{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T10:39:46Z","timestamp":1772102386081,"version":"3.50.1"},"reference-count":53,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T00:00:00Z","timestamp":1767571200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012325","name":"Post-doctoral Work Research Project of Guangdong Province and the National Social Science Fund of China","doi-asserted-by":"publisher","award":["24ATY001"],"award-info":[{"award-number":["24ATY001"]}],"id":[{"id":"10.13039\/501100012325","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Chinese adolescents face a dual burden of malnutrition, yet the weight-status-specific mechanisms underlying physical activity (PA) participation remain underexplored. Methods: We conducted a cross-sectional study among 1573 adolescents (aged 9\u201315 years) in Shangrao City, China. Validated scales measured social-ecological factors (family\/peer support, physical environment), psychological factors (stage of change, self-efficacy, decisional balance), and PA participation. Data preprocessing utilized full information maximum likelihood to handle missing values. Confirmatory factor analysis was performed to validate the measurement model, followed by multi-group structural equation modeling to analyze pathway configurations across underweight (n = 187), normal-weight (n = 1070), and overweight\/obese (n = 316) groups. Mediation effects were tested using bootstrapping with 5000 resamples. Results: Clear weight-specific patterns emerged. Normal-weight adolescents presented a fully functional comprehensive model where PA was predicted by the stage of change (\u03b2 = 0.211, p &lt; 0.001), friend support (\u03b2 = 0.120, p &lt; 0.001), self-efficacy (\u03b2 = 0.092, p &lt; 0.05), and perceived benefits (\u03b2 = 0.095, p &lt; 0.01). Underweight adolescents primarily relied on internal readiness driven by stage of change (\u03b2 = 0.270, p &lt; 0.001) and self-efficacy (\u03b2 = 0.164, p &lt; 0.05), with family support only indirectly influencing participation via psychological mediators. In contrast, overweight\/obese adolescents showed a \u201csocially dependent\u201d pattern: friend support directly predicted PA levels (\u03b2 = 0.136, p &lt; 0.05), significantly enhanced self-efficacy (\u03b2 = 0.370, p &lt; 0.01), and effectively lowered perceived barriers (\u03b2 = \u22120.165, p &lt; 0.05). Additionally, the physical environment strongly impacted perceived benefits (\u03b2 = 0.471, p &lt; 0.01) but did not translate into action. Conclusions: These findings underscore the significant differences in PA determinants across the spectrum of malnutrition, necessitating targeted public health interventions to support the Healthy China 2030 initiative.<\/jats:p>","DOI":"10.3390\/nu18010179","type":"journal-article","created":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T08:42:58Z","timestamp":1767688978000},"page":"179","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Physical Activity Determinants Under the Double Burden of Malnutrition: Contrasting Pathways for Underweight and Overweight Chinese Adolescents"],"prefix":"10.3390","volume":"18","author":[{"given":"Liying","family":"Yao","sequence":"first","affiliation":[{"name":"School of Physical Education and Sport Science, Guangzhou University, Guangzhou 510006, China"},{"name":"Exercise and Sports Science Programme, School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1809-9566","authenticated-orcid":false,"given":"Shuaishuai","family":"Jia","sequence":"additional","affiliation":[{"name":"Guangzhou Institute of International Finance, Guangzhou University, Guangzhou 510006, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaochang","family":"Lv","sequence":"additional","affiliation":[{"name":"School of Physical Education and Sport Science, Guangzhou University, Guangzhou 510006, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yongguan","family":"Dai","sequence":"additional","affiliation":[{"name":"School of Physical Education and Sport Science, Guangzhou University, Guangzhou 510006, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2125-7297","authenticated-orcid":false,"given":"Yee","family":"Kueh","sequence":"additional","affiliation":[{"name":"Biostatistics and Research Methodology Unit, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinfu","family":"Xu","sequence":"additional","affiliation":[{"name":"Journal Center, Guangzhou Sport University, Guangzhou 510500, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianqiu","family":"Cong","sequence":"additional","affiliation":[{"name":"College of Physical Education, Kaili University, Kaili 556011, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Garry","family":"Kuan","sequence":"additional","affiliation":[{"name":"Exercise and Sports Science Programme, School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e1115","DOI":"10.1016\/S2468-2667(24)00245-7","article-title":"Public health interventions against childhood obesity in China","volume":"9","author":"Yuan","year":"2024","journal-title":"Lancet Public Health"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1663","DOI":"10.1093\/advances\/nmaa064","article-title":"Double burden of malnutrition and nutrition transition in Asia: A case study of 4 selected countries with different socioeconomic development","volume":"11","author":"Gao","year":"2020","journal-title":"Adv. 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