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Trends in body mass index, blood pressure and parental smoking habits in middle socio-economic level Turkish adolescents

Abstract

Patterns of cardiovascular risk factors in populations are not static over time. We examined trends in body mass index (BMI), parental smoking and blood pressure over a 15-year period in Turkish children aged 15–17 years. Two cross-sectional studies were performed in secondary schools in Turkey in 1989–1990 and 2004–2005. Study participants were 673 children in 1989–1990 and 640 adolescents in 2004–2005. Main outcome measures were weight, height, BMI, presence and amount of parental smoking, systolic and diastolic blood pressure. Age and sex matched comparisons were performed to assess temporal trends in these measures. Children in 2004–2005 had increased weight, height, BMI and decreased systolic and diastolic blood pressure in all age groups compared with children in 1989–1990. According to the international criteria, 3.4% of children were obese and 15.8% were overweight in 2005, compared to 0.7% obese and 4.2% overweight in 1990 (P<0.001). However, a decrease was noted in blood pressure; 16% were classified as hypertensive in 1989–1990 versus 8% in 2004–2005 (P<0.001). The prevalence and amount of parental smoking also decreased over the last 15 years. We observed significant changes in BMI and blood pressure in Turkish children over the last 15 years. Temporal trends in these parameters may indicate a change in the pattern of cardiovascular disease in this population.

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References

  1. Ezzati M, Hoorn SV, Rodgers A, Lopez AD, Mathers CD, Murray CJ, Comparative Risk Assessment Collaborating Group. Estimates of global and regional potential health gains from reducing multiple major risk factors. Lancet 2003; 362: 271–280.

    Article  Google Scholar 

  2. Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJ . Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. Lancet 2006; 367: 1747–1757.

    Article  Google Scholar 

  3. Thom TJ . International mortality from heart disease: rates and trends. Int J Epidemiol 1989; 18: S20–S28.

    Article  CAS  Google Scholar 

  4. Chen W, Srinivasan S, Li S, Xu J, Berenson GS . Metabolic syndrome variables at low levels in childhood are beneficially associated with adulthood cardiovascular risk. The Bogalusa Heart Study. Diabetes Care 2005; 28: 126–131.

    Article  Google Scholar 

  5. Weiss R, Dziura J, Burgert TS, Tamborlane WV, Taksali SE, Yeckel CW et al. Obesity and metabolic syndrome in children and adolescents. N Eng J Med 2004; 350: 2362–2374.

    Article  CAS  Google Scholar 

  6. Caprio S . Insulin resistance in childhood obesity. J Pediatr Endocrinol Metab 2002; 15: S487–S492.

    Google Scholar 

  7. Gidding SS, Bao W, Srinivasan SR, Berenson GS . Effects of secular trends in obesity on coronary risk factors in children: the Bogalusa Heart Study. J Pediatr 1995; 127: 868–874.

    Article  CAS  Google Scholar 

  8. Luepker RV, Jacobs DR, Prineas RJ, Sinaiko AR . Secular trends of blood pressure and body size in a multi-ethnic adolescent population: 1986–1996. J Pediatr 1999; 134: 668–674.

    Article  CAS  Google Scholar 

  9. McCarron P, Okasha M, McEwen J, Smith GD . Changes in blood pressure among students attending Glasgow University between 1948 and 1968: analyses of cross sectional surveys. BMJ 2001; 322: 885–889.

    Article  CAS  Google Scholar 

  10. Watkins D, McCarron P, Murray L, Cran G, Boreham C, Robson P et al. Trends in blood pressure over 10 years in adolescents: analyses of cross sectional surveys in the Northern Ireland Young Hearts project. BMJ 2004; 329: 139.

    Article  Google Scholar 

  11. Muntner P, He J, Cutler JA, Wildman RP, Whelton PK . Trends in blood pressure among children and adolescents. JAMA 2004; 291: 2107–2113.

    Article  CAS  Google Scholar 

  12. Hajjar I, Kotchen TA . Trends in prevalence awareness treatment and control hypertension in the United States. JAMA 2003; 290: 199–206.

    Article  Google Scholar 

  13. Kuulasmaa K, Tunstall-Pedoe H, Dobson A, Fortmann S, Sans S, Tolonen H et al. Estimation of contribution of changes in classic risk factors to trends in coronary-event rates across the WHO MONICA Project populations. Lancet 2000; 355: 675–687.

    Article  CAS  Google Scholar 

  14. Law MR, Wald NJ . Environmental tobacco smoke and ischemic heart disease. Prog Cardiovasc Dis 2003; 46: 31–38.

    Article  Google Scholar 

  15. Teo KK, Ounpuu S, Hawken S, Pandey MR, Valentin V, Hunt D et al. On behalf of the INTERHEART study investigators. Tobacco use and risk of myocardial infarction in 52 countries in the INTERHEART study: a case control study. Lancet 2006; 368: 647–658.

    Article  Google Scholar 

  16. Agirbasli M, Cakir S, Ozme S, Ciliv G . Metabolic syndrome in Turkish children and adolescents. Metabolism 2006; 55: 1002–1006.

    Article  CAS  Google Scholar 

  17. Agirbasli M, Ciliv G, Cakir S, Srinivasan S, Berenson GS, Ozme S . Body mass index and lipid levels in children from Ankara, Turkey versus Bogalusa, Louisiana. Prev Med 2005; 41: 843–845.

    Article  CAS  Google Scholar 

  18. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH . Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 2000; 320: 1240–1243.

