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

OLIVEIRA, Alessandra Silva Dias de; MOREIRA, Naiara Ferraz; MORAES, Anelise Bezerra de Vasconcelos de; PEREIRA, Rosangela Alves; VEIGA, Glória Valeria de

doi:10.1590/1678-98652017000600007

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ORIGINAL ARTICLES • Rev Nutr 30 (6) • Nov-Dec 2017 • https://doi.org/10.1590/1678-98652017000600007 copy

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

Coocorrência de fatores de risco comportamentais para doenças crônicas não transmissíveis em adolescentes: prevalência e fatores associados

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective

To examine the prevalence of the behavioral risk factors – both isolated and clustered – for chronic diseases, among adolescents. Additionally, its association with various social and demographic variables was estimated.

Methods

This was a cross-sectional study conducted on 1,039 high school students, from public and private schools, elected for convenience, in Rio de Janeiro, Brazil. A Chi-square test, Mann-Whitney U test, as well as crude and adjusted ordinal logistic regression were used to assess the association between the variables.

Results

The most frequently observed risk factors were sedentary behavior (68.8%), alcohol consumption (36.8%), and overweight (26.8%). The clustering of risk factors was observed in 67.5% of the students. Being a girl (OR=1.28; 95%CI=1.01–1.63), Caucasian (OR=1.35; 95%CI=1.06–1.72) or private school student (OR=1.46; 95%CI=1.12–1.88) increased the chance of the clustering of risk factors. The co-occurrence of risk factors was predominantly observed in the case of smoking (OR=4.94; 95%CI=1.46–16.75), alcohol consumption (OR=1.43; 95%CI=1.09–1.88), high consumption of ultra-processed foods (OR=1.57; 95%CI=1.19–2.07), and sedentary behavior (OR=1.40; 95%CI=1.07–1.82).

Conclusion

The co-occurrence of behavioral risk factors was observed to be higher among girls, Caucasian adolescents, and private school students, as well as, among smokers, alcohol users and adolescents with sedentary habits and a high consumption of ultra-processed foods.

Keywords
Adolescent; Chronic disease; Demographic indicators; Social class; Risk factors

Categorical variables	n	%	95%CI
Sex
Male	482	46.4	42.3-49.7
Female	557	53.6	50.3-57.6
Age
≤15 years	710	68.3	65.5-71.2
>15 years	329	31.7	28.8-34.5
Skin color ^* * The number of adolescents varies for each attribute due to unknown information.
Caucasian	470	46.2	43.1-49.3
Black/brown	547	53.8	50.7-56.8
Type of school
Public	512	49.3	46.0-53.4
Private	527	50.7	46.6-54.0
Physical inactivity ^* * The number of adolescents varies for each attribute due to unknown information.
Yes	246	24.4	26.0-32.0
No	761	75.6	68.3-73.9
Sedentary behavior - TV
Yes	700	68.8	66.7-72.5
No	318	31.2	27.5-33.3
Weight status ^* * The number of adolescents varies for each attribute due to unknown information.
Without overweight	743	73.2	70.4-75.9
With overweight	272	26.8	24.1-29.5
Current consumption of alcohol^ * The number of adolescents varies for each attribute due to unknown information.*
Yes	372	36.8	33.8-39.8
No	638	63.2	60.2-66.1
Smoking ^* * The number of adolescents varies for each attribute due to unknown information.
Yes	28	2.8	1.7-3.8
No	990	97.2	96.2-98.3
Non-regular consumption of fruits and vegetables^ * The number of adolescents varies for each attribute due to unknown information.*
Yes	167	16.4	13.9-18.6
No	849	83.6	81.4-86.0
Continuous variable	n	Median (% of DEI)	Min. and Max (% of DEI)
Consumption of UPF	981	54.7	0-89.2
1st Tertile	-	40.2	0-48.0
2nd Tertile	-	54.7	48.0-60.4
3rd Tertile	-	66.8	60.4-89.2

