{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T23:19:47Z","timestamp":1776122387026,"version":"3.50.1"},"update-to":[{"DOI":"10.12688\/wellcomeopenres.16873.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2021,9,23]],"date-time":"2021-09-23T00:00:00Z","timestamp":1632355200000}}],"reference-count":24,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2021,9,23]],"date-time":"2021-09-23T00:00:00Z","timestamp":1632355200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009053","name":"The Wellcome Trust DBT India Alliance","doi-asserted-by":"publisher","award":["IA\/CPHE\/17\/1\/50334"],"award-info":[{"award-number":["IA\/CPHE\/17\/1\/50334"]}],"id":[{"id":"10.13039\/501100009053","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["wellcomeopenresearch.org"],"crossmark-restriction":false},"short-container-title":["Wellcome Open Res"],"abstract":"<ns3:p>\n                    <ns3:bold>Background<\/ns3:bold>\n                    : Limited evidence exists on the presence of collective non-communicable disease (NCD) risk factors among adolescents in Kerala, India. We aimed to assess the prevalence and factors associated with multiple NCD risk factors and the clustering of these risk factors among adolescents in Kasaragod District, Kerala.\n                  <\/ns3:p>\n                  <ns3:p>\n                    <ns3:bold>Methods<\/ns3:bold>\n                    : We selected 470 adolescents (mean age 16.6 years, male 53.8%) through multi-stage cluster sampling from higher secondary schools of Kasaragod district. Self-administered questionnaires were used, and anthropometric measurements were taken using standard techniques and protocols. Tobacco use, alcohol consumption, low fruits and vegetable consumption, inadequate physical activity, extra salt intake, overweight, consumption of soft drinks and packed foods were the eight NCD risk factors included.The factors associated with one, two and three or more NCD risk factors were analysed using multinomial logistic regression and the standard errors were adjusted for the four clusters.\n                  <\/ns3:p>\n                  <ns3:p>\n                    <ns3:bold>Results<\/ns3:bold>\n                    : Risk factor clusters with two risk factors (dyads) and three risk factors (triads) were observed in 163 (34.7%) and 102 (21.7%) of the sample, respectively. Adolescents residing in urban areas (odds ratio (OR) = 3.55; 95% confidence interval (CI) = 1.45-8.73), whose father\u2019s education level was lower (OR = 3.54; \u00a095% CI = 1.24-10.10), whose mother\u2019s education was lower (OR= 4.13; 95% CI = 1.27-13.51), who had restrictions on physical activity (OR = 5.41; 95% CI = 1.20-24.30) and who did not have a kitchen garden (an area where fruits and vegetables are grown for domestic use) (OR=4.51;95% \u00a0CI = 1.44-14.12) were more likely to have three or more NCD risk factors compared to their counterparts. \u00a0\n                  <\/ns3:p>\n                  <ns3:p>\n                    <ns3:bold>Conclusions<\/ns3:bold>\n                    :\u00a0Clustering of NCD risk factors was prevalent in more than half of the adolescents. Efforts are warranted to reduce multiple risk factors, focussing on children of low educated parents and urban residents.\n                  <\/ns3:p>","DOI":"10.12688\/wellcomeopenres.16873.2","type":"journal-article","created":{"date-parts":[[2021,9,23]],"date-time":"2021-09-23T07:35:52Z","timestamp":1632382552000},"page":"145","update-policy":"https:\/\/doi.org\/10.12688\/wellcomeopenres.crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Clustering of noncommunicable disease risk factors among adolescents attending higher secondary schools in Kasaragod District, Kerala, India"],"prefix":"10.12688","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3257-6330","authenticated-orcid":false,"given":"Thekke 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with reservations, Approved with reservations","URL":"https:\/\/wellcomeopenresearch.org\/articles\/6-145\/v2#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.21956\/wellcomeopenres.18612.r45163, Kuang H. Lim, Special Resource Centre, Institute for Medical Research, Kuala Lumpur, Malaysia, 12 Aug 2021, version 1, 1 approved with reservations","URL":"https:\/\/wellcomeopenresearch.org\/articles\/6-145\/v1#referee-response-45163","order":0,"name":"referee-response-45163","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/wellcomeopenres.19056.r51183, Sina Azadnajafabad, Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran, 11 Jul 2022, version 2, 2 approved with reservations","URL":"https:\/\/wellcomeopenresearch.org\/articles\/6-145\/v2#referee-response-51183","order":1,"name":"referee-response-51183","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"This work was supported by the Wellcome Trust [IA\/CPHE\/17\/1\/50334; a Wellcome Trust DBT\/India Alliance Early career fellowship award to EM]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":2,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}