Association between dietary sodium, calcium, saturated fat and blood pressure in obese Egyptian adolescents

Detecting and Managing Childhood Onset Hypertension in Africa: A Call to Action

PURPOSE OF REVIEW

To review recent evidence on childhood hypertension across Africa, identifying knowledge gaps, challenges and priorities, and highlight clinical perspectives in managing primary hypertension.

RECENT FINDINGS

Only 15 of the 54 African countries reported on absolute blood pressure (BP) measures, elevated BP, pre- and/or hypertension. The reported hypertension prevalence ranged between 0.0 and 38.9%, while elevated BP and/or pre-hypertnesion ranged from 2.7 to 50.5%. Childhood BP nomograms are lacking across Africa and the rates of hypertension were based on guidelines developed in countries with the lowest to no number of children from African ancestry. The recent studies across Africa also showed little to no detail when reporting BP specific methodology. No recent data informing the use or effectiveness of antihypertensive agents in children and adolesents are available. Childhood hypertension is on the rise, while data from Africa remains vastly under-represented. Collaborative research, resources, and policies need to be strengthened in addressing the growing public health concern of childhood onset hypertension on this continent.

Systematic review and meta-analysis: Prevalence of hypertension among adolescents in the Arab countries

PROBLEM

Hypertension (HTN) is one of the non-communicable diseases which prevalence is rising in both developed and developing countries. There is a scarcity of data on the prevalence of HTN in Arab countries. This review outlines what is currently known about prevalence and risk factors of HTN in adolescence in Arab world.

ELIGIBILITY CRITERIA

A systematic review and meta-analysis were conducted using PubMed, Cochrane Library, Scopus, CINAHL, Science Direct, and Google Scholar databases from 2011 to 2021.

SAMPLE

Fourteen studies from 9 Arab countries met inclusion criteria. Studies included a total of 777 adolescents with HTN and 2147 adolescents with pre-HTN.

RESULTS

The overall prevalence of HTN among adolescents in the Arab World was estimated at 12.6% (95CI 0.083-0.176), while pre-HTN was 13.9% (95CI 0.084-0205). Overweight and obesity resemble the higher risk of developing hypertension. Family history, high consumption of salt, smoking and low physical activity also increase the risk of HTN. The development of adolescent HTN can be predicted through anthropometric measurements such as Body Mass Index (BMI), wrist circumferences, and high waist circumference.

CONCLUSION

The prevalence of HTN among adolescents in the Arab world was significant, ranging from 4 to 26%. The heterogeneity between studies was high.

IMPLICATION

Local governments and policymakers must consider strengthening regulations to address environmental risk factors and improve public awareness about risk factors to HTN. A combined use of nurse- and patient targeted educational interventions could also help in reducing the burden of HTN in this population.

Paediatric Hypertension in Africa: A Systematic Review and Meta-Analysis

BACKGROUND

The burden of cardiovascular disease (CVD) and hypertension is rapidly increasing in low- and middle-income countries. This is evident not only in adults, but also in children. Recent estimates of prevalence in children are lacking, particularly in Africa. As such, we conducted a systematic review and meta-analysis to provide updated estimates of paediatric hypertension in Africa.

METHODS

We searched PubMed and EBSCO to identify articles published from January 2017 to November 2020. Studies were assessed for quality. We combined results for meta-analyses using a random effects model (Freeman-Tukey arcsine transformation). Heterogeneity was quantified using the I² statistic.

FINDINGS

In the narrative synthesis of 53 studies, publication bias was low for 28, moderate for 24, and high for one study. Hypertension prevalence ranged substantially (0·2%-38·9%). Meta-analysis included 41 studies resulting in data on 52918 participants aged 3 to 19 years from ten countries. The pooled prevalence for hypertension (systolic/diastolic BP≥95th percentile) was 7·45% (95%CI 5·30-9·92, I²=98.96%), elevated blood pressure (BP, systolic/diastolic BP≥90th percentile and <95th percentile) 11·38% (95%CI 7·94-15·33, I²=98.97%) and combined hypertension/elevated BP 21·74% (95%CI 15·5-28·69, I²=99.48%). Participants categorized as overweight/with obesity had a higher prevalence of hypertension (18·5% [95%CI 10·2-28·5]) than those categorized as underweight/normal (1·0% [95%CI 0·1-2·6], 4·8% [95%CI 2·9-7·1], p<0·001). There were significant differences in hypertension prevalence when comparing BP measurement methods and classification guidelines.

INTERPRETATION

Compared to a previous systematic review conducted in 2017, this study suggests a continued increase in prevalence of paediatric hypertension in Africa, and highlights the potential role of increasing overweight/obesity.

FUNDING

This research was funded in part by the Wellcome Trust [Grant number:214082/Z/18/Z]. LJW and SAN are supported by the DSI-NRF Centre of Human Development at the University of the Witwatersrand.

The analysis of the degree of 10–13-year-old children’s nutrition, dietary habits and physical activity in the selected rural and urban areas of Silesian Province (Poland)

Background

The nutrition disorders in the children’s population, in the form of malnutrition, as well as overweight and obesity constitute a significant clinical problem in the contemporary world. As a result of the improper way of children’s nutrition, their physical and mental development becomes dysfunctional, which leads in their adult life to serious health consequences, among others, complications of cardiovascular system, metabolic and endocrinological and disorders, improper development of osteoarticular system and mental diseases and social withdrawal.

