Socio-demographic association of non communicable diseases' risk factors in a representative population of school children: a cross-sectional study in Sousse (Tunisia)

Socio-demographic correlates of unhealthy lifestyle in Ethiopia: a secondary analysis of a national survey

BACKGROUND

Multiple lifestyle risk factors exhibit a stronger association with non-communicable diseases (NCDs) compared to a single factor, emphasizing the necessity of considering them collectively. By integrating these major lifestyle risk factors, we can identify individuals with an overall unhealthy lifestyle, which facilitates the provision of targeted interventions for those at significant risk of NCDs. The aim of this study was to evaluate the socio-demographic correlates of unhealthy lifestyles among adolescents and adults in Ethiopia.

METHODS

A national cross-sectional survey, based on the World Health Organization's NCD STEPS instruments, was conducted in Ethiopia. The survey, carried out in 2015, involved a total of 9,800 participants aged between 15 and 69 years. Lifestyle health scores, ranging from 0 (most healthy) to 5 (most unhealthy), were derived considering factors such as daily fruit and vegetable consumption, smoking status, prevalence of overweight/obesity, alcohol intake, and levels of physical activity. An unhealthy lifestyle was defined as the co-occurrence of three or more unhealthy behaviors. To determine the association of socio-demographic factors with unhealthy lifestyles, multivariable logistic regression models were utilized, adjusting for metabolic factors, specifically diabetes and high blood pressure.

RESULTS

Approximately one in eight participants (16.7%) exhibited three or more unhealthy lifestyle behaviors, which included low fruit/vegetable consumption (98.2%), tobacco use (5.4%), excessive alcohol intake (15%), inadequate physical activity (66%), and obesity (2.3%). Factors such as male sex, urban residency, older age, being married or in a common-law relationship, and a higher income were associated with these unhealthy lifestyles. On the other hand, a higher educational status was associated with lower odds of these behaviors.

CONCLUSION

In our analysis, we observed a higher prevalence of concurrent unhealthy lifestyles. Socio-demographic characteristics, such as sex, age, marital status, residence, income, and education, were found to correlate with individuals' lifestyles. Consequently, tailored interventions are imperative to mitigate the burden of unhealthy lifestyles in Ethiopia.

Temporal trend of simultaneous risk factors for chronic non-communicable diseases: National School Health Survey 2009, 2012, 2015

OBJECTIVE

To analyze the temporal trend of simultaneous occurrence of behavioral risk factors for chronic non-communicable diseases in Brazilian school adolescents.

METHODS

Ecological time-series study that analyzed data from the three editions of the National Survey of School Health with students in the 9th year of public and private schools. Cluster analysis was performed to identify the simultaneity of the following factors: irregular consumption of fresh or minimally processed foods, regular consumption of processed and ultra-processed foods, insufficient level of physical activity during leisure time, consumption of alcoholic beverages, use of cigarettes and illicit drugs. The cluster trend was tested using simple linear regression.

RESULTS

The sample was composed of 173,310 school adolescents. Sixty-four possible combinations were evaluated, resulting in the formation of six clusters. The grouping formed by all factors showed the highest ratios observed/expected prevalence in the last two years of the series. The highest ratios were observed for combinations in which alcohol and cigarettes were present. These substances integrated five of the six clusters. One of the groups (insufficient level of physical activity during leisure time + consumption of alcoholic beverages + use of cigarettes and illicit drugs) had an upward trend throughout the series.

CONCLUSION

The trend analysis showed four out of six clusters remaining stable throughout the series, which shows that the factors are persistently present among school adolescents.

Tendência temporal dos fatores de risco simultâneos para doenças crônicas não transmissíveis: Pesquisa Nacional de Saúde do Escolar 2009, 2012, 2015

RESUMO: Objetivo: Analisar a tendência temporal da ocorrência simultânea de fatores de risco comportamentais para doenças crônicas não transmissíveis em adolescentes escolares brasileiros. Métodos: Estudo ecológico de série temporal, que analisou os dados das três edições da Pesquisa Nacional de Saúde do Escolar dos alunos do 9º ano de escolas públicas e privadas. Realizou-se a análise de cluster para a identificação da simultaneidade dos seguintes fatores: consumo irregular de alimentos in natura ou minimamente processados, consumo regular de alimentos processados e ultraprocessados, nível insuficiente de atividade física no lazer, consumo de bebidas alcoólicas, uso de cigarro e de drogas ilícitas. A tendência dos clusters foi testada utilizando-se regressão linear simples. Resultados: A amostra constituiu-se de 173.310 escolares. Sessenta e quatro possíveis combinações foram avaliadas, havendo a formação de seis clusters. O agrupamento formado por todos os fatores apresentou as maiores razões entre prevalências observadas e esperadas para os dois últimos anos da série. As maiores razões foram verificadas para as combinações em que estavam presentes o álcool e o cigarro. Além disso, essas substâncias integraram cinco dos seis clusters. Um dos agrupamentos (nível insuficiente de atividade física no lazer + consumo de bebidas alcóolicas + uso de cigarro e drogas ilícitas) apresentou tendência crescente durante toda a série. Conclusão: A análise de tendência constatou que quatro de seis clusters mantiveram-se estáveis durante toda a série, demonstrando que os fatores continuam presentes de forma persistente entre os adolescentes escolares.

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

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.