Adolescent health-risk behaviours in Uruguay: Patterns from national cross-sectional school surveys conducted in 2006, 2012 and 2019.

BACKGROUND: There are no trend studies on various health risk behaviours among adolescents in Uruguay. Therefore, this study looked at trends in a number of health-risky behaviours among adolescents in Uruguay from three separate surveys. METHODS: Data from 9272 adolescents (age range: 11-16 years), who took part in three cross-sectional national in-school surveys in Uruguay in 2006, 2012 and 2019 were analysed. A self-administered survey was used to evaluate 24 health risk behaviours. By using logistic regression analyses to treat the study year as a categorical variable and adjusting food insecurity and age, linear trends were examined. RESULTS: We found a significant increase in the prevalence of being overweight, having obesity, inadequate fruit intake, sedentary behaviour in leisure-time, physical inactivity, bullying victimisation, loneliness, suicidal ideation, and sexual activity. We found a significant decrease in current cigarette use, physical fighting and current alcohol use. Among males, a significant increase of non-condom use, and a decrease in current other tobacco use (other than cigarettes), being physically attacked and the number of sexual partners. Among females, we found an increase in food insecurity, trouble from alcohol use, multiple sexual partners, and sleep problems. CONCLUSION: Overall, from 2006 to 2019, there was a decrease in seven health risk behaviours among boys and/or girls. Among boys, there was an increase in 10 health risk behaviours and among girls, 15 health risk behaviours increased, highlighting adolescent girls' greater vulnerability, thereby perpetuating further gendered health inequalities. In Uruguay, school health programmes for adolescents are recommended.

Tobacco use and heavy episodic drinking among persons aged 18-69 years in Bolivia in 2019.

OBJECTIVES: The aim of this study was to estimate the prevalence and sociodemographic factors associated with tobacco use and heavy episodic drinking (TUHED), current tobacco use only (TU), and current heavy episodic drinking only (HED) among people 18-69 years in Bolivia in 2019. STUDY DESIGN: Cross-sectional study. METHODS: The analysis used cross-sectional data from Bolivia's STEPS 2019 survey; 4472 individuals answered questions about substance use and socio-demographic information. RESULTS: The sample included 50.2% women and 49.8% men, 52.1% had secondary or higher education, 48.6% were Mestizo and 28.0% Quechua. The prevalence of TUHD was 6.0% (10.5% for men, 1.6% for women), TU 12.2% (20.0% for men, 4.4% for women), and HED 11.2% (13.4% for men and 9.1% for women). Male sex increased the risk of TU, HED and TUHED and belonging to the Amara ethnic group decreased the risk of TU and TUHED. Higher education was increased the odds of HED and among women of TUHED. Urban residence increased the risk of TUHED and among women of HED. For women, unemployment was associated with TU and marriage or cohabitation was inversely associated with TU, and for men, belonging to another ethnic group (such as Castellano or Tacana) increased the risk of TU and TUHED. CONCLUSION: More than 10% of the general adult population in Bolivia participated in TU and HED, and among men in TUHED. Various factors associated with the different categories of substance use were identified.

Prevalence and correlates of unintentional nonfatal injuries among school-going adolescents in Central America.

OBJECTIVES: The aim of this study is to report on the frequency of serious physical injuries (SPI) among adolescents in Central America during the previous decade, 2009-2018. METHODS: In total, 15,807 school adolescents (14.4 years mean age; SD=1.4) from six Central American countries participated in cross-sectional Global School-based Student Health Surveys in 2009-2018 (ranging from 1,779 students in Honduras in 2012 to 4,374 students in Guatemala in 2015). RESULTS: The prevalence of SPI was 33.8 % (22.9 % once, 7.4 % 2 or 3 times and 3.6 % 4 or more times), ranging from 31.8 % in Guatemala to 45.0 % in Belize and 45.6 % in Panama. The most frequent causes of SPI included fall (11.4 %, ranging from 6.9 % in Costa Rica to 15.6 % in Panama), and the type of SPI was fracture/dislocation (5.7 %, ranging from 4.3 % in Costa Rica to 6.7 % in Panama). In adjusted Poisson regression, male sex, food insecurity, a history of alcohol intoxication, soft drink consumption, fast food intake, truancy, multiple sexual partners, psychological distress, physical fight, physically attacked, bullied, and suicide attempt were significantly associated with a higher number of injury event counts. CONCLUSIONS: Overall, about one in three adolescents in Central America had sustained unintentional injuries in the past 12 months and several contributing factors were identified which if addressed could aid injury prevention among adolescents.

