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Nutrient Intake, Physical Activity, and CVD Risk Factors in Children

Project HeartBeat!

      Background

      Associations among dietary intake, physical activity, and cardiovascular disease (CVD) risk factors are inconsistent among male and female youth, possibly from lack of adjustment for pubertal status. The purpose of this report is to describe the associations of CVD risk factors among youth, adjusted for sexual maturation.

      Methods

      Data analyzed in 2007 from a sumsample of 556 children aged 8, 11, and 14 years in Project HeartBeat!, 1991–1993, provide cross-sectional patterns of CVD risk factors by age and gender, adjusting for sexual maturation, within dietary fat and physical activity categories.

      Results

      Girls consuming moderate- to high-fat diets were significantly less physically active than those consuming low-fat diets. Boys and girls consuming high-fat diets had higher saturated fat and cholesterol intakes than children in low-fat categories. Boys had no significant differences in physical activity, blood pressure, waist circumference, or plasma cholesterol levels across fat categories. Girls' plasma cholesterol levels showed no significant differences across fat categories. Dietary intake did not differ across moderate-to-vigorous physical activity (MVPA) categories within gender. There were no differences in BMI by fat or MVPA categories for either gender. Girls' waist circumference differed significantly by fat category, and systolic blood pressure differed significantly across fat and MVPA categories. Boys' fifth-phase diastolic blood pressure was significantly different across MVPA categories.

      Conclusions

      Girls consuming atherogenic diets were significantly less physically active than those with low fat intakes, whereas boys consuming high-fat diets did not show differences in physical activity measures. With the prevalence of overweight rising among youth, the impact of atherogenic diets and sedentary lifestyles on CVD risk factors is of concern to public health professionals.
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      References

        • Strong J.P.
        • McGill Jr, H.C.
        The natural history of coronary atherosclerosis.
        Am J Pathol. 1962; 40: 37-49
        • McNamara J.J.
        • Molot M.A.
        • Stremple J.F.
        • Cutting R.T.
        Coronary artery disease in combat casualties in Vietnam.
        JAMA. 1971; 216: 1185-1187
        • Strong J.P.
        • Zieske A.W.
        • Malcom G.T.
        Lipoproteins and atherosclerosis in children: an early marriage?.
        Nutr Metab Cardiovasc Dis. 2001; 11: 16-22
        • Zieske A.W.
        • Malcom G.T.
        • Strong J.P.
        Natural history and risk factors of atherosclerosis in children and youth: the PDAY study.
        Pediatr Pathol Mol Med. 2002; 21: 213-237
        • Berenson G.S.
        • Bao W.
        • Srinivasan S.R.
        Does adult onset diabetes begin in childhood?.
        Am J Med Sci. 1995; 310: S77-S82
        • Berenson G.S.
        • Bao W.
        • Srinivasan S.R.
        Rationale to study the early natural history of heart disease.
        Am J Med Sci. 1995; 310: S22-S28
        • Srinivasan S.R.
        • Berenson G.S.
        Childhood lipoprotein profiles and implications for adult coronary artery disease—the Bogalusa Heart study.
        Am J Med Sci. 1995; 310: S62-S67
        • Tracy R.E.
        • Newmn III, W.P.
        • Wattigney W.A.
        • Berenson G.S.
        Risk factors and atherosclerosis in youth.
        Am J Med Sci. 1995; 310: S37-S41
        • Webber L.S.
        • Wattigney W.A.
        • Srinivasan S.R.
        • Berenson G.S.
        Obesity studies in Bogalusa.
        Am J Med Sci. 1995; 310: S53-S61
        • Dwyer J.T.
        • Stone E.J.
        • Yang M.
        • et al.
        Prevalence of marked overweight and obesity in a multiethnic pediatric population: findings from the Child and Adolescent Trial for Cardiovascular Health (CATCH) study.
        J Am Diet Assoc. 2000; 100: 1149-1156
        • Hedley A.A.
        • Ogden C.L.
        • Johnson C.L.
