Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Relations between obesity and hypertension: preliminary data from a cross-sectional study in primary schoolchildren: The children study

European Journal of Clinical Nutrition volume 60, pages 1226–1234 (2006)Cite this article

Abstract

Objective:

To record the prevalence of overweight, obesity and hypertension in primary schoolchildren living in one of the poorest regions in Europe and furthermore to identify certain behavioural, lifestyle and physiological parameters associated with body mass index (BMI) and blood pressure (BP).

Design:

Cross-sectional study.

Setting:

Nineteen primary schools within the county of Ioannina, Greece.

Subjects and methods:

Demographic, dietary and physical activity data as well as anthropometrical, BP and cardiorespiratory fitness measurements were obtained from a representative sample of 312 school children (153 boys and 159 girls) attending 5th grade. Inclusion of subjects in the study was voluntary. One-way analysis of variance and multiple linear regression analysis were mainly applied for the evaluation of the tested hypotheses.

Results:

The prevalence of overweight and obesity was 29.4 and 11.8% for boys and 39.0 and 7.5% for girls. The prevalence of systolic and diastolic hypertension was 28.1 and 7.8% for boys and 26.4 and 17.0% for girls. Furthermore, BMI and BP (systolic and diastolic) were positively related to frequency of fast food meals (rho: +0.28, P=0.033, rho: +1.09, P=0.03 and rho: +0.86, P=0.014, respectively) but negatively to leisure time physical activity (rho: −5.55, P=0.005, rho: −3.32 × 10−2, P<0.001 and rho: −2.08 × 10−2, P<0.001, respectively).

Conclusions:

The current study revealed an increased prevalence of overweight, obesity and hypertension among schoolchildren in Ioannina, indicating the need for early preventive measures in one of the less privileged regions of Europe.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  • Baigi A, Fridlund B, Marklund B, Oden A (2002). Cardiovascular mortality focusing on socio-economic influence: the low-risk population of Halland compared to the population of Sweden as a whole. Public Health 116, 285–288.

    CAS  PubMed  Google Scholar 

  • Bao W, Threefoot SA, Srinivasan SR, Berenson GS (1995). Essential hypertension predicted by tracking of elevated blood pressure from childhood to adulthood: the Bogalusa Heart Study. Am J Hypertens 8, 657–665.

    Article  CAS  PubMed  Google Scholar 

  • Booth ML, Chey T, Wake M, Norton K, Hesketh K, Dollman J et al. (2003). Change in the prevalence of overweight and obesity among young Australians, 1969–1997. Am J Clin Nutr 77, 29–36.

    Article  CAS  PubMed  Google Scholar 

  • Boreham CA, Ferreira I, Twisk JW, Gallagher AM, Savage MJ, Murray LJ (2004). Cardiorespiratory fitness, physical activity, and arterial stiffness: the Northern Ireland Young Hearts Project. Hypertension 44, 721–726.

    Article  CAS  PubMed  Google Scholar 

  • Bouziotas C, Koutedakis Y, Nevill A, Ageli E, Tsigilis N, Nikolaou A et al. (2004). Greek adolescents, fitness, fatness, fat intake, activity, and coronary heart disease risk. Arch Dis Child 89, 41–44.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Burniat W (2002). Child and Adolescent Obesity: Causes and Consequences, Prevention and Management. Cambridge University Press: Cambridge, New York.

    Book  Google Scholar 

  • Butani L, Morgenstern BZ (2003). Are pitfalls of oxcillometric blood pressure measurements preventable in children? Pediatr Nephrol 18, 313–318.

    Article  PubMed  Google Scholar 

  • Chinn S, Rona RJ (2001). Prevalence and trends in overweight and obesity in three cross sectional studies of British Children, 1974–94. BMJ 322, 24–26.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Chu NF (2001). Prevalence and trends of obesity among school children in Taiwan–the Taipei Children Heart Study. Int J Obes Relat Metab Disord 25, 170–176.

    Article  CAS  PubMed  Google Scholar 

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

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Committee of Experts on Sports Research (1988). EUROFIT. Edigraf Editoriale Grafica: Rome.

