The association between high blood pressure, physical fitness, and body mass index in adolescents

High Systolic Blood Pressure of High-Income African American Children

BACKGROUND

According to the Minorities' Diminished Returns (MDRs) theory, racism may reduce the health returns of family socioeconomic status (SEP) resources such as family income for racial minorities, particularly African Americans, compared to Whites. However, we are unaware of any previous studies on racial variation in the protective effects of family income on children's blood pressure.

AIM

We conducted this study to compare the overall effects of family income on pre-adolescents' systolic and diastolic blood pressure, test racial variation in this effect, and investigate whether racial variation in this regard is due to racial differences in body mass index.

METHODS

In this cross-sectional study, we analyzed data from 4007 racially diverse US children 9-10 years old. The independent variable was family income measured as a three-level categorical variable: less than $50 K USD, 50-100 K USD, and 100 + K USD. The primary outcomes were systolic and diastolic blood pressure measured up to three times at 1-min time intervals. Body mass index was the mediator. Mixed-effects regression models were used for data analysis to adjust for data nested to the centers, families, and individuals. Age, gender, parental education, family structure, and Latino ethnicity were covariates.

RESULTS

In the pooled sample and in the absence of interaction terms in the model, family income did not show an inverse association with children's systolic (for 100 + K USD family income: β =  - 0.71, p = 0.233 and for 50-100 K USD family income: β = 0.01, p = 0.989) or diastolic blood pressure (for 100 + K USD family income: β =  - 0.66, p = 0.172 and for 50-100 K USD family income: β = 0.23, p = 0.600). However, race showed a significant interaction with family income on systolic blood pressure (for 50-100 K USD × African American: β = 2.75, p = 0.034), suggesting higher systolic blood pressure of African American adolescents from high-income backgrounds. Racial variation in the protective effect of family income on systolic BP was no more significant (for 50-100 K USD × African American: β = 2.14, p = 0.149) after we controlled for body mass index (BMI), which was higher for African American than White adolescents.

CONCLUSION

The association between high family income and reduced systolic blood pressure in pre-adolescence might be weaker for African Americans compared to Whites, a difference that African American adolescents' higher body mass index can explain.

The relationship between blood pressure and functional fitness of older adults in Korea

Hypertension, also known as high blood pressure (BP), is a critical health issue that can cause cardiovascular disease. It is observed more frequently in older adults. Thus, this study aimed to identify the functional fitness and body composition factors that significantly influence both systolic and diastolic BPs in older adults. Data from 155,266 older adults (51,751 men [33.3%] and 103,505 women [66.7%]) who underwent functional fitness tests between 2013 and 2018 were analyzed. The following seven functional fitness tests were conducted: (a) aerobic endurance (2-min step), (b) upper body muscle strength (hand grip strength), (c) lower body muscle endurance (chair sit-and-stand), (d) flexibility (sit-and-reach), (e) agility (Timed Up and Go), and (f) body composition (body mass index [BMI] and body fat percentage). Systolic and diastolic BPs were used as outcome variables. In examining the proposed relationships, the regression analysis revealed that BMI, body fat percentage, sit-and-reach, 2-min step, hand grip, chair sit-and-stand, and Timed Up and Go were significantly associated with reduced systolic and diastolic body pressures.

Cardiorespiratory fitness and development of childhood cardiovascular risk: The EXAMIN YOUTH follow-up study

Background: Obesity- and hypertension-related cardiovascular (CV) risk has been shown to originate in childhood. Higher body mass index (BMI) and blood pressure (BP) have been associated with increased large artery stiffness and a lower microvascular arteriolar-to-venular diameter ratio (AVR) in children. This study aimed to investigate the association of cardiorespiratory fitness (CRF) with development of BMI, BP and vascular health during childhood. Methods: In our prospective cohort study, 1,171 children aged 6-8 years were screened for CRF, BMI, BP, retinal vessel diameters and pulse wave velocity using standardized protocols. Endurance capacity was assessed by 20 m shuttle run test. After 4 years, all parameters were assessed in 664 children using the same protocols. Results: Children with a higher CRF at baseline developed a significantly lower BMI (β [95% CI] -0.09 [-0.11 to -0.06] kg/m2, p < 0.001), a lower systolic BP (β [95% CI] -0.09 [-0.15 to -0.03] mmHg, p = 0.004) and a higher AVR (β [95% CI] 0.0004 [0.00004 to 0.0007] units, p = 0.027) after 4 years. The indirect association of CRF with development of retinal arteriolar diameters was mediated by changes in BMI. Conclusion: Our results identify CRF as a key modulator for the risk trajectories of BMI, BP and microvascular health in children. Obesity-related CV risk has been shown to track into adulthood, and achieving higher CRF levels in children may help counteract the development of CV risk and disease not only in pediatric populations, but may also help reduce the burden of CVD in adulthood. Registration: http://www.clinicaltrials.gov/ (NCT02853747).

Cardiorespiratory Fitness and Health-Related Quality of Life in Secondary School Children Aged 14 to 18 Years: A Cross-Sectional Study

The main aim of this study is to examine age and gender differences in cardiorespiratory fitness (CRF) among Serbian secondary school children. The secondary aim is to explore the association between CRF and quality of life in Serbian adolescents. The sample consisted of 579 adolescents (285 males), aged from 14 to 18 years old. To evaluate their anthropometric measurements, body height and body weight were examined, the 20 m shuttle run test was used to access CRF, and the standardized global measure of wellbeing KIDSCREEN was used to access the wellbeing of adolescents. The results show that the boys possessed higher CRF compared to the girls, as well as higher scores on variable distance, but there were no significant differences according to age. CRF was positively associated with physical wellbeing, psychological wellbeing, total score HRQL, body height and body weight, and negatively correlated with BMI. Conversely, physical wellbeing showed positive correlation with the other subscales of KIDSCREEN (psychological wellbeing, autonomy and parents, peers and social support, and school environment), and total score of (Health–Related Quality of Life) HRQL. The results showed that better CRF would be beneficial for quality of life among Serbian adolescents, especially among girls. Moreover, the relationship between CRF and BMI shows that adolescents with regular values of BMI have better physical fitness and wellbeing.

