Adolescent Risk Research Articles

Lower Suicide Risks in Adolescents With Obesity Taking GLP-1 Drugs.

Lower Suicide Risks in Adolescents With Obesity Taking GLP-1 Drugs.

Lipid signatures of cardiometabolic risk in children and adolescents with obesity.

Lipid signatures of cardiometabolic risk in children and adolescents with obesity.

Parental mediation strategies for social media use: a thematic analysis of perspectives among Indonesian parents and adolescents

ABSTRACT As social media provides opportunities but also involves risks for adolescents, some parents apply strategies to help their children adaptively use social media. Taxonomies of these strategies were primarily based on research conducted in the Global North. However, while social media use is also highly prevalent in the Global South, research on parental mediation strategies in the Global South is relatively scarce. The aim of this study is to increase our understanding of parental mediation strategies for social media use that occur in Indonesia. We conducted a qualitative study consisting of eight focus group discussions and eight semi-structured interviews (15 Indonesian parents and 30 Indonesian adolescents). The thematic analysis revealed that participating Indonesian parents typically applied a combination of specific restrictive and enabling strategies, including access restriction, interaction restriction, technical mediation, monitoring, interpretative mediation, supervision/co-use, modelling, and norm implementation. Parents reported a range of difficulties when trying to implement mediation strategies but overall, they believed that their strategies help their children to use social media more adaptively.

Relationship of the Degree of Sarcopenia with the Severity of Nonalcoholic Fatty Liver Disease and Cardiometabolic Risk in Adolescents

The association between nonalcoholic fatty liver disease (NAFLD) and sarcopenia has been suggested. We investigated sarcopenia’s impact on NAFLD severity and its relationship with cardiometabolic risk in adolescents. We conducted a retrospective study on 122 patients aged 13–18 years and diagnosed with both NAFLD and sarcopenia by laboratory tests, abdominal ultrasound (US), and multifrequency bioelectrical impedance analysis. Sarcopenia was stratified into tertiles based on the skeletal muscle-to-fat ratio (MFR), NAFLD severity was established by the US, and cardiometabolic risk was assessed by the triglyceride–glucose (TyG) index and the atherogenic index of plasma (AIP). Compared with the other patients, those in the lower MFR tertiles exhibited a greater severity of NAFLD (p < 0.001) and significantly higher TyG index and AIP. The independent effect of MFR was observed to have a negative correlation with the severity of NAFLD (p < 0.001). Based on the aforementioned results, the degree of sarcopenia can be considered as one of the risk factors of severe NAFLD and might be an indicator of cardiometabolic risk in adolescents. Weight training to reach the amount of muscle mass could be included in the treatment strategies to improve or prevent NAFLD in adolescents with sarcopenia.

Parental obesity, health determinants, and cardiometabolic risk according to sleep duration in schoolchildren: analysis through structural equations

Backgroundthe independent association between parental obesity, sleep and lifestyle habits with cardiometabolic risk factors in children and adolescents has been widely explored in the literature. Our study represents a novel approach to comprehensively investigate a complex model encompassing various aspects associated with cardiometabolic risk in youth. Thus, the aim of the present study was to verify the relationship between parental obesity and cardiometabolic risk in children and adolescents, considering the mediator role of health indicators according to sleep time.MethodsThis cross-sectional study was conducted on 3,973 children and adolescents aged 6 to 17 years attending public and private schools in a city located in Southern Brazil. Sleep duration, lifestyle, physical activity, natural food consumption, and parental obesity were evaluated through self-reported questionnaires. Physical fitness was evaluated according to the protocols of Projeto Esporte Brasil. The body fat percentage was evaluated through the measures of tricipital and subscapular folds, and the body mass index was calculated. The clustered metabolic risk score (cMetS) considered the summing z-scores of waist circumference, systolic blood pressure, triglycerides, total cholesterol/high-density lipoprotein cholesterol ratio, and fasting glucose, divided by five. A structural equation model was applied for statistical analysis. Results: The relationship between parental obesity and cardiometabolic risk was observed in children and adolescents with adequate sleep, being significant (p < 0.05) mediated by physical activity, natural food, physical fitness, and lifestyle. This was also observed when parental education was included in the inadequate sleep cluster model. Conclusion: Present findings underscore the importance of sufficient sleep duration as a critical factor in understanding the complex interplay between parental obesity and cardiometabolic risk in children and adolescents.

