Clustering of diet, physical activity and sedentary behavior among Brazilian adolescents in the national school - based health survey (PeNSE 2015)

Abstract

BackgroundThere is a lack of evidence regarding clusters of health-related behaviors among adolescents from low, lower-middle, and upper-middle income countries. This study aimed to identify clustering patterns of health-related behaviors (diet, physical activity [PA] and sedentary behavior [SB]) and association with sociodemographic variables among a population-based sample of Brazilian adolescents.MethodsCross-sectional data from the 2015 National School-Based Health Survey (PeNSE). A total of 102,072 (females: 51.7%) students in ninth-grade (age: 14.3 ± 1.1 years-old) enrolled in public and private schools were investigated in this study. Healthy and unhealthy diet, PA and SB were measured using a validated questionnaire. Two-step cluster analysis was conducted to identify lifestyle patterns. The methodology for complex analysis and weighting was used to inferential statistical procedures. Multinomial logistic regression assessed associations between sociodemographic factors and the clusters.ResultsThree reliable and meaningful clusters were identified and labelled as follows: (1) health-promoting SB and diet (32.6%); (2) health-promoting PA and diet (44.9%), and (3) health-risk (22.5%). Compared to boys, girls were less likely to be in clusters 1 (OR = 0.85; 95% CI = 0.78–0.93, p < 0.001) and 2 (OR = 0.43; 95% CI = 0.40–0.46, p < 0.001) than the health-risk cluster. Higher socioeconomic status was positively associated with health-promoting PA and diet, and negatively related to health-promoting SB and diet. Older adolescents were more likely to be in cluster 1 than in cluster 3, compared to younger adolescents.ConclusionApproximately one-quarter of the population (health-risk cluster) reported engaging in multiple risk behaviors. Interventions may need to be tailored to specific adolescent groups, especially considering sociodemographic differences.Electronic supplementary materialThe online version of this article (10.1186/s12889-018-6203-1) contains supplementary material, which is available to authorized users.

Clustering of Sedentary Behaviours, Physical Activity, and Energy-Dense Food Intake in Six-Year-Old Children: Associations with Family Socioeconomic Status

“…On average, children in this cluster consumed one portion of calorie-rich snack and one portion of sugar-sweetened beverage per day, which was the lowest amount in all three clusters observed. Similar types of clusters defined by low sedentary behaviour and low snack and beverage consumption have been observed by other studies among children of different ages as well [ 9 , 11 , 30 ]. For example, Bel-Serrat et al reported that a “low beverage consumption and low sedentary” cluster was observed among children aged three to six years living in eight European countries [ 30 ].…”

“…Another study conducted by Bel-Serrat et al identified a “low beverage intake, low sedentary, and physically active” cluster among children aged six to nine years living in 17 European countries [ 9 ]. Matias et al observed a “health-promoting sedentary behaviour and diet” cluster in a sample of over 100,000 children aged 14 years in Brazil [ 11 ]. In addition, we found that the “relatively healthy lifestyle” was more likely to be observed in children of mothers with a high educational level or children from a high-income household.…”

“…Evaluating the synergetic effect instead of the isolated effects of lifestyle behaviours will help intervention development to further target lifestyle behaviours simultaneously [ 9 ]. Furthermore, studies have shown that socioeconomic status (SES) is associated with certain lifestyle behaviour clusters [ 10 , 11 , 12 , 13 ]. For example, Leech et al found that a higher proportion of children aged 10–12 years with mothers having low educational level tended to be in the “energy dense food/drink consumers who watch TV” cluster [ 10 ].…”

Family and School Context: Effects on the Mental Health of Brazilian Students

“…The PeNSE data collected between April and September 2015 have been evaluated for various health outcomes and risk behaviors in several studies [16,[22][23][24][25][26][27][28][29][30]. The survey's self-administered questionnaires were answered using smartphones, which were distributed by IBGE technicians to the students present on the day of collection.…”

Second Version of a Mini-Survey to Evaluate Food Intake Quality (Mini-ECCA v.2): Reproducibility and Ability to Identify Dietary Patterns in University Students

“…In other studies, dietary pattern analysis has led also to the identification of both healthy and non-healthy food intake. This identification may lead to specific actions of food intake improvement in populations where these dietary patterns have been identified [75][76][77]. In the case of university health students, dietary patterns of healthcare students and professionals was described and associated with sociodemographic, lifestyle, anthropometric and biochemical characteristics in a previous study [75].…”