Factors associated with the consumption of ultra-processed food by Brazilian adolescents: National Survey of School Health, 2015 / Fatores associados ao consumo de alimentos ultraprocessados em adolescentes brasileiros: Pesquisa Nacional de Saúde do Escolar, 2015

ABSTRACT Objective: To identify the prevalence and factors associated with the consumption of ultra-processed foods by Brazilian adolescents. Methods: The sample was representative of adolescents and participants in the cross-sectional population-based study National Survey of School Health, 2015 edition (PeNSE-2015). A self-administered questionnaire was used for data collection. The variable weekly consumption of ultra-processed foods was considered, and consumption more than seven times a week was considered excessive. Descriptive and inferential analyses of demographic, socioeconomic, behavioral and environmental characteristics potentially associated with the outcome were performed. Poisson's multiple regression model was adjusted to control for confounding factors. Results: The prevalence of excessive consumption of ultra-processed foods among 16,324 adolescents in Brazil was 75.4%. Nine factors independently associated with this outcome were identified: age under 15 years (RR 1.08; p<0.001), daily sitting time greater than four hours (RR 1.13; p<0.001), eating while watching TV or studying more than four days a week (RR 1.09; p<0.001), daily TV time greater than three hours (RR 1.08; p<0.001), breakfast frequency less than four days a week (RR 1,03; p=0.001), having a cell phone (RR 1.12; p<0.001), absent maternal education (RR 0.88; p<0.001), being enrolled in a private school (RR 1.05; p=0.002) located in the urban area (RR 1.13; p=0.002). Conclusions: The results express the multifactorial characteristic of excessive consumption of ultra-processed foods and suggest the need for the development and implementation of health policies to guide the consumption of these foods and the importance of adopting healthy behaviors for this population group in both school and home environments.

RESUMO Objetivo: Identificar a prevalência e os fatores associados ao consumo de alimentos ultraprocessados em adolescentes brasileiros. Métodos: Estudo transversal de base populacional com adolescentes participantes da Pesquisa Nacional de Saúde do Escolar, 2015 (PeNSE-2015). Um questionário autoaplicável foi utilizado para a coleta de dados, e construiu-se uma variável representativa do consumo de alimentos ultraprocessados, sendo considerado excessivo o consumo superior a sete vezes na semana. Realizou-se análise descritiva e inferencial das características demográficas, socioeconômicas, comportamentais e ambientais potencialmente associadas ao consumo de alimentos ultraprocessados. Um modelo de regressão de Poisson múltiplo foi ajustado para controle do confundimento. Resultados: A prevalência do consumo excessivo de alimentos ultraprocessados nos 16.324 adolescentes estudados no Brasil foi de 75,4%. Identificaram-se nove fatores associados de forma independente a esse desfecho: idade inferior a 15 anos (RR 1,08; p<0,001), tempo diário sentado superior a quatro horas (RR 1,13; p<0,001), comer assistindo à TV ou estudando por mais de quatro dias na semana (RR 1,09; p<0,001), tempo diário de uso de TV superior a três horas (RR 1,08; p<0,001), frequência de desjejum inferior a quatro dias semanais (RR 1,03; p=0,001), possuir telefone celular (RR 1,12; p<0,001), escolaridade materna ausente (RR 0,88; p<0,001), estar matriculado em escola privada (RR 1,05; p=0,002) e localizada em zona urbana (RR 1,13; p=0,002). Conclusões: Os resultados expressam a característica multifatorial do consumo de alimentos ultraprocessados e sugerem a necessidade de elaboração e execução de políticas de saúde para orientar sobre os prejuízos do consumo desses alimentos e a importância da adoção de comportamentos saudáveis para esse grupo populacional no ambiente escolar e familiar.

Factors associated with the consumption of ultra-processed food by Brazilian adolescents: National Survey of School Health, 2015.

OBJECTIVE: To identify the prevalence and factors associated with the consumption of ultra-processed foods by Brazilian adolescents. METHODS: The sample was representative of adolescents and participants in the cross-sectional population-based study National Survey of School Health, 2015 edition (PeNSE-2015). A self-administered questionnaire was used for data collection. The variable weekly consumption of ultra-processed foods was considered, and consumption more than seven times a week was considered excessive. Descriptive and inferential analyses of demographic, socioeconomic, behavioral and environmental characteristics potentially associated with the outcome were performed. Poisson's multiple regression model was adjusted to control for confounding factors. RESULTS: The prevalence of excessive consumption of ultra-processed foods among 16,324 adolescents in Brazil was 75.4%. Nine factors independently associated with this outcome were identified: age under 15 years (RR 1.08; p<0.001), daily sitting time greater than four hours (RR 1.13; p<0.001), eating while watching TV or studying more than four days a week (RR 1.09; p<0.001), daily TV time greater than three hours (RR 1.08; p<0.001), breakfast frequency less than four days a week (RR 1,03; p=0.001), having a cell phone (RR 1.12; p<0.001), absent maternal education (RR 0.88; p<0.001), being enrolled in a private school (RR 1.05; p=0.002) located in the urban area (RR 1.13; p=0.002). CONCLUSIONS: The results express the multifactorial characteristic of excessive consumption of ultra-processed foods and suggest the need for the development and implementation of health policies to guide the consumption of these foods and the importance of adopting healthy behaviors for this population group in both school and home environments.