Combined victimization of face-to-face and cyberbullying and adverse health outcomes among school-age adolescents in Argentina.

Face-to-face bullying victimization (FBV) and cyber bullying victimization (CBV) are of global concern, including in Latin America. The aim of this study was to evaluate the associations between combined FBV and CBV relative to single victimization (FBV or CBV) and no victimization with a wide range of adverse health outcomes among school-aged adolescents from Argentina. National cross-sectional school data from 56,981 adolescents that responded to questions on FBV, CBV, and adverse health outcomes were analyzed. The results showed a prevalence of 18.7% FBV alone, 8.1% CBV alone and 13.6% combined FBV and CBV. Combined FBV and CBV had higher odds than single victimization (FBV or CBV) in 18 negative health outcomes, including anxiety, suicidal ideation, loneliness, suicide plan and attempt, smoking, smokeless tobacco use, history of intoxication, alcohol-related problems, current cannabis use, ever use of amphetamine, school truancy, participation in physical fighting, physically attacked, injury, ever sex, multiple sexual partners and sedentary behaviour. In conclusion, combined FBV and CBV had higher odds than single BV or no BV in most adverse health outcomes.

Factors associated with single and multiple suicide attempts in adolescents attending school in Argentina: national cross-sectional survey in 2018.

BACKGROUND: Factors associated with single suicide attempts (SSA) and multiple suicide attempts (MSA) may differ. AIMS: The study aimed to assess the factors associated with MSA in adolescents with a history of suicide attempts during the past 12 months in Argentina. METHOD: National cross-sectional data from the Global School-based Student Health Survey in Argentina in 2018 were analysed. Students who reported having a history of suicide attempts in the past 12 months were included in the final sample (n = 8507). Students with MSA were compared with students with an SSA through multiple logistic regression. RESULTS: In a subsample of adolescents attending school (mean age 14.8 years, s.d. = 1.3), 59.4% had an SSA and 40.6% had MSA in the past 12 months. In the final adjusted logistic regression model, compared with participants with SSA, both male and female students with MSA more frequently had no close friends, reported feeling more lonely and had more anxiety-induced sleep disturbances. Furthermore, among female participants, having been physically attacked, having participated in physical fights, low parental support, current tobacco use and lifetime amphetamine use were associated with MSA. Among male students, multiple sexual partners were associated with MSA. Furthermore, among both boys and girls, compared with participants without psychosocial distress, participants with one, two, three or more psychosocial distress factors had higher odds of MSA. Compared with students with one or two social or environmental risk factors, students with seven or eight social or environmental risk factors had higher odds of MSA; compared with students who had zero or one health risk behaviours, students with six or more health risk behaviours had higher odds of MSA. CONCLUSIONS: Psychosocial distress (anxiety-induced sleep disturbance, having no close friends and loneliness) increased the odds of MSA among both sexes. The odds of MSA were increased by interpersonal violence, low parental support and substance use among girls, and by having multiple sexual partners among boys. This suggests the potential relevance of these variables in identifying multiple suicide attempters among adolescents attending school in Argentina.

Health risk behaviours among adolescents in Argentina: trends between 2007, 2012 and 2018 national cross-sectional school surveys.

