[Prevalence and factors associated with the co-occurrence of health risk behaviors in adolescents]

The 'big four' health risk behaviors among Vietnamese adolescents: co-occurrence and socio-cultural risk factors

Background

Health Risk Behaviors (HRBs) represent significant health threats for adolescents. However, there has been relatively little research on multiple HRBs in low-and-middle-income countries (LMIC), where the majority of the world’s youth reside. This study’s objective was to investigate common HRB, their co-occurrence, and socio-demographic risk and protective factors among Vietnamese adolescents.

Methods

A cross-sectional self-report survey examined four major HRBs (tobacco use, alcohol consumption, physical inactivity, unhealthy diet) among 431 adolescents aged 15–17 years in five Vietnam provinces. Key HRB risk and protective factors assessed included perceived social norms, parental monitoring of adolescents’ behavior, and health behavior literacy.

Results

Forty-one percent of participants reported no HRB, 39% reported one, and 20% reported two or more HRBs. The four HRBs appeared to be independent, with an exploratory factor analysis indicating no common factors. The most prevalent HRB was unhealthy diet (45%), the least prevalent smoking (1%). The most frequent co-occurring HRBs were unhealthy diet and physical inactivity. Adolescents’ perceptions of norms regarding HRBs and related healthy behaviors were the most consistent risk factor for the HRB. Diet was the HRB most influenced by the social variables perceived norms, monitoring, and health literacy.

Conclusions

Results highlight the importance of future research identifying the temporal order of co-occurrence of multiple HRB, how differing conceptualizations of socio-cultural roles impact on HRB, and health-related effects of HRB co-occurrence. Such information will be useful for maximizing the efficiency and effectiveness of prevention and intervention programs in LMIC.

Age, skin color, self-rated health, and depression associated with co-occurrence of obesogenic behaviors in university students: a cross-sectional study

BACKGROUND

The university context plays an important role in the health-disease process since students are potentially vulnerable to obesogenic behaviors that can influence long-term health.

OBJECTIVE

To estimate the prevalence of and factors associated with the co-occurrence of obesogenic behaviors among university students.

DESIGN AND SETTING

This was a cross-sectional study at a Brazilian public university.

METHODS

This study was conducted with all university students in the first and second semesters of 2019 at Universidade Federal de Ouro Preto, Minas Gerais, Brazil. Data were collected between April and September 2019, using a self-administered questionnaire. The outcome was the co-occurrence of obesogenic behaviors, measured as the sum of three risk behaviors: inadequate eating practices, leisure-time physical inactivity, and sedentary behavior. A Venn diagram was used to evaluate the simultaneous occurrence of risk behaviors. Pearson's chi-square test and multivariate logistic regression were used for statistical analyses.

RESULTS

A total of 351 students participated in the study. Inadequate eating practices constituted the most prevalent isolated risk behavior (80.6%), which was also the most prevalent when combined with sedentary behavior (23.6%). University students aged 20 years or younger, with non-white skin color, poor self-rated health, and symptoms of depression had increased chances of simultaneous occurrence of obesogenic behaviors.

CONCLUSION

These findings highlight the importance of developing and implementing actions to reduce combined obesogenic behaviors in the university environment. Institutions should focus on creating an environment that promotes health-protective behaviors such as physical activity and healthy eating.

Association between self-control and health risk behaviors: a cross-sectional study with 9th grade adolescents in São Paulo

BACKGROUND

Self-control (SC) has been consistently found associated with diverse health risk behaviors (HRBs), but little research refers to low- and middle-income countries. Furthermore, there is evidence that some HRBs tend to aggregate, however studies with the specific purpose of addressing the relation between SC and multiple health risk behaviors (MHRBs) are rare. The objective of this study is to analyze these associations and provide evidence to help filling these gaps.

METHODS

A sample of 2106 9th grade students from the city of São Paulo responded a self-administered questionnaire in 2017. We tested the association of SC measured as an ordinal variable with four levels (higher, high, medium and low) with six HRBs (binge drinking, marijuana use, smoking, high consumption of ultra-processed food, sedentary behavior and bullying perpetration), in both separated and aggregated forms (MHRBs), controlling for potential confounders. Binary logistic regression was used to test the association between exposure (SC) and single outcomes. In order to analyze the association of SC with MHRBs, multinomial logistic regression was employed.