Reduced rank regression dietary patterns and dyslipidemia in Brazilian adolescents: results from the Study of Cardiovascular Risk in Adolescents (ERICA).

Evidence on the harmful effects of diet on serum lipids in adolescence has not been consistent. The present study sought to establish which dietary patterns are associated with biomarkers of dyslipidemia. Data from 36,217 Brazilian adolescents participating in the Study of Cardiovascular Risk in Adolescents were evaluated. Dietary patterns were identified using the reduced rank regression analysis. Linear regression models were applied to verify the association between dietary pattern scores and the biomarkers of dyslipidemia. The two first dietary patterns identified by reduced rank regression (RRR-DP1 and RRR-DP2) were kept for further analysis. The RRR-DP1 was highly and positively loaded for sweets and red meat and negatively loaded for beans, fruits, vegetables, and rice. The RRR-DP2 was positively loaded for beans and rice and negatively loaded for sugar-sweetened beverages, fruit juices, and sweets. Linear regression models estimated that one standard deviation (SD) increase in the RRR-DP1 score was only associated with a mean increase of 0.29 mg/dL in HDL-cholesterol (95% CI 0.06;0.53), while one SD increase in the RRR-DP2 score was associated with the lower mean of triglycerides (β = -2.24, 95% CI -3.57;-0.91), LDL-c (β = -0.82 95% CI -1.53;-0.12), and total cholesterol (β = -1.30 95% CI -1.94;-0.65). Higher adherence to the dietary patterns positively loaded for red meat and sweets was associated with increased HDL-c levels, while adherence to a more Brazilian traditional dietary pattern (RRR-DP2) was associated with a better lipids profile.

Waist circumference and waist-to-height ratio: Exploring the associations for high blood pressure risk in school-age adolescents

BackgroundChildhood and adolescent obesity present a global health concern, notably due to its association with adverse outcomes such as high blood pressure (HBP). Waist circumference (WC) and waist-to-height ratio (WHtR) are promising indicators for assessing HBP risk in school-age adolescents. However, their association with Stavnsbo-recommended WC cutoff points and high BP prevalence necessitates further investigation, holding potential implications for early intervention and prevention strategies. ObjectiveInvestigate the association between high blood pressure (HBP) and WC cutoff points advised by Stavnsbo, along with WHtR, in adolescents from privileged socioeconomic backgrounds in Brazil. MethodsThis cross-sectional study in 2022 involved 216 students aged 9 to 16 from a private school in Londrina, Paraná, Brazil. Data, collected through an internal project monitoring anthropometric and social indicators, included validated blood pressure assessments. Statistical analyses, employing t-tests, chi-square tests, and logistic regression, explored relationships between WC, WHtR, and blood pressure, adjusting for covariates. ResultsFemale participants had a lower prevalence of obesity (2.9% vs 5.3%) but a higher prevalence of overweight (27.5% vs 17.5%) compared to males. The overall excess weight prevalence was 26.4%, with females showing lower absolute risk scores for WC (25.5% vs 34.2%), WHtR (19.6% vs 23.7%), and HBP (21.5% vs. 40.3%). Significant associations were observed between HBP and WC (X2 = 9.759, P = 0.002) as well as WHtR (X2 = 6.335, P = 0.012) among males, with those in the “Risk” category exhibiting higher HBP prevalence. Overall, both WC and WHtR demonstrated significant associations with HBP (X2 = 12.428, P < 0.001, and X2 = 9.550, P = 0.002, respectively). Logistic regression indicated higher odds for HBP in males with risk values for WC (OR 3.876 [1.714–8.765 CI], P = 0.001) or WHtR (OR 3.684 [1.457–9.315 CI], P = 0.006). In the overall analysis, participants with risk values for WC had 3.2 (1.688–6.080 CI, P < 0.001) times higher odds, and for WHtR, 3.4 (1.679–6.934 CI, P = 0.001) times higher odds of HBP. ConclusionThis study highlights the associations between WC, WHtR, and HBP in adolescent schoolchildren. The results underscore the significance of gender-specific assessments and emphasize the potential of these anthropometric measures as valuable tools for identifying and managing HBP risk in adolescents. Further research and clinical applications are imperative to deepen understanding and address the health needs of this vulnerable population.