  • Couch SC, Daniels SR (2005). Diet and blood pressure in children. Curr Opin Pediatr 17, 642–647.

    Article  PubMed  Google Scholar 

  • Dalstra JA, Kunst AE, Borrell C, Breeze E, Cambois E, Costa G et al. (2005). Socioeconomic differences in the prevalence of common chronic diseases: an overview of eight European countries. Int J Epidemiol 34, 316–326.

    Article  CAS  PubMed  Google Scholar 

  • El Assaad MA, Topouchian JA, Asmar RG (2003). Evaluation of two devices for self-measurement of blood pressure according to the international protocol: the Omron M5-I and the Omron 705IT. Blood Press Monit 8, 127–133.

    Article  PubMed  Google Scholar 

  • Fernandes MT, Sesso R, Martins PA, Sawaya AL (2003). Increased blood pressure in adolescents of low socioeconomic status with short stature. Pediatr Nephrol 18, 435–439.

    PubMed  Google Scholar 

  • Flegal KM, Ogden CL, Wei R, Kuczmarski RL, Johnson CL (2001). Prevalence of overweight in US children: comparison of US growth charts from the Centers for Disease Control and Prevention with other reference values for body mass index. Am J Clin Nutr 73, 1086–1093.

    Article  CAS  PubMed  Google Scholar 

  • General Secretary National Statistical Service of Greece (2002). Per capital income by Nuts II, III.

  • Hanley AJ, Harris SB, Gittelsohn J, Wolever TM, Saksvig B, Zinman B (2000). Overweight among children and adolescents in a Native Canadian community: prevalence and associated factors. Am J Clin Nutr 71, 693–700.

    Article  CAS  PubMed  Google Scholar 

  • Institute of Medicine Food and Nutrition Board (2001). Dietary Reference Intakes: Applications in Dietary Assessment. National Academy Press: Washington, DC.

  • Kafatos A, Mamalakis G (1993). Changing patterns of fat intake in Crete. Eur J Clin Nutr 47 (Suppl 1), S21–S24.

    PubMed  Google Scholar 

  • Kafatos A, Manios Y, Markatji I, Giachetti I, Vaz de Almeida MD, Engstrom LM (1999). Regional, demographic and national influences on attitudes and beliefs with regard to physical activity, body weight and health in a nationally representative sample in the European Union. Public Health Nutr 2, 87–95.

    CAS  PubMed  Google Scholar 

  • Kafatos A, Papoutsakis G (1998). Mortality rates in Greece and their relationship to the Mediterranean diet and ti health and nutrition education. Iatriki 73, 287–301.

    Google Scholar 

  • Katzmarzyk PT, Craig CL, Bouchard C (2001). Original article underweight, overweight and obesity: relationships with mortality in the 13-year follow-up of the Canada Fitness Survey. J Clin Epidemiol 54, 916–920.

    Article  CAS  PubMed  Google Scholar 

  • Kelley GA (1999). Aerobic exercise and resting blood pressure among women: a meta-analysis. Prev Med 28, 264–275.

    Article  CAS  PubMed  Google Scholar 

  • Kendall GE, Li J (2005). Early childhood socialization and social gradients in adult health: a commentary on Singh-Manoux and Marmot's ‘Role of socialization in explaining social inequalities in health’. Soc Sci Med 60, 2129–2133.

    Article  Google Scholar 

  • Kimm SY, Glynn NW, Kriska AM, Fitzgerald SL, Aaron DJ, Similo SL et al. (2000). Longitudinal changes in physical activity in a biracial cohort during adolescence. Med Sci Sports Exerc 32, 1445–1454.

    Article  CAS  PubMed  Google Scholar 

  • Krassas GE, Tzotzas T, Tsametis C, Konstantinidis T (2001a). Determinants of body mass index in Greek children and adolescents. J Pediatr Endocrinol Metab 14 (Suppl 5), 1327–1333; discussion 1365.

    PubMed  Google Scholar 

  • Krassas GE, Tzotzas T, Tsametis C, Konstantinidis T (2001b). Prevalence and trends in overweight and obesity among children and adolescents in Thessaloniki, Greece. J Pediatr Endocrinol Metab 14 (Suppl 5), 1319–1326; discussion 1365.

