Kumar Soumitra, Ray Saumitra, Roy Debabrata, Ganguly Kajal, Dutta Sibananda, Mahapatra Tanmay, Mahapatra Sanchita, Gupta Kinnori, Chakraborty Kaushik, Das Mrinal Kanti, Guha Santanu, Deb Pradip K, Banerjee Amal K
Department of Cardiology, Vivekananda Institute of Medical Sciences, Kolkata, West Bengal, 700026, India.
Department of Cardiology, Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, West Bengal, 700099, India.
BMC Public Health. 2017 May 18;17(1):468. doi: 10.1186/s12889-017-4390-9.
Unhealthy eating and lack of exercise during adolescence culminated into earlier onset and increasing burden of atherosclerotic cardiovascular diseases (CVDs) worldwide. Among urban Indian adolescents, prevalence of these risk factors of CVD seemed to be high, but data regarding their pattern and predictors was limited. To address this dearth of information, a survey was conducted among urban adolescent school-students in Kolkata, a highly populated metro city in eastern India.
During January-June, 2014, 1755 students of 9th-grade were recruited through cluster (schools) random sampling. Informed consents from parents and assents from adolescents were collected. Information on socio-demographics, CVD-related knowledge and perception along with eating and exercise patterns were collected with an internally validated structured questionnaire. Descriptive and regression analyses were performed in SAS-9.3.2.
Among 1652 participants (response rate = 94.1%), about 44% had poor overall knowledge about CVD, 24% perceived themselves as overweight and 60% considered their general health as good. Only 18% perceived their future CVD-risk and 29% were engaged in regular moderate-to-vigorous exercise. While 55% skipped meals regularly, 90% frequently consumed street-foods and 54% demonstrated overall poor eating habits. Males were more likely to engage in moderate-to-vigorous exercise [adjusted odds ratio (AOR) = 3.40(95% confidence interval = 2.55-4.54)] while students of higher SES were less likely [AOR = 0.59(0.37-0.94)]. Males and those having good CVD-related knowledge were more likely to exercise at least 1 h/day [AOR = 7.77(4.61-13.07) and 2.90(1.46-5.78) respectively]. Those who perceived their future CVD-risk, skipped meals more [2.04(1.28-3.25)] while Males skipped them less [AOR = 0.62(0.42-0.93)]. Subjects from middle class ate street-foods less frequently [AOR = 0.45(0.24-0.85)]. Relatively older students and those belonging to higher SES were less likely to demonstrate good eating habits [AOR = 0.70(0.56-0.89) and 0.23(0.11-0.47) respectively]. A large knowledge-practice gap was evident as students with good CVD-related knowledge were less likely to have good eating habits [AOR = 0.55(0.32-0.94)].
CVD-related knowledge as well as eating and exercise habits were quite poor among adolescent school-students of Kolkata. Additionally, there was a large knowledge-practice gap. Multi-component educational interventions targeting behavioral betterment seemed necessary for these adolescents to improve their CVD-related knowledge, along with appropriate translation of knowledge into exercise and eating practices to minimize future risk of CVDs.
青春期不健康的饮食和缺乏运动导致全球动脉粥样硬化性心血管疾病（CVD）发病更早且负担不断加重。在印度城市青少年中，这些心血管疾病风险因素的患病率似乎很高，但关于其模式和预测因素的数据有限。为了解决这一信息匮乏问题，在印度东部人口密集的大城市加尔各答的城市青少年学生中开展了一项调查。
2014年1月至6月期间，通过整群（学校）随机抽样招募了1755名九年级学生。收集了家长的知情同意书和青少年的同意书。使用经过内部验证的结构化问卷收集社会人口统计学、心血管疾病相关知识和认知以及饮食和运动模式方面的信息。在SAS-9.3.2中进行描述性和回归分析。
在1652名参与者中（应答率=94.1%），约44%对心血管疾病的总体知识掌握较差，24%认为自己超重，60%认为自己的总体健康状况良好。只有18%意识到自己未来患心血管疾病的风险，29%经常进行中度至剧烈运动。虽然55%的人经常不吃正餐，90%经常吃街头食品，54%的人总体饮食习惯较差。男性更有可能进行中度至剧烈运动[调整后的优势比（AOR）=3.40（95%置信区间=2.55-4.54）]，而社会经济地位较高的学生则可能性较小[AOR=0.59（0.37-0.94）]。男性和具有良好心血管疾病相关知识的人每天至少锻炼1小时的可能性更大[AOR分别为7.77（4.61-13.07）和2.90（1.46-5.78）]。那些意识到自己未来患心血管疾病风险的人更常不吃正餐[2.04（1.28-3.25）]，而男性则较少不吃正餐[AOR=0.62（0.42-0.93）]。中产阶级的人较少经常吃街头食品[AOR=0.45（0.24-0.85）]。相对年龄较大的学生和社会经济地位较高的学生表现出良好饮食习惯的可能性较小[AOR分别为0.70（0.56-0.89）和0.23（0.11-0.47）]。一个很大的知识-实践差距很明显，因为具有良好心血管疾病相关知识的学生养成良好饮食习惯的可能性较小[AOR=0.55（0.32-0.94）]。
加尔各答青少年学生中与心血管疾病相关的知识以及饮食和运动习惯相当差。此外，存在很大的知识-实践差距。针对行为改善的多成分教育干预措施似乎对这些青少年很有必要，以提高他们与心血管疾病相关的知识，并将知识适当地转化为运动和饮食习惯，以尽量降低未来患心血管疾病的风险。