Looking Beyond Sleep Duration in Understanding Obesity Risk in Adolescents: The Role of Circadian Timing and Misalignment on Adolescent Dietary Outcomes, Physical Activity, and Body Mass Index

Abstract Objectives This study evaluated the differences in obesity-related outcomes across multiple adolescent sleep health domains, including circadian misalignment (CM), circadian timing, and sleep duration. Methods 53 adolescents (aged 14-18; body mass index (BMI) percentile&amp;lt;95%; 53.7% female) completed a cross-sectional study that included baseline assessment of height; weight; demographics; and a 10-day assessment of sleep, physical activity, and dietary outcomes. Sleep duration, sleep timing, and physical activity data were collected from all participants using wrist-worn and waist-worn actigraphs. Dietary intake was measured using the Automated Self-Administered 24-Hour dietary recalls on three randomized days. Circadian timing was measured using dim-light melatonin onset (DLMO), and CM was calculated as the distance of time between DLMO and the average sleep onset time. Participants were categorized into groups (early versus late circadian timing, aligned versus misaligned circadian timing, and adequate sleep versus short sleep), and differences in dietary outcomes, physical activity, and BMI were analyzed using t-tests. Results Adolescents with later DLMO (M = 21:30 ± 1:11) had 0.63 higher BMI and 0.47% less averaged daily percent fat consumption than adolescents with early DLMO. Adolescents with CM (M = 1:42 ± 1:06) consumed 451.77 more averaged daily kcal consumption compared to those with circadian alignment. No statistically significant differences were found in any obesity-related outcome between sleep duration groups. Conclusions Our cross-sectional findings indicate that focusing on sleep timing and circadian alignment, beyond sleep duration, may promote better health outcomes for healthy adolescents. The findings of this study could enhance sleep education and inform clinical models for prevention efforts for pediatric obesity.

Prevalence of social jetlag and associated factors in Brazilian adolescents: Results from a country-wide cross-sectional study

ObjectivesSocial jetlag is a disturbance in the circadian rhythm caused by a desynchronization between an individual's biological rhythm and social commitments and responsibilities. It leads to sleep debt during the week and compensation on weekends. Social jetlag is associated with an increased risk of chronic diseases and cognitive dysfunction in adolescents. This study aims to assess the prevalence of social jetlag and associated factors in Brazilian adolescents. MethodsAdolescents of both sexes, aged between 12 and 17years, participating in the Study of Cardiovascular Risks in Adolescents (ERICA), were included. The sleep duration on a typical weekday and weekend day was collected through a self-reported questionnaire. The occurrence of social jetlag was defined as the difference between the midpoint of sleep on weekends and weekdays, with differences equal to or higher than 1hour considered as an indicator of positive social jetlag. Factors associated with the prevalence of social jetlag were investigated using Poisson regression models. ResultsThe sample included a total of 64,029 adolescents. Social jetlag affects more than 80% of Brazilian adolescents, with higher prevalence among girls in the age group of 16-17years, with white skin color, attending private schools, and those having morning classes. Additionally, unhealthy risk behaviors such as skipping breakfast, alcohol consumption, and increased screen time are associated with a higher prevalence of social jetlag. ConclusionThe prevalence of social jetlag was high in Brazilian adolescents, and, among its associated factors, studying in the morning shift and engaging in unhealthy risk behaviors stand out.

