Individual and school environment factors associated with overweight in adolescents of the municipality of Rio de Janeiro, Brazil

Abstract

Objective: To identify the association of individual and school environment factors with overweight among adolescents. Design: Cross-sectional study. Sociodemographic and behavioural information was collected using an anonymous self-administered questionnaire. Indicators on human and physical resources of the schools were based on information collected in interviews with school principals. Overweight was defined based on the BMI Z-score for age and sex recommended by WHO. Logistic regression models were used for statistical analysis. Setting: Rio de Janeiro, Brazil. Subjects: By means of a two-stage (classrooms and students) probabilistic sampling, subjects comprised 1632 students enrolled in the last year of primary education of the municipal public school network, stratified by city region. Results: The mean prevalence of overweight at schools was 17?2 %, ranging from 0 % to 50 %. Adolescents more likely to be overweight were those who attended schools without knives and forks or ceramic/glass plates for students in the school refectory (prevalence odds ratio (POR) 5 1?40; P 5 0?04), those whose head of household had completed between 8 and 10 years of schooling (POR 5 1?46; P 5 0?03), those who did not live with both parents (POR 5 1?24; P 5 0?06) and those who had not practised physical activity outside school on at least 1 d in the 7 d before the study (POR 5 1?56; P 5 0?04). Conclusions: Sociodemographic and behavioural variables of adolescents and school characteristics were associated with overweight, confirming individual and context effects on this health disorder. Studies such as the present one, identifying variables in context, may support actions to prevent overweight among adolescents.The concern of health professionals and authorities with the development and consequences of overweight on population health in several parts of the world is unquestionable. The WHO states that obesity is currently one of the most relevant and also one of the most neglected public health problems (1) . Although some studies have revealed a plateau and even a drop in the prevalence of overweight among children and adolescents in some countries of Europe in recent years (2)(3)(4) , in general terms the estimates of past decades are alarming. In the USA, the number of overweight children and adolescents has doubled and tripled, respectively, since 1980. Overweight is not restricted to developed countries; its increase has been even faster in developing countries (5) . Overweight (including obesity) in Brazilian adolescents has speeded up. Between 1974 and2003, the prevalence grew from 3?2 to 12?6 % (6) .Several authors agree that the change observed in the prevalence of overweight in increasingly younger individuals is due mainly to factors related to individual and family behaviours and the characteristics of the environment in which children and youth live. Literature reviews (that have analysed information of developing and developed countries) have highlighted that the total *Corresponding author: Email let...

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