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巴西青少年肥胖和发育迟缓的社会决定因素:多层次分析。

Social Determinants of Obesity and Stunting among Brazilian Adolescents: A Multilevel Analysis.

机构信息

Postgraduate Program in Collective Health, Federal University of Rio Grande do Norte, Natal 59056-000, RN, Brazil.

Federal Institute of Education, Science and Technology of Rio Grande do Norte, Natal 59015-300, RN, Brazil.

出版信息

Nutrients. 2022 Jun 2;14(11):2334. doi: 10.3390/nu14112334.

Abstract

(1) Background: The purpose of this study was to identify the prevalence of obesity and stunting among Brazilian adolescents and its associations with social determinants of health (individual, family, and school), grounded on the necessity of investigating the determinants of nutritional problems within this population. (2) Methods: A population-based survey was administered to 16,556 adolescents assessed by the 2015 National School Health Survey. Multivariate models of obesity and stunting were estimated from Multilevel Poisson Regressions. (3) Results: The prevalence of obesity among Brazilian adolescents (10.0%; 95% CI: 9.4-10.6) was associated directly with indifference or dissatisfaction with body image, with eating breakfast four or fewer days a week, living with up to four people in the household, studying in private schools, and being from the South region, and was inversely associated with being female, 15 years old or older, with having the highest nutritional risk eating pattern, dining at fast-food restaurants, and eating while watching television or studying. The prevalence of stunting (2.3%; 95% CI: 2.0-2.8) was directly associated with the age of 15 years or older, and inversely associated with the lower number of residents living in the household, maternal education-decreasing gradient from literate to college level education, studying in urban schools, and being from the South and Central-West regions. (4) Conclusions: Obesity in adolescence presented behavioral determinants. Stunting and obesity have structural social determinants related, respectively, to worse and better socioeconomic position among Brazilian adolescents.

摘要

(1) 背景:本研究旨在确定巴西青少年肥胖和发育迟缓的流行率及其与健康的社会决定因素(个人、家庭和学校)的关系,因为有必要调查这一人群中营养问题的决定因素。

(2) 方法:对 2015 年全国学校卫生调查评估的 16556 名青少年进行了一项基于人群的调查。采用多水平泊松回归对肥胖和发育迟缓的多变量模型进行了估计。

(3) 结果:巴西青少年肥胖的流行率为 10.0%(95%置信区间:9.4-10.6),与对身体形象的漠不关心或不满、每周吃早餐不超过 4 天、与 4 人以下的人一起生活、就读私立学校和来自南部地区直接相关,与女性、15 岁或以上、具有最高营养风险的饮食模式、在快餐店就餐以及边看电视或边吃饭直接相关。发育迟缓的流行率(2.3%,95%置信区间:2.0-2.8)与 15 岁或以上的年龄直接相关,与家庭中居民人数较少、母亲教育水平从识字到大学教育的递减梯度、在城市学校学习以及来自南部和中西部地区成反比。

(4) 结论:青少年肥胖存在行为决定因素。发育迟缓和肥胖有结构性的社会决定因素,分别与巴西青少年较差和较好的社会经济地位有关。

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