    PubMed  Google Scholar 

  • Magkos F, Manios Y, Christakis G, Kafatos AG (2005). Secular trends in cardiovascular risk factors among school-aged boys from Crete, Greece, 1982–2002. Eur J Clin Nutr 59, 1–7.

    Article  CAS  PubMed  Google Scholar 

  • Mamalakis G, Kafatos A (1996). Prevalence of obesity in Greece. Int J Obes Relat Metab Disord 20, 488–492.

    CAS  PubMed  Google Scholar 

  • Mamalakis G, Kafatos A, Manios Y, Anagnostopoulou T, Apostolaki I (2000). Obesity indices in a cohort of primary school children in Crete: a six year prospective study. Int J Obes Relat Metab Disord 24, 765–771.

    Article  CAS  PubMed  Google Scholar 

  • Manios Y, Moschandreas J, Hatzis C, Kafatos A (2002). Health and nutrition education in primary schools of Crete: changes in chronic disease risk factors following a 6-year intervention programme. Br J Nutr 88, 315–324.

    Article  CAS  PubMed  Google Scholar 

  • Manios Y, Panagiotakos DB, Pitsavos C, Polychronopoulos E, Stefanadis C (2005). Implication of socio-economic status on the prevalence of overweight and obesity in Greek adults: the ATTICA study. Health Policy 74, 224–232.

    Article  PubMed  Google Scholar 

  • Manios Y, Yiannakouris N, Papoutsakis C, Moschonis G, Magkos F, Skenderi K et al. (2004). Behavioral and physiological indices related to BMI in a cohort of primary schoolchildren in Greece. Am J Hum Biol 16, 639–647.

    Article  PubMed  Google Scholar 

  • Matheson DM, Killen JD, Wang Y, Varady A, Robinson TN (2004). Children's food consumption during television viewing. Am J Clin Nutr 79, 1088–1094.

    Article  CAS  PubMed  Google Scholar 

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

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  • Mo F, Turner M, Krewski D, Mo FD (2005). Physical inactivity and socioeconomic status in Canadian adolescents. Int J Adolesc Med Health 17, 49–56.

    Article  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  • National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents (2004). The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 114, 555–576.

  • National Research Council (1986). Nutrient Adequacy: Assessment Using Food Consumption Surveys. Report of the Food and Nutrition Board. National Academy of Sciences: Washington, DC.

  • Nicklas TA, Yang SJ, Baranowski T, Zakeri I, Berenson G (2003). Eating patterns and obesity in children. The Bogalusa Heart Study. Am J Prev Med 25, 9–16.

    Article  PubMed  Google Scholar 

  • Ogden CL, Flegal KM, Carroll MD, Johnson CL (2002). Prevalence and trends in overweight among US children and adolescents, 1999–2000. JAMA 288, 1728–1732.

    Article  PubMed  Google Scholar 

  • Papadopoulou-Alataki E, Papadopoulou-Legbelou K, Doukas L, Karatzidou K, Pavlitou-Tsiontsi A, Pagkalos E (2004). Clinical and biochemical manifestations of syndrome X in obese children. Eur J Pediatr 163, 573–579.

    CAS  PubMed  Google Scholar 

  • Pollitt RA, Rose KM, Kaufman JS (2005). Evaluating the evidence for models of life course socioeconomic factors and cardiovascular outcomes: a systematic review. BMC Public Health 5, 7.

    Article  PubMed  PubMed Central  Google Scholar 

  • Raitakari OT, Porkka KV, Rasanen L, Ronnemaa T, Viikari JS (1994). Clustering and six year cluster-tracking of serum total cholesterol, HDL-cholesterol and diastolic blood pressure in children and young adults. The Cardiovascular Risk in Young Finns Study. J Clin Epidemiol 47, 1085–1093.

    Article  CAS  PubMed  Google Scholar 

  • Ribeiro JC, Guerra S, Oliveira J, Teixeira-Pinto A, Twisk JW, Duarte JA et al. (2004). Physical activity and biological risk factors clustering in pediatric population. Prev Med 39, 596–601.

