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Musa DI, Goon DT, Okuneye RO, Onoja-Alexander MO, Momoh JI, Angba TO. Visceral adiposity index, fitness and clustered cardiovascular disease risk in adolescents. Afr J Prim Health Care Fam Med 2024; 16:e1-e7. [PMID: 38949442 PMCID: PMC11220134 DOI: 10.4102/phcfm.v16i1.4474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 04/06/2024] [Accepted: 04/06/2024] [Indexed: 07/02/2024] Open
Abstract
BACKGROUND Clustering of cardiovascular disease (CVD) risk factors have been observed in children and adolescents, but its association with visceral adiposity index (VAI) and cardiorespiratory fitness (CRF) in adolescents has rarely been studied. AIM This study determines the independent associations of VAI and CRF with the clustering of cardiovascular disease risk (CVDr) among Nigerian adolescents. SETTING Adolescents from specific secondary schools in Kogi East, North Central Nigeria participated in the study. METHODS A cross-sectional sample of 403 adolescents (202 boys and 201 girls) aged 11 years - 19 years were evaluated for VAI, CRF and CVDr. Using identified risk factors, a clustered CVDr score was generated. The association between VAI, CRF and clustered CVDr was evaluated using regression models that controlled for age, gender and maturity status. RESULTS Fitness was negatively associated with CVDr (β = -0.268, p 0.001), while VAI was positively correlated with CVDr (β = 0.379, p 0.001). After CRF or VAI adjustment, the independent association with the dependent variable remained significant. The odds of an adolescent with elevated VAI being at risk of CVD was 4.7 times higher than his peers. Unfit adolescents were 2.1 times more likely to develop CVDr. CONCLUSION Both VAI and CRF were independently associated with the clustering of CVDr in Nigerian adolescents. The findings suggest that health promotion efforts focusing on healthy diet and aerobic-type physical activity programmes should be encouraged among the youth to reduce the risk of CVD.Contribution: This study shows that improving visceral adipose tissue and fitness may lower CVD risk factors in adolescents, which is significant for public health.
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Affiliation(s)
- Danladi I Musa
- Department of Human Kinetics and Health Education, Faculty of Education, Kogi State University, Anyigba.
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Craig A, Breet Y, Gafane-Matemane LF, Norris SA, Kruger R. Detecting and Managing Childhood Onset Hypertension in Africa: A Call to Action. Curr Hypertens Rep 2023; 25:211-230. [PMID: 37318686 PMCID: PMC10491553 DOI: 10.1007/s11906-023-01247-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2023] [Indexed: 06/16/2023]
Abstract
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.
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Affiliation(s)
- A Craig
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Y Breet
- Hypertension in Africa Research Team (HART), North-West University, Private Bag X6001, Potchefstroom, 2520, South Africa
- MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - L F Gafane-Matemane
- Hypertension in Africa Research Team (HART), North-West University, Private Bag X6001, Potchefstroom, 2520, South Africa
- MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - S A Norris
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- School of Human Development and Health, University of Southampton, Southampton, UK
| | - R Kruger
- Hypertension in Africa Research Team (HART), North-West University, Private Bag X6001, Potchefstroom, 2520, South Africa.
- MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa.
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Yehuda MB, Barak S, Hutzler Y, Ng K, Giladi A, Meir LB, Marques A, Zigdon A, Zwilling M, Reges O, Fisch YH, Tesler R. Cardiovascular risk profiles clusters among children and adolescents with disabilities. BMC Public Health 2023; 23:896. [PMID: 37189074 DOI: 10.1186/s12889-023-15796-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 05/03/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Cardiovascular diseases (CVD) are a precursor for disabilities and death worldwide. Being overweight or obese in combination with physical inactivity and smoking habits may increase the risk for CVD and other health problems such as lower limb osteoarthritis, diabetes, stroke, and various cancer types among children and adolescents. The literature emphasizes the need to follow such groups and evaluate the risk of individuals developing CVD diseases. Therefore, the current study explores the variety of cardiovascular risks in children and adolescents' profiles clusters with and without disabilities. METHODS Data from 42 countries including Israel, was collected with the support of the world health organization (WHO, Europe) through a questionnaire from 11-19 years old school-aged. RESULTS The study finding shows that children and adolescents with disabilities demonstrated a higher prevalence of overweight than those who completed the HBSC youth behavior survey. Moreover, the prevalence of tobacco smoking and alcohol use was statisticaly significantly higher among the disabled group than the non-disabled group. In addition, socioeconomic status of responders who presented a very high CVD risk was found as significantly lower than those from the first and second low risk groups. CONCLUSION This led to the conclusion that children and adolescents with disability were at a higher risk of developing CVDs than their non-disabled peers. In addition, intervention programs tailored to the needs of adolescents with disability should consider lifestyle habit change and promoting healthy living thus improving their quality of life as well as reducing their risk of being exposed to severe CVD diseases.