Objective Assessment of Physical Activity and Associated Contexts During High School Sport Practices

Background: Organized sports provide children and adolescents with opportunities to achieve recommended amounts of moderate to vigorous physical activity (MVPA), and schools are a primary setting for sports programs. The main aims of this study were to examine participant physical activity (PA) levels during the most popular high school sports in the United States and to assess the influences of practice contextual factors on PA levels. Methods: Participant PA and its contexts were assessed during practices for the 10 most popular girls' and boys' high school sports in the United States. Data were obtained during 598 practice sessions in 12 schools in North Carolina using a validated direct observation instrument (System for Observing Fitness Instruction Time (SOFIT). A regression model was applied to understand the association between sport context and athletes' PA. Results: Overall, athletes were observed engaging in MVPA 60% of practice time. MVPA varied among sports and levels were highly influenced by practice contexts. Among girls' sports, cross country and soccer practices provided the highest proportion of MVPA and MVPA percent during boys' practice sessions was highest during cross country and track and field. Practice contexts were associated with MVPA accrual with time allocated for gameplay and fitness activities associated with the highest levels of PA. Conclusions: The results contribute to an understanding of which sports and how their practices are conducted facilitate increased PA. Findings indicate athletes accrue substantial amounts of PA during high school practices, but that it varies from sport to sport. As well, the context that characterizes sport practices is a significant determinant in how much PA occurs. Most sports that emphasized game simulation, fitness, and skill development drills had higher levels of MVPA. Given the length and frequency of practices and how the content is delivered, we can accurately predict how much PA athletes are likely to achieve during a given sport season. The findings from this study demonstrate that sport can make a useful, if not sufficient role in helping high school athletes reach recommended PA levels. PA engagement can be optimized by attending to the management of contexts surrounding the sports.

Prevalence of Hypertension and Associated Factors Among Public Servants in North Wollo Zone, Amhara Region, Ethiopia, 2020

Background

The leading preventable risk factor for premature death and disability worldwide is hypertension. Globally, 31.1% of adults (1.39 billion people) have hypertension and 9.4 million deaths are recorded annually, accounting for 13% of overall mortality.

Objective

The objective of this study is to assess the prevalence of hypertension and associated factors among public servants in North Wollo Zone, Amhara Region, Ethiopia.

Materials and Methods

An institutional-based cross-sectional study was conducted among 627 public servants. To classify candidate variables for multivariable logistic regression, a binary logistic regression model was applied. In order to analyze factors associated with hypertension among participants, all variables with a P-value<0.2 were entered into the multivariable logistic regression model. In order to determine statistical significance, a p value of less than 0.05 was taken. The assumptions of Chi square and multi-collinearity were verified. For model fitness, the Hosmer–Lemeshow goodness-of-fit was checked.

Results

The total hypertension rate was 27.6% (95% CI: 24.1–31.3). The prevalence was higher in males 129 (32.5%) than in females 444 (19.1%). History of diabetes mellitus (AOR= 9.64, 95% CI: 3.20–29.30), age >35 years (AOR= 2.94, 95% CI: 1.91–4.51) and body mass index 25kg/m² and above (AOR= 3.44, 95% CI: 2.21–5.34) have been found to be separately associated with hypertension.

Conclusion and Recommendation

Among public servants in the study setting (study area), hypertension has become a major public health issue. Half of the newly reported cases is hypertensive. The conclusion of this study calls for a more holistic approach to hypertension in terms of hypertension prevention, screening, and proper management.

Association between transportation noise and blood pressure in adults living in multi-storey residential buildings

Epidemiological studies have demonstrated that transportation noise is associated with blood pressure and hypertension, but little is known about its relationship in the adults living in multi-storey residential buildings, where neighbour noise is frequently heard. This study aimed to investigate the effects of transportation noise exposure on blood pressure in 400 adult residents of multi-storey residential buildings and modifying effects of indoor noise annoyance and self-rated noise sensitivity on the associations between transportation noise and blood pressure. Noise levels were measured on the top of buildings for 24 h, and levels of each house unit were then predicted for different sources and periods using noise maps. Adjusted linear regression analyses were performed to estimate the associations of noise exposure levels (L_DEN, L_Day, and L_Night) with systolic blood pressure (SBP) and diastolic blood pressure (DBP). The questionnaire also included questions related to annoyance caused by indoor noise, noise sensitivity, and sociodemographic variables. Adjusted regression models yielded significant effect estimates for a 5-dBA increase in overall transportation noise for 24 h (SBP β = 0.20; 95% confidence interval (CI): 0.25-1.81; DBP β = 0.16; 95% CI: 0.12-0.93). The overall (road traffic and railway noise) and road traffic noises showed stronger associations with the SBP than with the DBP, while the railway noise had similar associations with the SBP and the DBP. Stronger associations were estimated for the participants who reported higher indoor noise annoyance ratings. Furthermore, the regression coefficients between the noise exposure and blood pressure slightly increased (β = 0.26 and 0.22 for overall and road traffic noise, respectively for SBP) in a subgroup that excluded participants exposed to high railway noise. The results lend some support to the hypothesis that long-term exposure to transportation noise is associated with a higher blood pressure in adults living in multi-storey residential buildings.

Cardiorespiratory Fitness and Blood Pressure: A Longitudinal Analysis

OBJECTIVES

To examine the association between cardiorespiratory fitness and cardiovascular indices 2 years later, and to determine whether changes in cardiorespiratory fitness are associated with cardiovascular indices at a 2-year follow-up in adolescents.

STUDY DESIGN

The sample comprised 734 adolescents (349 girls) aged 12-18 years followed for 3 years from the LabMed Physical Activity Study. Cardiorespiratory fitness was assessed by the 20-meter shuttle run test. Height, weight, waist circumference, and resting blood pressure (BP) were measured according to standard procedures.

RESULTS

Regression analyses showed a significant inverse association between cardiorespiratory fitness at baseline and systolic BP (B = -0.126; P = .047) and rate pressure product (B = -29.94; P = .016), at follow-up after adjustments for age, sex, height, pubertal stage, socioeconomic status, and waist circumference. Significant differences were found between cardiorespiratory fitness groups (fit vs unfit) at baseline and systolic BP and rate pressure product at follow-up (P < .05 for all). Analysis of covariance showed a significant association between cardiorespiratory fitness changes and systolic BP (P = .024) and rate pressure product (P = .014), after adjustment for age, sex, height, pubertal status, socioeconomic status, and waist circumference.

CONCLUSIONS

Changes in cardiorespiratory fitness during adolescence were associated with cardiovascular indices over a 2-year period. Adolescents with persistently low levels of cardiorespiratory fitness exhibited the highest levels of systolic BP and rate pressure product.

Fatness and Fitness With Cardiometabolic Risk Factors in Adolescents

CONTEXT

The relative importance of fitness and fatness with cardiometabolic risk factors is uncertain during the crucial developmental stage of late adolescence.

OBJECTIVE

We aimed to compare the concurrent influences of cardiorespiratory fitness and fatness in relationship to cardiometabolic risk factors in adolescents from the Western Australian Pregnancy Cohort Study.

DESIGN, SETTING, AND PARTICIPANTS

Cross-sectional analysis was performed on 1128 participants with complete blood pressure (BP) data and 963 participants with complete blood biochemistry at 17 years of age. Fatness (waist circumference) and cardiorespiratory fitness (physical work capacity 170) were assessed as continuous measures to avoid the use of arbitrary cut points. Analyses used linear regression models adjusted for sex and potential lifestyle confounders.

MAIN OUTCOME MEASURE

Cardiometabolic risk factors.

