ERICA: prevalence of fish consumption and its association with cardiovascular risk factors and healthy behavior in Brazilian adolescents

Takey, Márcia; Giannini, Denise Tavares; Kuschnir, Maria Cristina Caetano

doi:10.1016/j.jped.2022.02.003

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ORIGINAL ARTICLE • J. Pediatr. (Rio J.) 98 (06) • Nov-Dec 2022 • https://doi.org/10.1016/j.jped.2022.02.003 copy

ERICA: prevalence of fish consumption and its association with cardiovascular risk factors and healthy behavior in Brazilian adolescents

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

To describe the prevalence of fish consumption and its association with cardiovascular risk factors and healthy behavior in Brazilian adolescents.

Method:

The authors investigated data from 71,533 participants of the Study of Cardiovascular Risk in Adolescents (Estudo de Riscos Cardiovasculares em Adolescentes - ERICA), a nationwide, cross-sectional, school-based study. Of these, 37,815 adolescents were included for blood analyses. All prevalence estimates were presented proportionally with their 95% confidence intervals. Bivariate relationships were evaluated with Pearson’s Chi-square test, and a multinomial logistic regression model was applied, considering p < 0.05.

Results:

Prevalence of fish consumption in the 7 days prior to the interview was 28.6% (95%CI 26.9-30.3), significantly higher among male adolescents (p = 0.0049), Asian descendants (p = 0.0270), private and rural school students (p < 0.001), and who resided in the Northern region (p < 0.001). A positive association between fish consumption and healthy behavior (breakfast consumption: OR=1.16; 95%CI 1.10-1.22; meals with family members: lunch: OR=1.07; 95%CI 1.01-1.13; dinner: OR=1.13; 95%CI 1.04-1.23; physical activity: OR=1.14; 95%CI 1.02-1.28) and an inverse association with hypertriglyceridemia (OR = 0.84; 95%CI 0.73-0.98) remained significant even after adjustment for possible confounding factors.

Conclusion:

This study demonstrated that fish consumption was associated with lower cardiovascular risk and may represent a marker of a healthy lifestyle in Brazilian adolescents.

KEYWORDS
Fishes; Health behavior; Triglycerides; Prevalence; Adolescent; Brazil

	Fish consumption in the last 7 days
	No		Yes		p^a a Chi-square test.
	%	(95% CI)	%	(95% CI)	p^a a Chi-square test.
Total	71.4	(69.7-73.1)	28.6	(26.9-30.3)
Sex					0.0049
Female	72.9	(71.3-74.5)	27.1	(25.5-28.7)
Male	69.9	(67.6-72.2)	30.1	(27.8-32.4)
Age (years)					0.7301
12-14	71.7	(69.4-73.8)	28.3	(26.2-30.6)
15-17	71.2	(68.9-73.3)	28.8	(26.7-31.1)
Race					0.0270
White	72.3	(69.5-74.9)	27.7	(25.1-30.5)
Black	73.1	(70.2-75.8)	26.9	(24.2-29.8)
Brown	70.7	(69.2-72.1)	29.3	(27.9-30.8)
Yellow	64.0	(57.8-69.8)	36.0	(30.2-42.2)
Native	67.2	(58.5-74.9)	32.8	(25.1-41.5)
Type of school					<0.001
Public	72.9	(70.8-74.8)	27.1	(25.2-29.2)
Private	64.7	(62.2-67.2)	35.3	(32.8-37.8)
Region of school					<0.001
Urban	72.2	(70.9-73.5)	27.8	(26.5-29.1)
Rural	51.9	(47.7-56.2)	48.1	(43.8-52.3)
Geographic region					< 0.001
North	58.1	(56.4-59.9)	41.9	(40.1-43.6)
Northeast	68.1	(65.7-70.3)	31.9	(29.7-34.3)
Southeast	72.8	(69.6-75.8)	27.2	(24.2-30.4)
South	78.5	(75.0-81.7)	21.5	(18.3-24.9)
Midwest	75.5	(73.7-77.1)	24.5	(22.9-26.3)
Pubertal stage					0.5695
Pre-pubescent	76.6	(69.3-82.6)	23.4	(17.4-30.7)
Pubescent	71.5	(69.3-73.5)	28.5	(26.5-30.7)
Post-pubescent	71.2	(69.3-73.0)	28.8	(26.9-30.7)
Physical activity					<0.001
Insufficient active	74.5	(72.6-76.4)	25.5	(23.6-27.4)
Active	69.2	(66.9-71.4)	30.8	(28.6-33.1)
Breakfast					<0.001
Never	76.3	(73.9-78.6)	23.7	(21.4-26.1)
Sometimes	72.6	(70.2-74.8)	27.4	(25.2-29.8)
Often	70.4	(67.4-73.2)	29.6	(26.8-32.6)
Everyday	67.8	(65.4-70.2)	32.2	(29.8-34.6)
Meals with family members Lunch					< 0.001
Never	75.7	(73.0-78.1)	24.3	(21.9-26.9)
Sometimes	72.7	(70.9-74.4)	27.3	(25.6-29.1)
Often	70.4	(68.6-72.1)	29.6	(27.9-31.4)
Always	68.6	(65.9-71.1)	31.4	(28.9-34.0)
Dinner					0.0019
Never	75.6	(73.1-77.9)	24.4	(22.1-26.8)
Sometimes	72.0	(69.8-74.1)	28.0	(25.9-30.2)
Often	71.6	(69.7-73.4)	28.4	(26.6-30.3)
Always	69.9	(67.4-72.2)	30.1	(27.8-32.6)
Maternal education					0.0056
Iliterate	73.3	(67.6-78.2)	26.7	(21.7-32.4)
Primary	72.5	(68.7-76.0)	27.5	(23.9-31.2)
Secondary	71.4	(69.7-73.1)	28.6	(26.9-30.3)
Tertiary	66.8	(64.8-68.7)	33.2	(31.2-35.2)

