FACTORS ASSOCIATED WITH INADEQUATE MILK CONSUMPTION AMONG ADOLESCENTS: NATIONAL SCHOOL HEALTH SURVEY - PENSE 2012

ABSTRACT Objective: To identify the prevalence and factors associated with inadequate milk consumption among adolescents. Methods: This was a cross-sectional study based on secondary data from the National School Health Survey (2012), a Brazilian survey carried out using a self-administered questionnaire in a representative sample of 9th-grade students from public and private schools. The frequency of milk intake and its association with socio-demographic characteristics, food consumption and physical activity were estimated. A descriptive and inferential analysis of factors associated with inadequate milk consumption (no consumption at least one of the seven days of the week) was performed. A multiple logistic model was adjusted to control confounders. Results: The sample included 108,828 adolescents and inadequate milk consumption ocurred in 58.9%. The final model included nine variables independently associated with inadequate milk intake: breakfast frequency less than 4 days per week (odds ratio [OR]=2.40; p<0.001), unprocessed or minimally processed foods intake less than 5 days per week (OR=1.93; p<0.001), living in the northeast region (OR=1.39; p<0.001), less maternal schooling (OR=1.35; p<0.001), physical inactivity (OR=1.33; p<0.001), attending public school (OR=1.26; p<0.001), not being white (OR=1.14; p<0.001), being older than 14 years old (OR=1.13; p<0.001) and having a habit of eating meals while watching TV or studying (OR=1.04; p=0.036). Conclusions: Inadequate milk consumption is prevalent among Brazilian adolescents. The identification of associated factors suggests the need to develop nutritional guidance strategies for the prevention of diseases that result from low calcium intake.

摘要 目的：明确青少年牛奶摄入不足的患病率及其相关影响因素。方法：本研究为横断面研究，数据来源于巴西2012年全国学校健康调查（National School Health Survey）的二手数据。该调查采用自填式问卷，对公立与私立学校九年级学生的代表性样本开展调研。本研究估算了牛奶摄入频率及其与社会人口学特征、食物摄入及身体活动的关联；针对牛奶摄入不足（每周至少1天未饮用牛奶）的相关影响因素进行描述性与推断性分析，并构建多因素logistic回归模型以控制混杂因素。结果：本研究共纳入108828名青少年，其中58.9%存在牛奶摄入不足的情况。最终模型显示9个变量与牛奶摄入不足独立相关：每周早餐摄入少于4天（比值比[OR]=2.40；p<0.001）、每周未加工或微加工食品摄入少于5天（OR=1.93；p<0.001）、居住于巴西东北部地区（OR=1.39；p<0.001）、母亲受教育程度较低（OR=1.35；p<0.001）、身体活动不足（OR=1.33；p<0.001）、就读于公立学校（OR=1.26；p<0.001）、非白种人（OR=1.14；p<0.001）、年龄超过14岁（OR=1.13；p<0.001）以及进餐时同时看电视或学习的习惯（OR=1.04；p=0.036）。结论：巴西青少年群体中牛奶摄入不足的现象较为普遍。本研究明确的相关影响因素提示，需制定针对性营养指导策略，以预防低钙摄入引发的相关疾病。