RESULTS

Fatness was positively associated with systolic BP (coefficient, 0.19; P < 0.001; β coefficient, 0.20), triglycerides (log coefficient, 0.009; P < 0.001; β coefficient, 0.24), low-density lipoprotein cholesterol (coefficient, 0.005; P = 0.007; β coefficient, 0.10), and high-sensitivity C-reactive protein (log coefficient, 0.05; P < 0.001; β coefficient, 0.35). There were no significant effects of fitness on any of these measures. A positive association between homeostasis model of assessment for insulin resistance and fatness (log coefficient, 0.02; P < 0.001; β coefficient, 0.33) was attenuated by fitness (log coefficient, -0.0.18; P < 0.001; β coefficient, -0.18). Fatness was inversely associated with high-density lipoprotein cholesterol (HDL-C) in both sexes (coefficient, -0.006; P < 0.001; β coefficient, -0.23), whereas fitness was positively associated with HDL-C only in females (coefficient, 0.08; P = 0.03; β coefficient, 0.15).

CONCLUSIONS

The adverse effects of central adiposity seen across a broad range of cardiometabolic risk factors were only partially ameliorated by fitness in this adolescent population.

Semiparametric methods for estimation of a nonlinear exposure-outcome relationship using instrumental variables with application to Mendelian randomization

Mendelian randomization, the use of genetic variants as instrumental variables (IV), can test for and estimate the causal effect of an exposure on an outcome. Most IV methods assume that the function relating the exposure to the expected value of the outcome (the exposure‐outcome relationship) is linear. However, in practice, this assumption may not hold. Indeed, often the primary question of interest is to assess the shape of this relationship. We present two novel IV methods for investigating the shape of the exposure‐outcome relationship: a fractional polynomial method and a piecewise linear method. We divide the population into strata using the exposure distribution, and estimate a causal effect, referred to as a localized average causal effect (LACE), in each stratum of population. The fractional polynomial method performs metaregression on these LACE estimates. The piecewise linear method estimates a continuous piecewise linear function, the gradient of which is the LACE estimate in each stratum. Both methods were demonstrated in a simulation study to estimate the true exposure‐outcome relationship well, particularly when the relationship was a fractional polynomial (for the fractional polynomial method) or was piecewise linear (for the piecewise linear method). The methods were used to investigate the shape of relationship of body mass index with systolic blood pressure and diastolic blood pressure.

Obesity as a Mediator between Cardiorespiratory Fitness and Blood Pressure in Preschoolers

OBJECTIVES

To analyze the relationships between body mass index (BMI), cardiorespiratory fitness (CRF), and blood pressure (BP), and to examine whether obesity acts as a mediator between fitness and BP in children.

STUDY DESIGN

A cross-sectional analysis using a population-based sample of 1604 school children aged 4-7 years attending 21 schools from the provinces of Ciudad Real and Cuenca, Spain, was undertaken. Data on anthropometric variables, BP measurements, and CRF were collected. The relationships between body composition (BMI, percent body fat, and waist circumference), CRF, and mean arterial pressure was estimated using Pearson correlation coefficients. ANCOVA tested the differences in BP measurements by categories of BMI and CRF, controlling for different sets of confounders. The PROCESS macro developed by Preacher and Hayes was used for mediation analysis.

RESULTS

BP values were significantly higher in school children with excess weight and poorer CRF. In addition, BMI acts as a full mediator in the association between CRF and mean arterial pressure in boys at 62.28% (z = -5.433; P ≤ .001) and a partial mediator in girls at 35.24% (z = -5.246; P ≤ .001).

CONCLUSIONS

BMI mediates the relationship between CRF and mean arterial pressure. These findings highlight the importance of maintaining a healthy weight for the prevention of high BP levels in childhood.

TRIAL REGISTRATION

ClinicalTrials.gov: NCT01971840.

Associated Factors and Standard Percentiles of Blood Pressure among the Adolescents of Jahrom City of Iran, 2014

Background. High blood pressure in adults is directly correlated with increased risk of cardiovascular diseases. Hypertension in childhood and adolescence could be considered among the major causes of this problem in adults. This study aimed to investigate the factors associated with hypertension among the adolescents of Jahrom city in Iran and also standard percentiles of blood pressure were estimated for this group. Methods. In this community-based cross-sectional study 983 high school students from different areas of the city were included using a multistage random cluster sampling method in 2014. Blood pressure, weight, and height of each student measured using standard methods. Data were analyzed by statistical software SPSS 16. Results. In total, 498 male and 454 female students were included in this study. Average systolic blood pressure of students was 110.27 mmHg with a variation range of 80.6–151.3. Average diastolic blood pressure was 71.76 mmHg with the variation range of 49.3–105. Results of this study indicated that there was a significant relationship between gender, body mass index, and parental education level with systolic and diastolic blood pressure of the students (P < 0.05). Conclusions. Body mass index was one of the most important changeable factors associated with blood pressure in adolescents. Paying attention to this factor in adolescence could be effective in prevention of cardiovascular diseases in adulthood.

International variability in 20 m shuttle run performance in children and youth: who are the fittest from a 50-country comparison? A systematic literature review with pooling of aggregate results

OBJECTIVES

To describe and compare 20 m shuttle run test (20mSRT) performance among children and youth across 50 countries; to explore broad socioeconomic indicators that correlate with 20mSRT performance in children and youth across countries and to evaluate the utility of the 20mSRT as an international population health indicator for children and youth.

METHODS

A systematic review was undertaken to identify papers that explicitly reported descriptive 20mSRT (with 1-min stages) data on apparently healthy 9-17 year-olds. Descriptive data were standardised to running speed (km/h) at the last completed stage. Country-specific 20mSRT performance indices were calculated as population-weighted mean z-scores relative to all children of the same age and sex from all countries. Countries were categorised into developed and developing groups based on the Human Development Index, and a correlational analysis was performed to describe the association between country-specific performance indices and broad socioeconomic indicators using Spearman's rank correlation coefficient.

RESULTS

Performance indices were calculated for 50 countries using collated data on 1 142 026 children and youth aged 9-17 years. The best performing countries were from Africa and Central-Northern Europe. Countries from South America were consistently among the worst performing countries. Country-specific income inequality (Gini index) was a strong negative correlate of the performance index across all 50 countries.

CONCLUSIONS

The pattern of variability in the performance index broadly supports the theory of a physical activity transition and income inequality as the strongest structural determinant of health in children and youth. This simple and cost-effective assessment would be a powerful tool for international population health surveillance.

International normative 20 m shuttle run values from 1 142 026 children and youth representing 50 countries

OBJECTIVE

To develop sex-specific and age-specific international norms for the 20 m shuttle run test (20mSRT) in children and youth (aged 9-17 years), and to estimate the prevalence meeting the FITNESSGRAM criterion-referenced standards for healthy cardiorespiratory endurance (CRE).

METHODS

A systematic review was undertaken to identify papers explicitly reporting descriptive 20mSRT (with 1 min stages) data on children and youth since 1981. Data were included on apparently healthy (free from known disease/injury) 9-17 years old. Following standardisation to a common metric and for protocol differences, pseudo data were generated using Monte Carlo simulation, with population-weighted sex-specific and age-specific normative centiles generated using the Lambda Mu and Sigma (LMS) method. Sex-related and age-related differences were expressed as per cent and standardised differences in means. The prevalence with healthy CRE was estimated using the sex-specific and age-specific FITNESSGRAM criterion-referenced standards for [Formula: see text].

