Consumo de frutas e vegetais associado a outros comportamentos de risco em adolescentes no Nordeste do Brasil

Adolescents who practice physical activity have adequate food choices, regardless of the level of somatic maturation and adiposity

OBJECTIVES

Regular physical activity and adequate food are part of a healthy lifestyle for the maintenance of physical and metabolic health. To verify the moderating role of physical activity (PA) in the relationship between dietary patterns and body adiposity in adolescents, according to somatic maturation.

METHODS

Study with cross-sectional design, sample of 336 adolescents of both sexes, aged between 11 and 17 years. Body mass, height, and waist circumference (WC) were evaluated. Body mass index (BMI), BMI z-score (BMI-z), waist-to-height ratio (WHtR), and somatic maturation by peak height velocity (PHV) were calculated. The level of PA was measured by the International Physical Activity Questionnaire and dietary pattern by the Food Frequency Questionnaire ELSA - Brazil (short version). Moderation analyzes were tested using multiple linear regression models, by PROCESS macro for SPSS.

RESULTS

An inverse interaction of PA was observed in the relationship between food consumption factor 5 (ultra-processed foods category) and WC in boys categorized as pre-pubertal and pubertal PHV (β=-5.344; CI95 % -10.108 -0.580; p=0.028). For girls, no interaction was observed in any of the models analyzed.

CONCLUSIONS

It was observed that the level of PA can influence food choices in prepubertal and pubertal boys, since the active boys showed better dietary pattern and lower central adiposity. Therefore, the findings reinforce the need to encourage the regular practice of physical activities from an early age, mainly aimed at preventing obesity in children and adolescents.

Validation of an instrument for perceived factors affecting fruit and vegetable intake based on Pender's health promotion model

Increasing fruit and vegetable (F&V) intake has a protective role against chronic conditions such as cardiovascular disease, cancer and diabetes. The present study aimed to validate an instrument for measuring the perception of effective factors on consumption behaviour of F&V based on Pender's health promotion model (HPM).This cross-sectional validation survey has consisted of five steps: literature review in order to plan and develop an instrument, face validity assessment, content validity assessment, reliability assessment and construct validity assessment with the cooperation of experts in health education, nutritionists and the target group (government employees). In the present study, reliability and validity of constructs were determined through Cronbach's alpha and exploratory factor analysis, respectively, in SPSS 22. The mean impact score was acceptable for 96·42 % of items in face validity. The mean scores of content validity ratio (CVR), content validity index (CVI) and reliability were 0·92, 0·97 and 0·96, respectively. According to the principal component analysis with varimax rotation, 104 items were identified in 15 factors contributing to 61·17 % of the model cumulative variance. Given the favourable scores of the research instrument in face validity, content validity and reliability as well as its ability to predict the extracted factors from the model, it can be used as a suitable instrument in future studies.

Time spent in different sedentary activity domains across adolescence: a follow-up study

OBJECTIVE

This longitudinal study aimed to verify possible changes in the time spent in sedentary activities occurring as screen-time, educational, cultural, social, and transportation domains in a sample of Brazilian adolescents between 2015 and 2017.

METHODS

It is a longitudinal prospective study with 586 adolescents from 12 to 15 years old at the Baseline (2015) enrolled in 14 public schools from Curitiba, Brazil. The Adolescent Sedentary Activity Questionnaire assessed the time spent in sedentary activities in five domains (recreational screen-time, educational, cultural, social, and transportation). A series of linear random effects regressions analyzed changes in the sedentary time between 2015 and 2017, with p < .05.

RESULTS

Overall, 323 adolescents dropped out of the study resulting in a retention rate of 44.9%. The overall sedentary time remained stable from 2015 to 2017 (-3.98 min/day, 95%CI: -15.39; 7.42). The screen-time decreased (-22.22 min/day, 95%CI: -30.30; -14.15), and educational (8.29 min/day, 95% CI: 3.52; 13.06), cultural (3.41 min/day, 95% CI: 0.66; 6.15) and social sedentary activities (8.20 min/day, 95% CI: 2.06; 14.34) increased from 2015 to 2017.