    Article  PubMed  Google Scholar 

  • Rona RJ, Qureshi S, Chinn S (1996). Factors related to total cholesterol and blood pressure in British 9 year olds. J Epidemiol Commun Health 50, 512–518.

    Article  CAS  Google Scholar 

  • Schmidt M, Affenito SG, Striegel-Moore R, Khoury PR, Barton B, Crawford P et al. (2005). Fast-food intake and diet quality in black and white girls: the National Heart, Lung, and Blood Institute Growth and Health Study. Arch Pediatr Adolesc Med 159, 626–631.

    Article  PubMed  Google Scholar 

  • Slyper AH (2004). The pediatric obesity epidemic: causes and controversies. J Clin Endocrinol Metab 89, 2540–2547.

    Article  CAS  PubMed  Google Scholar 

  • Smoak CG, Burke GL, Webber LS, Harsha DW, Srinivasan SR, Berenson GS (1987). Relation of obesity to clustering of cardiovascular disease risk factors in children and young adults. The Bogalusa Heart Study. Am J Epidemiol 125, 364–372.

    Article  CAS  PubMed  Google Scholar 

  • Trichopoulou A (2004). Composition tables of foods and Greek dishes. Department of Hygiene and Epidemiology, School of Medicine: Athens, Greece.

    Google Scholar 

  • Trudeau F, Shephard RJ, Bouchard S, Laurencelle L (2003). BMI in the Trois-Rivieres study: child–adult and child–parent relationships. Am J Hum Biol 15, 187–191.

    Article  PubMed  Google Scholar 

  • Tyroler HA (1999). The influence of socioeconomic factors on cardiovascular disease risk factor development. Prev Med 29, S36–40.

    Article  CAS  PubMed  Google Scholar 

  • Voukiklaris GE, Kafatos A, Dontas AS (1996). Changing prevalence of coronary heart disease risk factors and cardiovascular diseases in men of a rural area of Crete from 1960 to 1991. Angiology 47, 43–49.

    Article  CAS  PubMed  Google Scholar 

  • Wareham NJ, Rennie KL (1998). The assessment of physical activity in individuals and populations: why try to be more precise about how physical activity is assessed? Int J Obes Relat Metab Disord 22 (Suppl 2), S30–38.

    PubMed  Google Scholar 

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

    Article  PubMed  PubMed Central  Google Scholar 

  • Whitaker RC, Wright JA, Pepe MS, Seidel KD, Dietz WH (1997). Predicting obesity in young adulthood from childhood and parental obesity. N Engl J Med 337, 869–873.

    Article  CAS  PubMed  Google Scholar 

  • WHO (2000). Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organization Technical Report Series, i–xii. 1–253.

Download references

Acknowledgements

We thank Professor Haralampos M Moutsopoulos, Department of Pathophysiology, School of Medicine, University of Athens, for his guidance and assistance in completing the study. The valuable contribution of Chrisanthi Vlachaki, Zoi Bouloubasi and Mariana Zappi regarding dietary data analysis is also acknowledged.

Author information

Authors and Affiliations

  1. Department of Pathophysiology, School of Medicine, University of Athens, Athens, Greece

    P D Angelopoulos

  2. Department of Internal Medicine, School of Medicine, University of Ioannina, Ioannina, Greece

    H J Milionis

  3. Department of Nutrition and Dietetics, Harokopio University, Athens, Greece

    G Moschonis & Y Manios

Authors
  1. P D Angelopoulos
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. H J Milionis
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. G Moschonis
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Y Manios
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Y Manios.

Additional information

Guarantor: Y Manios.

Contributors: PDA contributed to the study design, participated and supervised all fieldwork. HJM participated in the study design and data collection. GM contributed to data management and the statistical analysis. YM was in charge of the study design, data collection and analysis. All authors contributed to the interpretation of the data and writing of the paper.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Angelopoulos, P., Milionis, H., Moschonis, G. et al. Relations between obesity and hypertension: preliminary data from a cross-sectional study in primary schoolchildren: The children study. Eur J Clin Nutr 60, 1226–1234 (2006). https://doi.org/10.1038/sj.ejcn.1602442

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ejcn.1602442

Keywords

This article is cited by

Search

Advanced search

Quick links