Prevalence of multiple non-communicable diseases risk factors among adolescents in 140 countries: A population-based study

Tuhin Biswas, Nick Townsend, M. Mamun Huda, Joemer Maravilla, Tahmina Begum, Sonia Pervin, Arpita Ghosh, Rashidul Alam Mahumud, Shariful Islam, Novera Anwar, Rukaiya Rifhat, Kerim Munir, Rajat Das Gupta, Andre M.N. Renzaho, Helda Khusun, Luh Ade Ari Wiradnyani, Tim Radel, Janeen Baxter, Lal B. Rawal, David McIntyreKjersti Mørkrid, Abdullah Mamun

Research output: Contribution to journalArticlepeer-review

14 Citations (SciVal)


Background: Modifiable non-communicable disease (NCD) risk factors are becoming increasingly common among adolescents, with clustering of these risk factors in individuals of particular concern. The aim of this study was to assess global status of clustering of common modifiable NCD risk factors among adolescents. Methods: We used latest available data from nationally representative survey for 140 countries, namely the Global School-based Student Health Survey, the Health Behaviour in School-Aged Children and the longitudinal study of Australian Children. Weighted mean estimates of prevalence with corresponding 95% confidence intervals of nine NCD risk factors - physical inactivity, sedentary behaviour, insufficient fruits and vegetable consumption, carbonated soft drink consumption, fast food consumption, tobacco use, alcohol consumption and overweight/obesity - were calculated by country, region and sex. Findings: Over 487,565 adolescents, aged 11–17 years, were included in this study. According to trend analysis, prevalence of four or more NCD risk factors increased gradually over time. Prevalence of four or more NCD risk factors was 14.8% in 2003–2007 and increased to 44% in 2013–2017, an approximately three-fold increase (44.0%). Similar trends were also observed for three and two risk factors. Large variation between countries in the prevalence of adolescents with four or more risk factors was found in all regions. The country level range was higher in the South-East Asia Region (minimum Sri Lanka = 8%, maximum Myanmar = 84%) than Western Pacific Region (minimum China = 3%, maximum Niue = 72%), European Region (minimum Sweden = 13.9%, maximum Ireland = 66.0%), African Region (minimum Senegal = 0.8%, maximum Uganda = 82.1%) and Eastern Mediterranean Region (minimum Libya = 0.2%, maximum Lebanon = 80.2%). Insufficient vegetable consumption, insufficient fruit consumption and physically inactivity were three of the four most prevalent risk factors in all regions. Interpretation: Our results suggest a high prevalence of four or more NCD risk factors in adolescents globally, although variation was found between countries. Results from our study indicate that efforts to reduce adolescent NCD risk factors and the associated health burden need to be improved. These findings can assist policy makers to target the rollout of country- specific interventions. Funding: None.

Original languageEnglish
Article number101591
Early online date12 Aug 2022
Publication statusPublished - 31 Oct 2022

Bibliographical note

Funding Information:
We thank the US Centers for Disease Control and WHO for making Global School-based Student Health Survey (GSHS), HBSC and LSAC data publicly available for analysis. This research was supported by the Australian Research Council Centre of Excellence for Children and Families over the Life Course CE200100025.


  • Adolescents
  • Burden
  • Non-communicable disease
  • Risk factors

ASJC Scopus subject areas

  • Medicine(all)


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