Clinician perspectives on barriers and facilitators to the treatment of adolescent cannabis use: A qualitative study

IntroductionCannabis use among adolescents is prevalent, and clinicians who work with adolescents have unique insights about how to treat cannabis use in this population. MethodsThis qualitative study interviewed 32 clinicians from addiction medicine recovery services (AMRS), the emergency department (ED), mental health (MH), and pediatrics in an integrated healthcare system to understand their perspectives and experiences regarding barriers and facilitators to treating adolescent cannabis use. The analysis was developed using thematic analysis of interviews. ResultsThirty-two clinicians (Mean age = 45.9, SD =7.6; 56.3 % Female; 56.3 % White) were recruited from AMRS (n = 13; 41.9 %), the ED (n = 7; 22.5 %), MH (n = 7; 22.5 %) and pediatrics (n = 5; 16.1 %). Clinicians discussed several key barriers and facilitators of treating adolescent cannabis use. Facilitators include the use of multiple screening tools for adolescent cannabis use (i.e., self-report and toxicology testing) which provide more comprehensive information; patient-centered treatment approaches; and discussing cannabis use in the context of adolescents' mental health. Barriers discussed included adolescents' and parents' minimization of adolescent cannabis use risks. Several factors were discussed as potential facilitators or barriers, depending on context, including the influence of peers, virtual treatment, and parental involvement or lack thereof in treatment. ConclusionsInterviews with clinicians who work with adolescents across settings highlighted factors that serve as barriers and facilitators to treating adolescent cannabis use. These findings have important implications for guiding future research and intervention efforts, including the inclusion of universal screening practices, addressing stigma, reducing adolescents' and parents' minimization of cannabis use-related harms, and improving adolescent and parent engagement in treatment.

Application of a Body Shape Index as an Anthropometric Predictor of Cardiometabolic Risks in Children and Adolescents (Systematic Review)

Application of a Body Shape Index as an Anthropometric Predictor of Cardiometabolic Risks in Children and Adolescents (Systematic Review)

Prediction of mental health risk in adolescents via a smartphone app: a feasibility pilot study

Abstract Background The prevalence of mental health problems in adolescents is a global public health concern. Machine learning (ML) can analyse multidimensional data collected by phone sensors (passive tracking) and symptom self-reporting (active tracking) to model and predict mental health states. However, research in adolescents is lacking. This study investigated the feasibility of using ML to predict mental health in a non-clinical population of adolescents from active and passive data collected through the Mindcraft mobile app. Methods We recruited 103 secondary students (aged 14-18) who first completed the Strengths and Difficulties Questionnaire (SDQ) and then used the Mindcraft app for two weeks. The app integrates sensor data (location, steps, noise, light, battery, app usage) and self-reports. We extracted 85 sensor-based features and 19 from questionnaires to develop a gradient-boosted ensemble ML model. This model identifies students with abnormal SDQ scores and was evaluated using leave-one-out cross-validation. Results All students completed the active questionnaires; 67 also provided passive sensor data. 31 had abnormal SDQ scores. Using passive data, the ML model reached a balanced accuracy of 0.64 and an AUC score of 0.57. Incorporating both data types improved accuracy to 0.67 and AUC to 0.70. Feature importance scores showed step count and questionnaire on racing thoughts and hopefulness as most significant. Conclusions Our findings affirm the potential of integrating passive and active data collection to monitor mental health in real-world settings. Our ML model demonstrated moderate accuracy in predicting adolescents’ mental health risk measured with a behavioural screening questionnaire. This study will guide the development of a ML-driven, personalised mobile intervention for early symptom detection and mental health self-management, which might constitute an innovative and scalable tool for mental health prevention and intervention in adolescents. Key messages • This study shows the feasibility of using active and passive data to predict mental health risk in adolescents. • This study informs the development of a personalised machine learning-driven mobile intervention.

Prediction of overweight/obesity risk in adolescence using static and dynamic multi-exposure models

