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:

Relationship between fat patterns, physical fitness and blood pressure of rural South African children: Ellisras Longitudinal Growth and Health Study

Journal of Human Hypertension volume 22, pages 311–319 (2008)Cite this article

Abstract

The present study investigated the relationship between blood pressure (BP), fat patterns and fitness parameters of Ellisras children aged 7–13 years. Furthermore, an assessment of body fat patterns was done to determine the subjects with the highest risk of overweight, hypertension and waist-to-hip ratio above the 90th percentile. Data were collected from 1817 subjects (938 boys and 879 girls), aged 7–13 years, participating in the Ellisras Longitudinal Study. Anthropometric measurements were taken according to the standard procedure of the International Society for the Advancement of Kinanthropometry. The EUROFIT test items were used to test the physical fitness of 1192 subjects (634 boys and 558 girls). Obesity was defined using the international recommended cutoff points for body mass index (BMI) in children. Hypertension was defined as the occurrence of BP levels greater or equal to the 95th percentile of height- and sex-adjusted reference levels. The prevalence of hypertension ranged from 1 to 11.4% and that of overweight 0.6–4.6%. Waist girth, BMI, triceps and subscapular skinfold showed significant (P<0.001–0.05) correlation with other fat pattern parameters (r ranging from −0.157 to 0.978) compared with significant correlations (P<0.001–0.05) with BP (r ranging from −0.071 to 0.164). Children with waist girth greater than the 90th percentile are more likely to have multiple risk factors than the children with a waist girth that is less than or equal to the 90th percentile. Longitudinal studies should verify whether changes in waist girth and skinfolds will indicate changes in cardiovascular risk factors during growth.

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

Figure 1

Similar content being viewed by others

References

  1. Murray CJL, Lopez AB . Global health statistics. Global Burden of Disease and Injury Series. Harvard School of Public Health: Boston MN, 1996, pp 22–43.

    Google Scholar 

  2. Kemper HC, Koppes LL, de Vente W, van Lenthe FJ, van Mechelen W, Twisk JW et al. Effects of health information in youth and young adulthood on risk factors for chronic diseases—20-year study results from the Amsterdam Growth and Health Longitudinal Study. Prev Med 2002; 35: 533–539.

    Article  CAS  Google Scholar 

  3. Twisk JW, Kemper HC, van Mechelen W . Tracking of activity and fitness and the relationship with cardiovascular disease risk factors. Med Sci Sports Exerc 2000; 32: 1455–1461.

    Article  CAS  Google Scholar 

  4. Dietz WH . Critical periods in childhood for the development for obesity. Am J Clin Nutr 1994; 59: 955–959.

    Article  CAS  Google Scholar 

  5. Kemper HC, Post GB, Twisk JW, van Mechelen W . Lifestyle and obesity in adolescence and young adulthood: results from the Amsterdam Growth and Health Longitudinal Study (AGAHLS). Int J Obes Relat Metab Disord 1999; 23: S34–S40.

    Article  Google Scholar 

  6. Freedman DS, Williamson DF, Croft JB, Ballew C, Byers T . Relation of body fat distribution to ischemic heart disease. The National Health and Nutrition Examination Survey I (NHANES I) Epidemiologic Follow-up Study. Am J Epidemiol 1995; 142: 53–63.

    Article  CAS  Google Scholar 

  7. Kemper HC, van Mechelen W, Post GB, Snel J, Twisk JW, van Lenthe FJ et al. The Amsterdam Growth and Health Longitudinal Study. The past (1976–1996) and future (1997–?). Int J Sports Med 1997; 18: S140–S150.

    Article  Google Scholar 

  8. van Lenthe FJ, van Mechelen W, Kemper HC, Twisk JW . Association of a central pattern of body fat with blood pressure and lipoproteins from adolescence into adulthood. The Amsterdam Growth and Health Study. Am J Epidemiol 1998; 147: 686–693.

    Article  CAS  Google Scholar 

  9. Daniels SR, Mossison JA, Sprecher DL, Khoury P, Kimball TR . Association of body fat distribution and cardiovascular risk factors in children and adolescents. Circulation 1999; 99: 541–545.

    Article  CAS  Google Scholar 

  10. Goran MI, Gower BA . Abdominal obesity and cardiovascular risk in children. Coron Art Dis 1998; 9: 483–487.

    Article  CAS  Google Scholar 

  11. Maffeis C, Pietrobelli A, Grezzani A, Provera S, Tato L . Waist circumference and cardiovascular risk factors in pre-pubertal children. Obes Res 2001; 9: 179–187.

