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


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.


Socioeconomic status Clustering metabolic risk factors Adolescents Azores Portugal 



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.


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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

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