Abstract Background Studying the risk factors for obesity development and timely identification of individuals at increased risk are key for obesity prevention. We aimed to assess the associations of multiple prenatal, infancy and childhood exposures with overweight/obesity at 13 years (y) and develop static and dynamic multiple-exposure prediction models. Methods In 4232 mother-child pairs from the Generation XXI birth cohort, we assessed, during pregnancy/infancy and childhood, 55 sociodemographic factors, anthropometric measures, lifestyle behaviors, and clinical exposures related to the mother and the child and categorized body mass index z-scores as normal weight and overweight/obesity at 13y. Static models for pregnancy/infancy, 4, 7 and 10y, and a dynamic model were fitted using Elastic Net and logistic regression and were compared in terms of predictive performance. Results Mothers with lower educational level and household income, no partner, overweight/obesity before and after pregnancy, excessive gestational weight gain, pregnancy complications and who were smokers during pregnancy had children with a higher risk of overweight/obesity at 13y. Children with higher BMI during infancy, overweight/obesity during childhood, an early introduction of solid foods (before 4 months), a higher consumption of soft drinks at 4y and females had a higher risk of overweight/obesity at 13y. We observed the lowest predictive performance for the pregnancy/infancy model (prediction error of 36%) and the highest predictive performance for the 10y and dynamic models (prediction errors of 17%). Conclusions We identified the most important predictors of overweight/obesity in adolescence, most of them modifiable, and able to be targeted in prevention strategies. Predicting overweight/obesity risk in adolescence might be suboptimal if only considering pregnancy/infancy data and improves as closer to the age of the outcome, with no additional benefit in using a complex dynamic model. Key messages • Prevention of overweight/obesity should start during prenatal life. • Children at higher risk of overweight/obesity may be identified years earlier using prediction models in clinical practice.

Association of childhood mental health and cardiovascular risk in adolescence and young adulthood

Abstract Introduction Mental health (MH), and in particular depression, is linked bi-directionally to cardiovascular disease through biological as well as behavioral pathways. Low MH has been associated with behaviors associated closely with cardiovascular risk (CVR) factors, such as reduced physical activity and sleep disturbances. It is not clear at what age the relation between MH and CVR begins to manifest and if MH in the young is also associated with vascular remodeling, operationalized as carotid-intima media thickness (CIMT). Methods We investigated the longitudinal association between childhood MH problems (age 3 to 17) and CVR factors as well as CIMT from carotid sonography in 4,361 14 to 28-year-olds of the KiGGS cohort. Using linear regression analyses adjusted for socioeconomic status, we analyzed the association of the Strength and Difficulties Questionnaire (SDQ) score with systolic blood pressure (SBP), body mass index (BMI), total cholesterol (TC), and CIMT in z-scores by sex and age. Additional cross-sectional analyses included scores of the Mental Health Inventory (MHI-5) and Patient Health Questionnaire (PHQ-9) in young adulthood. Results Childhood SDQ scores were significantly associated with SBP, BMI and TC one decade later (-0.03 ≤ ß ≥ 0.02). Cross-sectionally, no association of MHI-5 scores in young adults with CVR factors was found. PHQ-9 scores in young adults were associated significantly with SBP and BMI (-0.26≤ ß≥ 0.01). The investigated MH problems from childhood to young adulthood were not linked to CIMT. Conclusions Our results confirm an early association of MH with the examined CVR factors. However, we could not find evidence for an association between MH and vascular remodeling in this population-based sample of adolescents and young adults. Our results emphasize the importance of prevention strategies focusing on both, physical and MH of the young, in order to prevent vascular damage later in life. Key messages • Our results show an early association of childhood mental health with the examined cardiovascular risk factors systolic blood pressure, body mass index and total cholesterol one decade later. • Our results confirm the importance of prevention strategies focusing on both, physical and mental health of the young.

Development will (try to) find its way: a qualitative study of Chilean adolescent mental health during and after lockdown

