Noncommunicable Diseases among School-going Adolescents: A Case Study on Prevalence of Risk Factors from Sabarkantha District of Gujarat, India

Prevalence and determinants of behavioral risk factors for noncommunicable diseases among students aged 13-19 years in Turkey

OBJECTIVE

The aim of this study was to investigate the prevalence and determinants of behavioral risk factors for noncommunicable diseases (NCDs) among students aged 13-19 years in Turkey.

METHODS

This cross-sectional study included a total of 1218 high-school students (mean age = 15.97 years; 57.6 % females) in Turkey. A facilitated survey in the form of a questionnaire was used to gather data. Questions from the Global School-Based Student Health Survey were adapted for the study, and the responses were analyzed using IBM SPSS Statistics 28. Binary logistic regression and Poisson regression were applied to identify the contributing factors.

RESULTS

The prevalence of inadequate fruit and vegetable consumption was 85.5 %, sedentary leisure behavior 80.9 %, physical inactivity 65.3 %, carbonated soft drink consumption 60.4 %, overweight or obesity 38.1 %, current tobacco use 23.1 %, and current alcohol use 14.5 %. The adjusted Poisson regression analysis showed that the odds for having behavioral risk factors were increased by being male, being in grade 11, and attending physical education classes, whereas the odds were reduced by having multiple psychological distress issues, regularly attending school, and having moderate or high parental support.

CONCLUSION

The prevalence of clustering of modifiable risk factors for NCDs was high among students aged 13-19 years in Turkey, and there is a need to mount effective interventions. Risk factors for these diseases are often preventable: Appropriate health interventions before, during, and after pregnancy as well as throughout childhood and adolescence can significantly reduce their prevalence.

Lifestyle practices predisposing adolescents to non communicable diseases in Delhi

Background

Globally the prevalence of non- communicable diseases is on a rise. Adolescents are vulnerable to such diseases later on in life because of the susceptibility to behavioural risk factors like insufficient physical activity, unhealthy dietary practices and tobacco and alcohol consumption during this transition stage of their life. Adolescents who are from low-income families are also at increased risk of dual states of malnutrition such as underweight and obesity. So, this study aimed to estimate the prevalence of such behavioural risk factors among adolescents of low-income urban areas of Delhi.

Methodology

A cross-sectional study was conducted among 264 adolescents (10-19 years) of low-income Urban areas of Delhi.

Results

A total of 122 (46.2%) boys and 142 (53.8%) girls were enrolled in the study. The mean age of adolescents were 14.2 ± 2.4 years. The most prevalent NCD risk factor was physical inactivity (98.1% [96.4-99.7])). The screen time for television was significantly higher among boys than girls (p value 0.022). An age stratified analysis of risk factors showed that the intake of carbonated drinks (p value 0.026) and social media utilisation time (p value 0.037) was significantly higher among late adolescent boys (≥15 years) compared to early adolescents.

Conclusion

There is high prevalence of physical inactivity and unhealthy dietary behaviours among adolescents which could be a warning sign for prompt actions as they are at risk of NCD in future. Hence healthier practices should be promoted among adolescents at community level.

Co-occurrence of non-communicable disease risk factors and its determinants among school-going adolescents of Kathmandu Metropolitan City

Background

Adolescence is a critical transition in human growth and adolescents tend to engage in various risky behaviors which are likely to continue into adulthood. Co-occurrence of non-communicable disease risk factors has the potential to increase risks of chronic disease comorbidity and increased mortality in later life. Behavioral risk factors are adopted due to changes in lifestyle and adolescents are more prone to acquire them. This study aimed to determine the prevalence and associated factors of co-occurrence of non-communicable disease risk factors among school-going adolescents of Kathmandu Metropolitan City.

Methods

We conducted a cross-sectional study among school-going adolescents of Kathmandu Metropolitan City in January/February 2020. We used stratified random sampling to select 1108 adolescents studying in 9, 10, 11, and 12 grades. We used Global Schools Health Survey tools to collect data. We entered data in EpiData 3.1 and exported it into Statistical Package for Social Science (SPSS) version 20 for statistical analysis. We estimated prevalence of NCDs risk factors and co-occurrence of risk factors. We applied multivariate multinomial logistic regression analysis adjusting for age, gender, ethnicity, religion, education, type of school, and parental education to determine factors associated with co-occurrence of NCDs risk factors.

