Prevalence and factors associated with excess weight in adolescents in a low-income neighborhood - Northeast, Brazil

Barbosa, Lizelda Maria de Araújo; Arruda, Ilma Kruze Grande de; Canuto, Raquel; Lira, Pedro Israel Cabral de; Monteiro, Jailma Santos; Freitas, Déborah Lemos; Paula, Weslla Karla Albuquerque Silva de; Batista Filho, Malaquias

doi:10.1590/1806-93042019000300010

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Revista Brasileira de Saúde Materno Infantil

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ORIGINAL ARTICLES • Rev. Bras. Saude Mater. Infant. 19 (3) • Jul-Sep 2019 • https://doi.org/10.1590/1806-93042019000300010 copy

Prevalence and factors associated with excess weight in adolescents in a low-income neighborhood - Northeast, Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objectives:

to study the prevalence of excess weight and associated factors among adolescents from a low-income neighborhood located in the city of Recife, Pernambuco.

Methods:

cross-sectional study, in which behavioral, socioeconomic and demographic information was collected from June to December 2014. Excess weight was calculated based on body mass index for age and the cut-off points, by the World Health Organization (2007). To analyze associations between predictor variables and the outcome, multivariate data analysis was performed following the Poisson Regression (Prevalence Ratio - PR) with their respective 95% confidence intervals (95%CI).

Results:

twenty-five adolescents participated in the study, with a prevalence of 36.4% of excess weight: 20.4% overweight (95%CI=15.1-25.7) and 16.0% obesity (95%CI= 11.2-20.8), predominantly in female gender (42.5%; p=0.031). The outcome was associated with internet access (PR=1.20; 95%CI=1.01-1.43), the number of people in the family (PR= 1.12; 95%CI=1.01-1.28) and screen time (PR=1.13; 95%CI=1.01-1.27), but only in male gender.

Conclusions:

the prevalence found was higher than that of other national researches, especially for the female gender. In the male gender, not having internet access, a lesser number of family members and a longer screen time proved to be factors associated with being excess weight.

Key words
Adolescent; Poverty; Overweight; Obesity; Prevalence

Variables	Male		Female		p*
Variables	n	%	n	%
Age range					0.318
10 to 14 years	49	50.0	55	43.3
15 to 19 years	49	50.0	72	56.7
Socioeconomic Class					0.934
B1, B2, C1	25	25.5	33	26.0
C2	41	41.8	53	41.7
D, E	32	32.7	41	32.3
Internet access					0.943
Yes	76	77.6	99	78.0
No	22	22.4	28	22.0
Number of rooms					0.002^a a p<0.05 for Pearson's chi-squared test,
≤4	26	26.5	60	47.2
>4	72	73.5	67	52.8
Number of family members					0.703
≤4	52	54.2	65	51.6
>4	44	45.8	61	48.4
Nutritional status					0.031^c c p<0.05 Fisher exact test.
Underweight	6	6.1	2	1.6
Eutrophy	64	65.3	71	55.9
Overweight	15	15.3	31	24.4
Obesity	13	13.3	23	18.1
Type of house construction					0.018^a a p<0.05 for Pearson's chi-squared test,
Masonry / brick + mud	93	94.9	108	85.0
Cardboard / Canvas / Wood	5	5.1	19	15.0
House's floor type					0.023^a a p<0.05 for Pearson's chi-squared test,
Ceramics	65	66.3	65	51.2
Wood / cement / other	33	33.7	62	48.8
Video game or cell phone usage					0.001^a a p<0.05 for Pearson's chi-squared test,
Yes	72	73.5	65	51.2
No	26	26.5	62	48.8
Computer usage					0.078
Yes	74	75.5	82	64.6
No	24	24.5	45	35.4
Television usage					0.009^a a p<0.05 for Pearson's chi-squared test,
Yes	89	90.8	125	98.4
No	9	9.2	2c	1.6
Physical activity level					<0.001^b b p<0.05 for chi-squared test for trend,
Irregularly active	18	18.4	43	33.9
Active	47	48.0	70	55.1
Very active	33	33.7	14	11.0
Screen time on weekdays					0.379
<2 hours / day	12	12.2	11	8.7
≥2 hours / day	86	87.8	116	91.3
Screen time on weekends					0.158
<2 hours / day	15	15.3	29	22.8
≥2 hours / day	83	84.7	98	77.2
Self-perception of weight					0.083
"Skinny"	30	30.6	27	21.3
"Average"	48	49.0	65	51.2
"Fat"	20	20.4	35	27.6