BackgroundThe COVID-19 pandemic has had a well-evidenced impact on adolescents, who are especially sensitive to pandemic disruptions given the critical role of socialization in their development. In Chile too, evidence shows increases in mental health complaints among adolescents over the lockdown period. Our study aimed at exploring the experiences of Chilean adolescents regarding their mental health during the lockdown and school closure (March 2020-December 2021), and during the return to on-site education (2022) as informed by adolescents and school staff, with a focus on family, school, and social sources of risk and support for adolescents’ wellbeing during these periods.MethodsUsing a qualitative approach, we conducted semi-structured interviews with 19 adolescents and 16 staff members from schools in an urban area of Chile.ResultsThrough thematic analysis, we generated five themes: [1] Adolescents in a mental health crisis, comprising a range of distressing experiences and mental health problems. This crisis was fueled by alterations in the functioning of adolescents’ systems: [2] Broken support systems (peers and school); [3] The school agenda must go on, reflecting schools’ strict compliance with the educational curriculum; and [4] Blurred boundaries between home and school life and within the family. Finally [5], Development will (try to) find its way describes how most participants experienced a bouncing back to wellbeing in the course of the school year upon return, and how some developmental milestones took place despite the abnormal conditions, providing evidence for resilience amid pandemic adversity.ConclusionsThe findings give insight into how the exchanges between the adolescent and the social systems they are embedded in were interfered. The results help us understand the challenges for mental health during and after the pandemic, and highlight adolescents’ capacity to thrive as normality was restored. The results also underscore the importance of upholding stability across adolescents’ systems and routines, in order to mitigate impacts on wellbeing amid abnormal circumstances. The findings are relevant for development-informed initiatives in policy design in the aftermath of the pandemic and in future crisis management responses.

A longitudinal study of adolescent pathways differentiating suicide ideation and attempt in early adulthood.

Suicide ideation and attempt are leading risk factors for mortality in young adults. However, the adolescent risk factors distinguishing suicide ideation from attempt in young adults remain unclear. The present study aimed to examine the extent to which within-person stability and change in depressive symptoms, school difficulties, and peer victimization from ages 12 to 17 were differentially associated with later suicide ideation and attempt from ages 20 to 23. The study included 1647 participants from the Quebec Longitudinal Study of Child Development (QLSCD; 52% female). Participants reported on their depressive symptoms, school difficulties, and peer victimization at ages 12, 13, 15, and 17, and on suicide ideation and attempt at ages 20 and 23. Data were collected in the Province of Quebec, Canada, between 2010 and 2021. Results indicated that 11% (N = 121) and 8% (N = 86) reported suicide ideation and attempt, respectively, between ages 20 and 23. A random-intercept cross-lagged panel model showed that within-person increases in depressive symptoms during adolescence were related to both suicide ideation and attempt, whereas within-person increases in school difficulties and peer victimization were for the most part related to suicide attempt only. Within-person stability in depressive symptoms from ages 12 to 17 years were also related to suicide attempt, and not ideation. However, this association was only marginally significant. Findings suggest that experiencing unusual rises in school difficulties and peer victimization during adolescence, as well as depressive symptoms persisting over time, may distinguish young adults who think about suicide from those who attempt suicide.

Multi-scale asynchronous correlation and 2D convolutional autoencoder for adolescent health risk prediction with limited fMRI data.

Adolescence is a fundamental period of transformation, encompassing extensive physical, psychological, and behavioral changes. Effective health risk assessment during this stage is crucial for timely intervention, yet traditional methodologies often fail to accurately predict mental and behavioral health risks due to the intricacy of neural dynamics and the scarcity of quality-annotated fMRI datasets. This study introduces an innovative deep learning-based framework for health risk assessment in adolescents by employing a combination of a two-dimensional convolutional autoencoder (2DCNN-AE) with multi-sequence learning and multi-scale asynchronous correlation information extraction techniques. This approach facilitates the intricate analysis of spatial and temporal features within fMRI data, aiming to enhance the accuracy of the risk assessment process. Upon examination using the Adolescent Risk Behavior (AHRB) dataset, which includes fMRI scans from 174 individuals aged 17-22, the proposed methodology exhibited a significant improvement over conventional models. It attained a precision of 83.116%, a recall of 84.784%, and an F1-score of 83.942%, surpassing standard benchmarks in most pertinent evaluative measures. The results underscore the superior performance of the deep learning-based approach in understanding and predicting health-related risks in adolescents. It underscores the value of this methodology in advancing the precision of health risk assessments, offering an enhanced tool for early detection and potential intervention strategies in this sensitive developmental stage.

Are we preparing healthy & responsible adolescents? Exploratory qualitative study to understand the health and social issues of adolescent living in Karachi, Pakistan.