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Affiliation(s)
| | - Sharon Barak
- Department of Nursing, Faculty of Health Science, Ariel University, Ari'el, Israel
| | | | - Kwok Ng
- Physical Activity for Health Research Cluster, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland
- Faculty of Education, University of Turku, Rauma, Finland
| | - Ariela Giladi
- School of Education, Bar Ilan University, Ramat Gan, Israel
| | | | - Adilson Marques
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, 1499-002, Lisbon, Portugal
| | - Avi Zigdon
- Health Promotion Research Center, Ariel University, Ari'el, Israel
| | - Moti Zwilling
- Department of Economics & Business Administration, Faculty of Social Sciences, Ariel University, Ari'el, Israel
| | - Orna Reges
- Department of Health System Management, Faculty of Health Science, Ariel University, Ari'el, Israel
| | | | - Riki Tesler
- Health Promotion Research Center, Ariel University, Ari'el, Israel.
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Musa DI, Toriola AL, Abubakar NO, Omachi S, Olowoleni VB, Ayodele KB. Association of adiposity and fitness with triglyceride-to-high-density lipoprotein cholesterol ratio in youth. Ann Pediatr Cardiol 2023; 16:194-200. [PMID: 37876951 PMCID: PMC10593276 DOI: 10.4103/apc.apc_1_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 01/27/2023] [Accepted: 02/09/2023] [Indexed: 10/26/2023] Open
Abstract
Background The ratio of triglycerides-to-high-density lipoprotein cholesterol (TG/HDL-C) is considered a robust biomarker of metabolic syndrome (MetS) and is associated with several diseases, including type 2 diabetes mellitus (T2DM) and hypertension (HTN). This study examined the independent association of adiposity and fitness with the TG/HDL-C ratio. Materials and Methods This is a cross-sectional study comprising 403 (201 girls) Nigerian adolescents aged 11-19 years. Participants were evaluated for body mass index, cardiorespiratory fitness, and TG/HDL-C. Regression models adjusting for age and biological maturity were used to evaluate the association of adiposity and fitness with TG/HDL-C ratio. The TG/HDL-C ratios of 1.0 mmol/L and 1.1 mmol/L were used to stratify female and male participants into low- and high-risk groups, respectively. Results Of the 135 high-risk adolescents, 21.1%, 5.5%, 12.7%, 14.9%, and 0.5% were at risk of T2DM, systolic HTN, diastolic HTN, abdominal obesity, and MetS, respectively. The independent variables were significantly associated with TG/HDL-C ratio only in boys but not girls. In boys, high adiposity (β = 0.193; P = 0.025) and low fitness (β = -0.169; P = 0.048) were independently associated with the dependent variable. Unfit boys were 3.9 (95% confidence interval [CI] =1.37-10.94, P = 0.011) times more likely to develop elevated TG/HDL-C ratio than their fit peers. The likelihood of girls at risk of MetS developing a high TG/HDL-C ratio was 13.7 (95% CI = 3.89-48.32, P < 0.001) times compared to their counterparts without MetS. Conclusions Adiposity and fitness were independently associated with TG/HDL-C in boys but not in girls. Health promotion intervention focusing on lowering TG/HDL-C ratio among Nigerian adolescents should include an emphasis on healthy diet and endurance activity programs.
