Psychosocial and environmental risk factors of obesity and hypertension in children and adolescents-a literature overview

Is there an association between eye-level greenness and childhood hypertension using street view? Findings from the Seven Northeastern Cities study in China

There is a lack of evidence regarding associations of eye-level greenness exposure with blood pressure among children. We aimed to investigate the associations between different types of eye-level greenness and pediatric blood pressure in China. From 2012 to 2013, we recruited 9354 children aged between 5 and 17 years in northeast China. Eye-level of greenness was assessed with Street View Greenness (SVG), derived from Tencent Street View images surrounding participants' schools, utilizing a deep machine learning model. Hypertension was defined as blood pressure above the 95th percentile based on the fourth report's guidelines for children and adolescents. Generalized linear mixed-effects regression models were conducted to estimate adjusted odds ratio (aOR) and estimates of childhood hypertension and pediatric blood pressure per interquartile range (IQR) increase of SVG. Mediation analyses including air pollution and exercise time were also performed. We found the significant association of SVG-total with decreased odds of hypertension in Chinese children (aOR = 0.83, 95%CI: 0.75,0.91), especially with the decrease of SBP (β = -0.76, 95%CI: 1.09,-0.43). Interestingly, per IQR increase in SVG-tree 800m for trees was associated with lower adjusted odds of pediatric hypertension (aOR = 0.84; 95%CI: 0.76, 0.92), also with the decrease of systolic blood pressure. Mediation analyses showed that hypertension was significantly mitigated by lower levels of air pollutants, including PM2.5, PM10, SO2 and NO2. Results of this study suggested that eye-level greenness, especially trees, were associated with lower prevalence of hypertension in children, with air pollution exhibiting mediating effects. These findings emphasized the importance of incorporating more greenness, especially trees in both urban planning and public health interventions.

Relationship between the dietary inflammation index and hypertension in American children and adolescents: findings from the national health and nutrition examination survey 1999-2018

This study aimed to examine the relationship between the dietary inflammatory index (DII) and hypertension in children and adolescents using data from the National Health and Nutrition Examination Survey (NHANES) conducted between 1999 and 2018. The analysis included 18,460 participants aged 8 to 17 years, with 2,070 diagnosed with youth hypertension, defined as blood pressure above the 95th percentile for their age and gender. Dietary information was collected to calculate the DII, which was initially treated as a continuous variable and later categorized into tertiles. Multivariable weighted logistic regression and restricted cubic spline (RCS) analyses were conducted to explore the association between DII and youth hypertension. The results revealed a positive relationship between higher DII scores and increased likelihood of hypertension in youth, with both regression and RCS analyses showing a linear positive correlation after adjusting for potential confounders. The findings suggest that managing dietary inflammation may be an important strategy for preventing hypertension in children and adolescents.

Effect of Diet on HDL in Obesity

Alterations of plasma lipoprotein levels and oxidative stress are frequently observed in obese patients, including low high-density lipoprotein (HDL) cholesterol (HDL-C) levels and alterations of HDL composition. Dysfunctional HDL with lower antioxidant and anti-inflammatory properties have also been demonstrated in obesity. There is increasing evidence that white adipose tissue (WAT) participates in several metabolic activities and modulates HDL-C levels and function. In obese subjects, the changes in morphology and function of adipose tissue lead to impaired regulatory function and are associated with a state of low-grade chronic inflammation, with increased release of pro-inflammatory adipokines and cytokines. These alterations may affect HDL metabolism and functions; thus, adipose tissue is considered a potential target for the prevention and treatment of obesity. A cornerstone of obesity prevention and therapy is lifestyle modification through dietary changes, which is reflected in the modulation of plasma lipoprotein metabolism. Some dietary components and metabolites directly affect the composition and structure of HDL and modulate its anti-inflammatory and vasoprotective properties. The aims of the review are to summarize the crosstalk between adipocytes and HDL dysfunction in human obesity and to highlight recent discoveries on beneficial dietary patterns as well as nutritional components on inflammation and HDL function in human obesity.

Light-Intensity Physical Activity and Sedentary Behavior Are Associated With Blood Pressure Levels in Adolescents

PURPOSE

To investigate the associations between physical activity (PA) intensities, sedentary behavior (SB), and blood pressure (BP) in adolescents, according to sex.

METHOD

This cross-sectional study involved 95 male and female adolescents aged 15-18 years. Accelerometry was used to measure time spent in light-intensity PA (LPA), moderate to vigorous PA (MVPA), and vigorous PA, and SB. The BP was determined using an automated sphygmomanometer. Statistical analyses included multiple linear regression and command margins.

RESULTS

Significant associations were found between systolic BP (SBP) and time spent in LPA (B = -0.08; 95% CI, -0.15 to -0.01) and SB (B = 0.071; 95% CI, 0.004-0.138), albeit only in boys. Furthermore, an interaction was observed between time spent in SB and MVPA for SBP in boys (B = -0.002; 95% CI, -0.004 to -0.0008). The main interaction effect of increasing SBP was a combination of <75 minutes per day of MVPA and up to 600 minutes per day of SB.