BACKGROUND: The aim of this study was to assess trends of various health risk behaviours among adolescents across three different surveys in Argentina. METHODS: Data from 115,697 adolescents (mean age:14.6 years, SD=1.2) that participated in three cross-sectional national school surveys in 2007, 2012 and 2018 were analysed. In all, 27 health risk behaviours were assessed through a self-administered questionnaire. Significance of a linear trend was tested by treating study year as categorical variable in logistic regression analyses, adjusted by age group and food insecurity for boys and girls separately RESULTS: Among both sexes, four health risk behaviours (current cigarette use, passive smoking, trouble from alcohol use, and physically attacked) significantly reduced from 2007 to 2018. Among boys five health risk behaviours (experience of hunger, parental tobacco use, current alcohol use, involvement in physical fighting, and multiple sexual partners), and among girls, inadequate physical activity significantly reduced over time. Among both sexes, the prevalence of four health risk behaviours (overweight/obesity, obesity, leisure-time sedentary behaviour and insufficient fruit intake) significantly increased among both sexes, and among girls ten health risk behaviours (not walking/biking to school, current other tobacco use, bullying victimisation, lifetime drunkenness, having no close friends, suicide plan, suicidal ideation, worry-induced sleep disturbance, loneliness, and ever sexual intercourse) significantly increased over time. CONCLUSION: Nine health risk behaviours among boys and five health risk behaviours among girls decreased, and four health risk behaviours among boys and 14 health compromising behaviours among girls increased over a period of 11 years. School health programmes for adolescents should be strengthened in Argentina.

Ideal Cardiovascular Health Behaviours in Nationally Representative School-Based Samples of Adolescents in the Caribbean.

BACKGROUND: Ideal cardiovascular health behaviour (CVHB) measures four ideal health behaviours (non-smoking, body mass index <85th Percentile, healthy diet, and physical activity). This study aimed to determine the prevalence, distribution, and correlates of ideal CVHB among adolescents in the Caribbean. METHODS: Nationally representative cross-sectional data of 2016 or 2017 with complete CVHB measurements were analysed from 7556 school adolescents from four Caribbean countries. RESULTS: The prevalence of 0-1 ideal metrics CVHB was 20.4%, 2 ideal metrics 48.7%, and 3-4 ideal metrics 30.8%. Only 5.0% had all 4 ideal CVHB metrics, 41.0% intermediate CVH (≥1 metric in the intermediate category and none in the poor category), and 54.0% had poor CVH (≥1 metric in poor category). In adjusted logistic regression analysis, compared to students from Dominican Republic, students from Jamaica (Adjusted Odds Ratio-AOR: 1.36, 95% confidence interval-CI: 1.01-1.85), students from Trinidad and Tobago (AOR: 1.46, 95% CI: 1.17-1.82) and male sex (AOR: 1.35, 95% CI: 1.11-1.64) were positively associated with meeting 3-4 ideal CVHB metrics. In addition, in unadjusted analysis, rarely or sometimes experiencing hunger was negatively and high peer and parent support were positively associated with meeting 3-4 ideal CVHB metrics. CONCLUSION: The proportion of meeting 3-4 ideal CVHB metrics was low among adolescents in four Caribbean countries. Both high-risk and school-wide intervention programmes should be implemented in aiding to improve CVHB in Caribbean countries. Several factors associated with ideal CVHB were identified, which can be targeted in school health interventions.

Prevalence and Correlates of Self-Reported Cardiovascular Diseases Among a Nationally Representative Population-Based Sample of Adults in Ecuador in 2018.