Variables		Sex			Age			Color			School
Variables		Male	Female		≤15 years	>15 years		Black/ Brown	White		Public	Private
Physical inactivity ^* * X2: Chi-square test;
% (n)		17.2 (81)	30.7 (165)		26.9 (185)	19.1 (61)		21.8 (118)	27.6 (128)		22.1 (112)	26.7 (134)
p-value	p<0.01			p<0.01			p<0.05			p=0.09
Sedentary behavior ^* * X2: Chi-square test;
% (n)		70.9 (336)	66.9 (364)		71.1 (492)	63.8 (208)		65.4 (357)	72.7 (341)		67.9 (347)	69.6 (353)
p-value	p=0.17			p<0.05			p<0.05			p=0.55
Overweight ^* * X2: Chi-square test;
% (n)		29.2(138)	24.7 (134)		30.1 (208)	19.8 (64)		24.6 (132)	28.2 (129)		22.2 (113)	31.5 (159)
p-value	p=0.11			p<0.01			p=0.19			p<0.01
Alcohol consumption ^* * X2: Chi-square test;
% (n)		35.6 (167)	37.9 (205)		32.8 (226)	45.5 (146)		35.8 (194)	38.1 (177)		38.2 (193)	35.4 (179)
p-value	p=0.45			p<0.01			p=0.45			p=0.36
Smoking ^* * X2: Chi-square test;
% (n)		2.7 (13)	2.8 (15)		1.2 (8)	6.2 (20)		3.1 (17)	2.3 (11)		5.1 (26)	0.4 (2)
p-value	p=0.98			p<0.01			p=0.45			p<0.01
Non-regular consumption of FV ^* * X2: Chi-square test;
% (n)		16.5 (78)	16.5 (89)		16.9 (117)	15.5 (50)		12.5 (68)	20.9 (98)		10.6 (54)	22.3 (113)
p-value	p=0.99			p=0.59			p<0.01			p<0.01
% of energy consumed daily from UPF ^ Mann-Whitney U test.
Median (n)		52.4 (457)	53.6 (524)		52.9 (685)	53.4 (296)		54.4 (507)	53.8 (453)		53.3 (466)	52.9 (515)
p-value	p<0.05			p=0.84			p=0.48			p=0.34

Variables	Crude OR	95%CI	p-value	Adjusted OR	95%CI	p-value
Sex
Male	1	-	0.08	1	-	0.04
Female	1.24	0.98-1.57	0.08	1.28	1.01-1.63	0.04
Age
≤15 years	1	-	0.54	1	-	0.58
>15 years	0.92	0.71-1.19	0.54	1.08	0.82-1.42	0.58
Skin color
Black/brown	1		<0.01	1		0.02
Caucasian	1.45	1.14-1.84	<0.01	1.35	1.06-1.72	0.02
School
Public	1	-	<0.01	1	-	<0.01
Private	1.48	1.17-1.88	<0.01	1.46	1.12-1.88	<0.01

Risk factors for NTCDs	Crude OR	95%CI	p-value	Adjusted OR	95%CI	p-value
Current alcohol consumption	1.33	1.02-1.73	<0.05	1.43	1.09-1.88	<0.01
Smoking	3.80	1.13-12.7	<0.05	4.94	1.46-16.75	<0.05
Overweight	1.24	0.93-1.67	0.15	1.25	0.92-1.69	0.15
Physical inactivity	1.23	0.90-1.66	0.19	1.17	0.85-1.59	0.33
Sedentary behavior	1.41	1.09-1.83	<0.05	1.40	1.07-1.82	<0.05
Non-regular consumption of FV	1.48	1.02-2.14	<0.05	1.38	0.95-2.02	0.09
High consumption of UPF	1.54	1.17-2.03	<0.01	1.57	1.19-2.07	<0.01

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[1] Note:

[TFN01] ^*
The number of adolescents varies for each attribute due to unknown information.

[3] 95%CI: 95% Confidence Interval; % of DEI: percentage of Daily Energy Intake of the adolescents; Min. and Max: Minimum and Maximum value; UPF: Ultra-Processed Foods.