ENVIRONMENTAL CONTEXT AND ADOLESCENT ADIPOSITY IN TIRANA CITY: URBAN VERSUS RURAL COMPARISONS WITHIN AN ECOLOGICAL HEALTH FRAMEWORK

Adolescent adiposity is a public health concern influenced by biological maturation, behavioral patterns, and contextual exposures.Ecological health models propose that neighborhood and residential settings may shape opportunities for activity, sedentary routines, and health-related outcomes.This study examined whether environmental context (urban versus rural residence) is associated with adiposity indicators in adolescents from Tirana, and whether fitness-related adaptations (particularly aerobic capacity) outweigh contextual classification within an ecological interpretation.A cross-sectional study was conducted with 250 adolescents aged 13-17 years recruited from four secondary schools in Tirana.Anthropometric assessment included height, weight, body mass index (BMI), and subcutaneous fat thickness (SSF), including a trunk SSF composite.Physical fitness was assessed using the 20 m shuttle run test (estimated VOmax) and neuromuscular performance tests.Participants were classified as physically active or inactive based on structured sport participation beyond compulsory physical education.Statistical independent t-tests and chi-square tests, were applied.No statistically significant differences were observed between urban and rural adolescents in BMI, trunk SSF, or obesity prevalence.In contrast, aerobic capacity (VOmax) showed the strongest inverse association with both BMI and trunk SSF, and remained the dominant independent predictor in multivariate models.These findings suggest that within the Tirana region, residential context alone does not independently account for adiposity variation, and that physiological fitness adaptation represents a more sensitive determinant of adolescent body composition within an ecological framework.