indicates a worrisome trend in the incidence of type 2 diabetes in Costa Rica. Strategies for weight reduction, obesity prevention, and promotion of healthy lifestyles are necessary to prevent the onset of type 2 diabetes during childhood and adolescence.     

北京中学生营养知识现况及其影响因素分析

目的:了解北京市中学生营养知识掌握现况并探讨影响因素。方法:采用整群典型抽样,抽取北京核心城区和郊县城区数所代表性中学学生,开展现场问卷调查。结果:北京市6所中学1192名学生参与问卷调查,其中初中生789人、高中生392人,男生600人(50.80%)、女生581人(49.20%),平均年龄13.72±1.58岁(最小11岁、最大19岁);中学生营养知识平均得分为59.37,初中生59.78,高中生58.53;女生61.08,男生57.71;学生对不同类别营养知识的知晓率差异显著(P<0.05);女性学生、与父母同住、父母学历高与学生营养知识得分存在正相关关系。结论:北京市中学生营养知识得分处于不及格水平,对不同知识类别的知晓度差异显著,学生在初高中阶段学习和掌握营养知识缺乏系统连贯性。学校课程设置、年级、性别、父母学历、居住状况等影响学生营养知识掌握状况。学校应考虑家庭和社会参与,衔接初高中阶段课程教学,加强系统、综合和连贯性的学生营养教育。     

Effects of a food supplementation program on the nutritional status of pregnant women in Bangladesh

BACKGROUND: The Government of Bangladesh implemented a comprehensive nutrition intervention in 1997 to reduce the rates of malnutrition among women and children. The pilot program, the Bangladesh Integrated Nutrition Program (BINP), adopted a multisectoral approach targeting women and children through food supplementation, home gardening, and health and nutrition education. OBJECTIVE: This paper estimates the effectiveness of BINP's food supplementation and nutrition education on the nutritional status of pregnant women. Methods. Three effectiveness measures were considered: target efficiency, improvements in the nutritional status of beneficiaries, and the persistence of nutritional effects. To isolate the effects of the intervention, the nutritional status of participants and nonparticipants was compared after controlling for various demographic and socioeconomic characteristics. Data were collected in 2000 from a random sample of 3262 households in a BINP intervention area. RESULTS: Thirty-nine percent of pregnant women were correctly targeted by the program's food supplementation activities. The nutrition program reduced the prevalence of thinness among participant pregnant women by about 3 percentage points per month of enrollment. The prevalence of thinness among program graduates was 62%, which was much higher than that of the matched (nonparticipant) group (35%). This finding is perplexing but it may simply imply that those who enrolled at the initial phase of the project were severely underweight and they fell back to their original status within a short period of time. CONCLUSIONS: The nutrition program was intended to improve the nutritional status of women in the longer run through the provision of nutrition education during the food supplementation phase. The prevalence of thinness or severe underweight in women who exited the program after completion of the enrollment period was found to be much higher than in women of similar age and socioeconomic status in the community. This apparent lack of persistence of program benefits requires careful re-evaluation of alternative mechanisms for improving the long-term nutritional status of women.     

Constraints on good child-care practices and nutritional status in urban Dar-es-Salaam, Tanzania

BACKGROUND: Care is increasingly being recognized as a crucial input to child health and nutrition, along with food security, availability of health services, and a healthy environment. Although significant gains have been made in the fight against malnutrition in Tanzania, the nutritional status of preschool children in urban areas is not improving. OBJECTIVE: To assess child-care practices and the nutritional status of infants and young children with the aim of improvingfeeding practices and child nutritional status. METHODS: A cross-sectional study was undertaken in urban Dar-es-Salaam, Tanzania. The study involved 100 randomly selected mothers of children 6 to 24 months old from households in Ilala Municipality, one of the three municipalities that constitute the Dar-es-Salaam City Council. Data were collected by a structured questionnaire, spot-check observations, and anthropometric measurements. RESULTS: The prevalence rates of stunting, underweight, wasting, and morbidity were 43%, 22%, 3%, and 80%, respectively. The prevalence of exclusive breastfeeding was very low (9%), and most stunted children (88%) were not exclusively breastfed for the first 6 months. The mean age at which complementary foods and fluids were introduced was 3.26 +/- 1.12 months (range, 1 to 5 months). The fluids given were mainly water and thin cereal-based porridge. More than half of the households practiced good hygiene. Most of the psychosocial practices (e.g., caregiver's attention, affection, and involvement in child feeding, hygiene, health care, and training) were performed by mothers, except for cooking and feeding the children and child training, which were done mostly by alternative caregivers. Nearly half of the mothers (44%) worked out of the home. The mean number of working hours per day was long (10.32 +/- 2.13), necessitating the use of alternative caregivers. A negative correlation was found between height-for-age z-scores and the number of hours mothers worked outside the home. CONCLUSIONS: The prevalence rates of chronic malnutrition and morbidity are high, and child-feeding practices are inadequate in this urban population. Maternal employment and educational characteristics constrain good child-care practices, and alternative caregivers are taking a more important role in child care as mothers join the work force. We recommend that formative research be conducted to study the actual practices of caregivers in order to form the basis for a child-care education program. There is also a need to strengthen national health system support for improved child feeding.     

