Dietary and Lifestyle Factors Associated with Blood Pressure among U.S. Adolescents

Sugiyama, Takehiro; Xie, Dawei; Graham-Maar, Rose C.; Inoue, Kazuo; Kobayashi, Yasuki; Stettler, Nicolas

doi:10.1016/j.jadohealth.2006.09.006

« Previous Next »Journal of Adolescent Health
Volume 40, Issue 2 , Pages 166-172, February 2007

Dietary and Lifestyle Factors Associated with Blood Pressure among U.S. Adolescents

This study was presented in part at the Scientific Sessions of the American Heart Association, Dallas, TX, November 13, 2005 and the American Heart Association 46th Annual Conference on Cardiovascular Disease Epidemiology and Prevention, Phoenix, AZ, March 3, 2006.

Takehiro Sugiyama
- Faculty of Medicine, the University of Tokyo, Tokyo, Japan
Dawei Xie
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA
Rose C. Graham-Maar, M.D.
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA
- Division of Gastroenterology, Hepatology, and Nutrition, The Children’s Hospital of Philadelphia, Philadelphia, PA
Kazuo Inoue, M.D., Ph.D.
- Department of Public Health, the University of Tokyo, Tokyo, Japan
Yasuki Kobayashi, M.D., Ph.D.
- Department of Public Health, the University of Tokyo, Tokyo, Japan
Nicolas Stettler, M.D., M.S.C.E.
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA
- Division of Gastroenterology, Hepatology, and Nutrition, The Children’s Hospital of Philadelphia, Philadelphia, PA
- Address correspondence to: Nicolas Stettler, M.D., M.S.C.E., Division of Gastroenterology, Hepatology, and Nutrition, The Children’s Hospital of Philadelphia, North 1559, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104-4399.

Received 5 June 2005; accepted 7 September 2005. published online 30 November 2006.

Abstract

Purpose

To identify modifiable lifestyle factors associated with blood pressure among U.S. adolescents.

Methods

A cross-sectional study was conducted of 4508 12–19-year-old respondents of the 1999–2002 National Health and Nutrition Examination Survey. Systolic and diastolic blood pressure (SBP and DBP) were measured and adjusted for gender, age, and height using z-scores (SBPZ and DBPZ). Body mass index (BMI) was adjusted for gender and age (BMIZ). Questionnaires were used to measure nutrient intake (carbohydrate, protein, saturated and unsaturated fat, sodium, potassium, calcium, magnesium, fiber, and caffeine) and activities (physical activities and sedentary activities, including television watching).

Results

In the adjusted model (R² = .115), SBPZ was higher by .022 standard deviation (SD) (95% confidence interval [CI]: .007–.038, equivalent to ∼ .2 mmHg) per 1-hour increments in sedentary activities; higher by .244 SD (.198–.289, ∼ 2.6 mmHg) per 1 SD of BMIZ; and lower by .099 SD (−.192 to −.006, ∼ 1.1 mmHg) per 100 g of carbohydrate intake. Unexpectedly, BMIZ was negatively associated with DBPZ (−.078 per 1 SD, −.114 to −.043, ∼ .9 mmHg).

Conclusions

Among U.S. adolescents, sedentary activities and BMI are positively associated with SBP after adjustment for confounding factors and mediators, while BMI is negatively associated with DBP. If confirmed by further studies, population-based interventions aimed at sedentary activities may be practical approaches to decrease SBP and the risk of obesity among adolescents.

Keywords: Adolescent, Blood pressure, Body mass index, Cross-sectional studies, Exercise, Life style, Nutrition, Nutrition surveys, Obesity, Television