	OR	95%IC	p
Geographic region
North	1.0	-	-
Northeast	0.60	0.54 - 0.67	<0.001
Southeast	0.54	0.43 - 0.67	<0.001
South	0.38	0.29 - 0.51	<0.001
Midwest	0.42	0.37 - 0.48	<0.001
Sex
Female	1.0	-	-
Male	1.21	1.05-1.39	0.008
Age
12-14	1.0	-	-
15-17	0.88	0.73-1.08	0.225
Race
White	1.0	-	-
Black	0.90	0.75-1.08	0.253
Brown	1.02	0.87 - 1.19	0.823
Yellow	1.56	1.04 - 2.34	0.033
Native	0.89	0.49 - 1.61	0.694
Nutritional status
Normal weight	1.0	-	-
Underweight	0.90	0.66-1.24	0.537
Excess weight	1.13	0.99 - 1.29	0.074
Pubertal stage
Pre-pubescent	1.0	-	-
Pubescent	1.33	0.70 - 2.50	0.378
Post-pubescent	1.23	0.66 - 2.29	0.508
Blood pressure
Normal	1.0	-	-
High	1.06	0.94 - 1.19	0.374
Waist circumference
Normal	1.0	-	-
High	1.15	0.96 - 1.36	0.123
Type of school
Public	1.0	-	-
Private	1.52	1.27 - 1.82	<0.001
Region of school
Urban	1.0	-	-
Rural	2.80	2.33 - 3.37	<0.001
Physical activity
Insufficient active	1.0	-	-
Active	1.20	1.07 - 1.35	0.002
Breakfast
Never	1.0	-	-
Sometimes	1.34	1.20 - 1.50	<0.001
Often	1.54	1.16 - 2.05	0.003
Everyday	1.61	1.37 - 1.89	<0.001
Meals with family members
Lunch
Never	1.0	-	-
Sometimes	1.09	0.92 - 1.30	0.301
Often	1.33	1.09 - 1.61	0.005
Always	1.50	1.25 - 1.81	<0.001
Dinner
Never	1.0	-	-
Sometimes	1.23	1.02-1.48	0.030
Often	1.27	1.04 - 1.56	0.021
Always	1.58	1.29 - 1.95	<0.001
Maternal education
Iliterate	1.0	-	-
Primary	1.28	0.86-1.89	0.221
Secondary	1.29	0.93 - 1.79	0.126
Tertiary	1.61	1.17 - 2.22	0.004

	OR	95%IC	p
Breakfast	1.16	1.10 - 1.22	<0.001
Meals with family members
Lunch	1.07	1.01 - 1.13	0.015
Dinner	1.13	1.04 - 1.23	0.005
Physical activity	1.14	1.02 - 1.28	0.023

	OR	95%IC	p
Total cholesterol
< 150 mg/dL	1.0	-	-
> 150 mg/dL	1.07	0.95 - 1.22	0.270
LDL-c
< 100 mg/dL	1.0	-	-
> 100 mg/dL	1.08	0.89 - 1.31	0.457
HDL-c
> 45 mg/dL	1.0	-	-
< 45 mg/dL	1.08	0.93 - 1.25	0.332
Triglycerides
< 100 mg/dL	1.0	-	-
> 100 mg/dL	0.84	0.73 - 0.98	0.023
Fasting glucose
70-99 mgdL	1.0	-	-
> 100 mg/dL	0.98	0.68-1.40	0.902
Glycated hemoglobin
< 5.7%	1.0	-	-
> 5.7%	1.02	0.79-1.33	0.865
Insulin
< 15 mU/L	1.0	-	-
> 15 mU/L	1.03	0.90 - 1.18	0.684
HOMA-IR
< 2.80	1.0	-	-
> 2.80	1.05	0.94 - 1.18	0.396

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E-mail: jped@jped.com.br

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[1] Study conducted at the Universidade do Estado do Rio de Janeiro, Faculdade de Ciências Médicas, Programa de Pós-Graduação em Ciências Médicas, Núcleo de Estudos da Saúde do Adolescente, Rio de Janeiro, RJ, Brazil.