Advertisement

Pediatric Cardiology

, Volume 35, Issue 6, pp 959–964 | Cite as

Parental Education Level Is Associated With Clustering of Metabolic Risk Factors in Adolescents Independently of Cardiorespiratory Fitness, Adherence to the Mediterranean Diet, or Pubertal Stage

  • Rute Santos
  • Carla Moreira
  • Sandra Abreu
  • Luís Lopes
  • Jonatan R. Ruiz
  • Pedro Moreira
  • Pedro Silva
  • Jorge Mota
Original Article

Abstract

Few studies have reported associations between clustering metabolic risk factors and socioeconomic status (SES) in youth. This study aimed to analyze the association between clustering metabolic risk factors and SES in adolescents. It was hypothesized that SES is inversely related to clustering metabolic risk factors. This 2009 cross-sectional school-based study investigated 517 Portuguese adolescents ages 15–18 years. The study considered the age- and sex-adjusted z-scores for the ratio of total cholesterol/high-density lipoprotein, homeostasis model, triglycerides, and systolic blood pressure, and a metabolic risk score was constructed by summing all the z-scores (≥1 standard deviation was considered high risk). Cardiorespiratory fitness was estimated by the 20 m shuttle-run test and dietary intake by a food frequency questionnaire. The best of parental education was used as a proxy measure of SES. The results showed that adolescents with low SES were more likely to have a high metabolic risk score (odds ratio [OR], 1.96; p < 0.020) regardless of cardiorespiratory fitness, adherence to the Mediterranean diet, or pubertal stage. In conclusion, a lower SES was associated with increased risk for a high metabolic risk score among Azorean adolescents after adjustment for pubertal stage, adherence to the Mediterranean diet, and cardiorespiratory fitness. Future health-promotion strategies among Azorean adolescents should consider the impact of SES on their health.

Keywords

Socioeconomic status Clustering metabolic risk factors Adolescents Azores Portugal 

Notes

Acknowledgments

This study was supported by the Azorean Government; by Portuguese Foundation for Science and Techology Grants BD/44422/2008, BPD/65180/2009, and SAB/1025/2010; and by the Spanish Ministry of Science and Innovation (RYC-2010-05957). The authors are grateful for all the teachers, master students, and technical staff involved in the data collection procedures.

