Multiple behavioral risk factors for non-communicable diseases among the adolescent population in Brazil: the analysis derived from the Brazilian national survey of school health 2019

Abstract

Background: Health risk behaviors often emerge or intensify during adolescence and tend to co-occur, exposing individuals to an even greater risk for the development of non-communicable diseases (NCDs). The likelihood of exhibiting multiple health risk factors also increases throughout life and is associated with sociodemographic characteristics contributing to their escalation and severity. In this context, the objective of this study was to analyze the association between sociodemographic characteristics and multiple behavioral risk factors for non-communicable diseases among the adolescent population in Brazil.

Methods: This cross-sectional study utilized data from the Brazilian National Survey of School Health 2019. The sample comprised 121,580 adolescents aged 13 to 17. The analyzed variables included irregular intake of fruits and vegetables, regular consumption of soft drinks and treats, insufficient physical activity, sedentary lifestyle, cigarette smoking, and alcohol consumption. To analyze MBRFs, a classification ranging from zero to five was created, and associations were estimated using Odds Ratio (OR) with the respective 95% confidence interval (CI). The Backward method was employed for the multivariate regression model, utilizing ordinal logistic regression.

Results: Adolescents without behavioral risk factors for NCDs constituted only 3.9% (95% CI 3.7-4.1). The most prevalent categories were two and three MBRFs, accounting for 28.3% (95% CI: 27.7-28.8) and 27.0% (95% CI: 26.5-27.5), respectively. Adolescents aged 16 and 17 (ORadj: 1.39; 95% CI: 1.32-1.48), residing in the Brazilian Southeast (ORadj: 1.66; 95% CI: 1.52-1.81), and those reporting poor or very poor self-rated health (ORadj: 2.05; 95% CI: 1.87-2.25) were more likely to exhibit multiple behavioral risk factors. Conversely, male adolescents (adjusted OR: 0.65; 95% CI: 0.62-0.69), those of mixed race (adjusted OR: 0.92; 95% CI: 0.87-0.97), and residents of rural areas (adjusted OR: 0.76; 95% CI: 0.70-0.84) were less likely to manifest MBRFs for NCDs.

Conclusion: The majority of adolescents displayed MBRFs for NCDs, positively associated with age, region, and perceived health status. This underscores the necessity for healthcare promotional interventions throughout the life cycle, as these behaviors may persist into adulthood.

Keywords: Adolescent health; Brazil; Non-communicable diseases; Risk factors.