Osong Public Health and Research Perspectives · Published 2026-02-10 · DOI 10.24171/j.phrp.2025.0204
Objectives Non-communicable disease (NCD) risk among adolescents represents a growing concern due to modifiable, lifestyle-related behavioral risk factors. Early identification and control of these factors are essential for prevention. This study assessed the correlates and co-occurrence of NCD-related lifestyle risk factors among school-going adolescents in Karnataka, India, aiming to inform intervention development. Methods Screening was conducted among 1,100 school adolescents aged 13–16 years from 8 randomly selected urban and rural schools in Karnataka. Data were collected using a validated self-administered questionnaire covering sociodemographic characteristics and social cognitive theory predictors of lifestyle practices. Descriptive statistics, chi-square tests, and logistic regression were employed. Results Of the 1,100 adolescents surveyed, 552 and 548 were from urban and rural areas, respectively. Both groups reported high rates of insufficient fruit and vegetable (FV) intake (96.7% and 67.7%, respectively), inadequate physical activity (96.7% and 68.6%), tobacco use (5.6% and 11.5%), and alcohol consumption (5.6% and 10.8%). On logistic regression, urban adolescents were significantly more likely than rural peers to exhibit multiple behavioral risk factors, with 19-fold higher odds of having ≥1 factor (adjusted odds ratio [AOR], 19.04; p<0.001) and 4-fold higher odds of having ≥2 (AOR, 4.06; p<0.001). Parental (particularly maternal) education was associated with NCD risk (AOR, 1.82; p=0.001). Physical inactivity significantly co-occurred with low FV intake (71.7%) and junk food consumption (72.8%). Conclusion Unhealthy lifestyle behaviors among adolescents displayed significant co-occurrence, underscoring the critical need for comprehensive, theory-based school interventions to address multiple interconnected risk factors and mitigate the burden of NCDs.
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