This study aimed to understand the lives of adolescents living in squatter settlements of Karachi, Pakistan regarding their assigned roles and responsibilities, health and social issues, their decision-making process, and mechanism and channels of information. An exploratory descriptive qualitative study design was employed. Purposive sampling techniques were used to carry out Focus Group Discussions (FGDs) with adolescents (n = 10, Participants = 190), adolescents' parents (n = 10, Participants = 180), and In-Depth Interviews of with key adolescent stakeholders (n = 20). Adolescent stakeholder mapping was conducted for enrolling participants. The data were analysed thematically using deductive and inductive approaches. Based on gender norms parents assign specific roles and responsibilities to adolescent girls and boys. Due to societal norms, communication gap exists between adolescents and their parents. The most popular information channels are social media platforms and friends. Adolescents reported being subjected to a variety of physical, sexual, mental, social, and environmental pressures. Lack of guidance from parents, inadequate knowledge and skills to deal with physical, sexual, mental, social and environmental hazards, and misuse of social media lead to risky decisions, injuries, and social instability. This study underlines the urgent need for targeted interventions for addressing gender issues and improving adolescents' decision-making and life skills. We recommend Behavior Change Communication interventions to dismantle gender stereotypes and support a balanced domestic environment for children's education and well-being, awareness raising among parents, teachers, and healthcare providers about adolescent risks emphasizing their role in youth guidance, and advocacy for youth-led forums to co-create educational content engaging parents, educators, and health professionals focusing on life skills. These strategies would turn demographic transitions into productive dividends.

Predictors in Youth of Adult Cardiovascular Events.

Childhood risk factors are associated with cardiovascular events in adulthood. We compared the utility of a risk model based solely on nonlaboratory risk factors in adolescence versus a model that additionally included lipids to predict cardiovascular events in adulthood. The study comprised 11 550 participants from 7 longitudinal cohort studies in the United States, Australia, and Finland with risk factor measurements in adolescence and followed into adulthood. The adolescent risk factors were defined by using clinical standards including overweight or obesity, elevated blood pressure, smoking, and borderline high or high levels of total cholesterol and triglycerides. The main outcomes were medically adjudicated fatal or nonfatal cardiovascular disease events occurring after age 25. Of 11 550 participants (55.1% female, mean age 50.0 ± 7.7 years), 513 (4.4%) had confirmed cardiovascular events. In a multivariable model (hazard ratio [95% confidence interval]), elevated blood pressure (1.25 [1.03-1.52]), overweight (1.76 [1.42-2.18]), obesity (2.19 [1.62-2.98]), smoking (1.63 [1.37-1.95]), and high total cholesterol (1.79 [1.39-2.31]) were predictors of cardiovascular events (P < .05). The addition of lipids (total cholesterol and triglycerides) into the nonlaboratory model (age, sex, blood pressure, BMI, and smoking) did not improve discrimination in predicting cardiovascular events (C-statistics for the lipid model 0.75 [SD 0.07] and nonlaboratory model 0.75 [0.07], P = .82). Nonlaboratory-based risk factors and lipids measured in adolescence independently predicted adult cardiovascular events. The addition of lipid measurements to nonlaboratory risk factors did not improve the prediction of cardiovascular events.

O IMPACTO DO USO DE CIGARROS ELETRÔNICOS NA SAÚDE MENTAL DOS ADOLESCENTES: UMA REVISÃO SISTEMÁTICA

Objective: To analyze the impact of electronic cigarette use on adolescent mental health, identifying motivational and risk factors associated with the use of these devices. Method: A systematic literature review was conducted using the PubMed and Virtual Health Library (BVS) databases, with descriptors in Portuguese and English. Studies published between 2019 and 2024 that analyzed the relationship between electronic cigarette use and the mental health of adolescents aged 12 to 24 years were included. After applying inclusion and exclusion criteria, 10 studies were selected for analysis. Results: The main motivational factors for the use of electronic cigarettes include curiosity, the perception of lower risk compared to traditional cigarettes, sensory appeal, and social influence. Risk factors include adverse childhood experiences, mental health problems, substance use, and poor academic performance. The review indicated a strong association between the use of electronic cigarettes and increased symptoms of depression, anxiety, and other mental disorders in adolescents. Additionally, the importance of stricter public policies and psychological support programs is emphasized to mitigate the negative effects of electronic cigarette use among young people.