title: Clustering of Risk Factors for Non-Communicable Diseases among Adolescents from Southern Brazil.
abstract: BACKGROUND
  The aim of this study was to investigate the simultaneous presence of risk factors for non-communicable diseases and the association of these risk factors with demographic and economic factors among adolescents from southern Brazil.
  
  
  METHODS
  The study included 916 students (14-19 years old) enrolled in the 2014 school year at state schools in São José, Santa Catarina, Brazil. Risk factors related to lifestyle (i.e., physical inactivity, excessive alcohol consumption, smoking, sedentary behaviour and unhealthy diet), demographic variables (sex, age and skin colour) and economic variables (school shift and economic level) were assessed through a questionnaire. Simultaneous behaviours were assessed by the ratio between observed and expected prevalences of risk factors for non-communicable diseases. The clustering of risk factors was analysed by multinomial logistic regression. The clusters of risk factors that showed a higher prevalence were analysed by binary logistic regression.
  
  
  RESULTS
  The clustering of two, three, four, and five risk factors were found in 22.2%, 49.3%, 21.7% and 3.1% of adolescents, respectively. Subgroups that were more likely to have both behaviours of physical inactivity and unhealthy diet simultaneously were mostly composed of girls (OR = 3.03, 95% CI = 1.57-5.85) and those with lower socioeconomic status (OR = 1.83, 95% CI = 1.05-3.21); simultaneous physical inactivity, excessive alcohol consumption, sedentary behaviour and unhealthy diet were mainly observed among older adolescents (OR = 1.49, 95% CI = 1.05-2.12). Subgroups less likely to have both behaviours of sedentary behaviour and unhealthy diet were mostly composed of girls (OR = 0.58, 95% CI = 0.38-0.89); simultaneous physical inactivity, sedentary behaviour and unhealthy diet were mainly observed among older individuals (OR = 0.66, 95% CI = 0.49-0.87) and those of the night shift (OR = 0.59, 95% CI = 0.43-0.82).
  
  
  CONCLUSIONS
  Adolescents had a high prevalence of simultaneous risk factors for NCDs. Demographic (gender and age) and economic (school shift) variables were associated with the most prevalent simultaneous behaviours among adolescents.
authors.affiliation: Federal University of Santa Catarina, Research Center in Kinanthropometry and Human Performance, Florianópolis, Santa Catarina, Brasil.
authors.forename: Heloyse Elaine Gimenes
authors.initials: HE
authors.lastname: Nunes
authors.affiliation: Federal University of Santa Catarina, Research Center in Kinanthropometry and Human Performance, Florianópolis, Santa Catarina, Brasil.
authors.forename: Eliane Cristina de Andrade
authors.initials: EC
authors.lastname: Gonçalves
authors.affiliation: Federal University of Santa Catarina, Research Center in Kinanthropometry and Human Performance, Florianópolis, Santa Catarina, Brasil.
authors.forename: Jéssika Aparecida Jesus
authors.initials: JA
authors.lastname: Vieira
authors.affiliation: Federal University of Santa Catarina, Research Center in Kinanthropometry and Human Performance, Florianópolis, Santa Catarina, Brasil.
authors.forename: Diego Augusto Santos
authors.initials: DA
authors.lastname: Silva
mesh_terms: D000293:Adolescent; D000428:Alcohol Drinking / Q000009:adverse effects; D001938:Brazil / Q000453:epidemiology; D050171:Dyslipidemias / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D005191:Family Characteristics; D005247:Feeding Behavior; D005260:Female; D015438:Health Behavior / Q000502:physiology; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D006973:Hypertension / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D008019:Life Style; D008297:Male; D056128:Obesity, Abdominal / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D012307:Risk Factors; D057185:Sedentary Behavior; D012907:Smoking / Q000009:adverse effects; D012959:Socioeconomic Factors; D055815:Young Adult