RESULTS

SC was associated with five of six HRBs investigated and with MHRBs. The effect size of the association of SC and MHRBs increased in a steep pattern with accumulation of more HRBs.

CONCLUSION

Low self-control is associated with most HRBs investigated and the magnitude of the association increases when more than two or three HRBs are accumulated. There seems to be a group of adolescents in a position of pronounced vulnerability for MHRBs. This should be considered when designing public policy and prevention programs. In contexts of limited or scarce resources and public funds, interventions focusing the most vulnerable groups, instead of universal interventions, should be considered.

Co-occurrence of health risk behaviors and the family context among Brazilian adolescents, National Survey of School Health (2015)

OBJECTIVE

To evaluate the association between the co-occurrence of risk behaviors (RB) and the family context in Brazilian adolescents.

METHODS

Cross-sectional study on 101,534 students from the 9th grade of elementary school in the National Survey of School Health - PeNSE 2015. The co-occurrence of RB was estimated by the sum of the presence of sedentary behavior, low fruit consumption, regular consumption of alcohol and tobacco. Prevalence was assessed using the Venn diagram and multivariate analysis by the ordinal logistic regression model of partial proportional odds.

RESULTS

8.8% of the adolescents did not have RB; 34.5% had one; 42.7% had two; and 14.1%, three or four. The most prevalent combinations were between sedentary behavior and low fruit consumption (33.8%); sedentary behavior with low fruit consumption and regular consumption of alcohol (9.5%). Those who were more likely to present co-occurrence had mothers with higher education level in all models, did not live with their fathers [0, 1 and 2 vs. 3: (OR = 1.21; 95%CI 1.07-1.37)], had parents who sometimes, never or rarely understood their problems and concerns [0, 1 and 2 vs. 3: (OR = 1.62; 95%CI 1.49-1.76)] and monitored their homework [0, 1 and 2 vs. 3: (OR = 1.77; 95%CI 1.62-1.93)]; and had meals with parents or guardians <4 days/week for the three models.

CONCLUSION

Health RB tend to cluster among Brazilian adolescents and are related to characteristics of the family context. These findings point to the need for health promotion actions focusing on simultaneity and not in isolation.

Prevalence and Correlates of Alcohol Consumption among Hill-Tribe Adolescents below the Legal Drinking Age-A Community-based Cross-Sectional Study in Northern Thailand

Alcohol drinking has been prevalent among various hill tribes of northern Thailand due to their distinctively different lifestyles, traditions, cultures and beliefs than the general Thai population; the majority of these traditions involve annual rounds of customary rituals that make alcohol abundantly accessible to all age groups. To study the prevalence and predictors of alcohol use, a community-based analytical cross-sectional study was conducted between October 2017-September 2018 among 480 sampled adolescents aged 12 through 18 years drawn by stratified random sampling. A proprietary questionnaire developed by the researchers was used to collect the data which were analyzed using binary logistic regression. The prevalence of alcohol use in the previous 30 days was 46.7%. Drinking predictors were: having at least a drinking parent, drinking peers, ever been sent to buy alcohol, smoking, cordial relationship with peers, gambling, family violence experience, stress and leisure time company. Therefore, our results suggest that prevention interventions should be designed with a focus on discouraging parents from sending children to buy alcohol and drinking or smoking in their presence; to reduce both social and commercial access to alcohol, age limits should be imposed on alcohol intake at all ceremonious events, while strictly reinforcing the law that prohibits selling alcohol to minors.

Beyond Their HIV Status: the Occurrence of Multiple Health Risk Behavior Among Adolescents from a Rural Setting of Sub-Saharan Africa

Background

Health risk behaviors during adolescence may cluster into patterns that might be predicted by specific factors, among which HIV may have an important role.

Method

In a cross-sectional study conducted between 2017 and 2018, clustering of HRB and its associated factors was investigated in rural Kenya among 588 adolescents (36% perinatally HIV infected; 28% perinatally HIV exposed but uninfected; and 36% HIV unexposed/uninfected). Latent class analysis of 22 behaviors followed by multinomial logistic regression were conducted. Four risk behavior classes were identified.

