Common mental disorders in Brazilian adolescents: association with school characteristics, consumption of ultra-processed foods and waist-to-height ratio

Gratão, Lucia Helena Almeida; Silva, Thales Philipe Rodrigues da; Rocha, Luana Lara; Jardim, Mariana Zogbi; Oliveira, Tatiana Resende Prado Rangel de; Cunha, Cristiane de Freitas; Mendes, Larissa Loures

doi:10.1590/0102-311XEN068423

Acessibilidade / Reportar erro

Brasil

Cadernos de Saúde Pública

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

ARTICLE • Cad. Saúde Pública 40 (4) • 2024 • https://doi.org/10.1590/0102-311XEN068423 copy

Common mental disorders in Brazilian adolescents: association with school characteristics, consumption of ultra-processed foods and waist-to-height ratio

Transtornos mentais comuns em adolescentes brasileiros: associação com características escolares, consumo de alimentos ultraprocessados e razão cintura/estatura

Trastornos mentales comunes en adolescentes brasileños: asociación con características escolares, consumo de alimentos ultraprocesados y relación cintura/estatura

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract:

Half of all mental health problems diagnosed in adulthood have their onset before or during adolescence, especially common mental disorders (CMD). Thus, it is relevant to study the factors associated with these disorders. This study aimed to investigate the association of school characteristics, consumption of ultra-processed foods, and waist-to-height ratio with the presence of CMD in Brazilian adolescents. This is a school-based, cross-sectional study that analyzed data from 71,553 Brazilian adolescents aged 12-17 years. The prevalence of CMD in these adolescents was 17.1% (cut-off point 5 for the General Health Questionnaire-12). Associations were estimated using multilevel logistic models, with the presence of CMD as the dependent variable. The final model, adjusted for non-modifiable individual variables, modifiable individual variables and family characteristics, identified a positive association between private-funded schools (OR = 1.10; 95%CI: 1.07-1.14), advertisements for ultra-processed foods (OR = 1.13; 95%CI: 1.09-1.17), the second to fourth quartiles of ultra-processed food intake and waist-to-height ratio (OR = 2.26; 95%CI: 2.03-2.52). This study demonstrated that the private-funded schools , the presence of ultra-processed food advertisements, the consumption of ultra-processed food, and an increased waist-to-height ratio are risk factors for CMD in Brazilian adolescents.

Keywords:
Adolescent Health; Mental Health; Food and Beverages

Parameter	CMD
Parameter	Total sample (n) *	Total sample (%) **	CMD- (%)	CMD+ (%)	p-value ***
Individual and family characteristics
Sex
Female	39,690	49.79	46.05	67.92	< 0.001
Male	31,863	50.21	53.95	32.08	< 0.001
Age (years)
12-14	32,840	52.70	54.14	45.74	< 0.001
15-17	38,713	47.30	45.86	54.26	< 0.001
Region of residence
Central-West	9,331	7.67	7.60	7.98	0.7908
Northeast	22,205	21.34	21.41	20.97
North	14,494	8.43	8.38	8.67
Southeast	16,434	50.78	50.87	50.37
South	9,089	11.78	11.74	12.01
Work activities by the adolescent
No	54,190	73.97	74.93	69.32	< 0.001
Yes	17,363	26.03	25.07	30.68	< 0.001
Pattern of socioeconomic indicators (tertiles) ^#
First	31,609	46.26	46.08	47.11	0.2841
Second	24,864	35.04	35.32	33.68
Third	14,349	18.70	18.60	19.21
Lives with parents
Both parents or only with the mother/father	66,634	92.12	94.56	92.01	< 0.001
None of the parents	4,919	5.88	5.44	7.99	< 0.001
Practice of physical activity
Inactive	13,047	16.72	15.59	22.20	< 0.001
Insufficiently active 1	10,148	14.19	14.21	14.13
Insufficiently active 2	9,686	14.05	14.50	11.88
Active	38,672	55.04	55.71	51.79
Type of school funding
Public	56,703	83.61	83.70	83.19	0.4025
Private	14,850	16.39	16.30	16.81	0.4025
Ultra-processed food advertisements at school
No	62,201	95.35	95.41	95.05	0.1422
Yes	6,024	4.65	4.59	4.95	0.1422
		General mean (SD)	CMD mean (SD)	CMD+ mean (SD)	p-value ^##
Individual variable ^##
Daily energy intake	71,553	2,286.78 (20.21)	2,293.01 (22.07)	2,256.34 (23.89)	< 0.001
Ultra-processed foods consumption (quartiles)	71,553
First	17,910	87.13 (72.77)	86.69 (72.89)	89.18 (72.18)	0.080
Second	17,867	353.65 (84.39)	353.67 (84.48)	354.65 (83.98)	0.554
Third	17,888	725.38 (141.60)	724.24 (141.48)	730.30 (142.03)	0.026
Fourth	17,888	1,606.40 (725.11)	1,597.55 (713.56)	1,644.51 (771.87)	< 0.001
Waist-to-height ratio	71,553	0.43 (0.001)	0.43 (0.001)	0.44 (0.001)	< 0.001
Mean sleep time	71,553	8.41 (0.31)	8.46 (0.31)	8.16 (0.39)	< 0.001

