Diet intervention on obese children with hypertension in China

Differences in prevalence of prehypertension and hypertension in children and adolescents in the eastern, central and western regions of China from 1991-2011 and the associated risk factors

The present study aimed to estimate the differences in rates of prehypertension and hypertension in children and adolescents among three regions with different socioeconomic status in China, and explore the corresponding risk factors associated with prehypertension and hypertension to guide the prevention. Blood pressure measurements of 13 762 children and adolescents aged 6–17 years were obtained from a prospective national survey (the China Health and Nutrition Survey, 1991–2011). Prehypertension and hypertension were defined by age and gender, according to China’s standard criteria. Chi-square tests were used to compare the differences in the prevalence of prehypertension and hypertension among three regions. Trend chi-square tests were used to detect the trends in rates of prehypertension and hypertension over survey years. Logistic regression models were used to detect the potential risk factors of prehypertension and hypertension in children and adolescents. During the survey years, the overall prevalence of prehypertension and hypertension were 6.0% and 10.6%. The corresponding rates in the western region were lowest, but increased rapidly over the two decades (84.0% and 122.6% increases respectively, P<0.001). The overall hypertension rate remained high in the eastern region, despite the slower increase (24.2% increase). In the central region, although the prehypertension rate remained stable, the rate of hypertension had a 94.8% increase these years (P<0.0001). According to the results of logistic regression, age, body mass index (BMI) and waist/height ratio (WHtR) were associated with prehypertension and hypertension. Children and adolescents in the eastern region had the highest level of prehypertension and hypertension, while the rapid increase of blood pressure in the western and central regions were also supposed to concern. Improvement of the healthy lifestyle is urgent for prehypertension and hypertension prevention in children and adolescents.

Dietary pattern and its association with the prevalence of obesity, hypertension and other cardiovascular risk factors among Chinese older adults

AIM

This article examined the association between dietary patterns and cardiovascular risk factors in Chinese older adults.

METHODS

For this study, older adults with one or more cardiovascular risk factors or a history of cardiovascular disease were randomly selected using health check medical records from the Changshu and Beijing Fangshan Centers for Disease Control and Prevention. Exploratory factor analysis and cluster analysis was used to extract dietary pattern factors. Log binomial regression analysis was used to analyse the association between dietary patterns and chronic disease related risk factors.

RESULTS

Four factors were found through factor analysis. A high level of internal consistency was obtained, with a high Cronbach's alpha coefficient of 0.83. Cluster analysis identified three dietary patterns: healthy diet, Western diet, and balanced diet. Findings in this sample of Chinese adults correspond to those reported in previous studies, indicating that a Western diet is significantly related to likelihood of having obesity, hypertension and the metabolic syndrome. The identification of distinct dietary patterns among Chinese older adults and the nutritional status of people with chronic diseases suggest that the three dietary patterns have a reasonable level of discriminant validity.

CONCLUSIONS

This study provides evidence that a FFQ is a valid and reliable tool to assess the dietary patterns of individuals with chronic diseases in small- to medium-size urban and rural settings in China. It also validates the significant association between dietary pattern and cardiovascular disease risk factors, including body mass index, blood pressure, triglycerides, and metabolic conditions. Clinical diagnosis of chronic disease further confirmed this relationship in Chinese older adults.

Central adiposity and the risk of hypertension in Asian Indian girls

BACKGROUND

Elevated blood pressure during childhood is an established predictor of elevated blood pressure in adulthood. This study was undertaken to evaluate the relationship of general and central adiposity measures with hypertension and to find out the best adiposity measure in predicting hypertension.

METHODS

A cross-sectional study was carried out in 197 girls aged 5 to 16 years. Anthropometric measurements included stature, weight, waist circumference (WC) and hip circumference. Body mass index (BMI, kg/m(2)), waist hip ratio (WHR) and conicity index (CI) were calculated subsequently. Systolic blood pressure (SBP) and diastolic bold pressure (DBP) were taken and hypertension was defined as age and stature adjusted SBP and/or DBP ≥95(th) percentile. Linear and logistic regression analysis was made to determine the relationship of adiposity measure with blood pressure and hypertension and to find out the best adiposity measure in predicting hypertension.

RESULTS

Both WC [odds ratio (OR)=2.20, 95% confidence interval, 1.32-3.69] and CI (OR=1.85, 95% confidence interval, 1.14-3.0) were significantly associated with hypertension. However, there was no significant association in BMI and WHR with hypertension.

CONCLUSION

WC is the best adiposity measure in predicting hypertension in girls.

Perinatal programming of neuroendocrine mechanisms connecting feeding behavior and stress

Feeding behavior is closely regulated by neuroendocrine mechanisms that can be influenced by stressful life events. However, the feeding response to stress varies among individuals with some increasing and others decreasing food intake after stress. In addition to the impact of acute lifestyle and genetic backgrounds, the early life environment can have a life-long influence on neuroendocrine mechanisms connecting stress to feeding behavior and may partially explain these opposing feeding responses to stress. In this review I will discuss the perinatal programming of adult hypothalamic stress and feeding circuitry. Specifically I will address how early life (prenatal and postnatal) nutrition, early life stress, and the early life hormonal profile can program the hypothalamic-pituitary-adrenal (HPA) axis, the endocrine arm of the body's response to stress long-term and how these changes can, in turn, influence the hypothalamic circuitry responsible for regulating feeding behavior. Thus, over- or under-feeding and/or stressful events during critical windows of early development can alter glucocorticoid (GC) regulation of the HPA axis, leading to changes in the GC influence on energy storage and changes in GC negative feedback on HPA axis-derived satiety signals such as corticotropin-releasing-hormone. Furthermore, peripheral hormones controlling satiety, such as leptin and insulin are altered by early life events, and can be influenced, in early life and adulthood, by stress. Importantly, these neuroendocrine signals act as trophic factors during development to stimulate connectivity throughout the hypothalamus. The interplay between these neuroendocrine signals, the perinatal environment, and activation of the stress circuitry in adulthood thus strongly influences feeding behavior and may explain why individuals have unique feeding responses to similar stressors.

Diet and exercise intervention, with special reference to micronutrients, reduces cardiometabolic risk in overweight children

OBJECTIVE

To study the effect of lifestyle intervention in the presence of multivitamin-zinc supplementation in improving the cardiometabolic status of overweight children.

MATERIALS AND METHODS

Data were evaluated in 74 overweight children (11.3 ± 2.9 years) randomly assigned to three groups of intervention for 4 months as follows: group A: diet-exercise counseling with multivitamin-zinc supplementation; group B: diet-exercise counseling; and group C: placebo. Anthropometric, biochemical, carotid arterial and lifestyle parameters were assessed.

RESULTS

Lifestyle counseling resulted in significant reduction in inactivity, energy and fat intakes and increase in micronutrient density of diets and physical activity in groups A and B in comparison to group C. Percent decline in body fat was more in group A than in groups B and C. Percent change in triglycerides (-13.7%) was significantly higher in group A than in groups B (-5.9%) and C (5.7%). Pulse wave velocity and elasticity modulus reduced and arterial compliance improved significantly in group A than in group B.

CONCLUSION

Multivitamin-zinc supplementation with lifestyle intervention has a positive effect of on the cardiometabolic status of overweight children.