FACTORS ASSOCIATED WITH INADEQUATE MILK CONSUMPTION AMONG ADOLESCENTS: NATIONAL SCHOOL HEALTH SURVEY - PENSE 2012.

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.

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.

Factors associated with asthma in brazilian adolescents: national adolescent school-based health survey (pense-2012) / Fatores associados à asma em adolescentes brasileiros: pesquisa nacional de saúde do escolar (pense), 2012

ABSTRACT Objective: To identify factors associated with asthma in Brazilian adolescents. Methods: Cross-sectional study based on data from the 2012 National Adolescent School-based Health Survey (PeNSE), a Brazilian survey applied by a self-reported questionnaire in a representative sample of 9th-grade students. Descriptive and inferential analysis was made based on the demographic, socioeconomic, clinical, food consumption and environmental characteristics potentially associated with asthma. Adolescents who presented wheezing in the last 12 months were considered asthmatic. A multiple logistic regression model was adjusted for confounding factors. Significance was defined as p≤0.05. Results: A total of 106,983 adolescents were studied. The prevalence of asthma was 23.2%. The final model was composed of 11 variables that were independently associated with asthma: female sex (OR=1.17), <14 years old (OR=1.12), not living with parents (OR=1.06), the highest number of days consuming ultra-processed foods (OR=1.16), lunch or dinner time without presence of parents or guardians (OR=1.13), meals in front of the TV or while studying (OR=1.18), not having breakfast frequently (OR=1.22), having smoked cigarettes (OR=1.36), having tried alcoholic beverage (OR=1.37), having used illicit drugs (OR=1.29) and having sought health care in the last year (OR=1.67). Conclusions: The results of the present study reinforce the multifactorial characteristic of asthma diagnosis. Prevention and control strategies should focus on groups of adolescents living in inadequate conditions when it comes to family dynamics, food consumption and behavior (drug use).

RESUMO Objetivo: Identificar fatores associados à asma em adolescentes brasileiros. Métodos: Estudo transversal baseado em dados da Pesquisa Nacional de Saúde do Escolar (PeNSE-2012), que foi um inquérito brasileiro realizado por meio de questionário autoaplicável em amostra representativa de alunos do 9º ano do ensino fundamental. Foi realizada análise descritiva e inferencial das características demográficas, socioeconômicas, clínicas, alimentares e ambientais potencialmente ligadas à asma. Foram considerados com asma os adolescentes que apresentaram chiado no peito nos últimos 12 meses. Um modelo logístico múltiplo foi ajustado para controle do confundimento. O valor p≤0,05 foi eleito para determinar associação estatisticamente significante. Resultados: Foram estudados 106.983 adolescentes. A prevalência de asma foi de 23,2%. O modelo final foi composto de 11 variáveis, que se associaram à asma de forma independente e estatisticamente significante (p<0,001): sexo feminino (OR=1,17), idade inferior a 14 anos (OR=1,12), não morar com os pais (OR=1,06), o maior número de dias de consumo de alimentos ultraprocessados (OR=1,16), almoçar ou jantar sem a presença dos pais ou responsáveis (OR=1,13), realizar as refeições em frente à TV ou estudando (OR=1,18), não tomar café da manhã com frequência (OR=1,22), ter fumado cigarro (OR=1,36), ter experimentado bebida alcoólica (OR=1,37), ter usado droga ilícita (OR=1,29) e ter procurado serviço de saúde no último ano (OR=1,67). Conclusões: Os resultados do presente estudo reforçam a característica multifatorial de determinação da asma. Estratégias de prevenção e controle devem focar grupos de adolescentes que vivem em condições inadequadas do ponto de vista familiar, alimentar e comportamental (uso de drogas).

FACTORS ASSOCIATED WITH ASTHMA IN BRAZILIAN ADOLESCENTS: NATIONAL ADOLESCENT SCHOOL-BASED HEALTH SURVEY (PENSE-2012).

OBJECTIVE: To identify factors associated with asthma in Brazilian adolescents. METHODS: Cross-sectional study based on data from the 2012 National Adolescent School-based Health Survey (PeNSE), a Brazilian survey applied by a self-reported questionnaire in a representative sample of 9th-grade students. Descriptive and inferential analysis was made based on the demographic, socioeconomic, clinical, food consumption and environmental characteristics potentially associated with asthma. Adolescents who presented wheezing in the last 12 months were considered asthmatic. A multiple logistic regression model was adjusted for confounding factors. Significance was defined as p≤0.05. RESULTS: A total of 106,983 adolescents were studied. The prevalence of asthma was 23.2%. The final model was composed of 11 variables that were independently associated with asthma: female sex (OR=1.17), <14 years old (OR=1.12), not living with parents (OR=1.06), the highest number of days consuming ultra-processed foods (OR=1.16), lunch or dinner time without presence of parents or guardians (OR=1.13), meals in front of the TV or while studying (OR=1.18), not having breakfast frequently (OR=1.22), having smoked cigarettes (OR=1.36), having tried alcoholic beverage (OR=1.37), having used illicit drugs (OR=1.29) and having sought health care in the last year (OR=1.67). CONCLUSIONS: The results of the present study reinforce the multifactorial characteristic of asthma diagnosis. Prevention and control strategies should focus on groups of adolescents living in inadequate conditions when it comes to family dynamics, food consumption and behavior (drug use).