BACKGROUND: This study aimed to determine the prevalence and correlates of self-reported cardiovascular diseases (SRCVDs) among adults in Ecuador. METHODS: National cross-sectional survey data of 4638 persons aged 18-69 years in Ecuador were analysed. Research data were collected with an interview-administered questionnaire, physical and biochemical measurements. RESULTS: The prevalence of SRCVDs was 8.7%, 8.5% among men and 8.9% among women. In adjusted logistic regression analysis, being Montubio (adjusted odds ratio-AOR: 1.66, 95% confidence interval-CI: 1.10-2.50), family alcohol problems (AOR: 1.78, 95% CI: 1.19-2.65), past smoking tobacco (AOR: 1.36, 95% CI: 1.02-1.81), and poor oral health status (AOR: 1.74, 95% CI: 1.19-2.54) were associated with SRCVD. In addition, in unadjusted analysis, older age, alcohol dependence, obesity, and having hypertension were associated with SRCVD. CONCLUSION: Almost one in ten persons aged 18-69 years had SRCVD in Ecuador. Several associated factors, including Montubio by ethnicity, family alcohol problems, past smoking, and poor oral health status, were identified, which can be targeted in public health interventions.

Associations of number of victimizations with mental health indicators and health-risk behaviours among a nationally representative sample of in-school adolescents in Curaçao.

PURPOSE: The study aimed to estimate the association of experiencing a higher number of victimizations with mental health and health-risk behaviours among adolescents in the 2015 Curaçao Global School-Based Student Health Survey (GSHS). METHODS: In all, 2,765 in-school adolescents with a median age of 15 years from Curaçao responded to the cross-sectional GSHS. RESULTS: Results indicate that from six forms of victimization (bullied, parental physical victimization, physically attacked, physical intimate partner violence victimization, forced sex and violent injury) assessed, 29.6 % reported one type of victimization, 11.3 % two types and 4.9 % three or more types of victimization. In adjusted logistic regression analyses, PV was associated with four poor mental health indicators (worry-induced sleep disturbance, suicidal ideation, loneliness, and suicide attempt) and eleven health-risk behaviours (current tobacco use, current alcohol use, current cannabis use, early sexual debut, sex among students who were drunk, multiple sexual partners, non-condom use at last sex, school truancy, carrying a weapon, short sleep and skipping breakfast). CONCLUSION: Almost one in six students reported poly-victimization (≥2 types). Higher frequency of victimization was positively associated with four poor mental health indicators and eleven health-risk behaviours.

Prevalence and Correlates of Heavy Episodic Alcohol Consumption among Adults in Ecuador: Results of the First National STEPS Survey in 2018.

Thise study aimed to assess the prevalence and correlates of heavy episodic drinking (HED) among adults in Ecuador. In the national, cross-sectional 2018 Ecuador STEPwise approach to Surveillance (STEPS) survey, 4638 persons (median age = 39 years, range 18-69 years) responded to a questionnaire and physical measures. Logistic regression was used to assess the determinants of HED. Results indicate that 24.1% had past-month HED, 36.7% among men, and 12.0% of women; among past-12-month drinkers, 40.6% had past-month HED. In adjusted logistic regression analysis, male sex (adjusted odds ratio = AOR: 3.03, 95% confidence interval = CI: 2.44-3.77), past smoking (AOR: 1.42, 95% CI: 1.12-1.81), and current smoking (AOR: 2.94, 95% CI: 2.25-3.86) were positively associated with HED, and being aged 50-69 years (AOR: 0.52, 95% CI: 0.39-0.68) was negatively associated with HED. In sex-stratified analyses among men, being African Ecuadorean or Mulato (AOR: 1.74, 95% CI: 1.07-2.84) and high physical activity (AOR: 1.43, 95% CI: 1.02-2.01) were positively associated with HED, and among women, being Montubia (AOR: 0.38, 95% CI: 0.16-0.90) was negatively associated with HED and obesity (AOR: 1.58, 95% CI: 1.05, 2.38) was positively associated with HED. Almost one in four participants engaged in HED, and several sociodemographic and health indicators were identified associated with HED.

Hand and Oral Hygiene Practices among Adolescents in Dominican Republic, Suriname and Trinidad and Tobago: Prevalence, Health, Risk Behavior, Mental Health and Protective Factors.