References

  1. 1.
    Ortega FB, Ruiz JR, Castillo MJ, Sjostrom M (2008) Physical fitness in childhood and adolescence: a powerful marker of health. Int J Obes Lond 32:1–11. doi: 10.1038/sj.ijo.0803774 0803774 [pii]CrossRefPubMedGoogle Scholar
  2. 2.
    Brage S, Wedderkopp N, Ekelund U, Franks PW, Wareham NJ, Andersen LB, Froberg K (2004) Features of the metabolic syndrome are associated with objectively measured physical activity and fitness in Danish children: the European youth heart study (EYHS). Diabetes Care 27:2141–2148CrossRefPubMedGoogle Scholar
  3. 3.
    Andersen LB, Harro M, Sardinha LB, Froberg K, Ekelund U, Brage S, Anderssen SA (2006) Physical activity and clustered cardiovascular risk in children: a cross-sectional study (the European youth heart study). Lancet 368:299–304CrossRefPubMedGoogle Scholar
  4. 4.
    Kelishadi R, Razaghi EM, Gouya MM, Ardalan G, Gheiratmand R, Delavari A, Motaghian M, Ziaee V, Siadat ZD, Majdzadeh R, Heshmat R, Barekati H, Arabi MS, Heidarzadeh A, Shariatinejad K (2007) Association of physical activity and the metabolic syndrome in children and adolescents: CASPIAN Study. Horm Res 67:46–52. doi: 10.1159/000096121 HRE2007067001046 [pii]CrossRefPubMedGoogle Scholar
  5. 5.
    Chen W, Srinivasan SR, Li S, Xu J, Berenson GS (2007) Clustering of long-term trends in metabolic syndrome variables from childhood to adulthood in Blacks and Whites: the Bogalusa heart study. Am J Epidemiol 166:527–533. doi: 10.1093/aje/kwm105 kwm105 [pii]CrossRefPubMedGoogle Scholar
  6. 6.
    Isomaa B (2003) A major health hazard: the metabolic syndrome. Life Sci 73:2395–2411 S0024320503006465 [pii]CrossRefPubMedGoogle Scholar
  7. 7.
    Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith SC Jr, Spertus JA, Costa F (2005) Diagnosis and management of the metabolic syndrome: an American heart association/national heart, lung, and blood institute scientific statement. Circulation 112:2735–2752. doi: 10.1161/CIRCULATIONAHA.105.169404 CIRCULATIONAHA.105.169404 [pii]CrossRefPubMedGoogle Scholar
  8. 8.
    Pan Y, Pratt CA (2008) Metabolic syndrome and its association with diet and physical activity in USA adolescents. J Am Diet Assoc 108:276–286. doi: 10.1016/j.jada.2007.10.049 S0002-8223(07)02078-0 [pii]CrossRefPubMedGoogle Scholar
  9. 9.
    Hanson MD, Chen E (2007) Socioeconomic status and health behaviors in adolescence: a review of the literature. J Behav Med 30:263–285. doi: 10.1007/s10865-007-9098-3 CrossRefPubMedGoogle Scholar
  10. 10.
    Huurre T, Aro H, Rahkonen O (2003) Well-being and health behaviour by parental socioeconomic status: a follow-up study of adolescents aged 16 until age 32 years. Soc Psychiatry Psychiatr Epidemiol 38:249–255. doi: 10.1007/s00127-003-0630-7 CrossRefPubMedGoogle Scholar
  11. 11.
    Pollitt RA, Kaufman JS, Rose KM, Diez-Roux AV, Zeng D, Heiss G (2007) Early-life and adult socioeconomic status and inflammatory risk markers in adulthood. Eur J Epidemiol 22:55–66. doi: 10.1007/s10654-006-9082-1 CrossRefPubMedGoogle Scholar
  12. 12.
    Kivimaki M, Lawlor DA, Smith GD, Keltikangas-Jarvinen L, Elovainio M, Vahtera J, Pulkki-Raback L, Taittonen L, Viikari JS, Raitakari OT (2006) Early socioeconomic position and blood pressure in childhood and adulthood: the cardiovascular risk in young Finns study. Hypertension 47:39–44. doi: 10.1161/01.HYP.0000196682.43723.8a 01.HYP.0000196682.43723.8a [pii]CrossRefPubMedGoogle Scholar
  13. 13.
    Kivimaki M, Smith GD, Juonala M, Ferrie JE, Keltikangas-Jarvinen L, Elovainio M, Pulkki-Raback L, Vahtera J, Leino M, Viikari JS, Raitakari OT (2006) Socioeconomic position in childhood and adult cardiovascular risk factors, vascular structure, and function: cardiovascular risk in young Finns study. Heart 92:474–480. doi: 10.1136/hrt.2005.067108 hrt.2005.067108 [pii]PubMedCentralCrossRefPubMedGoogle Scholar