        • Carroll M.D.
        • Curtin L.R.
        • Flegal K.M.
        Prevalence of overweight and obesity among U.S. children, adolescents, and adults, 1999–2002.
        JAMA. 2004; 291: 2847-2850
        • Nicklas T.A.
        • Dwyer J.
        • Feldman H.A.
        • Luepker R.V.
        • Kelder S.H.
        • Nader P.R.
        Serum cholesterol levels in children are associated with dietary fat and fatty acid intake.
        J Am Diet Assoc. 2002; 102: 511-517
        • Clarke W.R.
        • Schrott H.G.
        • Leaverton P.E.
        • Connor W.E.
        • Lauer R.M.
        Tracking of blood lipids and blood pressures in school age children: the Muscatine study.
        Circulation. 1978; 58: 626-634
        • Kemper H.C.
        • Snel J.
        • Verschuur R.
        • Storm-van Essen L.
        Tracking of health and risk indicators of cardiovascular diseases from teenager to adult: Amsterdam Growth and Health Study.
        Prev Med. 1990; 19: 642-655
        • Laskarzewski P.
        • Morrison J.A.
        • deGroot I.
        • et al.
        Lipid and lipoprotein tracking in 108 children over a four-year period.
        Pediatrics. 1979; 64: 584-591
        • Lauer R.M.
        • Lee J.
        • Clarke W.R.
        Factors affecting the relationship between childhood and adult cholesterol levels: the Muscatine Study.
        Pediatrics. 1988; 82: 309-318
        • Lauer R.M.
        • Clarke W.R.
        Childhood risk factors for high adult blood pressure: the Muscatine Study.
        Pediatrics. 1989; 84: 633-641
        • Orchard T.J.
        • Donahue R.P.
        • Kuller L.H.
        • Hodge P.N.
        • Drash A.L.
        Cholesterol screening in childhood: does it predict adult hypercholesterolemia?.
        J Pediatr. 1983; 103: 687-691
        • Pagnan A.
        • Ambrosio G.B.
        • Vincenzi M.
        • Mormino P.
        • Maiolino P.
        • Gerin L.
        • Barbieri E.
        • Cappelletti F.
        • Dal Palu C.
        Precursors of atherosclerosis in children: the Cittadella study.
        Prev Med. 1982; 11: 381-390
        • Porkka K.V.
        • Viikari J.S.
        • Akerblom H.K.
        Tracking of serum HDL-cholesterol and other lipids in children and adolescents: the Cardiovascular Risk in Young Finns Study.
        Prev Med. 1991; 20: 713-724
        • Porkka K.V.
        • Viikari J.S.
        • Taimela S.
        • Dahl M.
        • Akerblom H.K.
        Tracking and predictiveness of serum lipid and lipoprotein measurements in childhood: a 12-year follow-up.
        Am J Epidemiol. 1994; 140: 1096-1110
        • Twisk J.W.
        • Kemper H.C.
        • Mellenbergh G.J.
        Longitudinal development of lipoprotein levels in males and females aged 12–28 years: the Amsterdam Growth and Health Study.
        Int J Epidemiol. 1995; 24: 69-77
        • Webber L.S.
        • Srinivasan S.R.
        • Wattigney W.A.
        • Berenson G.S.
        Tracking of serum lipids and lipoproteins from childhood to adulthood.
        Am J Epidemiol. 1991; 133: 884-899
        • Mueller W.H.
        • Harrist R.B.
        • Doyle S.R.
        • Ayars C.L.
        • Labarthe D.R.
        Body measurement variability, fatness, and fat-free mass in children 8, 11, and 14 years of age: Project HeartBeat!.
        Am J Human Biol. 1999; 11: 69-78
        • Ogden C.L.
        • Carroll M.D.
        • Flegal K.M.
        High body mass index for age among U.S. children and adolescents.
        JAMA. 2008; 299: 2401-2405
        • Hoelscher D.M.
        • Day R.S.
        • Lee E.L.
        • Frankowski R.
        • Kelder S.H.
