Skip to main content
Archives of Disease in Childhood logoLink to Archives of Disease in Childhood
. 2004 Jan;89(1):41–44.

Greek adolescents, fitness, fatness, fat intake, activity, and coronary heart disease risk

C Bouziotas 1, Y Koutedakis 1, A Nevill 1, E Ageli 1, N Tsigilis 1, A Nikolaou 1, A Nakou 1
PMCID: PMC1755891  PMID: 14709501

Abstract

Background: A dramatic increase in adult mortality rates from coronary heart disease (CHD) in Greece, accompanied by increased prevalence of CHD risk factors in children, has been documented. However, there is controversy about the independent effects of certain lifestyle parameters on primary CHD risk factors.

Aims and Methods: To examine the association between CHD risk factors (HDL-C, LDL-C, HDL-C/TC, triglycerides, systolic and diastolic blood pressure) and lifestyle parameters (fitness, fatness, fat intake, and physical activity) in 210 12-year old Greek pupils.

Results: Correcting for the fixed factors of gender and maturation, analyses of covariance (ANCOVA) with backward elimination of the lifestyle covariates revealed significant associations between three CHD risk factors (HDL-C, HDL-C/TC, systolic blood pressure) and physical activity levels. In contrast, the covariates aerobic fitness, fatness and fat intake failed to reach significance with any of the CHD risk factors.

Conclusions: In Greek schoolchildren, primary CHD risk factors are mainly associated with physical activity levels, independently of fitness, fatness, and/or fat intake. Prevention strategies should concentrate on enhancing physical activity early in life, if the increased prevalence of Greek adult CHD mortality is to be diminished.