Results

No significant differences were found in behavioral class membership across the three HIV groups (p = 0.366). The risk of membership to the higher risk behavioral classes relative to class 1 (the substance and drug abstinent low risk takers) increased with older adolescent age (p = 0.047), increased among adolescent who experienced mental distress (p < 0.001), and those who felt unsafe in their neighborhood (p < 0.002). Better working memory (p = 0.0037) was found to be protective.

Conclusion

The results highlight a need to include screening and interventions for internalizing mental health problems and deficits in executive functioning, as well as steps to involve family members and communities to address psychosocial risk factors in adolescents in Kenya.

Aggregation of behavioral risk factors to noncommunicable chronic diseases: A national school-based study with Brazilian adolescents

There is an increasing interest in the study of the aggregation of risk factors for noncommunicable chronic diseases. However, there are no studies among adolescents stratified by alcohol use. This study investigated the aggregation of cardiovascular risk factors in adolescents considering the use or not of alcohol. A total of 73,624 Brazilian adolescents aged 12-17 years from public and private schools were evaluated in a national cross-sectional study (March-2013 to December-2014). The aggregation of cardiovascular risk factors was the main outcome. The regression model was adjusted for sex, age, region of Brazil, and school type. Most alcohol users were 16 to 17 years old, while nonusers were between 12 and 13 years. Alcohol users showed a higher prevalence of smoking (8.1% vs. 0.8%) and sleep inadequacy (59.9% vs. 51.4%) than nonusers did. On the other hand, a sufficient level of physical activity was more frequent among alcohol users (51.2% vs. 44.2%). The presence of only one cardiovascular risk factor was more frequent in nonusers (42.3%) than alcohol users (38.9%). Alcohol users tended to aggregate more for the category of 3-4 cardiovascular risk factors when compared with the non-alcohol-using population (10.9% vs. 7.9%). Aggregation of three cardiovascular risk factors was more likely to be observed among male adolescent alcohol users. Inadequate sleep and smoking habit tended to aggregate among alcohol users. This finding highlights the importance of public policies aiming to reduce alcohol consumption at early ages and, consequently, to decrease the risk of future morbimortality of noncommunicable chronic diseases.

Simultaneity of risk factors for chronic non-communicable diseases in a rural population of a Southern Brazilian city

OBJECTIVES

To describe the occurrence of simultaneous risk factors for chronic noncommunicable diseases, and factors associated with these prevalences in rural adults of a Southern Brazilian city.

METHODS

The design of this study was cross-sectional with a sample of 1,445 adults from the rural area of Pelotas, RS. Four risk factors were considered: smoking, alcohol consumption, physical inactivity and inadequate consumption of vegetables. To verify the simultaneous occurrence of the outcomes, a cluster analysis was used. The association was tested by ordinal regression resulting in odds ratios.

RESULTS

Among the four risk factors evaluated, three were the most prevalent among men, and only physical inactivity was greater among women. In the cluster analysis, only the combination of alcohol consumption + smoking + inadequate vegetable consumption presented an observed prevalence that was significantly higher than the expected (O/E = 2.67, 95%CI 1.30, 5.48), and higher than another study in the south of the country. This can be justified because that study included an evaluation of urban dwellers and the consumption of fruits. After adjustment, men, single individuals, non-white people, those with less schooling, those with a worse socioeconomic status, those who reported poor perception of health, and those who do not work in specifically rural activities had a greater probability of having the simultaneity of risk factors.

CONCLUSION

The results show the importance of developing priority actions regarding the health of rural populations with special attention to the subgroups with an identified higher risk.

ASSOCIATION BETWEEN PHYSICAL ACTIVITY PRACTICE AND CLUSTERING OF HEALTH RISK BEHAVIORS IN ADOLESCENTS

Objective:

To verify the association between participation in physical activity (PA) and the clustering of health risk behaviors (HRB) in adolescents of both genders.

Methods:

A cross-sectional study involving 862 adolescents (11 to 17 years old) enrolled in 14 randomly selected public schools from Curitiba, Paraná, Brazil. Participation in PA, screen time, consumption of fruit, vegetables, cigarettes and alcoholic beverages were the criteria evaluated. Multinomial logistic regression tested the association between participation in PA and clustering of HRB, and results are expressed Odds Ratio (OR) with 95% confidence intervals (95%CI).