        • Ward J.
        • Scheurer M.E.
        Measuring the prevalence of overweight in Texas school children.
        Am J Public Health. 2004; 94: 1002-1008
        • Bjørge T.
        • Engeland A.
        • Tverdal A.
        • Smith G.D.
        Body mass index in adolescence in relation to cause-specific mortality: a follow-up of 230,000 Norwegian adolescents.
        Am J Epidemiol. 2008; 168: 30-37
        • Twisk J.W.
        • Kemper H.C.
        • van Mechelen W.
        Tracking of activity and fitness and the relationship with cardiovascular disease risk factors.
        Med Sci Sport Exerc. 2000; 32: 1455-1461
        • Ekelund U.
        • Anderssen S.A.
        • Froberg K.
        • Sardinha L.B.
        • Andersen L.B.
        • Brage S.
        Independent associations of physical activity and cardiorespiratory fitness with metabolic risk factors in children: the European Youth Heart Study.
        J Hypertens. 2007; 50: 1832-1840
        • Ferreira I.
        • Twisk J.W.
        • van Mechelen W.
        • Kemper H.C.
        • Stehouwer C.D.
        Development of fatness, fitness, and lifestyle from adolescence to the age of 36 years: determinants of the metabolic syndrome in young adults: the Amsterdam Growth and Health Study.
        Arch Intern Med. 2005; 165: 42-48
        • Boreham C.
        • Twisk J.
        • Neville C.
        • Savage M.
        • Murray L.
        • Gallagher A.
        Associations between physical fitness and activity patterns during adolescence and cardiovascular risk factors in young adulthood: the Northern Ireland Young Hearts Project.
        Int J Sport Med. 2002; 23: S22-S26
        • Hasselstrom H.
        • Hansen S.E.
        • Froberg K.
        • Andersen L.B.
        Physical fitness and physical activity during adolescence as predictors of cardiovascular disease risk in young adulthood.
        Int J Sport Med. 2002; 23: S27-S31
        • Balagopal P.
        • George D.
        • Patton N.
        • et al.
        Lifestyle-only intervention attenuates the inflammatory state associated with obesity: a randomized controlled study in adolescents.
        J Pediatr. 2005; 146: 342-348
        • Balagopal P.
        • George D.
        • Yarandi H.
        • Funanage V.
        • Bayne E.
        Reversal of obesity-related hypoadiponectinemia by lifestyle intervention: a controlled, randomized study in obese adolescents.
        J Clin Endocrinol Metab. 2005; 90: 6192-6197
        • Eliakim A.
        • Makowski G.S.
        • Brasel J.A.
        • Cooper D.M.
        Adiposity, lipid levels, and brief endurance training in nonobese adolescent males.
        Int J Sport Med. 2000; 21: 332-337
        • Harrell J.S.
        • McMurray R.G.
        • Bangdiwala S.I.
        • Frauman A.C.
        • Gansky S.A.
        • Bradley C.B.
        Effects of a school-based intervention to reduce cardiovascular disease risk factors in elementary-school children: the Cardiovascular Health in Children (CHIC) Study.
        J Pediatr. 1996; 128: 797-805
        • Guillaume M.
        • Lapidus L.
        • Lambert A.
        Differences in associations of familial and nutritional factors with serum lipids between boys and girls: the Luxembourg Child Study.
        Am J Clin Nutr. 2000; 72: 384-388
        • Ku C.Y.
        • Gower B.A.
        • Nagy T.R.
        • Goran M.I.
        Relationships between dietary fat, body fat, and serum lipid profile in prepubertal children.
        Obes Res. 1998; 6: 400-407
        • Kwiterovich Jr, P.O.
        • Barton B.A.
        • McMahon R.P.
        • et al.
        Effects of diet and sexual maturation on low-density lipoprotein cholesterol during puberty: the Dietary Intervention Study in Children (DISC).
        Circulation. 1997; 96: 2526-2533
        • Tell G.S.
        Cardiovascular disease risk factors related to sexual maturation: the Oslo Youth Study.