RESULTS

Norms were displayed as tabulated centiles and as smoothed centile curves for the 20mSRT using 4 common metrics (speed at the last completed stage, completed stages/minutes, laps and relative [Formula: see text]). The final data set included 1 142 026 children and youth from 50 countries, extracted from 177 studies. Boys consistently outperformed girls at each age group (mean difference±95% CI: 0.86±0.28 km/h or 0.79±0.20 standardised units), with the magnitude of age-related increase larger for boys than for girls. A higher proportion of boys (mean±95% CI: 67±14%) had healthy CRE than girls (mean±95% CI: 54±17%), with the prevalence of healthy CRE decreasing systematically with age.

CONCLUSIONS

This study provides the most comprehensive and up-to-date set of international sex-specific and age-specific 20mSRT norms for children and youth, which have utility for health and fitness screening, profiling, monitoring and surveillance.

Development of hypertension in overweight adolescents: a review

The upward trend in adolescent hypertension is widely attributed to the adolescent obesity epidemic. Secular trends in adolescent prehypertension and hypertension have risen in congruence with increasing trends in the prevalence of overweight and obesity. The correlation between body mass index and blood pressure in adolescence is moderate to strong in most studies and strongest in those classified as overweight or obese. The mechanisms relating to the development of hypertension in overweight adolescents are unclear; however, a number of nonmodifiable and modifiable factors have been implicated. Importantly, certain clinical and biochemical markers in overweight adolescents are indicative of high risk for hypertension, including family history of hypertension and hyperinsulinemia. These characteristics may prove useful in stratifying overweight adolescents as high or low risk of comorbid hypertension. The treatment of overweight and obesity related hypertension in this population focuses on two key modalities: lifestyle change and pharmacotherapy. These approaches focus almost exclusively on weight reduction; however, a number of emerging strategies target hypertension more specifically. Among adolescents with overt hypertension there are also several factors that indicate higher risk of concurrent subclinical disease, persistent adult hypertension, and adult cardiovascular disease. This group may benefit substantially from more aggressive pharmacological treatments. Limitations in the literature relate to the paucity of studies reporting specific effects for the adolescent age group of overweight and obese individuals. Nonetheless, intervention for adiposity-related hypertension in adolescence may partially mitigate some of the cardiovascular risk in adulthood.

Relationship between physical activity, physical fitness and multiple metabolic risk in youths from Muzambinho's study

Negative associations between physical activity (PA), physical fitness and multiple metabolic risk factors (MMRF) in youths from populations with low PA are reported. The persistence of this association in moderately-to highly active populations is not, however, well established. The aim of the present study was to investigate this association in a Brazilian city with high frequency of active youths. We assessed 122 subjects (9.9 ± 1.3 years) from Muzambinho city. Body mass index, waist circumference, glycaemia, cholesterolaemia, systolic and diastolic blood pressures were measured. Maximal handgrip strength and one-mile walk/run test were used. Leisure time PA was assessed by interview. Poisson regression was used in the analysis. The model explained 11% of the total variance. Only relative muscular strength and one-mile walk/run were statistically significant (p < .05). Those who needed more time to cover the one-mile walk/run test had an increased in metabolic risk of 11%, and those with greater strength reduced the risk by about 82%. In conclusion, children and youths from an active population who need less time to cover the one-mile walk/run test or who had greater muscular strength showed a reduced metabolic risk. These results suggest that even in children and youths with high leisure time PA, a greater aerobic fitness and strength might help to further reduce their MMRF.

Are smoking and passive smoking related with heart rate variability in male adolescents?

Objective

To analyze the relation between smoking and passive smoking with heart rate variability parameters in male adolescents.

Methods

The sample consisted of 1,152 males, aged 14 and 19 years. Data related to smoking and passive smoking were collected using a questionnaire. RR intervals were obtained by a heart rate monitor, on supine position, for 10 minutes. After collecting the RR intervals, time (standard deviation of all RR intervals, root mean square of the squared differences between adjacent normal RR intervals and the percentage of adjacent intervals over 50ms) and frequency domains (low and high frequency and sympathovagal balance) parameters of heart rate variability were obtained.

Results

No significant differences between smoker and nonsmoker adolescents were observed in heart rate variability parameters (p>0.05). Similarly, heart rate variability parameters did not show significant difference between exposed and not exposed to passive smoking (p>0.05).

Conclusion

Cigarette smoking and passive smoking are not related to heart rate variability in adolescence.

The relationship between BMI and blood pressure in children aged 7-12 years in Ankara, Turkey

OBJECTIVE

Recent studies have reported an increasing prevalence of childhood hypertension. Obesity is probably the most important risk factor. The relationship between hypertension and BMI in children has not been studied in Ankara, which is the second largest city in Turkey.

DESIGN

Cross-sectional study analysing direct data on height, weight and blood pressure of students.

SETTING

Population-based study in Ankara, the capital city of Turkey.

SUBJECTS

In three schools, 2826 students aged 7-12 years.

RESULTS

The overall prevalence of hypertension was 7·9 %. Among the 222 hypertensive children, 124 (56 %) were boys and ninety-eight (44 %) were girls (P=0·40). In the whole group, 3·6 % had only systolic hypertension, 0·7 % had only diastolic hypertension and 3·5 % had both systolic and diastolic hypertension. The prevalences of overweight and obesity were both 13·9 %. BMI was significantly correlated with blood pressure (P<0·001). Overweight and obesity were more common in boys (P<0·001).

CONCLUSIONS

Hypertension was more common than has been reported in other studies. Blood pressure measurement should be routine and frequent in children, especially obese children.

Gender comparisons of physical fitness indexes in Inner Mongolia medical students in China

Introduction:

The aim of present study was to investigate gender differences in physical fitness indexes in regard to BMI (body mass index) levels among Inner Mongolia medical students in China.

Methods:

Data on participant characteristics came from basic information contained in the school database. Physical fitness indexes including BMI, vital capacity index, sidestep test, and standing long jump, were conducted.

Results:

Female students had a higher rate of normal weight than those of males. The obesity rate of males was 5 times higher compared to females. Compared with male students, female students had a higher pass rate in vital capacity index, sidestep and standing long jump. Females were higher 17% than males in the pass rate of the sidestep test. Males performed better than females in the standing long jump. In both the malnutrition and normal weight group, the pass rate of the 3 physical fitness indexes for both male and female students was higher than obese group. The not pass rate was higher than pass rate both male and female students in the vital capacity index in the obese group.

Discussion:

Males had a poor physical fitness level compared with females. Male students may be more likely to spend more time using computers and it will cut down the time of participating in physical activities. So, in our university, more attention should pay on physical education, especially for males.