Factual nutrition and several indicators of health status of urban schoolchildren of the regions of Ukraine

Altogether 2334 schoolchildren (first-, fifth- and eighth-graders) were examined for the factual nutrition, health status and physical development. The diet received by the schoolgirls of the above grades and that of the first-grade boys correlated well with the recommended physiological standards, whereas the diet of the eight-grade boys and five-grade boys in particular was slightly lower as compared to those standards. Attention is drawn to an ever increasing number of obese children, which has an adverse effect on the percentage of harmoniously developed children, reducing it to 66.7%. To improve the nutrition of schoolchildren, the authors have developed sets of foods and exemplary menus which have been included into the methodological instructions for organization of schoolchildren's catering in nonspecialized schools of the Ukrainian Soviet Socialist Republic.     

Milk thickeners do not influence anthropometric indices in childhood

BACKGROUND: Pediatric obesity is an important risk factor for chronic diseases in adulthood. Some infant feeding practices may contribute to childhood obesity. OBJECTIVE: To investigate whether the introduction of milk thickeners to bottle-fed infants between 3 and 6 months of age was associated with higher anthropometric measurements and indices at 1 and 4 years of age. METHODS: A population-based birth cohort study was conducted in 1993 in the urban area of Pelotas, Brazil. Information was obtained at birth, at 1, 3, 6, and 12 months, and at 4 years. Data were analyzed from the 596 children for whom information was available from all follow-up visits. The exposure of interest was the use of milk thickener (flour added to cow's milk) between the third and sixth months of life. The outcomes investigated were weight and length/height and the anthropometric indices weight-for-age, length/height-for-age, and weight-for-length/height z-scores at 1 and 4 years. RESULTS: The prevalence of use of milk thickener at any time between the third and sixth months was 44.6%. In the adjusted analysis, children who received milk thickener were, on average, 160 g heavier and 0.5 cm longer at I year than those who did not receive it. Weight-for-age and length-for-age z-scores were positively associated with use of milk thickener. No association was observed between this feeding practice and weight-for-length z-score. In the adjusted analysis, no effect of use of milk thickener on any of the anthropometric outcomes studied was observed at 4 years. CONCLUSIONS: No association was found between the use of milk thickeners and weight-for-length/height z-scores in the first and fourth years of life. Future studies in other contexts would be helpful to further test this hypothesis.     

Influence of socioeconomic status on the prevalence of stunted growth and obesity in prepubertal Indonesian children

This cross-sectional study assesses the prevalence of stunting, overweight, and obesity in prepubertal children from different socioeconomic groups in Indonesia. Children from rural, poor urban, and nonpoor urban communities were studied (n = 3,010). The prevalences of stunting, wasting, overweight, and obesity were 19.3%, 5.0%, 2.7%, and 0.8%, respectively. The odds ratios (OR) for stunting, as compared with nonpoor urban children, were higher among rural children (2.92; 95% confidence interval [CI], 2.37-3.59) than among poor urban children (1.58; 95% CI, 1.18-2.13). The prevalence of wasting was not influenced by socioeconomic status. Both rural and poor urban children were significantly less likely to be overweight than were nonpoor urban children: in comparison with nonpoor urban children, the OR values were 0.19 (95% CI, 0.10-0.36) for rural and 0.13 (95% CI, 0.04-0.43) for poor urban children. Boys were more likely to be stunted or obese than girls: OR for stunting, 1.75 (95% CI, 1.44-2.12); OR for obesity, 4.07 (95% CI, 1.40-11.8). Stunted children were less likely than non-stunted children to be overweight: OR, 0.10 (95% CI, 0.03-0.43). In Indonesia, undernutrition is still related to poverty, whereas obesity is more related to prosperity.     

Biochemical indicators of vitamin provision to Orenburg's schoolchildren and effectiveness of prophylactic vitamin administration]

The study of providing with vitamins of schoolchildren in Orenburg conducted in the spring of 1985-1986 has revealed decreased content of ascorbic acid in 92%, vitamin E in 62%, vitamin A in 39%, folic acid in 38%, vitamin B12 in 14% of the children, the incidence rate of vitamin deficiency among the children in the senior forms was higher as compared to that in the junior forms and in boys it was more frequent than in girls. Additional intake of multivitamin "Undevitum" by schoolchildren during 2-4 months led to a significant improvement of their providing with vitamins that was expressed in normal vitamin levels and elimination of cases of deep vitamin deficiency.     

Susceptibility to smoking and its association with physical activity, BMI, and weight concerns among youth.

Research has yet to examine how physical activity, body mass index (BMI) and concerns about weight among youth populations are associated with susceptibility to smoking among never smokers. The Physical Activity Module of the School Health Action, Planning and Evaluation System (SHAPES) was completed by 25,060 students in grades 9 to 12 within 76 secondary schools in Ontario (Canada) to examine how being overweight, weight concerns, and physical activity are associated with susceptibility to smoking in a large sample of youth. Among the 14,795 students who were never smokers, 3,809 (25.8%) were classified as susceptible to future smoking and 10,986 (74.2%) were classified as non-susceptible to future smoking. Smoking susceptibility was negatively associated with being highly active or at risk of overweight and positively associated with perceptions of being slightly overweight or slightly underweight. Students who report 1 or more hours of screen or phone time per day were also more likely to be susceptible. This is the first study to identify that susceptibility to future smoking among never smokers is associated with physical activity, overweight and concerns about weight. This is valuable new insight for tailoring and targeting future school-based tobacco control and/or physical activity programming to youth populations.