CONCLUSION

Significant reductions in screen-time were evidenced along with increases in time spent on other sedentary activities of educational, cultural, and social nature. KeywordsSedentary behavior, Adolescent health, Longitudinal studies.

[Factors associated with inflammatory biomarkers in adolescents: analysis by structural equation modeling]

The study aimed to analyze factors associated with inflammatory biomarkers in adolescents. This was a cross-sectional study in 391 adolescents 17-18 years of age in public schools in São Luís, Maranhão State, Brazil. Three-stage random cluster sampling was performed in schools, classes, and students. Food consumption was studied with a food frequency questionnaire, and dietary patterns were extracted by principal components factor analysis. Assessment of factors associated with inflammatory biomarkers used structural equation modeling. Latent variables were constructed: socioeconomic status, which included maternal schooling, family income, and economic class; and inflammation, consisting of interleukin-1β, interleukin-6, and interleukin-8. A theoretical model was developed to assess factors associated with inflammatory biomarkers, indicating direct and indirect effects between the latent and observed variables. Three dietary patterns were identified (Western, basic Brazilian, and healthy), with 31% explained variance and the Western pattern with the largest share. No associations were found between the patterns and the latent variable inflammation (standardized coefficients = 0.281; p = 0.002). Extraction of the three patterns evidenced higher consumption of foods high in carbohydrates and fats, which are nutrients associated directly with the increase in chronic noncommunicable diseases. Excess weight was associated with higher levels of inflammatory biomarkers.

SPORTS PARTICIPATION ASSOCIATED WITH HEALTH RISK BEHAVIORS IN ADOLESCENT ATHLETES

ABSTRACT Introduction Participation in structured sports activities is essential for the health of adolescents, since adolescence is a period in which several physical, psychological, cognitive and social changes occur, where the sense of autonomy in decision-making may prompt them to adhere to certain health risk behaviors. Objective To verify the association of sports participation with health risk behaviors in adolescent athletes. Methods A cross-sectional study with 367 athletes (15.68 ± 0.78 years) from Curitiba/PR (state of Paraná). Associated factors and health risk behaviors (HRB) were assessed using questionnaires. Poisson regression with robust variance was used to analyze factors associated with HRB, adopting p <0.05. Results Team sport was positively associated with longer TV viewing time (PR: 3.11; 95% CI: 1.13-8.58). Years of participation were positively associated with longer TV viewing (PR: 1.14, 95% CI: 1.01-1.29) and video game playing time (PR: 1.12, 95% CI: 1.01-1.25). Negative associations were found for weekly training volume in longer video game playing time (OR: 0.92, 95% CI: 0.86-0.99), low vegetable consumption (PR: 0.98, 95% CI: 0.96-0.99), and in light (PR: 0.95, 95%CI: 0.92-0.99) and excessive (PR: 0.94, 95%CI: 0.89-0.99) alcoholic consumption. Conclusion The weekly training volume favors a reduction in video game playing time, lower alcohol consumption, and increased vegetable consumption in adolescent athletes. Level of Evidence III; Diagnostic studies - Investigation of a diagnostic test; Study of non-consecutive patients, without a “gold standard” applied uniformly.

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.

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.

Socio-Demographic and Diet-Related Factors Associated with Insufficient Fruit and Vegetable Consumption among Adolescent Girls in Rural Communities of Southern Nepal