A Pilot Physical Activity Initiative to Improve Mental Health Status amongst Iranian Institutionalized Older People

BACKGROUND

Sufficient level of physical activity may promote overall and mental health of old people. This study was carried out to investigate the practi-cability of a physical activity promotion initiative amongst institutionalized older people in Tabriz, Iran.

METHODS

Purposive sampling method was used in this semi-experimental study to recruit 31 older people living in a selected residential care in Tabriz. Moderate-intensity aerobic and mus-cle-strengthening activity was planned for those who had not severe baseline cognitive impairment or were not too frail to undertake the survey. The General Health Questionnaire (GHQ-28) was used to measure mental health status be-fore and after intervention through a face-to-face interview. Descriptive statistics, Wilkcoxon rank-sum, Mann-Whitney U and Chi-Square tests were employed to analyses the data.

RESULTS

The applied intervention was significantly improved status of physical health, anxiety and insomnia, social dysfunction and severe depression.

CONCLUSION

Incorporation of physical activity promotion programs into routines of older people residential care homes in Iran is feasible but may need training of physical activity specialists to work with older people based on their physical endurance and limitations.

Using Pedometers for Measuring and Increasing Physical Activity in Children and Adolescents

The science and practice of step counting in children (typically aged 6-11 years) and adolescents (typically aged 12-19 years) has evolved rapidly over a relatively brief period with the commercial availability of research-grade pedometers and accelerometers. Recent reviews have summarized considerations for assessing physical activity using pedometers in young people (both children and adolescents), but 3 areas have received little attention: pedometer monitoring protocols, minimal (as opposed to optimal) step counts necessary for maintaining basal levels of health, and appropriate pedometer-based interventions for young people. Therefore, the objective of this review was to evaluate the current evidence and identify future research directions in these areas. The challenges of objective monitoring of physical activity in children and adolescents reinforce the importance of using protocols that minimize participant burden and the potential for tampering/reactivity. Evidence for a sedentary lifestyle cut point is limited; researchers are therefore encouraged to investigate several cut points (ie, <5000, <6000, <7000 steps/d) in children and adolescents to identify the health consequences of very low levels of ambulatory activity. Personalized messages may be necessary for health behavior change in pedometer-based interventions, but there is a need for more high-quality studies to develop the existing evidence base.

Peak oxygen uptake and physical activity in 13- to 18-year-olds: the Young-HUNT study

PURPOSE

The present study describes the distribution of cardiorespiratory fitness (VO2peak) in a large sample of healthy adolescents and the associations between VO2peak, self-reported physical activity, and a selection of conventional markers for future cardiovascular health.

METHODS

In a substudy of the Young-HUNT study in Norway, 570 adolescents (289 girls and 281 boys) 13–18 yr. old were tested for directly measured VO2peak. Blood pressure, resting heart rate, height, weight, and waist circumference was measured by standardized procedures. Data about physical activity and pubertal development were obtained using self-administered questionnaires. General linear modeling and ANOVA were used to examine the relationships between VO2peak and age, physical activity, and cardiovascular risk factors.

RESULTS

The mean T SD VO2peak was 183.9 +/- 24.6 mL x kg(-0.67) x min(-1) (49.2 mL x kg(-0.67) x min(-1)) in girls and 235.1 +/- 35.3 mL x kg(-0.67) x min(-1) (59.5 mL x kg(-0.67) x min(-1)) in boys. Absolute VO2peak (L x min(-1)) was consistently higher in older age groups in both sexes (P trend < 0.001). VO2peak allometrically scaled to body mass (mL x kg(-0.67) x min(-1)) was similar across the age groups in girls (i.e., difference between 13- to 14-yr-olds and 17- to 18-yr-olds = -3.2 mL x kg(-0.67) x min(-1), 95% confidence interval = 3.8 to -10.1) and slightly higher in the older age groups in boys (i.e., difference between 13- to 14-yr-olds and 15- to 16-yr-olds = -31.0 mL x kg(-0.67) x min(-1), 95% confidence interval = -22.0 to -40.1). Physical activity was positively associated with VO2peak in all sex and age groups. Quartiles of VO2peak were inversely associated with resting heart rate (P trend = 0.004) in both sexes and body mass index (P trend = 0.004) and waist circumference (P trend = 0.006) in boys.

CONCLUSION

Although VO2peak was generally high across the age groups, VO2peak was higher in physically active adolescents of both sexes and physical activity in accordance with the recommended level may be sufficient to maintain or even increase VO2peak through adolescence.

Cardiovascular disease risk factors: a childhood perspective

Atherosclerotic cardiovascular disease (CVD) is one of the leading causes of death and disability worldwide including in developing countries like India. Indians are known to be predisposed to CVD, which occur almost a decade earlier in them. Though these diseases manifest in the middle age and beyond, it is now clear that the roots of CVD lie in childhood and adolescence. Many of the conventional risk factors of CVD such as high blood pressure, dyslipidemia, tobacco use, unhealthy diet and obesity have their beginnings in childhood and then track overtime. It is thus important to screen and identify these risk factors early and treat them to prevent onset of CVD. Similarly community based strategies to prevent onset of these risk factors is imperative to tackle this burgeoning public health crisis especially in countries like ours with limited resources.

Association of arterial stiffness with obesity in Australian women: a pilot study

This study investigated the arterial stiffness status in overweight/obese Australian women compared with their lean counterparts. Twenty-six Caucasian women were designated into one of two groups: overweight/obese (body mass index [BMI] 25-34.9 kg/m2 [ n=12]) and lean (BMI 18.5-24.9 kg/m2 [n=14]) groups. Participants were assessed for clinical, anthropometric, metabolic, and augmentation index (AIx) measurements. Age was similar between groups (P=.482). BMI was significantly higher in overweight/obese compared with lean participants (30.26±1.09 vs 21.62±0.52 kg/m2, P=.001) as well as the percentage of body fat (40.60±2.43 vs 21.57±1.13, P=.001), waist circumference (91.47±2.77 vs 70.67±1.60, P=.001), and waist/hip ratio (0.81±0.04 vs 0.71±0.03, P=.036). Overweight/obese group showed higher total cholesterol, triglyceride, low-density lipoprotein cholesterol, and fasting glucose levels compared with the lean group (all P<.05). Both systolic (122.92±3.18 mm Hg vs 108.14±2.42 mm Hg, P=.001) and diastolic (83.58±2.43 mm Hg vs 72.43±1.29 mm Hg, P=.0001) blood pressures, as well as AIx (50.08±4.7 vs 120.79±2.17, P=.001) were significantly higher in the overweight/obese group compared with the lean group. AIx was positively associated with measurements of body composition (P<.05), triglycerides (r=0.361, P=.035) and glucose levels (r=0.371, P=.031), and systolic and diastolic blood pressure (r=0.793 and r=0.718, respectively; P=.0001). This data suggests that arterial stiffness is associated with obesity, along with other metabolic abnormalities in Australian women.

