Abstract
Childhood overweight is associated with increased rates of hypertension (HTN) and acanthosis nigricans (AN), a known risk factor for diabetes. This cross-sectional study of predominantly Native American students examined relationships between diet and overweight, AN, and HTN among K-9th grade students. Eighty-six students completed a questionnaire regarding fruit and vegetable (F/V) consumption and physical activity (PA) behaviors. Anthropometric data, blood pressure (BP), and presence of AN were determined by trained screeners. Fifty-three percent of the Native American study participants were overweight or at-risk-for-overweight (BMI ≥85th percentile), while 35% of the non-Native American participants were overweight or at risk for overweight. At 60% vs. 35% respectively, the percentage of students either overweight or at risk for overweight was significantly higher (p=.02) among fourth through ninth graders compared with students in kindergarten through third grades. Fourteen percent were positive for AN, and 33% had either Pre-HTN or HTN (≥ 90th percentile) based on the first blood pressure reading. Analysis of variance results indicated that students with either pre-HTN or HTN had a significantly higher mean BMI (24.1 ± 8.0) vs. those with normal BP (20.4 ± 5.1; P=.012). BMI was positively correlated with AN (r=0.433, p=.01) such that all students positive for AN had a BMI ≥ 85th percentile (p=.001). Students who agreed with the Likert statement that they usually eat ≥5 F/V a day had a significantly lower mean systolic BP (107mmHg ± 17) vs. those who did not (123mmHg ± 17, P=.001). Regression results indicate that BMI and attitude toward the importance of fruit and vegetable consumption are independent predictors of systolic BP (p=.001). Results suggest that significant numbers of students in this sample are positive for AN, are overweight, and are at risk for hypertension and that more positive attitudes toward fruit and vegetable consumption are associated with lower blood pressure levels. Prevention programs to address these health problems are discussed.
Highlights
Introduction and BackgroundThe rate of overweight among youth is steadily increasing
Fifty-three percent of the Native American study participants were overweight or at-risk-foroverweight (BMI ≥85th percentile) compared to 35% of the non-Native American participants. This rate of 53% is notably higher than the 30% rate for all U.S children reported by Freedman and colleagues (1999) and is comparable to the 52% reported by Soddart and colleagues (2002) and the 63% reported by Smith and Rinderknecht (2003) for Native American school children
Sorof (2004) found that cases of elevated blood pressure decreased by half after each screening. In agreement with this finding, the current study found that 45% of the participants maintained elevated blood pressure at the second reading
Summary
Introduction and BackgroundThe rate of overweight among youth is steadily increasing. NIH (2006) warns, “A large number of studies have found that obesity persists from childhood through adolescence and into adulthood. The National Institute of Child and Human Development’s Study of Early Child Care and Youth Development (NIH, 2006; n=1,000) found that when compared to children who were not overweight, children who became overweight during two different time periods during the elementary school period were 159 times more likely to be overweight at 12 years old. Preschool and elementary age children in the NICHD study with BMIs between the 50th and 75th percentile had significantly higher rates of overweight when they reached age 12 (NIH, 2006). Because childhood overweight frequently persists into adulthood and is a risk factor for major diseases, early detection and treatment is imperative for disease prevention
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