Full Text

The Full Text of this article is available as a PDF (217.7 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aaron D. J., Kriska A. M., Dearwater S. R., Cauley J. A., Metz K. F., LaPorte R. E. Reproducibility and validity of an epidemiologic questionnaire to assess past year physical activity in adolescents. Am J Epidemiol. 1995 Jul 15;142(2):191–201. doi: 10.1093/oxfordjournals.aje.a117618. [DOI] [PubMed] [Google Scholar]
  2. Ainsworth B. E., Haskell W. L., Whitt M. C., Irwin M. L., Swartz A. M., Strath S. J., O'Brien W. L., Bassett D. R., Jr, Schmitz K. H., Emplaincourt P. O. Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc. 2000 Sep;32(9 Suppl):S498–S504. doi: 10.1097/00005768-200009001-00009. [DOI] [PubMed] [Google Scholar]
  3. Boreham C. A., Paliczka V. J., Nichols A. K. A comparison of the PWC170 and 20-MST tests of aerobic fitness in adolescent schoolchildren. J Sports Med Phys Fitness. 1990 Mar;30(1):19–23. [PubMed] [Google Scholar]
  4. Boreham C., Twisk J., Murray L., Savage M., Strain J. J., Cran G. Fitness, fatness, and coronary heart disease risk in adolescents: the Northern Ireland Young Hearts Project. Med Sci Sports Exerc. 2001 Feb;33(2):270–274. doi: 10.1097/00005768-200102000-00016. [DOI] [PubMed] [Google Scholar]
  5. Bouchard C., Daw E. W., Rice T., Pérusse L., Gagnon J., Province M. A., Leon A. S., Rao D. C., Skinner J. S., Wilmore J. H. Familial resemblance for VO2max in the sedentary state: the HERITAGE family study. Med Sci Sports Exerc. 1998 Feb;30(2):252–258. doi: 10.1097/00005768-199802000-00013. [DOI] [PubMed] [Google Scholar]
  6. Brotons C., Ribera A., Perich R. M., Abrodos D., Magaña P., Pablo S., Terradas D., Fernández F., Permanyer G. Worldwide distribution of blood lipids and lipoproteins in childhood and adolescence: a review study. Atherosclerosis. 1998 Jul;139(1):1–9. doi: 10.1016/s0021-9150(98)00056-2. [DOI] [PubMed] [Google Scholar]
  7. Brox J., Bjørnstad E., Olaussen K., Østerud B., Almdahl S., Løchen M. L. Blood lipids, fatty acids, diet and lifestyle parameters in adolescents from a region in northern Norway with a high mortality from coronary heart disease. Eur J Clin Nutr. 2002 Jul;56(7):694–700. doi: 10.1038/sj.ejcn.1601381. [DOI] [PubMed] [Google Scholar]
  8. Deckelbaum R. J. Nutrition, the child and atherosclerosis. A commentary. Acta Paediatr Scand Suppl. 1990;365:7–12. doi: 10.1111/j.1651-2227.1990.tb11578.x. [DOI] [PubMed] [Google Scholar]
  9. Friedewald W. T., Levy R. I., Fredrickson D. S. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972 Jun;18(6):499–502. [PubMed] [Google Scholar]
  10. Hardman A. E. Accumulation of physical activity for health gains: what is the evidence? Br J Sports Med. 1999 Apr;33(2):87–92. doi: 10.1136/bjsm.33.2.87. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Hofman A., Walter H. J. The association between physical fitness and cardiovascular disease risk factors in children in a five-year follow-up study. Int J Epidemiol. 1989 Dec;18(4):830–835. doi: 10.1093/ije/18.4.830. [DOI] [PubMed] [Google Scholar]
  12. Katzmarzyk P. T., Malina R. M., Bouchard C. Physical activity, physical fitness, and coronary heart disease risk factors in youth: the Québec Family Study. Prev Med. 1999 Dec;29(6 Pt 1):555–562. doi: 10.1006/pmed.1999.0592. [DOI] [PubMed] [Google Scholar]
  13. Mamalakis G., Kafatos A. Prevalence of obesity in Greece. Int J Obes Relat Metab Disord. 1996 May;20(5):488–492. [PubMed] [Google Scholar]
  14. Manios Y., Kafatos A., Codrington C. Gender differences in physical activity and physical fitness in young children in Crete. J Sports Med Phys Fitness. 1999 Mar;39(1):24–30. [PubMed] [Google Scholar]
  15. Manios Y., Moschandreas J., Hatzis C., Kafatos A. Evaluation of a health and nutrition education program in primary school children of Crete over a three-year period. Prev Med. 1999 Feb;28(2):149–159. doi: 10.1006/pmed.1998.0388. [DOI] [PubMed] [Google Scholar]
  16. McMurray Robert G., Harrell Joanne S., Bradley Chyrise B., Deng Shibing, Bangdiwala Shrikant I. Predicted maximal aerobic power in youth is related to age, gender, and ethnicity. Med Sci Sports Exerc. 2002 Jan;34(1):145–151. doi: 10.1097/00005768-200201000-00022. [DOI] [PubMed] [Google Scholar]
  17. Morrison J. A., Barton B. A., Biro F. M., Daniels S. R., Sprecher D. L. Overweight, fat patterning, and cardiovascular disease risk factors in black and white boys. J Pediatr. 1999 Oct;135(4):451–457. doi: 10.1016/s0022-3476(99)70167-8. [DOI] [PubMed] [Google Scholar]
  18. Petridou E., Malamou H., Doxiadis S., Pantelakis S., Kanellopoulou G., Toupadaki N., Trichopoulou A., Flytzani V., Trichopoulos D. Blood lipids in Greek adolescents and their relation to diet, obesity, and socioeconomic factors. Ann Epidemiol. 1995 Jul;5(4):286–291. doi: 10.1016/1047-2797(94)00094-a. [DOI] [PubMed] [Google Scholar]
  19. Sorof Jonathan, Daniels Stephen. Obesity hypertension in children: a problem of epidemic proportions. Hypertension. 2002 Oct;40(4):441–447. doi: 10.1161/01.hyp.0000032940.33466.12. [DOI] [PubMed] [Google Scholar]
  20. Strong W. B. Physical activity and children. Circulation. 1990 May;81(5):1697–1701. doi: 10.1161/01.cir.81.5.1697. [DOI] [PubMed] [Google Scholar]
  21. Superko H. R. Exercise training, serum lipids, and lipoprotein particles: is there a change threshold? Med Sci Sports Exerc. 1991 Jun;23(6):677–685. [PubMed] [Google Scholar]
  22. Takada H., Harrell J., Deng S., Bandgiwala S., Washino K., Iwata H. Eating habits, activity, lipids and body mass index in Japanese children: the Shiratori Children Study. Int J Obes Relat Metab Disord. 1998 May;22(5):470–476. doi: 10.1038/sj.ijo.0800610. [DOI] [PubMed] [Google Scholar]
  23. Third J. L., Montag J., Flynn M., Freidel J., Laskarzewski P., Glueck C. J. Primary and familial hypoalphalipoproteinemia. Metabolism. 1984 Feb;33(2):136–146. doi: 10.1016/0026-0495(84)90126-4. [DOI] [PubMed] [Google Scholar]
  24. Tolfrey K., Jones A. M., Campbell I. G. The effect of aerobic exercise training on the lipid-lipoprotein profile of children and adolescents. Sports Med. 2000 Feb;29(2):99–112. doi: 10.2165/00007256-200029020-00003. [DOI] [PubMed] [Google Scholar]
  25. Torun B., Davies P. S., Livingstone M. B., Paolisso M., Sackett R., Spurr G. B. Energy requirements and dietary energy recommendations for children and adolescents 1 to 18 years old. Eur J Clin Nutr. 1996 Feb;50 (Suppl 1):S37–S81. [PubMed] [Google Scholar]
  26. Twisk J. W., Boreham C., Cran G., Savage J. M., Strain J., van Mechelen W. Clustering of biological risk factors for cardiovascular disease and the longitudinal relationship with lifestyle of an adolescent population: the Northern Ireland Young Hearts Project. J Cardiovasc Risk. 1999 Dec;6(6):355–362. doi: 10.1177/204748739900600601. [DOI] [PubMed] [Google Scholar]
  27. Twisk J. W., Kemper H. C., van Mechelen W. Tracking of activity and fitness and the relationship with cardiovascular disease risk factors. Med Sci Sports Exerc. 2000 Aug;32(8):1455–1461. doi: 10.1097/00005768-200008000-00014. [DOI] [PubMed] [Google Scholar]

Articles from Archives of Disease in Childhood are provided here courtesy of BMJ Publishing Group

RESOURCES