  14. 14.
    Tamayo T, Christian H, Rathmann W (2010) Impact of early psychosocial factors (childhood socioeconomic factors and adversities) on future risk of type 2 diabetes, metabolic disturbances and obesity: a systematic review. BMC Public Health 10:525. doi: 10.1186/1471-2458-10-525 1471-2458-10-525 [pii]PubMedCentralCrossRefPubMedGoogle Scholar
  15. 15.
    Shrewsbury V, Wardle J (2008) Socioeconomic status and adiposity in childhood: a systematic review of cross-sectional studies 1990–2005. Obes Silver Spring 16:275–284. doi: 10.1038/oby.2007.35 oby200735 [pii]CrossRefGoogle Scholar
  16. 16.
    Walker SE, Gurka MJ, Oliver MN, Johns DW, Deboer MD (2012) Racial/ethnic discrepancies in the metabolic syndrome begin in childhood and persist after adjustment for environmental factors. Nutr Metab Cardiovasc Dis 22(2):141–148. doi: 10.1016/j.numecd.2010.05.006 PubMedCentralCrossRefPubMedGoogle Scholar
  17. 17.
    Nguyen TH, Tang HK, Kelly P, van der Ploeg HP, Dibley MJ (2010) Association between physical activity and metabolic syndrome: a cross-sectional survey in adolescents in Ho Chi Minh City, Vietnam. BMC Public Health 10:141. doi: 10.1186/1471-2458-10-141 1471–2458-10-141 [pii]PubMedCentralCrossRefPubMedGoogle Scholar
  18. 18.
    Budak N, Ozturk A, Mazicioglu M, Yazici C, Bayram F, Kurtoglu S (2010) Decreased high-density lipoprotein cholesterol and insulin resistance were the most common criteria in 12- to 19-year-old adolescents. Eur J Nutr 49:219–225. doi: 10.1007/s00394-009-0066-2 CrossRefPubMedGoogle Scholar
  19. 19.
    Seki M, Matsuo T, Carrilho AJ (2009) Prevalence of metabolic syndrome and associated risk factors in Brazilian schoolchildren. Public Health Nutr 12:947–952. doi: 10.1017/S1368980008003030 S1368980008003030 [pii]CrossRefPubMedGoogle Scholar
  20. 20.
    Mirhosseini NZ, Yusoff NA, Shahar S, Parizadeh SM, Mobarhen MG, Shakery MT (2009) Prevalence of the metabolic syndrome and its influencing factors among adolescent girls in Mashhad, Iran. Asia Pac J Clin Nutr 18:131–136PubMedGoogle Scholar
  21. 21.
    Loucks EB, Magnusson KT, Cook S, Rehkopf DH, Ford ES, Berkman LF (2007) Socioeconomic position and the metabolic syndrome in early, middle, and late life: evidence from NHANES 1999–2002. Ann Epidemiol 17:782–790. doi: 10.1016/j.annepidem.2007.05.003 S1047-2797(07)00206-2 [pii]CrossRefPubMedGoogle Scholar
  22. 22.
    Singh R, Bhansali A, Sialy R, Aggarwal A (2007) Prevalence of metabolic syndrome in adolescents from a north Indian population. Diabet Med 24:195–199. doi: 10.1111/j.1464-5491.2007.02066.x DME2066 [pii]CrossRefPubMedGoogle Scholar
  23. 23.
    Moreira C, Santos R, Vale S, Soares-Miranda L, Marques AI, Santos PC, Mota J (2010) Metabolic syndrome and physical fitness in a sample of Azorean adolescents. Metab Syndr Relat Disord 8:443–449. doi: 10.1089/met.2010.0022 CrossRefPubMedGoogle Scholar
  24. 24.
    Steinberger J, Daniels SR, Eckel RH, Hayman L, Lustig RH, McCrindle B, Mietus-Snyder ML (2009) Progress and challenges in metabolic syndrome in children and adolescents: a scientific statement from the American Heart Association Atherosclerosis, Hypertension, and Obesity in the Young Committee of the Council on Cardiovascular Disease in the Young; Council on Cardiovascular Nursing; and Council on Nutrition, Physical Activity, and Metabolism. Circulation 119:628–647. doi: 10.1161/CIRCULATIONAHA.108.191394 CIRCULATIONAHA.108.191394 [pii]CrossRefPubMedGoogle Scholar
  25. 25.
    FITNESSGRAM, The Cooper Institute for Aerobic Research (1999) FITNESSGRAM test administration manual. Human Kinrtics Books, ChampaignGoogle Scholar
  26. 26.
    Mota J, Silva G (1999) Adolescent’s physical activity: association with socioeconomic status and parental participation among a Portuguese sample. Sport Educ Soc 4:193–199CrossRefGoogle Scholar