OBJECTIVE: The study aimed to estimate the prevalence and correlates of oral hygiene (OH) and hand hygiene (HH) behavior among school adolescents in three Caribbean countries. METHOD: In all, 7476 school adolescents (median age 14 years) from the Dominican Republic, Suriname, and Trinidad and Tobago responded to the cross-sectional Global School-Based Student Health Survey (GSHS) in 2016-2017. RESULTS: The prevalence of poor OH (tooth brushing < 2 times/day) was 16.9%, poor HH (not always before meals) was 68.2%, poor HH (not always after toilet) was 28.4%, and poor HH (not always with soap) was 52.7%. In the adjusted logistic regression analysis, current cannabis use, inadequate fruit and vegetable intake, poor mental health, and low parental support increased the odds for poor OH. Rarely or sometimes experiencing hunger, trouble from alcohol use, inadequate fruit and vegetable intake, poor mental health, and low parental support were associated with poor HH (before meals and/or after the toilet, and/or with soap). CONCLUSION: The survey showed poor OH and HH behavior practices. Several sociodemographic factors, health risk behaviors, poor mental health, and low parental support were associated with poor OH and/or HH behavior that can assist with tailoring OH and HH health promotion.

Associations of physical partner violence and sexual violence victimization on health risk behaviours and mental health among university students from 25 countries.

BACKGROUND: The study aimed to investigate the associations between physical partner violence victimization (IPV) and/or sexual violence victimization and various health risk behaviours and mental health in university students in 25 countries. METHODS: Using a cross-sectional study design, 18,335 university students with a median age of 20 years from 25 countries in Africa, the Americas and Asia, replied to self-reported measures of interpersonal violence, health compromising behaviours, mental health measures and protective factors. RESULTS: In adjusted logistic regression analysis, physical IPV and/or sexual violence victimization was associated, among men and/or among women, with sexual risk behaviours (multiple sexual partners, alcohol use in the context of sex, diagnosed with HIV and pregnancy), violence related behaviour (in a physical fight and carrying a weapon), poor mental health (depression, loneliness, post-traumatic stress disorder, sleeping problem and short sleep), addictive behaviour (binge drinking, tobacco and drug use), and other health risk behaviour (skipping breakfast and frequent salt intake). CONCLUSIONS: We found evidence that physical IPV and/or sexual violence victimization among female and/or male university students was associated with 4 of 5 sexual risk behaviours, 2 violence related behaviours, 5 of 5 poor mental health indicators, 3 of 3 addictive behaviours and 2 of 7 other health risk behaviours.

Exploring the psychometric properties of the CES-D-10 and its practicality in detecting depressive symptomatology in 27 low- and middle-income countries.

The Center for Epidemiological Studies Depression-10 (CES-D-10) scale is known for its good psychometric properties in measuring depressive symptoms, however, some researchers question its applicability across various settings. This study explored the factor structure of the CES-D-10 in low- and middle-income countries (LMICs). This cross-sectional survey consisted of 16,723 university students across 27 LMICs that completed self-report instruments assessing socio-demographic information and depressive symptoms using the CES-D-10. Data analysis included: exploratory factor analysis, item response theory and differential item functioning. Results indicate that a two-factor model (depressive affect and positive affect) had the best fit for this population and accounted for 52% of the total observed variance with an internal consistency, α = .77 for the depressive affect items and α = .57 for the positive affect items. The graded response model (GRM), however, indicated that the depressive affect factor had a good fit, unlike the positive affect factor. The depressive affect factor was found to consistently model depression for females better than males. Relative to their Asian counterparts, African, Caribbean and South American participants of similar depressive affect responded differently on all items of the depressive affect factor. The depressive affect factor seems most ideal for LMICs and shows gender and cross-cultural variability.

Prevalence and correlates of past 12-month suicide attempt among in-school adolescents in Guatemala.

