Which modifiable health risk behaviours are related? A systematic review of the clustering of Smoking, Nutrition, Alcohol and Physical activity (‘SNAP’) health risk factors

OBJECTIVE: Rapid economic growth is transforming Thailand into a middle-income country. Also emerging are chronic diseases particularly hypertension, diabetes mellitus and kidney disease. There are few studies of the incidence of hypertension. We analyse the effect on 8-year incidence of hypertension of transitional health-risk factors including demography, socioeconomic status (SES), body mass index (BMI), sedentariness, physical activity, underlying diseases, personal behaviours, food, fruit and vegetable consumption.DESIGN & METHODS: Health-risk factors and their effects on the incidence of hypertension were evaluated prospectively in the national Thai Cohort Study from 2005 to 2013. All data were derived from 40,548 Sukhothai Thammathirat Open University students returning mail-based questionnaire surveys in both 2005 and 2013. Adjusted relative risks of association between each risk factor and incidence of hypertension were calculated after controlling for confounding factors.RESULTS: In Thailand, the 8-year incidence of hypertension was 5.1% (men 7.1%, women 3.6%). Hypertension was associated with ageing, higher BMI, diabetes mellitus, chronic kidney disease, high lipids, SES, lower education level, lower household asset, physical inactivity, smoking, instant food intake and soft drink. Sex, having a partner, urbanization and sedentary habits had no influence on hypertension.CONCLUSION: In Thailand, hypertension is becoming a serious risk factor for chronic disease with a wide array of associations with modern life. As Thailand’s socio-economy develops the health-risk transition will further impact on population health. Thais should be encouraged by government policy to consume less instant food, maintain normal BMI, increased physical activity, stop smoking and consume less soft drink.

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Multiple Health Risk Factors in Vocational Education Students: A Systematic Review

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18020637 ◽

2021 ◽

Vol 18 (2) ◽

pp. 637

Author(s):

Prince Atorkey ◽

Judith Byaruhanga ◽

Christine Paul ◽

John Wiggers ◽

Billie Bonevski ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Health Risk ◽

Vocational Education ◽

Health Risks ◽

Tobacco Smoking ◽

Assessment Tool ◽

Education Students ◽

Health Risk Factors ◽

Multiple Health

Health risk factors such as tobacco smoking, inadequate fruit intake, inadequate vegetable intake, risky alcohol consumption, physical inactivity, obesity, anxiety and depression often commence during adolescence and young adulthood. Vocational education institutions enrol many students in these age groups making them an important setting for addressing multiple health risk factors. This systematic review examined (i) co-occurrence of health risk factors, (ii) clustering of health risk factors, and (iii) socio-demographic characteristics associated with co-occurrence and/or clusters of health risks among vocational education students. MEDLINE, PsycINFO, EMBASE, CINAHL and Scopus were searched to identify eligible studies published by 30 June 2020. Two reviewers independently extracted data and assessed methodological quality using the National Heart, Lung and Blood Institute Quality Assessment Tool. Five studies assessed co-occurrence and three studies clustering of health risks. Co-occurrence of health risk factors ranged from 29–98% and clustering of alcohol use and tobacco smoking was commonly reported. The findings were mixed about whether gender and age were associated with co-occurrence or clustering of health risks. There is limited evidence examining co-occurrence and clustering of health risk factors in vocational education students. Comprehensive assessment of how all these health risks co-occur or cluster in vocational education students is required.

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