Results:

Adolescents with high participation in PA had lower odds of clustering 2-3 HRB (OR 0.38, 95%CI 0.21-0.68; p<0.01) and 4-5 HRB (OR 0.29; 95%IC 0.16-0.53; p<0.01). Boys with high participation in PA had lower chances of clustering 2-3 HRB (OR 0.31, 95%CI 0.13-0.75; p=0.01), and girls had lower odds of clustering 2-3 HRB (OR 0.41; 95%CI 0.17-0.99; p=0.04) and 4-5 HRB (OR 0.25; 95%CI 0.10-0.61; p<0.01).

Conclusions:

High participation in PA was inversely associated with the clustering of HRB in adolescents.

[Aggregation of cardiovascular risk factors: alcohol, smoking, excess weight, and short sleep duration in adolescents in the ERICA study]

This study aimed to analyze the aggregation of alcohol consumption, smoking, excess weight, and short sleep in Brazilian adolescents. This was a cross-sectional multicenter study conducted with teens participating in the Study of Cardiovascular Risk Factors in Adolescents (ERICA in Portuguese). The sample consisted of adolescents that answered the complete questionnaires on sleep, tobacco, and alcoholic beverages, in addition to having their weight and height measured. Aggregation was analyzed by comparing the observed and expected prevalence of risk factors in all possible groupings, with the respective 95% confidence intervals. Analyses were performed in Stata 14 using the svy (survey) command for complex sample data. The sample included 73,624 adolescents, of whom 25.5% had excess weight and 24.2% consumed alcoholic beverages. Aggregation of the four risk factors was O/E = 5.6. Aggregation of three factors was more prevalent in those 15 to 17 years of age (P = 4.8). In the POR (prevalence odds ratio) analysis of the combination of two risk factors, those that smoked showed 11.80 higher odds of also consuming alcohol, compared to those that did not smoke, and vice versa, in private schools. In relation to age, adolescents 12 to 14 years of age that smoked showed 15.46 times higher odds of also drinking, and vice and versa. Adolescents in the sample presented the aggregate presence of four risk factors, and there was a significant relationship between tobacco and alcohol consumption.

Behavioral Risk Factors Of Non-Communicable Diseases Among A Nationally Representative Sample Of School-Going Adolescents In Indonesia

Background

The aim of this study was to investigate the prevalence and correlates of behavioral non-communicable diseases (NCD) risk factors among adolescents in Indonesia.

Methods

Cross-sectional national data were analyzed from 11,124 in-school adolescents (mean age 14.0 years) of the Indonesia Global School-Based Student Health Survey (GSHS) in 2015. Seven behavioral NCD risk factors (substance use, dietary behavior, overweight or obesity, low physical activity, and sedentary behavior) were assessed by questionnaire in a classroom setting.

Results

The prevalence of low physical activity was 87.8%, insufficient fruit and vegetable intake 76.8%, having soft drinks daily 27.9%, leisure-time sedentary behavior 27.3%, overweight or obesity 15.8%, current tobacco use 12.8%, and alcohol use 4.4%. From the seven behavioral NCD risk factors, the mean was 2.5 (SD=1.0), and almost half (46.5%) had at least three risk factors. In adjusted linear regression analysis, being a boy, increasing age and psychological distress increased the odds and hunger or food insecurity and parental support decreased the odds for having behavioral risk factors.

Conclusion

A high co-occurrence of behavioral risk factors was identified. Several risk factors (older age, boys, distress, and poor parental support) were identified that can be targeted in intervention programs.

Prevalence and Correlates of Behavioral Non-Communicable Diseases Risk Factors among Adolescents in the Seychelles: Results of a National School Survey in 2015