BACKGROUND: The aim of this investigation was to estimate the prevalence of past 12-month suicide attempts and associated factors among in-school adolescents in Guatemala. METHODS: Cross-sectional data from the 2014 "Global School-based Health Survey (GSHS)" included 4,274 students (median age 14 years, interquartile range=2 years) that were representative of all middle school students in Guatemala. RESULTS: The prevalence of past 12-month suicide attempt was 16.6%, 12.2% among boys and 20.2% among girls. Among students with a suicide attempt in the past year, 52.8% had a suicide plan in the past year. In adjusted logistic regression analysis, male sex and loneliness were associated with past 12-month suicide attempt, and among boys, none of the variables, and among girls, loneliness and current alcohol use were associated with past 12-month suicide attempt. CONCLUSION: A high prevalence and several specific factors associated with suicide attempt were identified which can help in guiding preventive strategies.

Associations between behavioural risk factors and overweight and obesity among adults in population-based samples from 31 countries.

OBJECTIVE: Concern about overweight and obesity is growing worldwide, and more research to examine behaviours associated with the risk for increased weight in adult populations is needed. The aim of this study was to estimate associations between behavioural risk factors and overweight and obesity among adults in nationally representative population samples from 20 countries in Europe, 8 countries in Asia, Australia, Chile and USA. METHODS: This secondary analysis is based on the International Social Survey Program (ISSP), 2011-2013, Health and Health Care Module. In a cross-sectional population-based survey (N=48,741) (mean age 46.6 years, SD=17.4, age range 15-102 years) simple or multi-stage stratified random sampling was used, yielding representative samples of the adult population of respective countries. Body Mass Index was assessed by self-reported height and weight. Correlates were risk behaviours for chronic disease (smoking status, alcohol intake, consumption of fruits and vegetable (=FV), and physical activity). RESULTS: Overall, for all 31 countries the prevalence of overweight or obesity was 44.1%, 31.7% overweight and 12.4% obese. In adjusted logistic regression models, among men and among women ex-smoking was positively associated with both overweight and obesity, while light or moderate smoking overall and among men were inversely related with obesity. Moderate alcohol use was positively associated with both overweight and obesity, while heavy alcohol use was negatively associated with overweight. The daily consumption of FV was found to be protective from both overweight and obesity, overall and for men but not for women. Physical activity was positively associated with overweight but not obesity. CONCLUSIONS: Some risk behaviours for chronic disease appear to be associated with overweight and obesity among adults. Interventions targeting these risk behaviours may have the potential to reduce weight.

Religiosity and Health Risk Behaviour Among University Students in 26 Low, Middle and High Income Countries.

The aim of this study was to assess religiosity and health risk behaviours among university students from 26 low, middle and high income countries. Using anonymous questionnaires, data were collected from 20,222 undergraduate university students (mean age 20.8, SD = 2. 8) from 27 universities in 26 countries across Asia, Africa and the Americas. Among all students, 41.1 % engaged at least once a week in organized religious activity, 35.8 % practised a non-organized religious activity daily or more than once daily, and more or less two-thirds of the students agreed to the three different statements on intrinsic of subjective religiosity. In multivariate logistic regression analysis, higher reported involvement in organized religious activity was associated with addictive, injury, sexual and oral health risk behaviour, while lower reported involvement in organized religious activity was associated with physical inactivity and oral health risk behaviour. Lower reported involvement in non-organized religious activity was associated with addictive, nutrition risk, injury, sexual and oral health risk behaviour, while higher reported involvement in non-organized religious activity was associated with physical inactivity. Finally, lower reported intrinsic religiosity was associated with addictive and sexual risk behaviour, while higher reported intrinsic religiosity was associated with nutrition risk behaviour, physical inactivity and oral health risk behaviour.

