Skip to main content
Top
Published in: BMC Public Health 1/2015

Open Access 01-12-2015 | Research article

Nutritional and lifestyle risk behaviors and their association with mental health and violence among Pakistani adolescents: results from the National Survey of 4583 individuals

Authors: Saadiyah Rao, Nadia Shah, Nida Jawed, Sumera Inam, Kashif Shafique

Published in: BMC Public Health | Issue 1/2015

Login to get access

Abstract

Background

Unhealthy behaviors are associated with mental health problems and violence in adolescents, yet their combined association has been understudied. Using the Global School Health Survey, this study examined the association between combined unhealthy behaviors (including fast food, soft drink, smoking, other tobacco products and physical inactivity) and anxiety, suicidal ideation and involvement in physical fight among Pakistani adolescents.

Methods

Data were obtained from the Global School Health Survey conducted in Pakistan (2009). The study population consisted of school going adolescents aged 13 to 15 years. Association of combined unhealthy behaviors with anxiety, suicidal ideation and involvement in physical fight were studied through secondary analysis. We used univariate and multivariate logistic regression analysis by complex sample method, accounting for cluster sampling technique used for data collection.

Results

Of the total 4583 students, weighted percentage and unweighted count for one, two, three and four or more unhealthy behaviors was 39.4% (n = 1770), 22.1% (n = 963), 5.9% (n = 274) and 1.2% (n = 62) respectively. The weighted prevalence for anxiety, suicidal ideation and involvement in physical fight were 8.4%, 7.3% and 37.4% respectively. The results of multivariate logistic regression analysis after adjustment showed that students who had four or more unhealthy behaviors had higher odds of; being anxious (OR 2.45, 95%CI 1.31-4.59, p value 0.004), suicide ideation (OR 4.56, 95%CI 2.58-8.07, p value <0.001) and being involved in physical fight (OR 3.15, 95% CI 1.63–6.08, p value <0.001) as compared to those who had not adopted any unhealthy behaviors.

