Alamian Arsham, Paradis Gilles
National Public Health Institute of Quebec, Montreal, Quebec, Canada.
Prev Med. 2009 May;48(5):493-9. doi: 10.1016/j.ypmed.2009.02.015. Epub 2009 Feb 27.
We assessed the prevalence, socioeconomic distribution and clustering of five major chronic disease behavioral risk factors (physical inactivity, sedentary behavior, tobacco smoking, alcohol drinking and high body mass index) in a representative sample of Canadian children and adolescents aged 10-17 years.
Cross-sectional data (n=4724) from Cycle 4 (2000/2001) of the National Longitudinal Survey of Children and Youth were used. Clustering was assessed using an observed to expected ratio method.
Overall, 65% of Canadian youth had two or more behavioral risk factors compared to only 10% with none of the five risk factors. The prevalence of having multiple behavioral risk factors was greater among older youth and those from low socioeconomic status families. Behavioral risk factors clustered in multiple combinations. Specifically, the simultaneous occurrence of all five risk factors was 120% greater in males (Observed/Expected ratio: 2.20; 95% CI: 1.31-3.09) and 94% greater in females (Observed/Expected ratio: 1.94; 95% CI: 1.24-2.64) than expected. Ever smoking and ever drinking showed the strongest association among the pairwise clusters.
Multiple chronic disease behavioral risk factors are frequent and occur more often than expected among Canadian children and adolescents. Early prevention programs targeting clusters of behavioral risk factors in youth are needed.
我们评估了10至17岁加拿大儿童和青少年代表性样本中五种主要慢性疾病行为危险因素（身体活动不足、久坐行为、吸烟、饮酒和高体重指数）的患病率、社会经济分布及聚集情况。
使用了儿童和青少年全国纵向调查第4轮（2000/2001年）的横断面数据（n = 4724）。采用观察与期望比率法评估聚集情况。
总体而言，65%的加拿大青少年有两种或更多行为危险因素，相比之下，没有这五种危险因素的青少年仅占10%。年龄较大的青少年以及来自社会经济地位较低家庭的青少年中，存在多种行为危险因素的患病率更高。行为危险因素以多种组合形式聚集。具体而言，所有五种危险因素同时出现的情况在男性中比预期高120%（观察/期望比率：2.20；95%置信区间：1.31 - 3.09），在女性中比预期高94%（观察/期望比率：1.94；95%置信区间：1.24 - 2.64）。曾经吸烟和曾经饮酒在两两聚类中显示出最强的关联。
多种慢性疾病行为危险因素在加拿大儿童和青少年中很常见，且出现频率高于预期。需要针对青少年行为危险因素聚集情况开展早期预防项目。