Parameter	Null model	Model 1 *		Model 2 **		Model 3 ***
Parameter	OR (95%CI)	OR (95%CI)	p-value	OR (95%CI)	p-value	OR (95%CI)	p-value
School characteristics
Type of school funding
Public	-	Reference	< 0.001	Reference	< 0.001	Reference	< 0.001
Private	-	1.11 (1.08-1.14)	< 0.001	1.12 (1.09-1.15)	< 0.001	1.11 (1.08-1.15)	< 0.001
Ultra-processed foods advertising
No	-	Reference	< 0.001	Reference	< 0.001	Reference	< 0.001
Yes	-	1.16 (1.13-1.20)	< 0.001	1.12 (1.09-1.16)	< 0.001	1.10 (1.06-1.14)	< 0.001
Individual characteristics of adolescents
Ultra-processed foods intake (quartiles)
First	-	Reference	< 0.001	Reference	< 0.001	Reference	< 0.001
Second	-	1.10 (1.08-1.12)	< 0.001	1.08 (1.06-1.10)	< 0.001	1.08 (1.06-1.10)	< 0.001
Third	-	1.07 (1.05-1.09)	< 0.001	1.03 (1.01-1.05)	< 0.001	1.04 (1.02-1.05)	< 0.001
Fourth	-	1.17 (1.15-1.19)	< 0.001	1.19 (1.17-1.22)	< 0.001	1.20 (1.18-1.22)	< 0.001
Waist-to-height ratio	-	2.88 (2.61-3.18)	< 0.001	2.32 (2.08-2.58)	< 0.001	2.16 (1.94-2.41)	< 0.001
Fixed effects
Intercept	0.20 (0.205-0.209)	0.13 (0.13-0.14)	< 0.001	0.44 (0.41-0.47)	< 0.001	0.44 (0.41-0.47)	< 0.001
Random effects
Variance	0.18 (0.003)	0.15 (0.0034)		0.17 (0.0040)		0.17 (0.0039)
Variance partition coefficient	0.0518	0.0461		0.0505		0.0498
AIC	1,009,926	893,945.8		779,477.8		769,378.3

Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz Rua Leopoldo Bulhões, 1480 , 21041-210 Rio de Janeiro RJ Brazil, Tel.:+55 21 2598-2511, Fax: +55 21 2598-2737 / +55 21 2598-2514 - Rio de Janeiro - RJ - Brazil
E-mail: cadernos@ensp.fiocruz.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Correspondence
L. H. A. Gratão Escola de Enfermagem, Universidade Federal de Minas Gerais. Av. Prof. Alfredo Balena 190, Belo Horizonte, MG 30130-100, Brasil. luciagratao@gmail.com