Conclusions

This study suggests that the co-occurrence of unhealthy behaviors is associated with anxiety, suicidal ideation and physical fight among adolescents. These findings should be considered when developing interventions to combat detrimental outcomes of unhealthy behaviors during adolescence.
Literature
1.
go back to reference Mulder M, Ranchor AV, Sanderman R, Bouma J, van den Heuvel WJ. The stability of lifestyle behaviour. Int J Epidemiol. 1998;27(2):199–207.CrossRefPubMed Mulder M, Ranchor AV, Sanderman R, Bouma J, van den Heuvel WJ. The stability of lifestyle behaviour. Int J Epidemiol. 1998;27(2):199–207.CrossRefPubMed
2.
go back to reference Geckova A, Tuinstra J, Pudelsky M, Kovarova M, van Dijk JP, Groothoff JW, et al. Self-reported health problems of Slovak adolescents. J Adolesc. 2001;24(5):635–45.CrossRefPubMed Geckova A, Tuinstra J, Pudelsky M, Kovarova M, van Dijk JP, Groothoff JW, et al. Self-reported health problems of Slovak adolescents. J Adolesc. 2001;24(5):635–45.CrossRefPubMed
4.
go back to reference Mushtaq MU, Gull S, Mushtaq K, Shahid U, Shad MA, Akram J. Dietary behaviors, physical activity and sedentary lifestyle associated with overweight and obesity, and their socio-demographic correlates, among Pakistani primary school children. Int J Behav Nutr Phys Act. 2011;8(1):130.CrossRefPubMedPubMedCentral Mushtaq MU, Gull S, Mushtaq K, Shahid U, Shad MA, Akram J. Dietary behaviors, physical activity and sedentary lifestyle associated with overweight and obesity, and their socio-demographic correlates, among Pakistani primary school children. Int J Behav Nutr Phys Act. 2011;8(1):130.CrossRefPubMedPubMedCentral
5.
go back to reference World Health Organization. WHO report on the global tobacco epidemic, 2013 country profile Pakistan. Geneva: WHO; 2013 [accessed on April 26 2014]. World Health Organization. WHO report on the global tobacco epidemic, 2013 country profile Pakistan. Geneva: WHO; 2013 [accessed on April 26 2014].
6.
go back to reference Ishaque A, Ahmad F, Zehra N, Amin H. Frequency of and factors leading to obesity and overweight in school children. J Ayub Med Coll Abbottabad. 2012;24(2):34–8.PubMed Ishaque A, Ahmad F, Zehra N, Amin H. Frequency of and factors leading to obesity and overweight in school children. J Ayub Med Coll Abbottabad. 2012;24(2):34–8.PubMed
7.
go back to reference Mirza I, Jenkins R. Risk factors, prevalence, and treatment of anxiety and depressive disorders in Pakistan: systematic review. BMJ. 2004;328(7443):794.CrossRefPubMedPubMedCentral Mirza I, Jenkins R. Risk factors, prevalence, and treatment of anxiety and depressive disorders in Pakistan: systematic review. BMJ. 2004;328(7443):794.CrossRefPubMedPubMedCentral
8.
go back to reference Sabir I, Zaman M. Youth Violence in Pakistan: The Social Structure and Culture of Violence. Profilaktyka Społeczna i Resocjalizacja. 2013;21:7–24. Sabir I, Zaman M. Youth Violence in Pakistan: The Social Structure and Culture of Violence. Profilaktyka Społeczna i Resocjalizacja. 2013;21:7–24.
9.
go back to reference Verger P, Lions C, Ventelou B. Is depression associated with health risk-related behaviour clusters in adults? Eur J Public Health. 2009;19(6):618–24.CrossRefPubMed Verger P, Lions C, Ventelou B. Is depression associated with health risk-related behaviour clusters in adults? Eur J Public Health. 2009;19(6):618–24.CrossRefPubMed
10.
go back to reference Singh AK, Maheshwari A, Sharma N, Anand K. Lifestyle associated risk factors in adolescents. Indian J Pediatr. 2006;73(10):901–6.CrossRefPubMed Singh AK, Maheshwari A, Sharma N, Anand K. Lifestyle associated risk factors in adolescents. Indian J Pediatr. 2006;73(10):901–6.CrossRefPubMed
11.
go back to reference Johnson JG, Cohen P, Pine DS, Klein DF, Kasen S, Brook JS. Association between cigarette smoking and anxiety disorders during adolescence and early adulthood. JAMA. 2000;284(18):2348–51.CrossRefPubMed Johnson JG, Cohen P, Pine DS, Klein DF, Kasen S, Brook JS. Association between cigarette smoking and anxiety disorders during adolescence and early adulthood. JAMA. 2000;284(18):2348–51.CrossRefPubMed
12.
go back to reference Ströhle A. Physical activity, exercise, depression and anxiety disorders. J Neural Transm. 2009;116(6):777–84.CrossRefPubMed Ströhle A. Physical activity, exercise, depression and anxiety disorders. J Neural Transm. 2009;116(6):777–84.CrossRefPubMed
13.
go back to reference McGee R, Williams S, Nada-Raja S. Is cigarette smoking associated with suicidal ideation among young people? Am J Psychiatr. 2005;162(3):619–20.CrossRefPubMed McGee R, Williams S, Nada-Raja S. Is cigarette smoking associated with suicidal ideation among young people? Am J Psychiatr. 2005;162(3):619–20.CrossRefPubMed
14.
go back to reference Rudatsikira E, Siziya S, Kazembe L, Muula A. Prevalence and associated factors of physical fighting among school-going adolescents in Namibia. Ann Gen Psychiatry. 2007;6:18.CrossRefPubMedPubMedCentral Rudatsikira E, Siziya S, Kazembe L, Muula A. Prevalence and associated factors of physical fighting among school-going adolescents in Namibia. Ann Gen Psychiatry. 2007;6:18.CrossRefPubMedPubMedCentral
15.
go back to reference Solnick SJ, Hemenway D. Soft drinks, aggression and suicidal behaviour in US high school students. Int J Inj Contr Saf Promot. 2013;21(3):1–8. Solnick SJ, Hemenway D. Soft drinks, aggression and suicidal behaviour in US high school students. Int J Inj Contr Saf Promot. 2013;21(3):1–8.
16.