Índice de massa corpórea, sobrepeso e pressão arterial em escolares na província de Limpopo, África do Sul

OBJETIVO: Avaliar a relação entre índice de massa corporal, sobrepeso e pressão arterial em crianças e adolescentes da área rural da África do Sul. MÉTODOS: A amostra abrangeu 1.172 escolares (541 meninos e 631 meninas) com idades entre 10 e 16 anos. Estatura, massa corporal e dobras cutâneas foram medidas por meio de procedimentos padrão. O sobrepeso foi definido pelo índice de massa corporal para idade e sexo. A pressão arterial foi monitorada três vezes em cada criança com o uso de aparelhos eletrônicos validados (Omron HEM-705 CP, Omron, Tóquio, Japão). A hipertensão foi determinada como a média de três leituras da pressão arterial, em que a sistólica ou a diastólica foi igual ou acima do percentil 90 para idade e sexo. Estatísticas descritivas foram calculadas para todas as variáveis. RESULTADOS: A prevalência de sobrepeso foi de 5,5% para meninos e 4,4% para meninas. A taxa de crianças com pressão arterial acima do percentil 90 variou de 2,3 a 5,9%. A probabilidade do desenvolvimento de hipertensão em crianças é perceptível aos dez anos, tanto para os meninos (0,2%) quanto para as meninas (0,1%), e oscilou de 0,2 a 1,7% para o sexo masculino e de 0,1 a 1,2% para o feminino. Considerando-se a amostra total, a prevalência de hipertensão foi de 4,1% para os meninos e 2,8% para as meninas. A pressão arterial apresentou correlação positiva com estatura, massa corporal, índice de massa corporal, gordura corpórea e soma das dobras cutâneas (p<0,001). CONCLUSÕES: A pressão arterial aumentou com a idade tanto para os meninos quanto para as meninas. A medição da pressão arterial de rotina, como parte do exame físico em escolares, é crucial para fins de prevenção e medidas de intervenção precoces.

Prevalence of elevated mean arterial pressure and how fitness moderates its association with BMI in youth

OBJECTIVE

Cardiorespiratory fitness is known to be cardioprotective and its association with the components of the metabolic syndrome in children is becoming clearer. The aim of the present study was to examine the extent to which cardiorespiratory fitness may offset the weight-related association with mean arterial pressure (MAP) in schoolchildren.

DESIGN

Cross-sectional study.

SETTINGS

Schoolchildren from the East of England, U.K.

SUBJECTS

A total of 5983 (48% females) schoolchildren, 10 to 16 years of age, had height, weight and blood pressure measured by standard procedures and cardiorespiratory fitness assessed by the 20 m shuttle-run test. Participants were classified as fit or unfit using internationally accepted fitness cut-off points; and as normal weight, overweight or obese based on BMI, again using international cut-off points. Age-adjusted ANCOVA was used to determine the main effects and interaction of fitness and BMI on MAP Z-score. Logistic regression models were used to estimate odds ratios of elevated MAP.

RESULTS

Prevalence of elevated MAP in schoolchildren was 14.8% overall and 35.7% in those who were obese-unfit. Approximately 21% of participants were overweight and 5% obese, while 23% were classified as unfit. MAP generally increased across BMI categories and was higher in the aerobically unfit participants. Obese-fit males had lower MAP compared with obese-unfit males (P < 0.001); this trend was similar in females (P = 0.05).

CONCLUSIONS

Increasing fitness level may have a positive impact on the weight-related elevations of MAP seen in obese and overweight schoolchildren.

Monitoring of blood pressure among children and adolescents in a coastal province in China: results of a 2010 survey

BACKGROUND

Several studies have provided ample evidence that hypertension in adults has its onset in childhood; children and adolescents with elevated blood pressure (BP) are more likely to become hypertensive adults. The present study examined the prevalence of relatively high BP among children and adolescents in Shandong, China.

SUBJECTS AND METHODS

Data for this study were obtained from a large cross-sectional survey of schoolchildren carried out in 2010. A total of 38 860 students (19 481 boys and 19 379 girls) aged 7 to 17 years participated in this study. Relatively high BP status was defined as systolic blood pressure and/or diastolic blood pressure ≥95th percentile for age and gender.

RESULTS

Shandong children had a high BP level, with the 50th percentiles of systolic and diastolic blood pressure of children and adolescents aged 7 to 17 years in Shandong being above the reference values for Chinese children and adolescents by 3 to 12 mm Hg and 3 to 7 mm Hg for boys, and by 3 to 6 mm Hg and 3 to 5 mmHg for girls, respectively. The overall prevalence of relatively high BP was 26.22% for boys and 20.27% for girls.

CONCLUSION

There is a high prevalence of relatively high BP among children and adolescents in Shandong, China. It has become a threatening hazard to children and adolescents and should arouse special attention.

The effects of concurrent resistance and endurance training follow a specific detraining cycle in young school girls

The purpose of this study was to compare the effects of an 8-week training period of strength training alone (GR), or combined strength and endurance training (GCOM), followed by 12-weeks of de-training (DT) on body composition, power strength and VO2max adaptations in a schooled group of adolescent girls.

METHODS

Sixty-seven healthy girls recruited from a Portuguese public high school (age: 13.5+1.03 years, from 7(th) and 9th grade) were divided into three experimental groups to train twice a week for 8 wks: GR (n=21), GCOM (n=25) and a control group (GC: n=21; no training program). Anthropometric parameters variables as well as performance variables (strength and aerobic fitness) were assessed.

RESULTS

No significant training-induced differences were observed in 1kg and 3kg medicine ball throw gains (2.7 to 10.8%) between GR and GCOM groups, whereas no significant changes were observed after a DT period in any of the experimental groups. Significant training-induced gains in CMVJ (8 to 12%) and CMSLJ (0.8 to 5.4%) were observed in the experimental groups. Time of 20m significantly decreased (GR: -11.5% and GCOM: -10%) after both treatment periods, whereas only the GR group kept the running speed after a DT period of 12 weeks. After training VO2max increased only slightly for GCOM (4.0%). No significant changes were observed after the DT period in all groups, except to GCOM in CMVJ and CMSLJ.

CONCLUSION

Performing simultaneous strength and endurance training in the same workout does not appear to negatively influence power strength and aerobic fitness development in adolescent girls. Indeed, concurrent strength and endurance training seems to be an effective, well-rounded exercise program that can be prescribed as a means to improve initial or general strength in healthy school girls. De-training period was not sufficient to reduce the overall training effects.

