Clustering patterns of oral and general health-risk behaviours in Brazilian adolescents: Findings from a national survey.

OBJECTIVES: To evaluate how oral and general health-risk behaviours cluster among Brazilian adolescents. METHODS: The study comprised a total of 109 104 adolescents (52.2% female) participating in the Brazilian National School-based Student Health Survey (PeNSE). Seventeen behaviours (including diet; oral and hand hygiene; frequency of dental visits; tobacco, alcohol and drug use; sexual behaviour; physical activity, and risk for external causes) were measured using a self-reported questionnaire. Pairwise correlations between the health-risk behaviours were performed, and clustering was assessed by the hierarchical agglomerative cluster analysis (HACA), which was used to identify stable cluster solutions of the health-risk behaviours. RESULTS: All health-risk behaviours were correlated with at least 1 behaviour (P < .01). HACA indicated 2 broad stable clusters (n = 105 604). The first cluster included current smoking, illegal drug use, no hand washing before meals, unprotected sex, no helmet use, less frequent toothbrushing, no seatbelt use, physical fighting, skipping breakfast, current drinking, high sugar intake and, at the final stage, no dental visits. The second cluster included insufficient physical activity, eating while watching TV or studying, and low fruit intake. CONCLUSIONS: The health-risk behaviours clustered into 2 specific patterns among Brazilian adolescents. One cluster gathered a combination of lack of adherence to preventive behaviours and the undertaking of risky conduct, while the second reflected an unhealthy lifestyle (sedentary habits and low fruit diet). Knowledge about the clustering patterns of oral and general health behaviours in adolescents can better direct the integration of oral and general health promotion interventions.

Análise das recomendaçöes internacionais sobre o consumo de açúcares publicadas entre 1961 a 1991 / An analysis of the recommendations on the consumption of sugars published throughout the world between 1961 and 1991

Realiza levantamento das recomendaçöes nutricionais sobre o consumo de açúcares contidas nas publicaçöes especializadas em todo o mundo, nos últimos 30 anos. Objetiva investigar as recomendaçöes sobre o consumo de açúcares e identificar qual orientaçäo deveria ser dada ao público e autoridades competentes sobre os níveis ideais de açúcares na dieta compatíveis com uma boa saúde. As informaçöes foram obtidas de 116 publicaçöes elaboradas por comitês de especialistas de 37 diferentes países e regiöes do mundo, incluindo principalmente países desenvolvidos, mas também aqueles em desenvolvimento. Os resultados permitiram concluir que a grande maioria (84,5 por cento das publicaçöes analisadas) fazem recomendaçöes sobre o consumo de açúcares extrínsecos ou livres, havendo consenso de que estes açúcares, principalmente a sacarose, devem ser reduzidos da dieta. A recomendaçäo mais freqüente é 10 por cento de calorias a partir dos açúcares extrínsecos como um nível máximo. Tais recomendaçöes säo geralmente dirigidas à toda a populaçäo com a finalidade de manter a saúde geral, mas sobretudo prevenir a cárie dental e a obesidade. Conclui que as recomendaçöes sobre o consumo de açúcares contidas nas publicaçöes editadas nas últimas três décadas säo coerentes com a evidência científica da relaçäo entre os açúcares e as doenças crônicas e, portanto, deveriam ser integradas às políticas de alimentaçäo e saúde