The aim of this study was to investigate the prevalence and correlates of behavioral non-communicable disease (NCD) risk factors among a national sample of school-going adolescents in the Seychelles. Cross-sectional data were analyzed from 2540 school adolescents (median age 14 years, interquartile range = 2), in the Seychelles "Global School-Based Student Health Survey (GSHS)" in 2015. Behavioral NCD risk factors (current tobacco use, current alcohol use, inadequate fruit and vegetable consumption, soft drink consumption, overweight or obesity, physical inactivity, and leisure-time sedentary behavior) were assessed by self-report. Among the seven individual behavioral risk factors, the highest prevalence was physical inactivity (82.7%), followed by daily soft drink consumption (68.3%), inadequate fruit and vegetable consumption (60.9%), leisure-time sedentary behavior (51.0%), current alcohol use (47.6%), overweight or obesity (28.2%), and current tobacco use (23.4%). The total mean number of behavioral NCD risk factors was 3.6 (Standard Deviation = 1.3), and the proportion of co-occurrence of having three or more behavioral NCD risk factors was 80.7%. In adjusted linear regression analysis, male sex, older age, and psychological distress were positively, and school attendance and peer support were negatively associated with the total number of behavioral NCD risk factors. A high prevalence of multiple behavioral NCD risk factors were found and several associated factors were identified, such as male sex, older age, psychological distress, school truancy, and lack of peer support, which may help in aiding intervention programs in this population.

Clustering of oral and general health risk behaviors among adolescents

Since the co-occurrence of several health-risk behaviors is associated with an increase in chronic diseases, the study of clustering is relevant. The aim of this study was to evaluate how seven types of general and oral health-risk behaviors, cluster among adolescents. A cross-sectional analysis was performed with a sample of high school students from state public schools in São Lourenco da Mata, State of Pernambuco, Brazil (n = 1154). Data were obtained using a self-reported questionnaire. To identify cluster solutions of seven general and oral health-risk behaviors, Hierarchical Agglomerative Cluster Analysis (HACA) was performed. Most of the adolescents participating in the study was female (54.3%) and aged <16 years old (77.1%). HACA indicated two broad stable clusters for the seven health-risk types of behaviors. The first cluster included following behaviors: smoking, drinking and less frequent tooth brushing. The second cluster reveals the combination of high bread, pasta and snack intake; high intake of sweets; high intake of soft drinks; low intake of fruits and vegetables. Results provided by HACA identified two groups of health-risk behaviors. The first cluster mainly shows risk (problematic) behaviors, whereas the second cluster denotes the non-adhesion of preventive behavior (non-healthy diet). Health-compromising behaviors are common among teens and occur in distinct clusters. These findings could be used by schools, health promotion authorities and other stakeholders to design and implement tailored preventive interventions in Pernambuco, Brazil. Therefore, clustering of several types of behavior has important implications for a comprehensive strategy in health promotion policies and practices.

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Health-related behaviors tend to cluster in different patterns.

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Two broad stable clusters were indicated for the seven health-risk types of behaviors.

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Risk behaviors affect not merely oral health but also overall health.

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Clustering was similar for males and females.

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Clustering of behavior has important implications for a comprehensive plan in health promotion.

Simultaneity and aggregation of risk factors for noncommunicable diseases among brazilian adolescents

Abstract Objective: To estimate the prevalence of concurrency of risk factors for Noncommunicable Diseases and non-random aggregation of these in Brazilian school adolescents. Method: Descriptive study, with data from the National School Health Survey (Pesquisa Nacional de Saúde do Escolar), 2015. The prevalence of concurrent risk factors was estimated: smoking, alcohol use, physical inactivity and low consumption of fruits and vegetables. Aggregation was verified when the observed-expected prevalence ratio was greater than 1. The analyses were performed in Stata 15.0 software. Results: The proportion of concurrent risk factors was higher for those who had two risk factors (56.1%; 95%CI: 55.5-56.6). The most prevalent risk factors combination was “Low consumption of fruits and vegetables + Physical inactivity” (66%; 95% CI: 65.8-66.9). There was an aggregation of risk factors, and the highest ratio between observed and expected prevalence was: “Smoking + Alcohol” (79.0%; 95%CI: 73.8-84.2). Conclusion and implications for practice: The findings show a high prevalence of concurrent risk factors, with aggregation of these in adolescents. Identifying these risk groups may favor early interventions by minimizing exposure and targeting primary prevention strategies in early exposure to risk factors.

EXERCISE OR PHYSICAL ACTIVITY: WHICH IS MORE STRONGLY ASSOCIATED WITH THE PERCEPTION OF SLEEP QUALITY BY ADOLESCENTS?