    Article  CAS  Google Scholar 

  12. Han TS, Feskens EJ, Lean ME, Seidell JC . Association of body composition with type 2 diabetes mellitus. Diabet Med 1998; 15: 129–135.

    Article  CAS  Google Scholar 

  13. Van Lenthe FJ, Kemper HCG, van Mechelen W, Twisk JWR . The development of a central pattern of subcutaneous fat in adolescence and childhood: The Amsterdam Growth and Health Longitudinal Study. Int J Epidemiol 1996; 25: 1162–1171.

    Article  CAS  Google Scholar 

  14. Okosun IS, Prewitt TE, Liao Y, Cooper RS . Association of waist circumference with ApoB to ApoA1 ratio in black and white Americans. Int J Obes Relat Metab Disord 1999; 23: 498–504.

    Article  CAS  Google Scholar 

  15. Kemper HC, de Vente W, van Mechelen W, Twisk JW . Adolescent motor skill and performance. Ann Hum Biol 2001; 13: 180–189.

    Article  CAS  Google Scholar 

  16. Burns TL, Mall PP, Lauer RM . The relationship between ponderosity and coronary risk factors in children and their relatives: the Muscatine Ponderosity Family Study. Am J Epidemiol 1989; 72: 490–495.

    Google Scholar 

  17. Sidiropoulos E, Jeffery A, Mackay S, Gallocher R, Forgey, H, Chips C . South Africa Survey 1995/1996. South African Institute of Race and Relations: Johannesburg, 1996, pp 234–360.

    Google Scholar 

  18. Bradshaw D, Steyn K . Poverty and Chronic Disease in South Africa: Technical Report. Medical Research Council: Cape Town, 2001, pp 38–45.

    Google Scholar 

  19. Statistics South Africa. Cause of Death in South Africa 1997–2001: Advance Release of Records of Death. Statistics South Africa: Pretoria, 2002, pp 18–42.

  20. Monyeki KD, Cameron N, Getz B . Growth and nutritional status of rural South African children 3–10 years old: The Ellisras Growth Study. Am J Hum Biol 2000; 12: 42–49.

    Article  Google Scholar 

  21. Monyeki KD, Van Lenthe FJ, Steyn NP . Obesity: does it occur in African children in a rural community. Int J Epidemiol 1999; 28: 287–292.

    Article  CAS  Google Scholar 

  22. Norton K, Olds T . Anthropometrica. University of New South Wales Press: Sydney, 1996, pp 396–410.

    Google Scholar 

  23. Tanner JM, Whitehouse RH, Takaishi M . Standards from birth to maturity for height weight, weight velocity: British children, 1965. Arch Dis Child 1966; 41: 454–495.

    Article  CAS  Google Scholar 

  24. Slaughter MH, Lohman TG, Boileau RA, Horswill CA, Stillman RJ, van Loan MD et al. Skinfold equations for estimation of body fatness in children and youth. Hum Biol 1988; 60: 709–723.

    CAS  PubMed  Google Scholar 

  25. Lohman TG . Application of body composition techniques and constant for children and youth. Exerc Sport Sci Rev 1986; 14: 325–357.

    Article  CAS  Google Scholar 

  26. National High Blood Pressure Education Program (NHBPEP) 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; 98: 649–658.

    Google Scholar 

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

    Article  Google Scholar 

  28. EUROFIT. Handbook for the European Test of Physical Fitness. Council of European committee for Development in Sports: Rome, 1988, pp 4–18.

  29. American Alliance for Health Physical Education, Recreation and Dance. Lifetime Health-Related Physical Fitness Test Manual. AAHPERD: Reston, VA, 1980, pp 3–19.

  30. Monyeki MA, Kemper HCG, Twisk JWR, Monyeki KD, Toriola AL, Steyn NP . Anthropometric indicators of nutritional status and physical fitness of Ellisras rural primary school children, South Africa. Med Sport 2003; 7: E93–E104.

    Google Scholar 

  31. Monyeki KD, de Ridder JH, Steyn NP, Toriola AL, Kemper HCG, van Lenthe FJ et al. Stability of somatotypes in 4–10 year-old rural South African girls. Ann Hum Biol 2002; 29: 37–49.

    Article  CAS  Google Scholar 

  32. 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 

  33. Monyeki KD, Kemper HCG, Makgae PJ . The association of fat patterning with blood pressure in rural South African children: The Ellisras Longitudinal Growth and Health Study. Int J Epidemiol 2006; 35: 114–120.