Variables	Total			With excess weight ^* * Excess weight= overweight + obesity,			p
Variables	n	%	n	%	Gross PR^a a gross PR= gross Prevalence Ratio,	CI95%^b b CI95%= 95% Confidence Interval.	p
Gender
Male	98	43.6	28	28.6	1
Female	127	56.4	54	42.5	1.11	1.01-1.21	0.029
Age range
15 to 19 years	121	53.8	43	35.5	1
10 to 14 years	104	46.2	39	37.5	1.01	0.91-1.10	0.978
Socioeconomic Class
D, E	73	32.4	25	34.2	1
C2	94	41.8	34	36.2	1.01	0.91-1.13	0.529
B1, B2, C1	59	25.8	23	39.7	1.04	0.92-1.17
Internet access
Yes	175	77.8	59	33.7	1
No	50	22.2	23	46.0	1.09	0.98-1.22	0.112
Number of rooms
>4	139	61.8	46	33.1	1
≤4	86	38.2	36	41.9	1.06	0.97-1.17	0.185
Number of family members
>4	108	47.3	33	31.4	1
≤4	117	52.7	48	41.0	1.07	0.98-1.18	0.136
Type of house construction
Masonry / brick + mud	201	89.3	71	35.3	1
Cardboard / Canvas / Wood	24	10.7	11	45.8	1.08	0.93-1.24	0.314
House's floor type
Ceramics	130	57.8	45	34.6	1
Wood / cement / other	95	42.2	37	38.9	1.03	0.94-1.13	0.506
Video game or cell phone usage
Yes	137	60.9	47	34.3	1
No	88	39.1	35	39.8	1.04	0.95-1.14	0.407
Computer usage
Yes	156	69.3	48	30.8	1
No	69	30.7	34	49.3	1.14	1.04-1.26	0.007
Television usage
Yes	11	4.9	3	27.3	1
No	214	95.1	79	36.9	1.07	0.87-1.33	0.501
Physical activity level
Very Active	47	20.9	13	27.7	1
Active	117	52.0	39	33.3	1.04	0.93-1.18	0.016
Irregularly active	61	27.1	30	49.2	1.17	1.02-1.33
Screen time on weekdays
<2 hours / day	23	10.2	5	21.7	1
≥2 hours / day	202	89.8	77	38.1	1.13	0.98-1.31	0.092
Screen time on weekends
<2 hours / day	44	19.6	16	36.4	1
≥2 hours / day	181	80.4	66	36.5	0.98	0.87-1.10	0.738
Self-perception of weight
"Skinny"	57	25.3	4	7.0	1
"Average"	113	50.2	35	31.0	1.22	1.11-1.34	<0.001
"Fat"	55	24.4	43	78.2	1.65	1.52-1.83

Variables	Total			Masculino			Feminino
Variables	Gross RP (CI95%)^a a Prevalence ratio and its respective confidence intervals of 95%,	Adjusted PR (CI95%)^a a Prevalence ratio and its respective confidence intervals of 95%,	p	Gross RP (CI95%)^a a Prevalence ratio and its respective confidence intervals of 95%,	Adjusted PR (CI95%)^a a Prevalence ratio and its respective confidence intervals of 95%,	p	Gross RP (CI95%)^a a Prevalence ratio and its respective confidence intervals of 95%,	Adjusted PR (CI95%)^a a Prevalence ratio and its respective confidence intervals of 95%,	p
Level1^b b Level 1= adjusted to the other variables on this level,
Gender
Male	1	1		-	-	-	-	-	-
Female	1.11 (1.01-1.21)	1.09 (1.00-1.20)	0.052	-	-	-	-	-	-
Internet access
Yes	1	1		1	1		-	-	-
No	1.09 (0.98-1.22)	1.09 (0.97-1.22)	0.126	1.17 (0.99-1.38)	1.20 (1.01-1.43)	0.037	-	-	-
Number of rooms
>4	1	1		-	-	-	1	1
≤4	1.06 (0.97-1.17)	1.02 (0.93-1.12)	0.617	-	-	-	1.10 (0.98-1.24)	1.10 (0.98-1.24)	0.105
Number of family members
>4	1	1		1	1		-	-	-
≤4	1.07 (0.98-1.18)	1.07 (0.98-1.17)	0.142	1.13 (0.99-1.30)	1.12(1.01-1.28)	0.049	-	-	-
Level 2^c c Level 2= adjusted by variables on level 1.
Computer usage
Yes	1	1		1	1		1	1
No	1.14 (1.04-1.26)	1.07 (0.97-1.17)	0.157	1.13 (0.97-1.34)	1.09 (0.94-1.25)	0.244	1.12 (0.99-1.27)	1.05 (0.94-1.18)	0.349
Physical activity level
Very Active	1	1		1	1		-	-	-
Active	1.04 (0.93-1.18)	1.02 (0.92-1.13)	0.229	0.96 (0.82-1.11)	0.97 (0.84-1.12)	0.207	-	-	-
Irregularly active	1.17 (1.02-1.33)	1.06 (0.94-1.19)		1.30 (1.08-1.56)	1.13 (0.95-1.34)		-	-	-
Screen time on weekdays
<2 hours / day	1	1		-	-	-	-	-	-
≥2 hours / day	1.13 (0.98-1.31)	1.12 (0.98-1.27)	0.086	-	-	-	-	-	-
Screen time on weekends
<2 hours / day	-	-	-	1	1		1	1
≥2 hours / day	-	-	-	1.17 (0.99-1.38)	1.13 (1.01-1.27)	0.048	0.91 (0.79-1.04)	0.92 (0.81-1.03)	0.165
Self-perception of weight
"Skinny"	1	1		1	1		1	1
"Average"	1.22 (1.11-1.34)	1.22 (1.11-1.34)	< 0.001	1.23 (1.09-1.38)	1.21 (1.07-1.37)	< 0.001	1.20 (1.05-1.38)	1.18 (1.03-1.36)	< 0.001
"Fat"	1.65 (1.52-1.83)	1.61 (1.48-1.78)		1.64 (1.44-1.88)	1.50 (1.30-1.73)		1.64 (1.45-1.87)	1.60 (1.41-1.84)

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[1] Authors' contributions

Barbosa LMA - bibliographic survey, data analysis and interpretation, article writing, approval of the final version to be submitted. Arruda IKG, Lira PIC and Paula WKAS - study design and conception, data analysis and interpretation, critical review of relevant intellectual content, approval of the final version to be submitted. Canuto R - Data analysis and interpretation, critical review of relevant intellectual content, approval of the final version to be submitted. Monteiro JS, Freitas DL and Batista Filho M - study design and conception, data analysis and collection, approval of the final version to be submitted. All authors approved the final version of the manuscript.