        J Chronic Dis. 1985; 38: 633-642
        • Marshall W.A.
        • Tanner J.M.
        Variations in the pattern of pubertal changes in girls.
        Arch Dis Child. 1969; 44: 291-303
        • Marshall W.A.
        • Tanner J.M.
        Variations in the pattern of pubertal changes in boys.
        Arch Dis Child. 1970; 45: 13-23
        • Eissa M.A.H.
        • Meininger J.C.
        • Nguyen T.Q.
        • Chan W.
        The relationship of ambulatory blood pressure to physical activity in a tri-ethnic population of obese and nonobese adolescents.
        Am J Hypertens. 2007; 20: 140-147
        • Labarthe D.R.
        • Nichaman M.Z.
        • Harrist R.B.
        • Grunbaum J.A.
        • Dai S.
        Development of cardiovascular risk factors from ages 8 to 18 in Project HeartBeat!: study design and patterns of change in plasma total cholesterol concentration.
        Circulation. 1997; 95: 2636-2642
        • McPherson R.S.
        • Nichaman M.Z.
        • Kohl H.W.
        • Reed D.B.
        • Labarthe D.R.
        Intake and food sources of dietary fat among schoolchildren in The Woodlands Texas.
        Pediatrics. 1990; 86: 520-526
        • Block G.
        • Hartman A.M.
        • Dresser C.M.
        • Carroll M.D.
        • Gannon J.
        • Gardner L.
        A data-based approach to diet questionnaire design and testing.
        Am J Epidemiol. 1986; 124: 453-469
        • Thompson F.E.
        • Byers T.
        Dietary assessment resource manual.
        J Nutr. 1994; 124: 2455S-3175S
        • U.S. Department of Agriculture Human Nutrition Information Service
        USDA Nutrient Data Base for Individual Intake Surveys.
        National Technical Information Service, Springfield VA1991
        • Simons-Morton B.G.
        • Taylor W.C.
        • Huang I.W.
        Validity of the physical activity interview and Caltrac with preadolescent children.
        Res Q Exerc Sport. 1994; 65: 84-88
        • Ainsworth B.E.
        • Haskell W.L.
        • Leon A.S.
        • et al.
        Compendium of physical activities: classification of energy costs of human physical activities.
        Med Sci Sports Exerc. 1993; 25: 71-80
        • Reynolds E.L.
        • Wines J.V.
        Individual differences in physical changes associated with adolescence in girls.
        Am J Dis Child. 1948; 75: 329-350
        • Reynolds E.L.
        • Wines J.V.
        Physical changes associated with adolescence in boys.
        Am J Dis Child. 1951; 82: 529-547
        • Tanner J.M.
        Growth at adolescence.
        2nd ed. Blackwell Scientific Publications, Oxford1962
        • Dai S.
        • Labarthe D.R.
        • Grunbaum J.A.
        • Harrist R.B.
        • Mueller W.H.
        Longitudinal analysis of changes in indices of obesity from age 8 to 18 years: Project HeartBeat!.
        Am J Epidemiol. 2002; 156: 720-729
        • Houtkooper L.B.
        • Going S.B.
        • Lohman T.G.
        • Roche A.F.
        • Van Loan M.
        Bioelectrical impedance estimation of fat-free body mass in children and youth: a cross-validation study.
        J Appl Physiol. 1992; 72: 366-373
        • Baumgartner R.N.
        • Heymsfield S.B.
        • Roche A.F.
        Human body composition and the epidemiology of chronic disease.
        Obes Res. 1995; 3: 73-95
        • Guo S.M.
        • Roche A.F.
        • Houtkooper L.
        Fat-free mass in children and young adults predicted from bioelectric impedance and anthropometric variables.
        Am J Clin Nutr. 1989; 50: 435-443
        • Cameron N.
        The methods of auxological anthropometry.
        in: Falkner F. Tanner J.M. Human growth: a comprehensive treatise. Plenum Press, New York1986: 3-46
        • Weidman W.
        • Kwiterovich P.
