Clustering of Risk Factors for Non-Communicable Diseases among Adolescents from Southern Brazil

Abstract

IntroductionThe aim of this study was to investigate the simultaneous presence of risk factors for non-communicable diseases and the association of these risk factors with demographic and economic factors among adolescents from southern Brazil.MethodsThe study included 916 students (14–19 years old) enrolled in the 2014 school year at state schools in São José, Santa Catarina, Brazil. Risk factors related to lifestyle (i.e., physical inactivity, excessive alcohol consumption, smoking, sedentary behaviour and unhealthy diet), demographic variables (sex, age and skin colour) and economic variables (school shift and economic level) were assessed through a questionnaire. Simultaneous behaviours were assessed by the ratio between observed and expected prevalences of risk factors for non-communicable diseases. The clustering of risk factors was analysed by multinomial logistic regression. The clusters of risk factors that showed a higher prevalence were analysed by binary logistic regression.ResultsThe clustering of two, three, four, and five risk factors were found in 22.2%, 49.3%, 21.7% and 3.1% of adolescents, respectively. Subgroups that were more likely to have both behaviours of physical inactivity and unhealthy diet simultaneously were mostly composed of girls (OR = 3.03, 95% CI = 1.57–5.85) and those with lower socioeconomic status (OR = 1.83, 95% CI = 1.05–3.21); simultaneous physical inactivity, excessive alcohol consumption, sedentary behaviour and unhealthy diet were mainly observed among older adolescents (OR = 1.49, 95% CI = 1.05–2.12). Subgroups less likely to have both behaviours of sedentary behaviour and unhealthy diet were mostly composed of girls (OR = 0.58, 95% CI = 0.38–0.89); simultaneous physical inactivity, sedentary behaviour and unhealthy diet were mainly observed among older individuals (OR = 0.66, 95% CI = 0.49–0.87) and those of the night shift (OR = 0.59, 95% CI = 0.43–0.82).ConclusionAdolescents had a high prevalence of simultaneous risk factors for NCDs. Demographic (gender and age) and economic (school shift) variables were associated with the most prevalent simultaneous behaviours among adolescents.

Co-occurrence of behavioral risk factors for chronic non-communicable diseases in adolescents: Prevalence and associated factors

“…In this study, both sedentary habits and physical inactivity were more prevalent among the youngest adolescents. This result corroborates the data obtained by Nunes et al [8] who also showed that younger adolescents are at a greater risk of being both physically inactive and sedentary, compared to their peers. However, this association is still not well-established, as another study reported no association between physical inactivity and adolescents' age [7]; in yet another study, this association was observed only among older adolescents [34].…”

“…Of the isolated risk behaviors, our study highlights the high prevalence of sedentary habits, which affect almost 70% of adolescents; this is similar to what has already been described in other studies, conducted on Brazilian adolescents [8,25]. In this study, both sedentary habits and physical inactivity were more prevalent among the youngest adolescents.…”

“…The high frequency of the co-occurrence of risk factors for NTCDs (almost 70.0%), observed in this study, has also been described by other authors (ranging from 45.0% to 72.2%) [7][8][9][10][11][12][13][14]. However, comparison with the findings of those studies should be performed with caution due to the diversity in the risk behaviors assessed.…”

“…In Brazil, only one study assessed the simultaneous occurrence of the five main factors cited [7]. Nunes et al [8], also studied five factors, but did not take into account overweight to compose the variable co-occurrence. Other authors studied four factors, without evaluating the consumption of alcohol [9] or overweight [10][11][12][13], or three factors, without evaluating tobacco consumption or excess weight [14].…”

“…Such behaviour has been pointed out as an important risk factor for NTCD development, regardless of the physical activity status [16,17]; therefore, it is important to consider it as one of the risk factors that compose the variable co-occurrence. However, sedentary behavior has been investigated in only two studies focusing on co-occurrence, in Brazilian adolescents [8,14].…”