  27. 27.
    Tanner JM, Whitehouse RH (1976) Clinical longitudinal standards for height, weight, height velocity, weight velocity, and stages of puberty. Arch Dis Child 51:170–179PubMedCentralCrossRefPubMedGoogle Scholar
  28. 28.
    Lopes C, Aro A, Azevedo A, Ramos E, Barros H (2007) Intake and adipose tissue composition of fatty acids and risk of myocardial infarction in a male Portuguese community sample. J Am Diet Assoc 107:276–286. doi: 10.1016/j.jada.2006.11.008 S0002-8223(06)02496-5 [pii]CrossRefPubMedGoogle Scholar
  29. 29.
    Sofi F, Abbate R, Gensini GF, Casini A (2010) Accruing evidence on benefits of adherence to the Mediterranean diet on health: an updated systematic review and meta-analysis. Am J Clin Nutr 92:1189–1196. doi: 10.3945/ajcn.2010.29673 ajcn.2010.29673 [pii]CrossRefPubMedGoogle Scholar
  30. 30.
    Trichopoulou A, Costacou T, Bamia C, Trichopoulos D (2003) Adherence to a Mediterranean diet and survival in a Greek population. N Engl J Med 348:2599–2608. doi: 10.1056/NEJMoa025039348/26/2599 CrossRefPubMedGoogle Scholar
  31. 31.
    Tur JA, Serra-Majem L, Romaguera D, Pons A (2005) Profile of overweight and obese people in a Mediterranean region. Obes Res 13:527–536CrossRefPubMedGoogle Scholar
  32. 32.
    Ball K, Crawford D (2006) Socioeconomic factors in obesity: a case of slim chance in a fat world? Asia Pac J Clin Nutr 15(Suppl):15–20PubMedGoogle Scholar
  33. 33.
    Berenson GS, Srinivasan SR, Bao W, Newman WP III, Tracy RE, Wattigney WA (1998) Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. The Bogalusa heart study. N Engl J Med 338:1650–1656. doi: 10.1056/NEJM199806043382302 CrossRefPubMedGoogle Scholar
  34. 34.
    Cohen S, Janicki-Deverts D, Chen E, Matthews KA (2010) Childhood socioeconomic status and adult health. Ann N Y Acad Sci 1186:37–55. doi: 10.1111/j.1749-6632.2009.05334.x NYAS5334 [pii]CrossRefPubMedGoogle Scholar
  35. 35.
    Popkin BM (2003) The nutrition transition in the developing world. Dev Policy Rev 21:581–597CrossRefGoogle Scholar
  36. 36.
    Loucks EB, Rehkopf DH, Thurston RC, Kawachi I (2007) Socioeconomic disparities in metabolic syndrome differ by gender: evidence from NHANES III. Ann Epidemiol 17:19–26. doi: 10.1016/j.annepidem.2006.07.002 S1047-2797(06)00188-8 [pii]CrossRefPubMedGoogle Scholar
  37. 37.
    Cook S, Weitzman M, Auinger P, Nguyen M, Dietz WH (2003) Prevalence of a metabolic syndrome phenotype in adolescents: findings from the third National Health and Nutrition Examination Survey, 1988–1994. Arch Pediatr Adolesc Med 157:821–827. doi: 10.1001/archpedi.157.8.821157/8/821 CrossRefPubMedGoogle Scholar
  38. 38.
    Carmo R (2003) Desigualdades sociais 2010: estudos e indicadores [Social inequalities 2010: studies and indicators]. Editora Mundos Sociais, LisboaGoogle Scholar
  39. 39.
    EU (1997) União Europeia. Europa Glossário [European Union. Europe Glossary]. Accessed Oct 2006 at http://europa.eu/scadplus/glossary/outermost_regions_en.htm
  40. 40.
    Shi L (1998) Sociodemographic characteristics and individual health behaviors. South Med J 91:933–941CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Rute Santos
    • 1
    • 2
  • Carla Moreira
    • 1
  • Sandra Abreu
    • 1
  • Luís Lopes
    • 1
  • Jonatan R. Ruiz
    • 3
  • Pedro Moreira
    • 1
    • 4
  • Pedro Silva
    • 1
    • 2
  • Jorge Mota
    • 1
  1. 1.Research Centre in Physical Activity, Health, and Leisure, Faculty of SportsUniversity of PortoPortoSpain
  2. 2.Maia Institute of Higher Education (CIDAF)MaiaPortugal
  3. 3.Department of Physical Education and Sports, Faculty of Sport SciencesUniversity of GranadaGranadaSpain
  4. 4.Faculty of Nutrition and Food SciencesUniversity of PortoPortoPortugal

Personalised recommendations