    Article  CAS  Google Scholar 

  19. Katzmarzyk PT, Tremblay A, Perusse L, Despres JP, Bouchard C . The utility of the international child and adolescent overweight guidelines for predicting coronary heart disease risk factors. J Clin Epidemiol 2003; 56: 456–462.

    Article  Google Scholar 

  20. NIH. Clinical Guidelines for the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. National Institutes of Health: Bethesda, MD, 1998.

  21. Neyzi O, Gunoz H . Buyume ve gelisme bozukluklari. In: Neyzi O, Ertugrul T (eds). Pediatri, 2nd edn. Nobel Tip kitabevleri: Istanbul, 2000, pp 69–100 (in Turkish).

    Google Scholar 

  22. Rosner B, Prineas RJ, Loggie JM, Daniels SR . Blood pressure nomograms for children and adolescents, by height, sex, and age, in the United States. J Pediatr 1993; 123: 871–886.

    Article  CAS  Google Scholar 

  23. National High Blood Pressure Education Program Working Group on Hypertension Control in Children and Adolescents. Update on the 1987 task force report on high blood pressure in children and adolescents: a working group report from the National High Blood Pressure Education Program. Pediatrics 1996; 8: 649–658.

    Google Scholar 

  24. Onat A, Uysal O, Hergenc G . Assessment of the cohort of the Turkish Risk Factor Study with the Framingham risk function: an additional indicator of the high absolute coronary risk among Turks. Arch Turk Soc Cardiol 2001; 29: 208–214 (in Turkish).

    Google Scholar 

  25. McCarron P, Smith GD, Okasha M . Secular changes in blood pressure in childhood, adolescence and young adulthood: systematic review of trends from 1948 to 1998. J Hum Hypertens 2002; 16: 677–689.

    Article  CAS  Google Scholar 

  26. Roberts J . Cardiovascular conditions of children aged 6–11 years and youths 12–17 years United States 1963–1965 and 1966–1970. National Center for Health Statistics, Vital Health Stat II 1978; 166: 1–47.

    Google Scholar 

  27. Galal O . Nutrition related health patterns in the Middle East. Asia Pac J Clin Nutr 2003; 12: 337–343.

    PubMed  Google Scholar 

  28. Hakeem R, Thomas J, Badruddin SH . Urbanization and coronary heart disease risk factors in South Asian children. J Pak Med Assoc 2001; 51: 22–28.

    CAS  PubMed  Google Scholar 

  29. Kelishadi R, Hashemipour M, Sarraf-Zadegan N, Amiri M . Trend of atherosclerosis risk factors in children of Isfahan. Asian Cardiovasc Thorac Ann 2001; 9: 36–40.

    Article  Google Scholar 

  30. Lawlor DA, Riddoch CJ, Page AS, Anderssen SA, Froberg K, Harro M et al. The association of birthweight and contemporary size with insulin resistance among children from Estonia and Denmark: findings from the European Youth Heart Study. Diabetic Med 2005; 22: 921–930.

    Article  CAS  Google Scholar 

  31. Fredriks AM, van Buuren S, Jeurissen SE, Dekker FW, Verloove-Vanhorick SP, Wit JM . Height, weight, body mass index and pubertal development reference values for children of Turkish origin in the Netherlands. Eur J Pediatr 2003; 162: 788–793.

    Article  Google Scholar 

  32. Roville-Sausse F, Truc JB, Jacob D . Maternal weight gain during pregnancy in various immigrant communities living in France. Rev Epidemiol Sante Publique 2001; 49: 439–447.

    CAS  PubMed  Google Scholar 

  33. Levitt NS, Steyn K, De Wet T, Morrell C, Edwards R, Ellison GT et al. An inverse relation between blood pressure and birth weight among 5 year old children from Soweto, South Africa. J Epid and Commun Health 1999; 53: 264–268.

    Article  CAS  Google Scholar 

  34. Huxley RR, Shiell AW, Law CM . The role of size at birth and postnatal catch-up growth in determining systolic blood pressure: a systematic review of the literature. J Hypertens 2000; 18: 815–831.

    Article  CAS  Google Scholar 

  35. Huxley R, Neil A, Collins R . Unravelling the fetal origins hypothesis: is there really an inverse association between birthweight and subsequent blood pressure? Lancet 2002; 360: 659–665.

    Article  Google Scholar 

  36. Uncu Y, Ozcakir A, Ercan I, Bilgel N, Uncu G . Pregnant women quit smoking; What about fathers? Survey study from Bursa Region, Turkey. Croat Med J 2005; 46: 832–837.

    PubMed  Google Scholar 

  37. Geleijnse JM, Hofman A, Witteman JC, Hazebroek AA, Valkenburg HA, Grobbee DE . Long-term effects of neonatal sodium restriction on blood pressure. Hypertension 1997; 29: 913–917.

    Article  CAS  Google Scholar 

  38. Bas M, Altan T, Dincer D, Aran E, Kaya HG, Yuksek O . Determination of dietary habits as a risk factor of cardiovascular heart disease in Turkish adolescents. Eur J of Nutr 2005; 44: 174–182.

    Article  Google Scholar 

  39. Crofton J . Tobacco: a future disaster for Turkey's children. Turk J Pediatr 1996; 38: 1–11.

    CAS  PubMed  Google Scholar 

Download references

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Agirbasli, M., Tanrikulu, B., Arikan, S. et al. Trends in body mass index, blood pressure and parental smoking habits in middle socio-economic level Turkish adolescents. J Hum Hypertens 22, 12–17 (2008). https://doi.org/10.1038/sj.jhh.1002262

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