Results

The prevalence of physical inactivity, unhealthy diet, harmful use of alcohol and tobacco among school-going adolescents were 72.3% (95%CI: 69.6–74.9), 41.1% (95%CI: 38.2–44.0), 14.8% (95%CI: 12.8–17.0) and 7.8% (95%CI:6.3–9.5) respectively. The adolescent with co-occurrence of two or more risk factors was 40.7% (95%CI: 37.8–43.7). The school-going adolescents who were in higher age group (AOR = 1.72, 95% CI- 1.06, 2.77), Hindus (AOR = 1.78, 95% CI-1.09, 2.89), other than Brahmin/Chhetri by ethnicity (AOR = 2.11, 95% CI-1.39, 2.22) and with lower education level of mothers (AOR = 2.40, 95% CI- 1.46,3.98) were more likely to have co-occurrence of NCDs risk factors after adjusting for all socio-demographic variables.

Conclusion

The co-occurrence of non-communicable disease risk factors was high among school going adolescents and was associated with age, religion, ethnicity and mother’s education. Integrated and comprehensive interventional programs should be developed by concerned authorities.

Why The Knowledge of Indian School-Going Adolescents Regarding NCDs is Not Transforming into Lifestyle Changes?

Background

There is a paucity of research to demonstrate the quantification of adolescents' risk behavior toward Non-Communicable Diseases (NCD) in India. This study aims to explain the knowledge of school-aged adolescents about NCD and whether their knowledge is truly translating into lifestyle changes and if not, what are the potential underlying factors responsible for that.

Methodology

A school-based cross-sectional study was conducted on adolescents in Jodhpur district, India, in grades 6 to 12. The data was gathered via a semi-structured questionnaire. The participant's weight and height were assessed using a digital weighing machine and a stadiometer, respectively. SPSS v.23 was used to analyze the data. Univariate (chi-square) and multivariate (logistic regression) analysis were used to quantify knowledge and risk factors, and inferences were derived.

Results

A total of 1010 students participated in the study. The mean scores of knowledge and risk behavior were 32.82±6.43 (out of 40) and 9.23+2.63 (out of 30), respectively. Adolescent risk behavior and knowledge were not found to be significantly related. Physical activity, spending fewer hours sitting, not skipping breakfast, and habit of fruit and vegetable consumption were significant factors for a healthy lifestyle among them.

Conclusion

Due to differences in underlying predictors, adolescents' understanding of NCDs did not translate into healthy lifestyle modifications. These findings highlight the importance of developing tailored interventions for adolescents that target identified risk domains.

Socioeconomic, intrapersonal and food environmental correlates of unhealthy snack consumption in school-going adolescents in Mumbai

Background

Unhealthy snacking habits in adolescents are typically triggered by obesogenic food environments and possibly perpetuated through interactions between socio-environmental factors and personal perceptions, attitudes, and motivations to change eating behaviors. This study attempted to address the knowledge gap regarding the association of intrapersonal, socioeconomic, and food environmental characteristics with unhealthy snack consumption in Indian adolescents, presenting several targets for effective interventions.

Methods

A representative sample of 10–12 years old adolescents (n 712) completed a cross-sectional survey including eating habits, characteristics of school and home food environments, and perceptions related to affordability, convenience, and barriers within the food environments. The frequency of unhealthy snack consumption was assessed using a validated qualitative food frequency questionnaire. Multivariate regression analyses determined the associated factors of unhealthy snack consumption in adolescents attending private and public schools.

Results

The mean age of adolescents was 10.9 (1.1) years, 48.2% were girls and 53.9% attended private schools. The most frequently consumed unhealthy snacks were biscuits/ cookies (5.2d/wk) followed by wafers (3.4d/wk) and Indian fried snacks- samosa/ vada pav (2.8 d/wk). Among the public-school adolescents, the odds of unhealthy snack consumption were 0.89 times lower when meals were had frequently at the dinner table and 4.97 times higher when the perceived barriers related to the affordability of healthy snacks were greater. Maternal education (OR 0.78, 95% CI 0.66–0.82, p < 0.001), family income (OR 2.15, 95% CI 1.98–2.32, p < 0.001), availability of unhealthy snacks (OR 2.98, 95% CI 1.36–3.46, p < 0.001) and fruits (OR 0.57, 95% CI 0.49–0.69, p < 0.001) at home, having evening meals together (OR 0.71, 95% CI 0.63–0.81, p 0.031), and perceived parental control during mealtimes (OR 0.67, 95% CI 0.62–0.72, p < 0.001) were associated with unhealthy snack consumption in adolescents attending private schools.

