Abstract
Background: Unhealthy dietary and lifestyle behaviors are associated with a higher prevalence of non-communicable chronic diseases and higher mortality in adults. However, there remains some uncertainty about the magnitude of the associations between lifestyle behaviors and cardiovascular factors in adolescents.Methods: We conducted a school-based cross-sectional study of 895 Chinese adolescents aged 15–19 years. They participated in a questionnaire survey, physical examination, and blood sample collection. Latent class analysis (LCA) was used to identify heterogeneous subgroups of lifestyle behaviors. A set of 12 latent class indicators, which reflected lifestyle behaviors including dietary habits, physical activity, sleep duration, screen time, and pressure perception, were included in the analysis. Logistic regression analysis was performed to determine whether the derived classes were related to a cardiometabolic risk.Results: In total, 13.7 and 5.6% of the participants were overweight and obese, respectively, and 8.4 and 14.1% reported having pre-hypertension and hypertension, respectively. A two-class model provided the best fit with a healthy lifestyle pattern (65.8%) and a sub-healthy lifestyle pattern (34.2%). There were more female participants with a healthy lifestyle (56.2 vs. 43.8%), whereas there were more males with a sub-healthy lifestyle (45.4 vs. 54.6%), (all P = 0.002). Increased risk of cardiometabolic abnormality (BMI categories, blood pressure and lipids) was not significant across lifestyle patterns, except for waist circumference (70.5 vs 69.1 cm, P = 0.044). There was no significant difference in physical activity and intake of fruit and vegetable between the two patterns.Conclusion: Primary prevention based on lifestyle modification should target patterns of behaviors at high risk in adolescents. Due to the complex effect of lifestyle clusters on cardiometabolic risks, well-designed and prospective studies in adolescents are needed in the future.
Highlights
Childhood and adolescent obesity are known to be associated with a range of cardiovascular complications, and regarded as a global public health concern [1]
When defined according to the American Academy of Pediatrics (AAP) guidelines, elevated blood pressure (EBP) is prevalent in 8.6% of the pediatric population in 2017 [9]
The difference between the included and excluded adolescents are shown in Supplementary Table S2
Summary
Childhood and adolescent obesity are known to be associated with a range of cardiovascular complications, and regarded as a global public health concern [1]. Obesity in children and adults is identified as a primary risk factor for hypertension [2]. Unhealthy dietary and lifestyle behaviors are known to be associated with a higher prevalence of non-communicable chronic diseases (NCCDs) and increased mortality in adults [11]. The magnitude of the associations between lifestyle behaviors and cardiovascular factors in adolescents remains unclear to date. Unhealthy dietary and lifestyle behaviors are associated with a higher prevalence of non-communicable chronic diseases and higher mortality in adults. There remains some uncertainty about the magnitude of the associations between lifestyle behaviors and cardiovascular factors in adolescents
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