        • Jesse M.J.
        • Nugent E.
        Diet in the healthy child: Task Force Committee of the Nutrition Committee and Cardiovascular Disease in the Young Council of the American Heart Association.
        Circulation. 1983; 67: 1141A-1144A
        • Consensus Development Panel
        Lowering blood cholesterol to prevent heart disease.
        JAMA. 1986; 253: 2080
        • American Academy of Pediatrics Committee on Nutrition
        Prudent life style for children: dietary fat and cholesterol.
        Pediatrics. 1986; 78: 521-525
        • Bendich A.
        • Deckelbaum R.J.
        Preventive nutrition.
        1st ed. Humana Press, Inc, Totowa NJ1997
        • Ziegler E.E.
        • Filer Jr, L.J.
        Present knowledge in nutrition.
        7th ed. ILSI Press, Washington DC1996
        • National Research Council
        Diet and health.
        3rd ed. National Academy Press, Washington DC1991
        • Dietz W.H.
        Childhood weight affects adult morbidity and mortality.
        J Nutrition. 1998; 128: 411S-414S
        • Williams C.L.
        • Hayman L.L.
        • Daniels S.R.
        • et al.
        A statement for health professionals from the Committee on Atherosclerosis, Hypertension, and Obesity in the Young (AHOY) of the Council on Cardiovascular Disease in the Young, American Heart Association.
        Circulation. 2002; 106: 143-160
        • U.S. Department of Agriculture, Agriculture Research Service
        Food and nutrient intakes by children 1994–96, 1998.
        • Lichtenstein A.H.
        • Appel L.J.
        • Brands M.
        • Carnethon M.
        • Daniels S.
        • Franch H.A.
        • Franklin B.
        • Kris-Etherton P.
        • Harris W.S.
        • Howard B.
        • Karanja N.
        • Lefevre M.
        • Rudel L.
        • Sacks F.
        • Van Horn L.
        • Winston M.
        • Wylie-Rosett J.
        Diet and lifestyle recommendations revision 2006: a scientific statement from the American Heart Association Nutrition Committee.
        Circulation. 2006; 114: 82-96
        • Boone J.E.
        • Gordon-Larsen P.
        • Adair L.S.
        • Popkin B.M.
        Screen time and physical activity during adolescence: longitudinal effects on obesity in young adulthood.
        IJBNPA. 2007; 4: 26-36
        • Wells J.C.K.
        • Hallal P.C.
        • Reichert F.F.
        • Menezes A.M.B.
        • Araujo C.L.P.
        • Victora C.G.
        Sleep patterns and television viewing in relation to obesity and blood pressure: evidence from an Adolescent Brazilian Birth Cohort.
        Int J Obes. 2008; 32: 1042-1049
        • O'Brien M.
        • Nader P.R.
        • Houts R.M.
        • et al.
        The ecology of childhood overweight: a 12-year longitudinal analysis.
        Int J Obes. 2007; 31: 1469-1478
        • Vandewater E.A.
        • Bickham D.S.
        • Lee J.H.
        Time well spent?.
        Pediatrics. 2006; 117: e181-e191
        • Wardle J.
        • Guthrie C.
        • Sanderson S.
        • Birch L.
        • Plomin R.
        Food and activity preferences in children of lean and obese parents.
        Int J Obes Relat Metab Disord. 2001; 25: 971-977
        • Coon K.A.
        • Goldberg J.
        • Rogers B.L.
        • Tucker K.L.
        Relationships between use of television during meals and children's food consumption patterns.
        Pediatrics. 2001; 107: E7
        • Lowry R.
        • Wechsler H.
        • Galuska D.A.
        • Fulton J.
        • Kann L.
        Television viewing and its associations with overweight, sedentary lifestyle, and insufficient consumption of fruits and vegetables among U.S. high school students: differences by race, ethnicity, and gender.
        J Sch Health. 2002; 72: 413-421
        • Matheson D.M.
        • Killen J.D.
        • Wang Y.
        • Varady A.
        • Robinson T.N.