Conclusions

The results highlighted a pervasiveness of unhealthy snacks in adolescents’ food environments. Improving provisions and affordability of fruits and healthy snacks at schools, encouraging family mealtimes, and limiting the availability of unhealthy snacks at home whilst addressing the perceived barriers within food environments, and inculcating self-efficacy skills can improve snacking habits in Indian adolescents, irrespective of socioeconomic backgrounds.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13449-6.

Knowledge, attitude, and behaviours on diet, physical activity, and tobacco use among school students: A cross-sectional study in two Indian states

Background: Non-communicable diseases (NCDs) are escalating in India and can be attributed to behavioural risk factors such as unhealthy diet, physical inactivity and tobacco use that began in early years. Understanding adolescents' knowledge, attitudes and behaviours (KAB) related to NCD risk factors would inform the development of school-based health programmes to prevent NCDs. Methods: Sixth-grade students (n=1026) in 20 schools (10 private, 10 public) from two Indian cities (n=667 from Pune; n=359 from Bengaluru) participated in a KAB survey in 2019. Differences in KAB by gender, school type within cities were investigated. Results: Knowledge about the harms of tobacco use was higher than knowledge about a healthy diet and importance of physical activity. Only a small proportion of students did not eat breakfast (8.7%) or fruits (11.3%) daily. Only 33.4% of students read nutrition labels before choosing their food. Moderate-to-vigorous physical activity of less than an hour per day was reported by 42.5% of students. Approximately one-third of students had ever tried smoking tobacco (30.1%), smokeless tobacco (30.5%), and e-cigarettes (32.4%). Differences in these behaviours by gender and school type showed that both boys, girls and students of private and public schools are vulnerable. Conclusions: The study findings highlight that knowledge is low for thematic areas like diet and physical activity. While knowledge of tobacco related harms is better but the prevalence of ever tobacco use was found to be high. Socio-demographic factors such as school type and gender had a varying effect on various KAB indicators. There is a need to strengthen health education activities by developing context-specific health intervention materials by engaging school children, their parents, teachers, and communities to promote healthy behaviours among adolescents. Need to augment school health programmes in India with a differential approach based on the issues, specific to school type and city.

Knowledge, attitude, and behaviours on diet, physical activity, and tobacco use among school students: A cross-sectional study in two Indian states

Background: Non-communicable diseases (NCDs) are escalating in India and can be attributed to behavioural risk factors such as unhealthy diet, physical inactivity and tobacco use that began in early years. Understanding adolescents' knowledge, attitudes and behaviours (KAB) related to NCD risk factors would inform the development of school-based health programmes to prevent NCDs. Methods: Sixth-grade students (n=1026) in 20 schools (10 private, 10 public) from two Indian cities (n=667 from Pune; n=359 from Bengaluru) participated in a KAB survey in 2019. Differences in KAB by gender, school type within cities were investigated. Results: Knowledge about the harms of tobacco use was higher than knowledge about a healthy diet and the importance of physical activity. Only a small proportion of students did not eat breakfast (8.7%) or fruits (11.3%) daily. Only 33.4% of students read nutrition labels before choosing their food. Moderate-to-vigorous physical activity of less than an hour per day was reported by 42.5% of students. Approximately one-third of students had ever tried smoking tobacco (30.1%), smokeless tobacco (30.5%), and e-cigarettes (32.4%). Differences in these behaviours by gender and school type showed that both boys, girls and students of private and public schools are vulnerable. Conclusions: The findings highlight that knowledge is low for thematic areas like diet and physical activity. Low knowledge can be attributed to unfavourable behaviours like lack of reading nutrition labels and indulgence in sedentary activities. To protect India's young population (adolescents), there is a need to amplify health education activities and context-specific health intervention materials for them by engaging parents and communities. Thus, these programmes should be incorporated into the curriculum as part of the regular teaching, as they may induce positive changes in their knowledge and behaviours. In India, school health programmes should dedicate significant time to health promotion and NCD risk prevention.