Sufficient fruit and vegetable (FV) consumption has been associated with reduced risks of chronic diseases and adverse health conditions. However, the determinants of insufficient of FV intake among adolescent girls in Nepal have not been determined. This study was undertaken to identify associations between socio-demographic and diet-related factors with insufficient fruit and vegetable consumption among adolescent girls living in rural communities. This community-based, cross-sectional study was conducted on 407 adolescent girls from rural communities in the Bateshwar rural municipality of Dhanusha district, Southern Nepal between 12 October, 2018 and 14 December, 2018. The study subjects responded to FV consumption and dietary factor-related questionnaires, and anthropometric measurements were taken. Data were analyzed using the univariate logistic regression followed by multivariable logistic regression analyses. Unadjusted and adjusted odds ratios with 95% confidence intervals (CI) are reported. From the 407 study subjects, 359 (88.2%) reported insufficient FV consumption. The factors significantly associated with insufficient FV consumption were education to under the 10th grade, household income in the first tercile, lack of awareness of the importance of FV consumption, the non-availability of FVs at the household level, the low level of dietary diversity, and undernutrition (BMI (body mass index) (<18.5)). The study shows almost 90% of adolescent girls consumed inadequate amounts of FV and that socio-demographic and dietary factors should be taken into account while designing preventive strategies to increase fruit and vegetable consumption to recommended levels.

Prevalence of excessive screen time and TV viewing among Brazilian adolescents: a systematic review and meta-analysis

PURPOSE

To evaluate the prevalence of excessive screen-based behaviors among Brazilian adolescents through a systematic review with meta-analysis.

DATA SOURCE

Systematic review and meta-analysis were recorded in the International Prospective Register of Ongoing Systematic Reviews (PROSPERO-CRD 2017 CRD42017074432). This review included observational studies (cohort or cross-sectional) that evaluated the prevalence of excessive screen time (i.e. combinations involving different screen-based behaviors) or TV viewing (≥2h/day or >2h/day in front of screen) through indirect or direct methods in adolescents aged between 10 and 19 years. The research strategy included the following databases: MEDLINE, LILACS, SciELO and ADOLEC. The search strategy included terms for "screen time", "Brazil", and "prevalence". Random effect models were used to estimate the prevalence of excessive screen time in different categories.

DATA SUMMARY

Twenty-eight out of 775 studies identified in the search met the inclusion criteria. The prevalence of excessive screen time and TV viewing was 70.9% (95% CI: 65.5-76.1) and 58.8% (95% CI: 49.4-68.0), respectively. There was no difference between sexes in both analyses. The majority of studies included showed a low risk of bias.

CONCLUSIONS

The prevalence of excessive screen time and TV viewing was high among Brazilian adolescents. Intervention are needed to reduce the excessive screen time among adolescents.

Dyslipidemia in Adolescents Seen in a University Hospital in the city of Rio de Janeiro/Brazil: Prevalence and Association

BACKGROUND

Early exposure to obesity favors greater risks of cardiovascular factors such as dyslipidemia.

OBJECTIVES

To establish the prevalence of dyslipidemia, and to evaluate its association with nutritional status of the adolescents attended at the ambulatory of the Adolescent Health Studies Center of the University Hospital Pedro Ernesto.

METHODS

This is a cross-sectional, observational study, the sample of which was of convenience, consisting of adolescents from 12 to 18 years old of both genders. The lipid profile was evaluated, along with its association with the anthropometric indicators: body mass index and waist circumference. For statistical analysis, a significance level of 5% was used.

RESULTS

A total of 239 adolescents, 104 boys (43.5%) and 135 girls (56.5%) were evaluated and, of these, 52 (21.8%) were eutrophic, 60 (25.1%) overweight, and 127 (53.1%) obese. Obeseadolescents had significantly lower mean values of HDL-cholesterol (44.7 mg/dl vs 53.9 mg/dl; p < 0.001) and higher triglycerides (109.6 mg/dl vs 87.3 mg/dl; p = 0.01). The changes with higher prevalence were low HDL-cholesterol (50.6%), hypercholesterolemia (35.1%), and hypertriglyceridemia (18.4%). A negative association of HDL-cholesterol with body mass index and a positive association of triglycerides with body mass index could be observed, even after adjustment for gender and skin color.

CONCLUSION

This study demonstrated high prevalence of dyslipidemia among adolescents. In view of the significant association between lower levels of HDL-cholesterol and increased triglycerides with overweight, the control of these factors should receive attention, with the precocious diagnosis of the dyslipidemia being important, mainly if it is associated with another cardiovascular risk, to develop effective intervention strategies.