        Children's food consumption during television viewing.
        Am J Clin Nutr. 2004; 79: 1088-1094
        • Giammattei J.
        • Blix G.
        • Marshak H.H.
        • Wollitzer A.O.
        • Pettitt D.J.
        Television watching and soft drink consumption: associations with obesity in 11–13 year old schoolchildren.
        Arch Pediatr Adolesc Med. 2003; 157: 882-886
        • Andersen L.B.
        • Harro M.
        • Sardinha L.B.
        • et al.
        Physical activity and clustered cardiovascular risk in children: a cross-sectional study (The European Youth Heart Study).
        Lancet. 2006; 368: 299-304
        • Ribeiro J.C.
        • Guerra S.
        • Oliveira J.
        • et al.
        Physical activity and biological risk factors clustering in pediatric population.
        Prev Med. 2004; 39: 596-601
        • Azizi F.
        • Mirmiran P.
        • Azadbakht L.
        Predictors of cardiovascular risk factors in Tehranian adolescents: Tehran Lipid and Glucose Study.
        Int J Vitamin Nutr Res. 2004; 74: 307-312
        • Gidding S.S.
        • Barton B.A.
        • Dorgan J.A.
        • et al.
        Higher self-reported physical activity is associated with lower systolic blood pressure: the Dietary Intervention Study in Childhood (DISC).
        Pediatrics. 2006; 118: 2388-2393
        • Dasgupta K.
        Sex differences in the development of higher systolic blood pressure during adolescence.
        Cardiol Rev. 2008; 25: 54-57
        • Pardee P.E.
        • Norman G.J.
        • Lustig R.H.
        • Preud'homme D.
        • Schwimmer J.B.
        Television viewing and hypertension in obese children.
        Am J Prev Med. 2007; 33: 439-443
        • Moran A.
        • Jacobs Jr, D.R.
        • Steinberger J.
        • et al.
        Changes in insulin resistance and cardiovascular risk during adolescence: establishment of differential risk in males and females.
        Circulation. 2008; 117: 2361-2369
        • Shankar R.R.
        • Eckert G.J.
        • Saha C.
        • Tu W.
        • Pratt J.H.
        The change in blood pressure during pubertal growth.
        J Clin Endocrinol Metab. 2005; 90: 163-167
        • McPherson R.S.
        • Montgomery D.H.
        • Alexander M.
        • Scanlon K.
        • Serdula M.K.
        Dietary assessment methods among school-aged children: validity and reliability.
        Prev Med. 2000; 31: S11-S33
        • Day R.S.
        • Hoelscher D.M.
        • Eastham C.
        • Koers E.
        Lessons learned over 35 years: dietary assessment methods for school aged children.
        in: Berdanier C.D. Dwyer J. Beldman E.B. Handbook of nutrition and food. CRC Press, Taylor & Francis Group, Boca Raton FL2008
        • McPherson R.S.
        • Hoelscher D.M.
        • Alexander M.
        • Scanlon K.S.
        • Serdula M.K.
        Validity and reliability of dietary assessment in school-age children (a 30 year review).
        in: Berdanier C.D. Handbook of nutrition and food. CRC Press, Boca Raton FL2002
        • Sallis J.F.
        • Buono M.J.
        • Roby J.J.
        • Micale F.G.
        • Nelson J.A.
        Seven-day recall and other physical activity self-reports in children and adolescents.
        Med Sci Sports Exerc. 1993; 25: 99-108
        • Sirard J.R.
        • Pate R.R.
        Physical activity assessment in children and adolescents.
        Sports Med. 2001; 31: 439-454
        • Daniels S.R.
        • Greer F.R.
        • Committee on Nutrition
        Lipid screening and cardiovascular health in childhood.
        Pediatrics. 2008; 122: 198-208
        • Wang Y.
        • Beydoun M.A.
        • Liang L.
        • Caballero B.
        • Kumanyika S.K.
        Will all Americans become overweight or obese?.
        Obesity (Silver Spring). 2008; 16: 2323-2330