Adolescents are highly susceptible to environmental factors (e.g., the media, family and friends) which may have negative effects on their choices of health-related behaviors. Considering that many behaviors are established during adolescence and continue into adulthood, the study of behavioral risk factors (BRFs) among adolescents is a very relevant topic for public health interventions. We performed a survey that aimed to identify the prevalence of BRFs (insufficiently active, excessive TV watching, alcohol and tobacco use, daily soft drinks consumption and insufficient fruit and vegetable [F&V] consumption) among adolescents from a municipality in southern Brazil. In this paper, we have highlighted the results related to F&V consumption.

A survey conducted in elementary and secondary schools in southern Brazil

We performed a cross-sectional study with 1,628 adolescents (aged 11-17.9 years, 52.5% males) who were randomly selected from 44 public schools (classes from the 6th grade of elementary school to the 2nd year of secondary school) in Curitiba, southern Brazil. Self-report instruments were used to assess the BRFs. A food frequency questionnaire validated for the Brazilian population was used to estimate eating behaviors outcomes. Six BRFs were analyzed:

• daily soft drinks consumption
• insufficient F&V consumption (< 5 F&V portions per day)
• insufficiently active (< 420 minutes of moderate-to-vigorous physical activity per week)
• excessive TV watching (> 3 hours of TV watching every day)
• current alcohol and tobacco use (the use of these substances in the month preceding the survey).

Adjusted prevalence ratios (Poisson regression) were used as an association measure.

How are adolescents doing in southern Brazil?

The highest prevalence rates were observed in the following BRFs: being insufficiently active (50.5%) and daily soft drinks consumption (47.6%). Insufficient F&V consumption was the third BRF with the highest rate of prevalence among Brazilian adolescents, involving an estimated 35.5% of adolescents. The prevalence rates obtained from current alcohol use (32.4%), excessive time watching TV (28.8%) and current tobacco use (7.9%) were lower than the prevalence of insufficient F&V consumption. Only 8.4% of the adolescents did not show any BRFs.

The estimates of insufficient F&V consumption (≤ 5 portions per day) were below those found in previous studies1,2. These previous studies also used food frequency questionnaires to estimate people’s intake of fruit and vegetables. Our results showed that the habit of insufficient F&V consumption was estimated as being lower among Brazilian adolescents when compared to their counterparts from other countries. Some environmental and demographic factors (e.g., the availability of F&V throughout the year, the encouragement from parental patterns of consumption and seasonal reductions in the price of F&V) may explain the adoption of this healthy habit among Brazilian adolescents. However, 35% of adolescents ate less than five F&V portions per day, which was the third BRF with the highest prevalence rates. Thus, the development of actions to promote healthy eating among young people from Brazil should be considered.

Active lifestyle may prevent insufficient F&V consumption and promote healthy eating

Adolescents who did not participate in organized physical activity had a higher prevalence of insufficient F&V consumption. Additionally, adolescents who used computer/video games daily were the high-risk subgroups for daily soft drinks consumption.  The association between active lifestyle and BRFs has been highlighted previously³. The encouragement of physical activity inside and outside of the school can also play an important role, not only in protecting against cardiovascular health problems, but also in encouraging a healthy lifestyle based on different behaviors. The association between sedentary behavior and inappropriate eating habits was also highlighted in a systematic review⁴ and may be related to the consumption of these foods during sedentary activities. Thus, interventions to promote healthy eating in Brazilians adolescents can be focused from the perspective of an active lifestyle. Public policies on physical activity-related behaviors can contribute to the reduction of other behaviors that are associated with the development of cardiovascular problems, including eating behaviors such as the insufficient consumption of F&V and excessive soft drinks consumption.

BASED ON: Barbosa Filho VC, Campos W, Bozza R, Lopes AS. The prevalence and correlates of behavioral risk factors for cardiovascular health among Southern Brazil adolescents: a cross sectional study. BMC Pediatr. 2012;12:130.