| dc.description.abstract | Background Modifiable non-communicable disease (NCD) risk factors are becoming increasingly common among
adolescents, with clustering of these risk factors in individuals of particular concern. The aim of this study was to
assess global status of clustering of common modifiable NCD risk factors among adolescents.
Methods We used latest available data from nationally representative survey for 140 countries, namely the Global
School-based Student Health Survey, the Health Behaviour in School-Aged Children and the longitudinal study of
Australian Children. Weighted mean estimates of prevalence with corresponding 95% confidence intervals of nine
NCD risk factors - physical inactivity, sedentary behaviour, insufficient fruits and vegetable consumption, carbonated
soft drink consumption, fast food consumption, tobacco use, alcohol consumption and overweight/obesity - were cal-
culated by country, region and sex.
Findings Over 487,565 adolescents, aged 11−17 years, were included in this study. According to trend analysis,
prevalence of four or more NCD risk factors increased gradually over time. Prevalence of four or more NCD
risk factors was 14.8% in 2003−2007 and increased to 44% in 2013−2017, an approximately three-fold
increase (44.0%). Similar trends were also observed for three and two risk factors. Large variation between
countries in the prevalence of adolescents with four or more risk factors was found in all regions. The country
level range was higher in the South-East Asia Region (minimum Sri Lanka = 8%, maximum
Myanmar = 84%) than Western Pacific Region (minimum China = 3%, maximum Niue = 72%), European Region (minimum Sweden = 13.9%, maximum Ireland = 66.0%), African Region (minimum Senegal = 0.8%,
maximum Uganda = 82.1%) and Eastern Mediterranean Region (minimum Libya = 0.2%, maximum
Lebanon = 80.2%). Insufficient vegetable consumption, insufficient fruit consumption and physically inactivity
were three of the four most prevalent risk factors in all regions.
Interpretation Our results suggest a high prevalence of four or more NCD risk factors in adolescents globally,
although variation was found between countries. Results from our study indicate that efforts to reduce adolescent
NCD risk factors and the associated health burden need to be improved. These findings can assist policy makers to
target the rollout of country- specific interventions.
Funding None. | en_US |