CONCLUSIONS

Increased time in LPA and reduced time spent in SB during the day are associated with lower SBP in male adolescents. Additionally, the relation between SB and SBP was attenuated by MVPA. These findings provide crucial insights for PA recommendations to promote cardiovascular health in adolescents.

Study on the relationship between body mass index and blood pressure indices in children aged 7-17 during COVID-19

Background

To explore the relationship between body mass index (BMI), age, sex, and blood pressure (systolic blood pressure, SBP; diastolic blood pressure, DBP) in children during COVID-19, providing reference for the prevention and screening of hypertension in children.

Methods

This study adopted a large-scale cross-sectional design to investigate the association between BMI and blood pressure in 7-17-year-old students in City N, China, during COVID-19. Thirty-six primary and secondary schools in City N were sampled using a stratified cluster sampling method. A total of 11,433 students aged 7-17 years in City N, China, were selected for blood pressure (Diastolic blood pressure, DBP, Systolic blood pressure, SBP), height, and weight, Resting heart rate (RHR), chest circumference, measurements, and the study was written using the STROBE checklist. Data analysis was conducted using SPSS 26.0, calculating the mean and standard deviation of BMI and blood pressure for male and female students in different age groups. Regression analysis was employed to explore the impact of BMI, age, and sex on SBP and DBP, and predictive models were established. The model fit was evaluated using the model R2.

Results

The study included 11,287 primary and secondary school students, comprising 5,649 boys and 5,638 girls. It was found that with increasing age, BMI and blood pressure of boys and girls generally increased. There were significant differences in blood pressure levels between boys and girls in different age groups. In regression models, LC, Age, BMI, and chest circumference show significant positive linear relationships with SBP and DBP in adolescents, while RHR exhibits a negative linear relationship with SBP. These factors were individually incorporated into a stratified regression model, significantly enhancing the model's explanatory power. After including factors such as Age, Gender, and BMI, the adjusted R2 value showed a significant improvement, with Age and BMI identified as key predictive factors for SBP and DBP. The robustness and predictive accuracy of the model were further examined through K-fold cross-validation and independent sample validation methods. The validation results indicate that the model has a high accuracy and explanatory power in predicting blood pressure in children of different weight levels, especially among obese children, where the prediction accuracy is highest.

Conclusion

During COVID-19, age, sex, and BMI significantly influence blood pressure in children aged 7-17 years, and predictive models for SBP and DBP were established. This model helps predict blood pressure in children and reduce the risk of cardiovascular diseases. Confirmation of factors such as sex, age, and BMI provide a basis for personalized health plans for children, especially during large-scale infectious diseases, providing guidance for addressing health challenges and promoting the health and well-being of children.

Male Youth Tobacco Usage Pattern in Banned Smoking Area in Comparison With Non-banned Smoking Area: A Cross-Sectional Study

OBJECTIVES

This study aimed to assess the impact of smoking bans in schools on smoking prevalence and behavior among Saudi male youth aged 13-15 years.

METHODS

A cross-sectional comparative study was conducted involving students from two intermediate schools in Jeddah - one with a smoking ban and the other without. Data collection utilized the Global Youth Tobacco Survey questionnaire, and statistical analysis was performed using SPSS version 21.0.

RESULTS

The study had a 93.9% response rate, with 659 students participating. Notably, a lower percentage of ever-smoking was observed in the banned area compared to the non-banned area (39.6% vs. 50.9%; p=0.002). Current smoking rates were also lower in the banned area (14.2% vs. 23.8%; p=0.014). Family and peer influences on smoking were reduced in the banned area, and more students discussed the harmful effects of smoking with family (72.8% vs. 59.8%; p=0.003). Students in the non-banned area found it easier to access cigarettes. A significantly higher percentage of students in the banned area were resolute in not smoking if offered a cigarette by their best friend (65.0% vs. 59.2%; p=0.006). Students in the non-banned area reported higher exposure to cigarette smoke at home and in other places compared to those in the banned area (15.8% vs. 10.8%; p=0.008), respectively. A higher percentage of smokers in the banned area expressed a desire to quit smoking, though the difference was not statistically significant. More anti-smoking media messages were reported in the banned area (35.6% vs. 33.6%; p=0.004). Fewer respondents in the banned area had items with cigarette brand logos (13.6% vs. 19.9%; p=0.03).

CONCLUSION

The findings underscore the effectiveness of smoking bans in schools in reducing smoking prevalence among students. This suggests a broader societal shift in attitudes toward smoking, highlighting the need for comprehensive bans as part of public health strategies. However, there remains a need for targeted interventions to address the complexities of smoking behavior in both banned and non-banned areas.