The association of nutrition behaviors and physical activity with general and central obesity in Caribbean undergraduate students / Asociación de los comportamientos nutricionales y la actividad física con la obesidad general y central en estudiantes de pregrado del Caribe

Objective. To quantify the prevalence of obesity and obesity-related factors in a crosssectional,observational study of Caribbean students using the results of three recent surveys of health behavior among undergraduates in Barbados, Grenada, and Jamaica. Methods. A total of 1 578 Caribbean undergraduate students from Barbados, Grenada, and Jamaica (ages 18–30 years) completed questionnaires and had physical measurements recorded. Multivariable logistic regression was used to estimate odds ratios (ORs) for the association of nutrition behaviors with prevalence of obesity (body mass index ≥ 30 kg/m2); elevated waist-toheight ratio (W/ht) (> 0.50); and high waist circumference (WC) (> 88 cm in females, > 102 cm in males). Models were adjusted for age, year in university, socioeconomic status, and sex. Results. There was a higher prevalence of obesity (13% versus 10%), high WC (21% versus 7%), and high W/ht (35% versus 25%) in females relative to males. Compared to females, males had reduced odds of obesity (OR 0.46), high WC (OR 0.22), and high W/ht (OR 0.61) (P < 0.05 for all). Both females (46%) and males (24%) reported high levels of physical inactivity. Fruit and vegetable consumption was low (approximately two servings per day). Many students reported avoiding fatty foods (40%); this behavior was associated with high W/ht (OR 1.68), obesity (OR 1.90), and high WC (OR 1.82) (P < 0.05 for all). Irregular breakfast consumption, age, and year of study were also positively associated with obesity. Physical activity was not significantly associated with any obesity measure. Conclusions. There was a low prevalence of healthy behaviors and a high prevalence of obesity in this sample of Caribbean young adults.

Objetivo. Cuantificar la prevalencia de la obesidad y los factores relacionados con esta mediante un estudio transversal y de observación de estudiantes del Caribe, que utilizó los resultados de tres encuestas recientes sobre comportamientos con respecto a la salud en estudiantes de pregrado de Barbados, Granada y Jamaica. Métodos. Un total de 1 578 estudiantes de pregrado caribeños de Barbados, Granada y Jamaica, de 18 a 30 años de edad, completaron cuestionarios y se sometieron a una serie de mediciones antropométricas, que fueron registradas. Se utilizó un modelo de regresión logística multivariable para calcular las razones de posibilidades (OR) de las asociaciones de los comportamientos nutricionales con la prevalencia de obesidad (índice de masa corporal ≥ 30 kg/m2); índice cintura-talla (ICT) elevado (> 0,5); y circunferencia de la cintura (CC) elevada (> 88 cm en mujeres, > 102 cm en hombres). Los modelos se ajustaron para la edad, el número ordinal del curso universitario, la situación socioeconómica y el sexo. Resultados. Se observó una mayor prevalencia de obesidad (13 frente a 10%), CC más elevada (21 frente a 7%) e ICT más elevado (35 frente a 25%) en las mujeres que en los hombres. En comparación con las mujeres, los hombres mostraron menores probabilidades de obesidad (OR 0,46), CC elevada (OR 0,22) e ICT elevado (OR 0,61) (P < 0,05 para todos ellos). Tanto las mujeres (46%) como los hombres (24%) notificaron altos niveles de inactividad física. El consumo de frutas y verduras era bajo (aproximadamente de dos raciones por día). Muchos estudiantes notificaron que evitaban los alimentos grasos (40%); este comportamiento se asoció con ICT elevado (OR 1,68), obesidad (OR 1,90) y CC elevada (OR 1,82) (P < 0,05 para todos ellos). El consume irregular en el desayuno, la edad y el número ordinal del curso universitario también se asociaron positivamente con la obesidad. La actividad física no se asoció significativamente con ninguna medición de obesidad. Conclusiones. En esta muestra de adultos jóvenes del Caribe se observó una Baja prevalencia de comportamientos saludables y una alta prevalencia de obesidad.