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Affiliation(s)
- Danladi Ibrahim Musa
- Department of Human Kinetics and Health Education, Faculty of Education, Kogi State University, Anyigba, Nigeria
| | - Abel Lamina Toriola
- Department of Sport, Rehabilitation and Dental Sciences, Tshwane University of Technology, Pretoria, South Africa
| | - Nurudeen O Abubakar
- Department of Sport, Rehabilitation and Dental Sciences, Kogi State University, Anyigba, Nigeria
| | - Sunday Omachi
- Department of Sport, Rehabilitation and Dental Sciences, Kogi State University, Anyigba, Nigeria
| | - Victor B Olowoleni
- Department of Sport, Rehabilitation and Dental Sciences, Kogi State University, Anyigba, Nigeria
| | - Kolade B Ayodele
- Department of Sport, Rehabilitation and Dental Sciences, Kogi State University, Anyigba, Nigeria
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Brand C, Sehn AP, Fochesatto CF, de Castro Silveira JF, Mota J, Gomez DM, Gaya AR, Reuter CP, Renner JDP. Body fat percentage, cardiorespiratory fitness and arterial blood pressure in children and adolescents: a longitudinal analysis. BMC Cardiovasc Disord 2022; 22:267. [PMID: 35705925 PMCID: PMC9199228 DOI: 10.1186/s12872-022-02704-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 06/03/2022] [Indexed: 11/10/2022] Open
Abstract
Background A better understanding of how cardiorespiratory fitness (CRF) and adiposity interact to associate with arterial blood pressure over time remains inconclusive. Thus, the aim of the present study was to examine whether changes in CRF moderates the association between body fat percentage (BF%) and arterial blood pressure in children and adolescents. Methods This is an observational longitudinal study with 407 children and adolescents aged 8–17 years followed-up for three years from a city in Southern Brazil. Participants were evaluated in 2011 and 2014. CRF was measured by validated field-based tests following the Projeto Esporte Brazil protocols and peak oxygen uptake (VO2peak) was estimated. BF% was determined by the measures of tricipital and subscapular skinfolds using equations according to sex. Systolic and diastolic blood pressure (SBP, DBP) were measured with a sphygmomanometer according to standard procedures. Moderation analyses included multiple linear regression models adjusted for sex, age, pubertal status, height, socioeconomic level, skin color, and the arterial blood pressure variable itself at baseline. Results It was observed a significant inverse association between VO2peak at baseline with SBP (β = − 0.646 CI95% = − 0.976 − 0.316) and DBP (β = − 0.649 CI95% = − 0.923 − 0.375) at follow-up and a positive association between BF% at baseline with SBP (β = 0.274; CI95% = 0.094 0.455) and DBP (β = 0.301; CI95% = 0.150 0.453) at follow-up. In addition, results indicated a significant interaction term between changes in VO2peak and BF% at baseline with both SBP (p = 0.034) and DBP at follow-up (p = 0.011), indicating that an increase of at least 0.35 mL/kg/min and 1.78 mL/kg/min in VO2peak attenuated the positive relationship between BF% with SBP and DBP. Conclusion CRF moderates the relationship between BF% and SBP and DBP in children and adolescents.
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Affiliation(s)
- Caroline Brand
- Graduate Program in Health Promotion, University of Santa Cruz do Sul (UNISC), Independência Av, 2293 - Bloco 42, s. 4206, RS, Santa Cruz do Sul, Rio Grande do Sul, Brazil.
