Factors associated with inadequate milk consumption among adolescents: national school health survey - pense 2012 / Fatores associados ao consumo inadequado de leite em adolescentes: pesquisa nacional de saúde do escolar - pense 2012

ABSTRACT Objective: To identify the prevalence and factors associated with inadequate milk consumption among adolescents. Methods: This was a cross-sectional study based on secondary data from the National School Health Survey (2012), a Brazilian survey carried out using a self-administered questionnaire in a representative sample of 9th-grade students from public and private schools. The frequency of milk intake and its association with socio-demographic characteristics, food consumption and physical activity were estimated. A descriptive and inferential analysis of factors associated with inadequate milk consumption (no consumption at least one of the seven days of the week) was performed. A multiple logistic model was adjusted to control confounders. Results: The sample included 108,828 adolescents and inadequate milk consumption ocurred in 58.9%. The final model included nine variables independently associated with inadequate milk intake: breakfast frequency less than 4 days per week (odds ratio [OR]=2.40; p<0.001), unprocessed or minimally processed foods intake less than 5 days per week (OR=1.93; p<0.001), living in the northeast region (OR=1.39; p<0.001), less maternal schooling (OR=1.35; p<0.001), physical inactivity (OR=1.33; p<0.001), attending public school (OR=1.26; p<0.001), not being white (OR=1.14; p<0.001), being older than 14 years old (OR=1.13; p<0.001) and having a habit of eating meals while watching TV or studying (OR=1.04; p=0.036). Conclusions: Inadequate milk consumption is prevalent among Brazilian adolescents. The identification of associated factors suggests the need to develop nutritional guidance strategies for the prevention of diseases that result from low calcium intake.

RESUMO Objetivo: Identificar a prevalência e os fatores associados ao consumo inadequado de leite em adolescentes. Métodos: Estudo transversal com base em dados secundários da Pesquisa Nacional de Saúde do Escolar (PeNSE; 2012), inquérito brasileiro realizado por meio de questionário autoaplicável em amostra representativa de alunos do nono ano do ensino fundamental de escolas públicas e privadas. Estimou-se a frequência da ingestão de leite e sua associação com características sociodemográficas, consumo alimentar e prática de atividade física. Foi realizada análise descritiva e inferencial dos fatores associados ao consumo inadequado de leite (ausência em pelo menos um dos sete dias da semana). Um modelo logístico múltiplo foi ajustado para controle das variáveis de confusão. Resultados: A amostra incluiu 108.828 adolescentes e o consumo inadequado de leite foi de 58,9%. O modelo final incluiu 9 variáveis independentemente associadas à ingestão inadequada de leite: frequência de desjejum inferior a 4 dias semanais (odds ratio [OR]=2,40; p<0,001), consumo de alimentos in natura e minimamente processados inferior a 5 dias semanais (OR=1,93; p<0,001), residir na Região Nordeste (OR=1,39; p<0,001), menor escolaridade materna (OR=1,35; p<0,001), inatividade física (OR=1,33; p<0,001), frequentar escola pública (OR=1,26; p<0,001), não ser da raça branca (OR=1,14; p<0,001), ter idade superior a 14 anos (OR=1,13; p<0,001) e possuir o hábito de realizar as refeições assistindo à TV ou estudando (OR=1,04; p=0,036). Conclusões: O consumo inadequado de leite é frequente entre adolescentes brasileiros. A identificação de fatores associados sugere a necessidade do desenvolvimento de estratégias de orientação nutricional para a prevenção de doenças resultantes da baixa ingestão de cálcio.

Pobreza y procedencia indígena como factores de riesgo de problemas nutricionales de los niños que ingresan a la escuela / Poverty and indigenous origin as risk factors of nutritional problems among children who enroll in school

OBJETIVO:Determinar el efecto de ser indígena y de la pobreza, en los problemas nutricionales de escolares chilenos. MATERIAL Y MÉTODOS:Se usaron bases de datos de niños que ingresaron a la escuela (1997-2004) que tenían información antropométrica, socioeconómica y origen étnico. Se construyeron modelos de regresión logística para talla baja y obesidad controlando el efecto de la pobreza y la etnia por sexo, edad y año de análisis. RESULTADOS:Se estudió a 1580103 niños: indígenas (7.4%), con talla baja (2.9%) y obesidad (16%). Al estratificar por etnia, los más pobres tuvieron mayor riesgo de talla baja: en indígenas RM: 2.30 (IC95%: 2.27-2.33) y no indígenas RM: 2.29 (IC95%: 2.28-2.30). A la inversa, los escolares más pobres tuvieron menos riesgo de ser obesos (RM: 0.63; IC95%: 0.62-0.64). Ser indígena proporcionó 6% más posibilidad de presentar obesidad, comparado con no ser indígena (RM: 1.06; IC95%: 1.05-1.08). CONCLUSIÓN:. En niños chilenos, la pobreza es factor de riesgo de talla baja pero protector de obesidad independiente de la etnia. El mayor riesgo de obesidad en los escolares indígenas, si bien es pequeño, debe ser una voz de alerta para prevenir en ellos el aumento de las cifras.

OBJECTIVE:To estimate the effect of indigenous ancestry and poverty on nutritional outcomes in Chilean schoolchildren. MATERIAL AND METHODS:We used the national database of children entering to the public educational system in 1997-2004. This includes anthropometric assessment, socioeconomic status and parental surnames, used to derive the ethnic origin. Logistic regression models related poverty and ethnicity on stunting and obesity were done, controlling for sex, age and calendar year. RESULTS:Data convey 1580103 children being 7.4% indigenous; 2.9% had stunting and around 16.0% were obese. Stratifying by poverty, it was shown that the poorest had higher risk of stunting both in indigenous (OR= 2.30; CI95%=2.27-2.33) and non indigenous (OR= 2.29; CI95%= 2.28-2.30). Conversely, poverty was a "protective factor" for obesity (OR= 0.63; CI95%= 0.62-0.64). Indigenous origin showed a significant OR slightly over the null. CONCLUSIONS:In Chilean children, poverty is a risk factor for stunting but still protects from obesity, independent of indigenous origin.