The cross-cultural study of U.S. and Greek adolescents: blood pressure data

School health education programs in Crete: evaluation of behavioural and health indices a decade after initiation

OBJECTIVE

To assess the long-term effectiveness of a school-based health education intervention program 10 years after its initiation.

METHOD

In 1992 the total population of first grade students from three counties of Crete participated in the study. Over 1000 students were randomly selected for initial and periodic evaluation. Biochemical and behavioural parameters (anthropometric, lipoproteins, blood pressure, physical activity, dietary record and health habits) were measured. Re-evaluation of the program was performed at 3, 6 and 10 years after its initiation.

RESULTS

Ten years after the initiation of the program, the results showed that BMI had increased significantly less (p<0.001) and performance in the shuttle run test was significantly better (p<0.001) in the intervention group as compared to the control group. The reduction in total cholesterol noted in both groups was significantly greater in the intervention group than in the control group (p<0.001). The incidence of smoking was also significantly lower in the intervention group (intervention group 7%, control group 13%, p<0.005).

CONCLUSION

This program appears to improve children's health and decrease risk factors for chronic diseases. If these positive effects are maintained in the forthcoming decades, the risk of chronic diseases may well be reduced.

Age-dependent changes in body size of Greek boys from 1982 to 2002

OBJECTIVE

The prevalence of childhood obesity has been rising during the past decades in many parts of the world, including Greece. The dispersion of these trends across age, however, is less clear. The aim of this study was to examine the relationship between age and 20-year changes in anthropometric characteristics of Greek boys.

RESEARCH METHODS AND PROCEDURES

A total of 204 and 106 boys 9 years old, 163 and 274 boys 12 years old, and 161 and 240 boys 15 years old were randomly recruited in 1982 and 2002, respectively, throughout the county of Iraklio, Crete, Greece. Height, weight, and BMI were measured.

RESULTS

Contemporary 9 and 12 year olds were taller than their peers in 1982 (+2.9% and +1.2%, respectively; p < 0.005), but this was not the case for 15 year olds (-0.8%; p = 0.083). Body weight and BMI were higher now than in the 1980s, and this held true for all age groups (p < 0.001). Increases in weight also showed a decline with advancing age (+17.4%, +13.9%, and +4.0% for 9, 12, and 15 year olds, respectively), whereas BMI changes were similar for those 9 and 12 years of age (approximately 10.5%), but were almost 2-fold higher than in 15 year olds (+5.5%).

DISCUSSION

Contemporary boys are taller, heavier, and have higher BMI values than their peers in 1982, but the magnitude of these increases gradually declines with advancing age. Rates of increase in BMI, however, seem to have greatly accelerated compared with previous decades.

Changing relationships of obesity and dyslipidemia in Greek children: 1982-2002

BACKGROUND

The prevalence of childhood overweight and obesity has been increasing rapidly during the past decades in many parts of the world. Less is known with respect to the effects of increasing adiposity on blood lipid profile. The present study was designed to examine the influence of adiposity on secular trends in anthropometric characteristics and plasma lipids of Greek children.

METHODS

A total of 419 and 374 boys with normal body weight and 109 and 246 boys with abnormal body weight (overweight and obese) were randomly recruited in 1982 and 2002, respectively (aged 12.1 +/- 0.1 years). Height, weight, body mass index (BMI, kg/m(2)), Rohrer index (kg/m(3)), plasma total cholesterol (TC), high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), triglyceride (TG), TC/HDL-C ratio, and LDL-C/HDL-C ratio were determined.

RESULTS

Temporal changes in weight (positive), BMI (positive), HDL-C (negative), and cholesterol ratios (positive) were greater among overweight and obese vs. normal-weight boys (P < 0.05), while those for height (positive), LDL-C (positive), TG (positive), and TC (no change) were of similar magnitude. The increase in Rohrer index since 1982 failed to reach significance for children with normal body weight (P = 0.077) but did so for overweight and obese subjects (P = 0.027).

CONCLUSIONS

These results indicate that secular increases in measures of fatness and adverse changes in plasma lipids were more pronounced among overweight and obese children than among normal-weight individuals, although qualitatively similar shifts were observed across the entire population.

Twenty-year dynamics in adiposity and blood lipids of Greek children: regional differences in Crete persist

AIM

To examine whether secular trends in adiposity and blood lipid profile of Greek children manifested equally among individuals from urban and rural provinces.

METHODS

Cretan boys (aged 12.1+/-2.3 y) from urban and rural areas of Crete were recruited in 1982 (n=277 and 251, respectively) and 2002 (n=440 and 180, respectively). Height, weight, and body mass index (BMI), as well as plasma lipid concentrations were measured and compared across cohorts (1982 vs 2002) and regions (urban vs rural) by two-way analysis of covariance (adjusted for age) with interaction.

RESULTS

Temporal changes in height (positive), weight (positive), and BMI (positive) manifested equally in children from urban and rural provinces, as no interaction was detected. Similar results were obtained for triacylglycerol (positive), low-density lipoprotein cholesterol (LDL-C, positive) and high-density lipoprotein cholesterol (negative) concentrations. A significant interaction was observed only for total cholesterol (TC), which increased from 1982 among rural (by 6.2%, p < 0.05) but not among urban boys. In all other instances, regional differences in 1982 persisted in 2002. More specifically, children from urban provinces were taller, heavier, and had higher BMI values than those from rural areas, while they also had higher LDL-C concentrations, whether nowadays or 20 y ago. Regional differences in TC in 1982 were not apparent in 2002.

CONCLUSION

These findings suggest that changes in anthropometric characteristics and plasma lipids during the past 20 y have occurred largely in parallel among urban and rural Cretan children, and they emphasize the importance of developing a common national strategy for the prevention and treatment of childhood obesity in Greece.

Secular trends in cardiovascular risk factors among school-aged boys from Crete, Greece, 1982-2002

OBJECTIVE

The aim of the present study was to examine secular trends in major cardiovascular disease (CVD) risk factors, that is, obesity and dyslipidaemia, among Cretan children during 1982-2002.

DESIGN

Epidemiological survey.

SETTING AND SUBJECTS

A total of 528 boys in 1982 and 620 boys in 2002, aged 12.1+/-0.1 y, were randomly selected from urban and rural regions throughout the county of Iraklio, Crete, Greece. Care was taken so that all procedures in 2002 closely matched those in 1982.

RESULTS

Mean height, weight, and body mass index (BMI) were 1.1, 9.6, and 8.4% higher, respectively, in 2002 vs 1982 (P<0.001). The prevalence of overweight and obesity has risen by 63 and 202%, respectively (P<0.001). Contemporary children were found to have 3.6% higher total cholesterol (TC), 24.9% lower high-density lipoprotein-cholesterol (HDL-C), 25.3% higher low-density lipoprotein-cholesterol (LDL-C), 19.4% higher triacylglycerol, 36.6% higher TC/HDL-C ratio, and 60.3% higher LDL-C/HDL-C ratio compared with their peers in 1982 (P<0.003). These differences persisted even when adjusting for BMI (P<0.02). The proportion of children having abnormal lipid values was much greater nowadays than in the 1980s, yielding odds ratios of 1.4-8.8 (P<0.005).

CONCLUSIONS

Results are indicative of a largely deteriorated CVD risk profile in Cretan children since 1982, and predict an unfavourable CVD morbidity and mortality for this population in the foreseeable future.