OBJECTIVE

To analyze the association of exercises and physical activity with the perception of sleep quality by adolescents.

METHODS

This is a cross-sectional epidemiological survey with statewide coverage, whose sample was composed of 6,261 adolescents (14-19 years old) who were selected by random sampling of conglomerates. The Global School-Based Student Health Survey questionnaire was used for data collection. The chi-square test and the binary logistic regression were applied for data analyses.

RESULTS

In the sample, 29% of adolescents did not exercise and were not classified as physically active. Adolescents who did not exercise were more likely to present a negative perception of sleep quality (OR 1.13, 95%CI 1.04-1.28, p=0.043). No association between the level of physical activity and the perception of sleep quality was found (OR 1.01, 95%CI 0.89-1.14, p=0.868). Those who practiced exercises only had less chance of perceiving sleep quality as poor (OR 0.82, 95%CI 0.71-0.95). However, those who practiced exercise and had a physically active life had less chances of having a negative perception of their sleep (OR 0.79, 95%CI 0.68-0.93).

CONCLUSIONS

Practicing physical activity alone was not enough to increase the chances of positive sleep quality perception. Only physical exercise had a positive association with sleep quality perception.

ASSOCIATION BETWEEN PERCEPTION OF SLEEP QUALITY AND ASSIMILATION OF CONTENT COVERED IN CLASS

Objective:

To analyze the association between self-perception of sleep quality and assimilation of content covered in classes by adolescents.

Methods:

Epidemiological cross-sectional study conducted with 481 high-school students (14 to 19 years), both genders, enrolled in public schools in the city of Caruaru, Pernambuco, and selected by random cluster sampling strategy. Analyses were conducted using the Chi-square test and binary logistic regression.

Results:

44.1% of the adolescents reported learning difficulties during classes, 77.1% slept less than eight hours per day, and 28.9% had a bad perception of their sleep quality. Young people who studied at least one extra hour per day out of school had less difficulty in assimilating class content (OR=0.34; 95%CI 0.19-0.58). We also found that participants who reported a bad perception of sleep quality were more likely to have learning difficulties at school (OR=1.73; 95%CI 1.13-2.65) regardless of gender, age, school shift, study time out of school, and sleeping hours.

Conclusions:

Perception of sleep quality was associated with learning difficulties at school regardless of the number of sleeping and study hours.

Simultaneidade de fatores de risco comportamentais para doença cardiovascular em estudantes universitários

RESUMO: Objetivo: Analisar a prevalência e os fatores associados à simultaneidade de quatro fatores de risco comportamentais - inatividade física, elevado consumo de gorduras, consumo abusivo de álcool e tabagismo - para as doenças cardiovasculares (DCV) em estudantes de graduação da Universidade Federal do Rio Grande, Rio Grande, Rio Grande do Sul, Brasil. Métodos: Estudo de delineamento transversal. Foram analisadas variáveis sociodemográficas, o hábito de tomar café da manhã, a satisfação com a imagem corporal, o índice de massa corporal (IMC) e a autopercepção de saúde. O desfecho foi a simultaneidade de fatores de risco para as DCV. Foi realizada regressão logística ordinal, extraindo as razões de odds com os respectivos intervalos de confiança de 95% (IC95%) e valores p. Resultados: A amostra foi composta por 1.123 estudantes (taxa de resposta de 66,0%); desses, 24,7% apresentavam 2 fatores de risco ou mais. Na análise ajustada, apresentaram associação estatisticamente significativa (p < 0,05) com o desfecho as variáveis escolaridade materna intermediária, não ter o hábito de tomar café da manhã e autopercepção de saúde ruim/regular. Conclusões: Os achados deste estudo indicam uma importante prevalência de estudantes com simultaneidade de dois ou mais fatores de risco. Foi possível traçar quais são os grupos mais susceptíveis a apresentar maior número de fatores, ressaltando a associação com a falta de hábito de tomar café da manhã e a autopercepção de saúde ruim/regular.