    Article  CAS  Google Scholar 

  34. De Ridder CM, Thijssen JH, Bruning PF, Van den Brande JL, Zonderland ML, Erich WB . Body fat mass, body fat distribution, and pubertal development: a longitudinal study of physical and hormonal sexual maturations of girls. J Clin Endocrinol Metab 1992; 75: 442–446.

    CAS  PubMed  Google Scholar 

  35. Twisk JWR, Kemper HCG, van Mechelen W, Post GB, van Lenthe FJ . Body fatness: longitudinal relationship of body mass index and the sum of skinfolds with other risk factors for coronary heart disease. Int J Obes Relat Metab Disord 1998; 22: 915–922.

    Article  CAS  Google Scholar 

  36. Chu NF, Rimm EB, Wang DJ, Liou HS, Shieh SM . Relationship between anthropometric variables and lipid levels among school children: The Taipei Children Health Study. Int J Obes Relat Metab Disord 1998; 22: 66–72.

    Article  CAS  Google Scholar 

  37. Savva SC, Tornaritis M, Savva ME, Kourides Y, Panagi A, Silikiotou N et al. Waist circumference and waist to height ratio are a better predictor of cardiovascular disease risk factors in children than body mass index. Int J Obes Relat Metab Disord 2000; 24: 1453–1458.

    Article  CAS  Google Scholar 

  38. Cameron N . African obesity—a puzzle solved. S Afr Med J 1997; 87: 1396–1397.

    CAS  PubMed  Google Scholar 

  39. Bojorntor P . Regional obesity. In: Bjortorp P, Brodoff BN (eds). Obesity. Lippincott: Philadelphia, 1992, pp 579–586.

    Google Scholar 

  40. Gutin B, Islam S, Manos T, Cucuzzo N, Smith C, Sachura ME . Relationship of percentage of body fat and maximal aerobic capacity to risk factors for atherosclerosis and diabetes in black and white seven to eleven year old children. J Pediatr 1994; 125: 847–852.

    Article  CAS  Google Scholar 

  41. Van Niekerk CC, Strydom GL, Wilders CJ, Steyn HS . An analysis of physical work capacity, serum lipid ratios and influence of cigarette smoking in South African women age 35–64 years. Afr J Phys Health Edu Recreation Dance 2003; 9: 140–150.

    Google Scholar 

  42. Raudsepp L, Jurimae T . Relationship of physical activity and somatic characteristics with physical fitness and motor skill in prepubertal girls. Am J Hum Biol 1997; 9: 513–521.

    Article  Google Scholar 

  43. Monyeki MA, Koppes LLJ, Monyeki KD, Kemper HCG, Twisk JWR . Longitudinal relationships between nutritional status, body composition and physical fitness in rural children of South Africa: the Ellisras Longitudinal study. Am J Hum Biol 2007; 19: 551–558.

    Article  Google Scholar 

  44. Taylor RW, Jones IE, Williams SM, Goulding A . Evaluation of waist circumference waist to hip ratio and the conicity index as screening tools for high trunk fat mass as measured by dual-energy X-ray absorptiometry in children aged 3–19 years. Am J Clin Nutr 2000; 72: 490–495.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

The financial support received from Vrije University, Amsterdam, The Netherlands, and the University of the North, South Africa, National Research Foundation and the Medical Research Council of South Africa for the Ellisras Longitudinal Growth and Health study is also acknowledged with gratitude. We are indebted to the ELS administrators Mr TT Makata, Ms L Majadibodu and Mr UT Motlogeloa for coding the data. Monyeki MS and Malatji MJ (Makgoka Secondary School, Limpopo Province) are thankfully acknowledged for editing this paper.

Author information

Authors and Affiliations

  1. Chronic Disease of Lifestyle Unit, Medical Research Council, Tygerberg, South Africa

    K D Monyeki

  2. VU University Medical Center, Institute for Research in Extramural Medicine (EMGO), Amsterdam, The Netherlands

    H C G Kemper

  3. Department of Kinesiology and Physical Education, University of Limpopo, Sovenga, South Africa

    P J Makgae

Authors
  1. K D Monyeki
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. H C G Kemper
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. P J Makgae
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to K D Monyeki.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Monyeki, K., Kemper, H. & Makgae, P. Relationship between fat patterns, physical fitness and blood pressure of rural South African children: Ellisras Longitudinal Growth and Health Study. J Hum Hypertens 22, 311–319 (2008). https://doi.org/10.1038/jhh.2008.3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/jhh.2008.3

Keywords

This article is cited by

Search

Advanced search

Quick links