go back to reference Hasumi T, Ahsan F, Couper CM, Aguayo JL, Jacobsen KH. Parental involvement and mental well-being of Indian adolescents. Indian Pediatr. 2012;49(11):915–8.CrossRefPubMed Hasumi T, Ahsan F, Couper CM, Aguayo JL, Jacobsen KH. Parental involvement and mental well-being of Indian adolescents. Indian Pediatr. 2012;49(11):915–8.CrossRefPubMed
17.
go back to reference Margolese SK, Markiewicz D, Doyle AB. Attachment to parents, best friend, and romantic partner: Predicting different pathways to depression in adolescence. J Youth Adolesc. 2005;34(6):637–50.CrossRef Margolese SK, Markiewicz D, Doyle AB. Attachment to parents, best friend, and romantic partner: Predicting different pathways to depression in adolescence. J Youth Adolesc. 2005;34(6):637–50.CrossRef
18.
go back to reference Cheng Y, Tao M, Riley L, Kann L, Ye L, Tian X, et al. Protective factors relating to decreased risks of adolescent suicidal behaviour. Child Care Health Dev. 2009;35(3):313–22.CrossRefPubMed Cheng Y, Tao M, Riley L, Kann L, Ye L, Tian X, et al. Protective factors relating to decreased risks of adolescent suicidal behaviour. Child Care Health Dev. 2009;35(3):313–22.CrossRefPubMed
19.
go back to reference Conry MC, Morgan K, Curry P, McGee H, Harrington J, Ward M, et al. The clustering of health behaviours in Ireland and their relationship with mental health, self-rated health and quality of life. BMC Public Health. 2011;11(1):692–701.CrossRefPubMedPubMedCentral Conry MC, Morgan K, Curry P, McGee H, Harrington J, Ward M, et al. The clustering of health behaviours in Ireland and their relationship with mental health, self-rated health and quality of life. BMC Public Health. 2011;11(1):692–701.CrossRefPubMedPubMedCentral
20.
go back to reference Kvaavik E, Batty GD, Ursin G, Huxley R, Gale CR. Influence of individual and combined health behaviors on total and cause-specific mortality in men and women: the United Kingdom health and lifestyle survey. Arch Intern Med. 2010;170(8):711–8.CrossRefPubMed Kvaavik E, Batty GD, Ursin G, Huxley R, Gale CR. Influence of individual and combined health behaviors on total and cause-specific mortality in men and women: the United Kingdom health and lifestyle survey. Arch Intern Med. 2010;170(8):711–8.CrossRefPubMed
24.
go back to reference Rudatsikira E, Muula A, Siziya S. Variables associated with physical fighting among US high-school students. Clin Pract Epidemiol Ment Health. 2008;4(1):16.CrossRefPubMedPubMedCentral Rudatsikira E, Muula A, Siziya S. Variables associated with physical fighting among US high-school students. Clin Pract Epidemiol Ment Health. 2008;4(1):16.CrossRefPubMedPubMedCentral
26.
go back to reference Samanta A, Mukherjee S, Ghosh S, Dasgupta A. Mental health, protective factors and violence among male adolescents: A comparison between urban and rural school students in West Bengal. Indian J Public Health. 2012;56(2):155.CrossRefPubMed Samanta A, Mukherjee S, Ghosh S, Dasgupta A. Mental health, protective factors and violence among male adolescents: A comparison between urban and rural school students in West Bengal. Indian J Public Health. 2012;56(2):155.CrossRefPubMed
27.
go back to reference Rodrigo C, Welgama S, Gurusinghe J, Wijeratne T, Jayananda G, Rajapakse S. Symptoms of anxiety and depression in adolescent students; a perspective from Sri Lanka. Child Adolesc Psychiatry Ment Health. 2010;4(1):10.CrossRefPubMedPubMedCentral Rodrigo C, Welgama S, Gurusinghe J, Wijeratne T, Jayananda G, Rajapakse S. Symptoms of anxiety and depression in adolescent students; a perspective from Sri Lanka. Child Adolesc Psychiatry Ment Health. 2010;4(1):10.CrossRefPubMedPubMedCentral
28.
go back to reference Spring B, Moller AC, Coons MJ. Multiple health behaviours: overview and implications. J Public Health (Oxf). 2012;34(1):i3–10.CrossRef Spring B, Moller AC, Coons MJ. Multiple health behaviours: overview and implications. J Public Health (Oxf). 2012;34(1):i3–10.CrossRef
29.
go back to reference Sharma R, Grover VL, Chaturvedi S. Risk behaviors related to inter-personal violence among school and college-going adolescents in south Delhi. Indian J Community Med. 2008;33(2):85.CrossRefPubMedPubMedCentral Sharma R, Grover VL, Chaturvedi S. Risk behaviors related to inter-personal violence among school and college-going adolescents in south Delhi. Indian J Community Med. 2008;33(2):85.CrossRefPubMedPubMedCentral
30.
go back to reference Bott S, Jejeebhoy S, Shah I, Puri C. Towards adulthood: exploring the sexual and reproductive health of adolescents in South Asia: World Health Organization; 2003. Bott S, Jejeebhoy S, Shah I, Puri C. Towards adulthood: exploring the sexual and reproductive health of adolescents in South Asia: World Health Organization; 2003.
31.
go back to reference Towe VL, Ul Hasan S, Zafar ST, Sherman SG. Street life and drug risk behaviors associated with exchanging sex among male street children in Lahore, Pakistan. J Adolesc Health. 2009;44(3):222–8.CrossRefPubMed Towe VL, Ul Hasan S, Zafar ST, Sherman SG. Street life and drug risk behaviors associated with exchanging sex among male street children in Lahore, Pakistan. J Adolesc Health. 2009;44(3):222–8.CrossRefPubMed
Metadata
Title
Nutritional and lifestyle risk behaviors and their association with mental health and violence among Pakistani adolescents: results from the National Survey of 4583 individuals
Authors
Saadiyah Rao
Nadia Shah
Nida Jawed
Sumera Inam
Kashif Shafique
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2015
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-015-1762-x

Other articles of this Issue 1/2015

BMC Public Health 1/2015 Go to the issue