| | - Ana Paula Sehn
- Graduate Program in Health Promotion, University of Santa Cruz do Sul (UNISC), Independência Av, 2293 - Bloco 42, s. 4206, RS, Santa Cruz do Sul, Rio Grande do Sul, Brazil
| | - Camila Felin Fochesatto
- School of Physical Education, Physiotherapy and Dance, Federal University of Rio Grande do Sul, Felizardo Street, 750, Porto Alegre, Brazil
| | - João Francisco de Castro Silveira
- Graduate Program in Health Promotion, University of Santa Cruz do Sul (UNISC), Independência Av, 2293 - Bloco 42, s. 4206, RS, Santa Cruz do Sul, Rio Grande do Sul, Brazil.,School of Physical Education, Physiotherapy and Dance, Federal University of Rio Grande do Sul, Felizardo Street, 750, Porto Alegre, Brazil
| | - Jorge Mota
- Faculty of Sport, University of Porto, Dr. Plácido da Costa St, Porto, Portugal
| | - David Martinez Gomez
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid/IdiPaz, CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,IMDEA Research Institute on Food & Health Sciences, Campus of International Excellence (CEI), Universidad Autónoma de Madrid (UAM) + Spanish National Research Council (CSIC), Madrid, Spain
| | - Anelise Reis Gaya
- School of Physical Education, Physiotherapy and Dance, Federal University of Rio Grande do Sul, Felizardo Street, 750, Porto Alegre, Brazil
| | - Cézane Priscila Reuter
- Graduate Program in Health Promotion, University of Santa Cruz do Sul (UNISC), Independência Av, 2293 - Bloco 42, s. 4206, RS, Santa Cruz do Sul, Rio Grande do Sul, Brazil
| | - Jane Dagmar Pollo Renner
- Graduate Program in Health Promotion, University of Santa Cruz do Sul (UNISC), Independência Av, 2293 - Bloco 42, s. 4206, RS, Santa Cruz do Sul, Rio Grande do Sul, Brazil
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Crouch SH, Soepnel LM, Kolkenbeck-Ruh A, Maposa I, Naidoo S, Davies J, Norris SA, Ware LJ. Paediatric Hypertension in Africa: A Systematic Review and Meta-Analysis. EClinicalMedicine 2022; 43:101229. [PMID: 34917909 PMCID: PMC8665406 DOI: 10.1016/j.eclinm.2021.101229] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 11/16/2021] [Accepted: 11/22/2021] [Indexed: 12/19/2022] Open
Abstract
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.
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Affiliation(s)
- Simone H. Crouch
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Larske M. Soepnel
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Correspondence and reprint to: Dr. Larske M. Soepnel. Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Huispost nr. STR 6.131 P.O. Box 85500 3508 GA, Utrecht, The Netherlands
| | - Andrea Kolkenbeck-Ruh
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Innocent Maposa
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa School of Public Health
| | - Sanushka Naidoo
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Justine Davies
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Shane A. Norris
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- School of Health and Human Development, University of Southampton, Southampton, United Kingdom
| | - Lisa J. Ware
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
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Physical Activity, Cardiorespiratory Fitness and Clustered Cardiovascular Risk in South African Primary Schoolchildren from Disadvantaged Communities: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18042080. [PMID: 33669905 PMCID: PMC7924629 DOI: 10.3390/ijerph18042080] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 02/10/2021] [Accepted: 02/17/2021] [Indexed: 11/17/2022]
Abstract
The coexistence of multiple cardiovascular risk factors has been reported in school-aged children from the age of nine years, but most evidence stems from high-income countries. This cross-sectional study aimed at describing the cardiovascular health risk, physical activity (PA) behavior and cardiorespiratory fitness (CRF) levels of South African primary schoolchildren, and at examining the associations between PA/CRF and a composite measure of cardiovascular risk. Cross-sectional data from 832 primary schoolchildren (grade 1–4) were analyzed. Total cholesterol/HDL ratio, triglycerides, systolic/diastolic blood pressure, body fat, and glycated hemoglobin were assessed as cardiovascular risk markers. Data were analyzed via mixed linear regressions and analyses of covariance. Overall, 24.2% of the participants did not meet current PA standards. Higher CRF/PA were associated with lower body fat and lower clustered cardiovascular risk (p < 0.05). When categorizing children into CRF/PA quartiles, a lower clustered cardiovascular risk gradient was found in children with higher CRF (p < 0.05) or PA (p < 0.05). Our data shows that higher CRF/PA is associated with lower clustered cardiovascular risk already from a young age. Given that clustered cardiovascular risk present during childhood can track into adulthood, we advocate for PA participation and a healthy weight from a young age onwards.
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