Association of the human CYP11B2 gene and essential hypertension in southwest Han Chinese population: a haplotype-based case-control study

Aldosterone synthase produces aldosterone, which regulates electrolytes and thereby blood pressure (BP). The aldosterone-synthase gene (CYP11B2) has been regarded as a candidate gene for essential hypertension. To address this issue, we carried out a haplotype-based, case-control study to explore the association between a human CYP11B2 gene and essential hypertension (EH) in the southwest Han population of China (n = 1020 individuals). Four tag single-nucleotide polymorphisms (SNPs) (rs4536, rs4545, rs3097, and rs3802230) and the C-344T polymorphism, as well as the K173R polymorphism in the CYP11B2 gene, were genotyped using the PCR-RFLP method. Single-locus analysis showed that the C allele of rs3802230 was significantly more prevalent in the EH subjects as compared to control subjects, adjusted for covariates. Haplotype analysis showed that the haplotype AAGC constructed by the tag SNPs (rs4536, rs4545, rs3097, and rs3802230), which carried the susceptible rs3802230 C allele, significantly increased the risk of essential hypertension with an odds ratios equal to 3.56 (P = 0.0001). The present results indicated that the rs3802230 C allele might be a risk marker for essential hypertension and haplotype AAGC might confer high genetic susceptibility to essential hypertension in a southwest Han Chinese population.

Thin adolescents: Who are they? What do they do? Socio-demographic and use-of-time characteristics

OBJECTIVES

Examine: (1) the anthropometric, socio-demographic and use-of-time characteristics of thin adolescents, and (2) compare these characteristics to other weight status categories.

METHODS

Data were from the 2007 National Children's Nutrition and Physical Activity Survey which collected data on a random sample of 2200 9 to 16 year old Australians from February to August 2007. Seven socio-demographic variables, anthropometric data (height and weight were measured) and nine use-of-time variables were used, and compared across the weight status categories. Physical activity was measured using pedometers and the Multimedia Activity Recall for Children and Adults.

RESULTS

5.3% of adolescents were classified as thin, a percentage which did not significantly vary by age, sex, indigenous status, household income, education level or family structure. Relative to other adolescents, thin adolescents were shorter and lighter. Thin adolescents were less active than their normal weight peers, but walked further and accumulated significantly less screen and TV time than obese adolescents.

CONCLUSION

Thin adolescents were found in similar proportions across all socio-demographic bands. Thin adolescents recorded similar physical activity levels to their normal weight peers, but were more active than obese adolescents. The findings from the study support in part the theory of thinness related developmental delay.

Physical fitness in northern European youth: Reference values from the Latvian Physical Health in Youth Study

Aims: Physical fitness has the potential to be used as a key health determinant in youth. The aim of this study was to establish age- and sex-stratified reference values for health-related physical fitness in Latvian school-age children and to identify notable sex differences. Methods: Physical fitness was assessed using the EUROFIT test battery. Data were gathered from schoolchildren aged between 6 and 17 years (n = 10,464) by a medical team using standardised methods (EUROFIT battery). Fitness levels, stratified by chronological age and sex, were computed as mean ± SD. Each test was also analysed for differences between males and females in each age group. Results: Boys performed better than girls in muscular endurance and strength, cardiorespiratory endurance, and speed—agility fitness tests. Girls had better flexibility than boys (p < 0.001). There was also a more pronounced improvement in physical fitness scores with age in boys compared with girls. Conclusions: Physical fitness reference values were developed for Latvian children and adolescents. These reference values will permit comparisons between students during physical education lessons and provide a baseline against which progress in physical fitness among northern European youths can be compared.

Systematic review of the health benefits of physical activity and fitness in school-aged children and youth

Background

The purpose was to: 1) perform a systematic review of studies examining the relation between physical activity, fitness, and health in school-aged children and youth, and 2) make recommendations based on the findings.

Methods

The systematic review was limited to 7 health indicators: high blood cholesterol, high blood pressure, the metabolic syndrome, obesity, low bone density, depression, and injuries. Literature searches were conducted using predefined keywords in 6 key databases. A total of 11,088 potential papers were identified. The abstracts and full-text articles of potentially relevant papers were screened to determine eligibility. Data was abstracted for 113 outcomes from the 86 eligible papers. The evidence was graded for each health outcome using established criteria based on the quantity and quality of studies and strength of effect. The volume, intensity, and type of physical activity were considered.

Results

Physical activity was associated with numerous health benefits. The dose-response relations observed in observational studies indicate that the more physical activity, the greater the health benefit. Results from experimental studies indicate that even modest amounts of physical activity can have health benefits in high-risk youngsters (e.g., obese). To achieve substantive health benefits, the physical activity should be of at least a moderate intensity. Vigorous intensity activities may provide even greater benefit. Aerobic-based activities had the greatest health benefit, other than for bone health, in which case high-impact weight bearing activities were required.

Conclusion

The following recommendations were made: 1) Children and youth 5-17 years of age should accumulate an average of at least 60 minutes per day and up to several hours of at least moderate intensity physical activity. Some of the health benefits can be achieved through an average of 30 minutes per day. [Level 2, Grade A]. 2) More vigorous intensity activities should be incorporated or added when possible, including activities that strengthen muscle and bone [Level 3, Grade B]. 3) Aerobic activities should make up the majority of the physical activity. Muscle and bone strengthening activities should be incorporated on at least 3 days of the week [Level 2, Grade A].

Associations between physical activity and health parameters in adolescent pupils in Egypt

Physical activity (PA) could be protective against hypertension, atherosclerosis, coronary heart disease and cardiovascular disease. This quantitative study assessed the association between a PA intervention and three anthropometric parameters (weight, body mass index, body fat) and four physiological parameters (cholesterol level, systolic blood pressure, diastolic blood pressure, heart rate) among secondary school pupils (N = 160) in Egypt through the school term. The pupils were randomised to an intervention group (80 pupils) and controls (80 pupils). Measurements were obtained for all pupils twice: at baseline; and then again after three months. The PA intervention programme comprised an ‘afterschool’ one hour of moderate exercise three times a week for three months. Both the controls and the intervention pupils attended the ‘normal’ exercise schedule provided by the school; in addition, the intervention group attended afterschool PA programme from about 2–3 o’clock in the afternoon. At baseline, employing pupil’s BMI, 27.5% and 28.8% of the intervention and control pupils respectively were classified as overweight. After three months, the percentage of overweight decreased to 12.5% in the intervention pupils, while it increased to 37.3% in the controls. At the end of the three months period, there were significant improvements across most anthropometric and physiological parameters of the intervention pupils when compared with the control children. The correlation coefficient of the improvements for the boys and the girls was 0.97, indicating clearly that the intervention was having nearly the same beneficial effect for boys and girls. A moderate PA programme for a modest period of 3 months could be effective in maintaining or enhancing pupil’s anthropometric and physiological parameters in comparison to the controls where there was deterioration in both parameters. Policy makers and secondary schools in Egypt might need to pay more attention to PA programmes conducted on school days, in order to motivate pupils to attend such programmes. There is also an urgent need to look at current PA systems within schools in Egypt in order to assess PA outside school times.