Coexistence of risk behaviors for being overweight among Brazilian adolescents

This study aimed to evaluate the magnitude of and the factors associated with the coexistence of risk behaviors for being overweight among Brazilian adolescents. This is a cross-sectional study with a representative sample of adolescents (mostly aged 13-15years) enrolled from public and private schools of Brazil in 2012. The co-occurring sedentary behavior and inadequate food consumption (regular intake of sugary and fried foods, and irregular consumption of fruits and vegetables-FV) was estimated using a Venn diagram. Sociodemographic, familial, and behavioral factors associated with the number of risk behaviors for being overweight were identified using an ordinal logistic regression analysis. Sedentary behavior was observed in 62.0% of adolescents. Regular intake of sugary or fried food was observed in 55.3% and 23.5% of adolescents, respectively, with 51.9% having an inadequate intake of FV. At least one risk behavior was reported in >90.0% of adolescents; 6.1% reported all 4. Being female, having a higher maternal education level, attending private school, not having breakfast or meals with parents regularly, eat watching television, and not practicing weekly leisure time physical activity were associated with an increased chance of having multiple risk behaviors. This study observed a high prevalence of coexisting of risk behaviors, which was associated with sociodemographic, familial, and behavioral factors. These findings may contribute to a clearer understanding of the associations between different behaviors among adolescents, and may be used to improve public health surveillance and to develop strategies that address multiple behaviors, in order to prevent overweight among adolescents.

Urban versus rural lifestyle in adolescents: associations between environment, physical activity levels and sedentary behavior

Objective

To analyze the levels of physical activity and sedentary behavior in adolescents living in urban and rural areas.

Methods

An epidemiological, cross-section study with quantitative design, carried out at the regional level. The sample comprised 6,234 students aged 14 to 19 years, selected using random cluster sampling. The χ2 test and binary logistic regression were used in the analysis.

Results

A total of 74.5% of adolescents lived in urban areas. After adjustment, rural residents spent less time watching television (odds ratio - OR: 0.45; 95% confidence interval - 95%CI: 0.39-0.52), using a computer and/or playing video games (OR: 0.30; 95%CI: 0.22-0.42), or sitting down (OR: 0.66; 95%CI: 0.54-0.80); chose passive leisure less often (OR: 0.83; 95%IC: 0.72-0.95) and were less likely to be classified as insufficiently active (OR: 0.88; 95%IC: 0.78-0.99) when compared to urban residents, regardless of sex or age. The fact that adolescents living in rural areas who did not work were more likely to be classified as insufficiently active (OR: 2.59; 95%CI: 2.07-3.24) emphasized the significant role of occupation in physical activity levels in this group.

Conclusion

Adolescents living in rural areas were less exposed to the sedentary behaviors, chose more active leisure, and had higher levels of physical activity. Place of residence and occupation may play a major role in youth lifestyle.

Objetivo

Analisar os níveis de atividade física e o comportamento sedentário em adolescentes das áreas urbanas e rurais.

Métodos

Estudo epidemiológico, transversal, com abordagem quantitativa e abrangência estadual, cuja amostra foi constituída por 6.234 estudantes (14 a 19 anos), selecionados por meio de uma estratégia de amostragem aleatória de conglomerados. As análises foram realizadas por meio do teste χ2 e da regressão logística binária.

Resultados

Na amostra, 74,5% dos adolescentes eram residentes em área urbana. Após o ajuste, constatou-se que os adolescentes oriundos da área rural usavam menos televisão (odds ratio - OR: 0,45; intervalo de confiança de 95% - IC95%: 0,39-0,52), computador e/ou videogame (OR: 0,30; IC95%: 0,22-0,42), passavam menos tempo sentados (OR: 0,66; IC95%: 0,54-0,80), optaram menos pelo lazer passivo (OR: 0,83; IC95%: 0,72-0,95) e tinham menos chances de serem classificados como insuficientes ativos (OR: 0,88; IC95%: 0,78-0,99), quando comparados àqueles que residiam na área urbana, independentemente do sexo e da idade. Os adolescentes da área rural que não trabalhavam apresentaram mais chances de serem classificados como insuficientemente ativos (OR: 2,59; IC95%: 2,07-3,24), mostrando que a ocupação tinha um papel importante no nível de atividade física deste grupo.

Conclusão

Os adolescentes residentes na área rural estiveram menos expostos aos comportamentos sedentários, optaram mais por um lazer ativo e apresentaram um melhor nível de atividade física, podendo a zona de domicílio e a ocupação influenciar no estilo de vida deles.