Abstract
Background: Limited evidence exists on the presence of collective non-communicable disease (NCD) risk factors among adolescents in Kerala, India. We aimed to assess the prevalence and factors associated with multiple NCD risk factors and clustering of these risk factors among adolescents in Kasaragod District, Kerala.Methods: We selected 470 adolescents (mean age 16.6 years, male 53.8%) through multi-stage cluster sampling from higher secondary schools of Kasaragod district. Self-administered questionnaires were used, and anthropometric measurements were taken using standard techniques and protocols. Tobacco use, alcohol consumption, low fruits and vegetable consumption, inadequate physical activity, extra salt intake, overweight, consumption of soft drinks and packed foods were the eight NCD risk factors included. Multinomial logistic regression analysis was done to find out the factors associated with one, two and three or more NCD risk factors.Results: Risk factor clusters with two risk factors (dyads) and three risk factors (triads) were observed in 163 (34.7%) and 102 (21.7%) of the sample, respectively. Adolescents residing in urban areas (odds ratio (OR) = 3.55; 95% confidence interval (CI) = 1.45-8.73), whose father’s education level was lower (OR = 3.54; 95% CI = 1.24-10.10), whose mother’s education was lower (OR= 4.13; 95% CI = 1.27-13.51), who had restrictions on physical activity (OR = 5.41; 95% CI = 1.20-24.30) and who did not have a kitchen garden (an area where fruits and vegetables are grown for domestic use) (OR=4.51;95% CI = 1.44-14.12) were more likely to have three or more NCD risk factors compared to their counterparts. Conclusions: Clustering of NCD risk factors was prevalent in more than half of the adolescents. Efforts are warranted to reduce multiple risk factors, focussing on children of low educated parents and urban residents. Parents of adolescents may be encouraged to have kitchen gardens and not to restrict adolescent’s physical activity.
Highlights
Non-communicable diseases (NCDs) such as cardiovascular diseases, cancer, diabetes, chronic respiratory diseases are the leading cause of death globally
Our study found that NCD risk factors among the adolescents were majorly on unhealthy diet and physical inactivity
While limited evidence exists concerning the consumption of packaged food among adolescents in Indian context, studies from other developing countries argue that affordability of packaged foods, peer influence, absence of healthy alternatives and perception of packaged foods as safer options make them popular food choice among adolescents[19]
Summary
Non-communicable diseases (NCDs) such as cardiovascular diseases, cancer, diabetes, chronic respiratory diseases are the leading cause of death globally. According to the latest NCD risk factor survey in the state using the World Health Organization (WHO) stepwise approach to surveillance (STEPs) approach, the state had a diabetes prevalence of 19.2% and a hypertension prevalence of 30% in the adult population of the state[9]. Studies conducted among adolescents reported the presence of soaring prevalence of certain NCDs risk factors globally and in India. Limited evidence exists on the presence of collective non-communicable disease (NCD) risk factors among adolescents in Kerala, India. We aimed to assess the prevalence and factors associated with multiple NCD risk factors and clustering of these risk factors among adolescents in Kasaragod District, Kerala.
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