Socioeconomic inequalities in clustering of health-compromising behaviours among Indian adolescents

Abstract

Background: The simultaneous occurrence of health-compromising behaviors can accentuate the risk of noncommunicable diseases (NCDs). This study aimed to examine the existence and patterns of clustering of four NCD risk behaviors among adolescents and its association with social position. In addition, socioeconomic inequalities in the occurrence of clustering of NCD risk behaviors were also assessed. Methods: A cross-sectional study was undertaken among 1218 adolescents (14–19 years old) in the city of New Delhi, India. An interviewer-administered questionnaire was used to assess health-compromising behaviors (tobacco and alcohol use, fruit/vegetable intake, and physical inactivity). Clustering was assessed using pairwise correlations, counts of clustering of health-compromising behaviors, comparison of observed/expected ratios, and hierarchical agglomerative cluster analysis. Multivariable logistic regressions were used to test the associations of clustering with social position (education and wealth). The relative and slope indices of inequalities in the presence of clustering of behaviors according to education and wealth were estimated. Results: Three major clusters of health behaviors emerged: (a) physical inactivity + lower fruit and vegetable intake, (b) tobacco + alcohol use, and (c) lower fruit and vegetable intake + tobacco + alcohol use. Pronounced clustering of health-compromising behaviors was observed with lower educational attainment and wealth. Conclusion: The presence of clustering of health-compromising behaviors was considerably higher among adolescents with lower educational attainment and wealth. The area of residence has an important influence on socioeconomic inequalities in clustering of NCD risk factors.

Clustering of noncommunicable disease risk factors among adolescents attending higher secondary schools in Kasaragod District, Kerala, India

“…In the study it was found that females had higher odds (OR-5.51) of having at least two NCD risk factors (dyads) compared to males. This is in contrast to a recent study from north India which reported a higher prevalence of NCD risk factor dyads among males compared to females 20 . Similarly, adolescents from urban regions had higher odds of NCD risk factors and their clustering compared to rural counter parts.…”

“…A recent study from north India reported that physical inactivity and inadequate fruit and vegetable intake make up the largest of the behavioural risk factor dyads among adolescents 20 . While in our study inadequate fruit and vegetable intake, physical inactivity and consumption of packaged food were found to be strong contributors to NCD risk factor clusters, earlier studies reported obesity and overweight as predominant risk factors in NCD clusters among adolescents in north India 21 .…”

Inequalities in energy drink consumption among UK adolescents: a mixed-methods study

“…Clustering of unhealthy behaviours among energy drink consumers was also apparent in both our quantitative and qualitative data results, showing that energy drink consumers had poorer quality diets, higher daily energy intake and larger BMI. Previous research has shown that multiple unhealthy behaviours cluster among young people from disadvantaged backgrounds, particularly low fruit and vegetable intake and high tobacco and alcohol use, as well as low fruit and vegetable intake and low physical activity levels coupled with high sedentary behaviour and high sugary drinks intake (35,36) . In our study, each additional SD increase in BMI was associated with 9 % greater likelihood of adolescents' consuming energy drinks.…”

Determinants of Sugar-Sweetened Beverage Consumption Among Adults in Perambalur District of India

“…The English word "sugar" is derived from the Sanskrit word "sarkara," which signifies gravel [1]. Sugar is a ubiquitous element in many processed meals and is a major source of the energy we derive from them [2]. Particularly among young people, there has been an increase in the consumption of sugary sodas, flavored carbonated water, and juice with added sugar while milk consumption has decreased significantly [3].…”

“…Most of the research regarding the parameters related to SSB consumption comes from high-income nations or countries that have strict policies in place to regulate the amount of sugary drinks that their citizens consume [2]. The consumption trends of SSBs among various socioeconomic and demographic categories in low-and middle-income countries such as India have only a few studies.…”