Pressão arterial de adolescentes de escolas particulares de Fortaleza-CE

OBJETIVO: Identificar a pressão arterial de adolescentes de escolas particulares da cidade de Fortaleza-CE. MÉTODOS: Estudo do tipo quantitativo com delineamento transversal no qual foram investigados 794 adolescentes, entre 12-17 anos de idade de 14 escolas privadas dessa cidade no período de março a setembro de 2007, mediante aplicação de um formulário que abrangeu o registro das características sóciodemográficas, pressão arterial, Índice de Massa Corporal (IMC), prática de atividade física e glicemia capilar. RESULTADOS: Verificou-se que 19,7% dos jovens apresentavam pressão arterial elevada. Os adolescentes do sexo masculino apresentaram pressão arteial sistólica (PAS) e pressão arterial diastólica (PAD) maiores do que a do sexo feminino (p=0,0001). A pesquisa constatou valores maiores de PAS e PAD naqueles com excesso de peso (p=0,0001). CONCLUSÃO: A pressão arterial foi influenciada sobretudo pelo sexo e IMC.

Metabólitos séricos da vitamina D não se correlacionam com pressão arterial em adolescentes

OBJETIVO: O objetivo deste estudo foi avaliar a associação entre o estado nutricional da vitamina D, a adiposidade e a pressão arterial (PA) em adolescentes. MÉTODOS: Foi realizada avaliação antropométrica, da composição corporal, da ingestão alimentar, de medidas bioquímicas e aferição da PA de 205 adolescentes, com média de idade de 18,2 anos. RESULTADOS: Destes, 12,19% apresentaram PA elevada. O nível sérico médio da 25OHD foi 29,2(0,8) ng/mL, e 62% dos adolescentes apresentaram insuficiência de vitamina D. Não foi encontrada correlação significativa entre a PAS e a PAD com a 25OHD e a 1,25(OH)2D. Houve correlação negativa entre a PAD com os níveis séricos de adiponectina, e tanto a PAS quanto a PAD apresentaram correlação positiva com a circunferência da cintura em ambos os sexos. CONCLUSÃO: Não houve relação entre os níveis séricos de vitamina D e a PA. Porém, a gordura visceral apresenta risco potencial para elevação da PA em adolescentes.

[Atherosclerotic risk factors associated with cardiorespiratory fitness and BMI in adolescents]

Previous research has demonstrated high prevalence of atherosclerotic risk factors in adolescents; however, the associate factors related to its onset are unclear. Therefore, the objective of this study was to relate inadequate blood pressure levels, total cholesterol (TC), HDL-C, LDL-C and triglycerides (TG) with different VO2máx and BMI levels in a sample of 249 adolescents, aged between 12 to 16 years old. For VO2máx prediction, the 20 meters test was used. The BMI was calculated using the body mass/heigh(2) equation. The considerate inadequate levels were: blood pressure > or =90th percentile; total cholesterol > or =150 mg/dL; LDL-C > or = 100 mg/dL, TG > or =100 mg/dL and HDL-C <45 mg/dL. Logistic regression was used as statistical procedures, with p<0.05. For the boys, significant associations were observed between the low VO2máx with TC (OR 4.33; IC=1.23-15.20) and TG (OR=4.88; IC=1.15-20.79) and between overweight and TG (OR=4.33; IC=1.42-13.21). After BMI correction, the males subjects with low VO2máx maintained their significant associations with TC (OR=5.73; IC=1.52-21.58) and TG (OR=3.81; IC=1.86-16.94). The evidences in this study suggested an inverse relationship of the cardiorespiratory fitness with TC and TG for boys, independently of the BMI.

Cardiovascular risk factors in Chinese American children: associations between overweight, acculturation, and physical activity

INTRODUCTION

Understanding cardiovascular disease (CVD) risk factors among Chinese American children would allow us to target individuals in this group who are at the greatest risk for developing CVD early in life. The purpose of this study is to examine cardiovascular risk factors (increased blood pressure [BP], total cholesterol, low-density lipoproteins, triglycerides, decreased high-density lipoproteins, and increased body mass index [BMI]) in Chinese American children.

METHOD

A cross-sectional design was used. A total number of 65 children, aged 8 to 10 years, and their mothers participated in the study. Measurements of the children's weight, height, BP, blood sample, level of physical fitness, activity level, and dietary intake were collected. Mothers completed questionnaires regarding family history of CVD and level of acculturation.

RESULTS

A low level of physical activity and high paternal BMI were associated with higher systolic BP in the children. A low level of physical activity was also found to be a risk factor for higher LDL and systolic BP in the children. A high birth weight and lower parental acculturation level were risk factors for higher BMI in the children.

DISCUSSION

The findings suggest that a low level of physical activity and high BMI are associated with increased risk of CVD in Chinese American children. The development of culturally appropriate programs that promote an active lifestyle and reduce weight is critical in CVD prevention in Chinese American populations.

Assessing, understanding and modifying nutritional status, eating habits and physical activity in European adolescents: The HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) Study

Objectives

To identify the main knowledge gaps and to propose research lines that will be developed within the European Union-funded ‘Healthy Lifestyle in Europe by Nutrition in Adolescence’ (HELENA) project, concerning the nutritional status, physical fitness and physical activity of adolescents in Europe.

Design

Review of the currently existing literature.

Results

The main gaps identified were: lack of harmonised and comparable data on food intake; lack of understanding regarding the role of eating attitudes, food choices and food preferences; lack of harmonised and comparable data on levels and patterns of physical activity and physical fitness; lack of comparable data about obesity prevalence and body composition; lack of comparable data about micronutrient and immunological status; and lack of effective intervention methodologies for healthier lifestyles.

Conclusions

The HELENA Study Group should develop, test and describe harmonised and state-of-the-art methods to assess the nutritional status and lifestyle of adolescents across Europe; develop and evaluate an intervention on eating habits and physical activity; and develop and test new healthy food products attractive for European adolescents.

Fatores de risco associados à pressão arterial elevada em adolescentes

Níveis elevados de pressão arterial (PA) na infância e adolescência têm sido freqüentemente associados a outros fatores de risco cardiovasculares, além de hipertensão arterial na fase adulta da vida. O presente estudo objetivou identificar fatores de risco associados à PA elevada em adolescentes. Participaram do estudo 674 adolescentes de escolas públicas e privadas, de ambos os sexos (303 rapazes e 371 moças), com idade de 14 a 17 anos (16,5 DP 0,9), da cidade de João Pessoa, Paraíba. Mediante aplicação de um questionário, foram levantadas informações sobre: a) indicadores sociodemográficos; b) nível de prática da atividade física; c) hábitos alimentares; c) índice de massa corporal; e) fumo e bebidas alcoólicas; e foram realizadas medidas de PA. A prevalência de PA elevada foi de 7,4%, sendo maior nos rapazes (10,2%) quando comparada com a das moças (5,1%, p < 0,01). Os resultados da análise multivariada demonstraram que adolescentes com excesso de peso apresentaram probabilidade cerca de cinco a seis vezes maior de ter PA elevada, comparados com os de baixo peso/peso normal (rapazes: OR = 5,5; IC 95% = 1,11-27,53 e moças: OR = 4,8; IC 95% = 1,51-15,45). As demais variáveis não se mostraram associadas à PA elevada. Nesse estudo, entre os diversos fatores de risco analisados, o excesso de peso corporal se apresentou como o único fator de risco potencial para elevação da PA em adolescentes.