Results

Five hundred eighty-nine parents of children aged 10–13 participated in the survey questionnaire, where 304 respondents were constituted by girls (51.61%); however, the remaining 285 people were represented by boys (48.39%). It turned out that overweight and obesity concern approximately 44% of respondents; however, approximately 22% of children have too low body weight in relation to age and sex. While analysing dietary habits, it was observed that main meals are not consumed by all children; breakfast is consumed by approximately 90% of respondents, packed lunch just by 70% and lunch and supper by 90% of respondents. In the course of subsequent analyses, it turned out that over ¾ of respondents declared that their child drinks mineral water every day, only approximately 44% of them drink milk every day; however, almost 18% of children reach for sweet drinks. Children eat sweet or salty snacks too often (over 55% every day or several times a week), resigning from consuming fruit and vegetables (just half of respondents every day), fish and brown bread (below 30% of children eat these products less than once a week); every fifth child dedicates less than 3 h to physical activity, 39% of respondents do exercise from 3 to 5 h a week, the next 25% from 5 to 10 h.

Conclusions

It was observed in the analysed population that over half of them struggle with the degree of nutrition disorders in the form of overweight and obesity or malnutrition. We may conclude, based on the obtained results, that children have inappropriate dietary habits, consuming too small quantities of fruit and vegetables, brown bread, fish and drinking improper quantities of water and milk. Repeatedly, they replace these full-value products by consuming sweets and salty snacks and by drinking sweet drinks, they also more and more often reach for processed food in fast food bars. What is worrying, it was also observed that in the analysed population, children dedicate too little of their free time to physical activity and additional physical activities.

Metabolic syndrome in Thai adolescents and associated factors: the Thai National Health Examination Survey V (NHES V)

Background

Presence of metabolic syndrome (MetS) in early life may influence cardiovascular outcome later in adulthood. There is limited data regarding MetS among Thai adolescents. This study aimed to estimate the prevalence of MetS and related factors in Thai adolescents.

Methods

Data on MetS components of 1934 Thai adolescents aged 10–16 years were obtained from the 5th National Health Examination Survey. Age at first screen time exposure, duration of screen time, frequency of food intake and physical activities were collected from interviews. MetS was defined according to 3 definitions: International Diabetes Federation (IDF), Cook’s, and de Ferranti’s.

Results

The prevalence of MetS was 4.1% by IDF, 8.0% by Cook’s, and 16.8% by de Ferranti’s definition. The overall prevalence was higher in male (19.0%) than female adolescents (15.3%). The most common MetS components composition among Thai adolescents was high waist circumference with high serum triglyceride and low HDL-cholesterol (40.0% for IDF, 22.6% for Cook’s and 43.5% for de Ferranti’s definition). Exposure to screen media during the first 2 years of life had a 1.3- fold increased odds of MetS by 1 out of 3 definitions (OR 1.30, 95% CI. 1.01–1.68). Duration of physical activity associated with decreased odds of MetS by Cook’s definition (OR 0.96, 95% CI. 0.92–0.99).

Conclusions

The prevalence of MetS among Thai adolescents was higher than previously reported by other studies. Screen media exposure during the first 2 years of life should be discouraged and measures to promote physical activity among children and adolescents should be strengthen.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10728-6.

Dietary Sodium Intake and Health Indicators: A Systematic Review of Published Literature between January 2015 and December 2019

As the science surrounding population sodium reduction evolves, monitoring and evaluating new studies on intake and health can help increase our understanding of the associated benefits and risks. Here we describe a systematic review of recent studies on sodium intake and health, examine the risk of bias (ROB) of selected studies, and provide direction for future research. Seven online databases were searched monthly from January 2015 to December 2019. We selected human studies that met specified population, intervention, comparison, outcome, time, setting/study design (PICOTS) criteria and abstracted attributes related to the study population, design, intervention, exposure, and outcomes, and evaluated ROB for the subset of studies on sodium intake and cardiovascular disease risks or indicators. Of 41,601 abstracts reviewed, 231 studies were identified that met the PICOTS criteria and ROB was assessed for 54 studies. One hundred and fifty-seven (68%) studies were observational and 161 (70%) focused on the general population. Five types of sodium interventions and a variety of urinary and dietary measurement methods were used to establish and quantify sodium intake. Five observational studies used multiple 24-h urine collections to assess sodium intake. Evidence mainly focused on cardiovascular-related indicators (48%) but encompassed an assortment of outcomes. Studies varied in ROB domains and 87% of studies evaluated were missing information on ≥1 domains. Two or more studies on each of 12 outcomes (e.g., cognition) not previously included in systematic reviews and 9 new studies at low ROB suggest the need for ongoing or updated systematic reviews of evidence on sodium intake and health. Summarizing evidence from assessments on sodium and health outcomes was limited by the various methods used to measure sodium intake and outcomes, as well as lack of details related to study design and conduct. In line with research recommendations identified by the National Academies of Science, future research is needed to identify and standardize methods for measuring sodium intake.