The association of nutrition behaviors and physical activity with general and central obesity in Caribbean undergraduate students / Asociación de los comportamientos nutricionales y la actividad física con la obesidad general y central en estudiantes de pregrado del Caribe

OBJECTIVE: To quantify the prevalence of obesity and obesity-related factors in a crosssectional, observational study of Caribbean students using the results of three recent surveys of health behavior among undergraduates in Barbados, Grenada, and Jamaica. METHODS: A total of1 578 Caribbean undergraduate students from Barbados, Grenada, and Jamaica (ages 18-30 years) completed questionnaires and had physical measurements recorded. Multivariable logistic regression was used to estimate odds ratios (ORs) for the association of nutrition behaviors with prevalence of obesity (body mass index > 30 kg/m² ); elevated waist-to-height ratio (W/ht) (> 0.50); and high waist circumference (WC) (> 88 cm in females, > 102 cm in males). Models were adjusted for age, year in university, socioeconomic status, and sex. RESULTS: There was a higher prevalence of obesity (13% versus 10%), high WC (21% versus 7%), and high W/ht (35% versus 25%) in females relative to males. Compared to females, males had reduced odds of obesity (OR 0.46), high WC (OR 0.22), and high W/ht (OR 0.61) (P < 0.05 for all). Both females (46%) and males (24%) reported high levels of physical inactivity. Fruit and vegetable consumption was low (approximately two servings per day). Many students reported avoiding fatty foods (40%); this behavior was associated with high W/ht (OR 1.68), obesity (OR 1.90), and high WC (OR 1.82) (P < 0.05 for all). Irregular breakfast consumption, age, and year of study were also positively associated with obesity. Physical activity was not significantly associated with any obesity measure. CONCLUSIONS: There was a low prevalence of healthy behaviors and a high prevalence of obesity in this sample of Caribbean young adults.

OBJETIVO: Cuantificar la prevalencia de la obesidad y los factores relacionados con esta mediante un estudio transversal y de observación de estudiantes del Caribe, que utilizó los resultados de tres encuestas recientes sobre comportamientos con respecto a la salud en estudiantes de pregrado de Barbados, Granada y Jamaica. MÉTODOS: Un total de 1 578 estudiantes de pregrado caribeños de Barbados, Granada y Jamaica, de 18 a 30 años de edad, completaron cuestionarios y se sometieron a una serie de mediciones antropométricas, que fueron registradas. Se utilizó un modelo de regresión logística multivariable para calcular las razones de posibilidades (OR) de las asociaciones de los comportamientos nutricionales con la prevalencia de obesidad (índice de masa corporal > 30 kg/m²); índice cintura-talla (ICT) elevado (> 0,5); y circunferencia de la cintura (CC) elevada (> 88 cm en mujeres, > 102 cm en hombres). Los modelos se ajustaron para la edad, el número ordinal del curso universitario, la situación socioeconómica y el sexo. RESULTADOS: Se observó una mayor prevalencia de obesidad (13 frente a 10%), CC más elevada (21 frente a 7%) e ICT más elevado (35 frente a 25%) en las mujeres que en los hombres. En comparación con las mujeres, los hombres mostraron menores probabilidades de obesidad (OR 0,46), CC elevada (OR 0,22) e ICT elevado (OR 0,61) (P < 0,05 para todos ellos). Tanto las mujeres (46%) como los hombres (24%) notificaron altos niveles de inactividad física. El consumo de frutas y verduras era bajo (aproximadamente de dos raciones por día). Muchos estudiantes notificaron que evitaban los alimentos grasos (40%); este comportamiento se asoció con ICT elevado (OR 1,68), obesidad (OR 1,90) y CC elevada (OR 1,82) (P < 0,05 para todos ellos). El consumo irregular en el desayuno, la edad y el número ordinal del curso universitario también se asociaron positivamente con la obesidad. La actividad física no se asoció significativamente con ninguna medición de obesidad. CONCLUSIONES: En esta muestra de adultos jóvenes del Caribe se observó una baja prevalencia de comportamientos saludables y una alta prevalencia de obesidad.