Co-occurrence and clustering of the four major non-communicable disease risk factors in Brazilian adolescents: Analysis of a national school-based survey

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorRICARDO, Camila Zancheta
dc.contributor.authorAZEREDO, Catarina Machado
dc.contributor.authorREZENDE, Leandro Fornias Machado de
dc.contributor.authorLEVY, Renata Bertazzi
dc.date.accessioned2019-11-06T18:57:45Z
dc.date.available2019-11-06T18:57:45Z
dc.date.issued2019
dc.description.abstractBackground The major non-communicable chronic diseases (NCD) are associated with a small group of modifiable lifestyle-related risk factors, including smoking, insufficient physical activity, unhealthy eating, and alcohol abuse. In this study, we evaluated the co-occurrence and clustering of the major NCD risk factors among Brazilian adolescents. Methods This cross-sectional study analyzed data of 101,607 adolescents from the Brazilian National Survey of School Health (PeNSE) 2015. The risk factors included were: regular consumption of ultra-processed foods, irregular consumption of fruits and vegetables, insufficient physical activity, smoking, and alcohol consumption. Clustering was defined through the ratio between observed and expected prevalences of combination of risk factors greater than 1. Expected prevalence of the co-occurrence of risk factors was calculated from the joint probability of the behaviors. Additionally, we examined the presence of at least four risk factors according to socioeconomic characteristics. Results Of the 32 combinations of risk factors, 13 corresponded to clustering. We observed a strong correlation between alcohol consumption and smoking, which were found together in 8 of the 13 clusters identified. The most frequent combinations of risk factors involved unhealthy eating and insufficient physical activity. Only 2.9% of the adolescents did not present any risk behaviors, while 38.0%, 32.9%, 9.4% and 1.8% accumulated two, three, four and five risk factors, respectively. The accumulation of risk factors was higher in girls, older adolescents, those who did not live with both parents, children of less-educated mothers, students attending public school, and residents of cities in more developed urban areas of the country. Conclusions The main risk factors for NCD are frequent and not randomly distributed among Brazilian adolescents. Our results provide information for policymakers to target specific groups and joint behavioral risk factors for health improvement in adolescents.eng
dc.description.indexMEDLINEeng
dc.description.sponsorshipCoordination for the Improvement of Higher Education Personnel (CAPES)CAPES
dc.description.sponsorshipSao Paulo Research Foundation (FAPESP)Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP) [2014/26711-3]
dc.identifier.citationPLOS ONE, v.14, n.7, article ID e0219370, 13p, 2019
dc.identifier.doi10.1371/journal.pone.0219370
dc.identifier.issn1932-6203
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/34221
dc.language.isoeng
dc.publisherPUBLIC LIBRARY SCIENCEeng
dc.relation.ispartofPlos One
dc.rightsopenAccesseng
dc.rights.holderCopyright PUBLIC LIBRARY SCIENCEeng
dc.subject.otherultra-processed foodseng
dc.subject.otherrio-de-janeiroeng
dc.subject.otherphysical-activityeng
dc.subject.otherhealth-surveyeng
dc.subject.otherunhealthy behaviorseng
dc.subject.otherconsumptioneng
dc.subject.otheralcoholeng
dc.subject.otherindicatorseng
dc.subject.othermortalityeng
dc.subject.otherpatternseng
dc.subject.wosMultidisciplinary Scienceseng
dc.titleCo-occurrence and clustering of the four major non-communicable disease risk factors in Brazilian adolescents: Analysis of a national school-based surveyeng
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.author.externalAZEREDO, Catarina Machado:Univ Fed Uberlandia, Fac Med, Uberlandia, MG, Brazil
hcfmusp.citation.scopus27
hcfmusp.contributor.author-fmusphcCAMILA ZANCHETA RICARDO
hcfmusp.contributor.author-fmusphcLEANDRO FORNIAS MACHADO DE REZENDE
hcfmusp.contributor.author-fmusphcRENATA BERTAZZI LEVY
hcfmusp.description.articlenumbere0219370
hcfmusp.description.issue7
hcfmusp.description.volume14
hcfmusp.origemWOS
hcfmusp.origem.pubmed31269084
hcfmusp.origem.scopus2-s2.0-85069269173
hcfmusp.origem.wosWOS:000484927300062
hcfmusp.publisher.citySAN FRANCISCOeng
hcfmusp.publisher.countryUSAeng
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