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Data from the StEP TWO programme showing the effect on blood pressure and different parameters for obesity in overweight and obese primary school children

Published online by Cambridge University Press:  03 May 2005

Christine Graf ,
Sylvia V. Rost ,
Benjamin Koch ,
Sandy Heinen ,
Gisa Falkowski ,
Sigrid Dordel ,
Birna Bjarnason-Wehrens ,
Narayanswami Sreeram ,
Konrad Brockmeier  and
Hildegard Christ
...Show all authors
Christine Graf
Affiliation:
Institute for Cardiology and Sportsmedicine, University of Cologne, Germany
Sylvia V. Rost
Affiliation:
Institute for Cardiology and Sportsmedicine, University of Cologne, Germany
Benjamin Koch
Affiliation:
Institute for Cardiology and Sportsmedicine, University of Cologne, Germany
Sandy Heinen
Affiliation:
Institute for Cardiology and Sportsmedicine, University of Cologne, Germany
Gisa Falkowski
Affiliation:
Institute for Cardiology and Sportsmedicine, University of Cologne, Germany
Sigrid Dordel
Affiliation:
Institute for Sports Didactics, German Sport University, University of Cologne, Germany
Birna Bjarnason-Wehrens
Affiliation:
Institute for Cardiology and Sportsmedicine, University of Cologne, Germany
Narayanswami Sreeram
Affiliation:
Clinic of Pediatric Cardiology, University of Cologne, Germany
Konrad Brockmeier
Affiliation:
Clinic of Pediatric Cardiology, University of Cologne, Germany
Hildegard Christ
Affiliation:
Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Germany
Hans-Georg Predel
Affiliation:
Institute for Cardiology and Sportsmedicine, University of Cologne, Germany
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Abstract

Obesity in childhood, which is associated with cardiovascular risk factors such as hypertension, is on the increase. Countermeasures are necessary. In this paper, we present the baseline and final data from the StEP TWO programme, a prospective study to prevent overweight and obesity in primary schools. Methods: We recorded and calculated, from 1689 children, anthropometric data, including analyses of bioelectric impedance, waist and hip circumferences, body mass index and its standard deviation, and the ratio of waist to hip. Blood pressure was measured after 5 minutes at rest. From the three schools involved in a programme of intervention, 121 children were invited to take part, and 40 (33.1 per cent) completed the programme. The effect was compared with 155 overweight and obese children identified at the 4 control schools. Results: 830 (49.5 per cent) boys and 848 girls (50.5 per cent) took part. Their mean age was 8.2 plus or minus 1.3 years, their height was 1.31 plus or minus 0.09 metres, they weighed 30.0 plus or minus 8.2 kilograms, and their mean index of body mass was 17.1 plus or minus 2.9 kilograms per metre squared. Of the children, 7.3 per cent were obese, 10.4 per cent were overweight, 75.7 per cent had normal weights, and 6.6 per cent were underweight. Resting hypertension was observed in 2.3 per cent of the children. Increased blood pressure was associated with a higher body weight, body mass index, standard deviation score for body mass index, and waist and hip circumferences (each p < 0.001), but not with the ratio of waist to hip. Hypertension at rest was also found in 11.0 per cent of obese children, 4.4 per cent of those who were overweight, 1.2 per cent of those with normal weight, and 1.0 per cent of underweight children (p < 0.001). After the intervention, the increase of the body mass index tended to be lower in those in whom we had intervened (p = 0.069), and in these the decrease of the standard deviation score for body mass index was significantly higher (p = 0.028). Systolic blood pressure was reduced by about 10 millimetres of mercury in those in whom we had intervened (p = 0.002), while there were no changes in the control group. Diastolic blood pressure was lowered by 3 millimetres of mercury, but this was not significant. Conclusion: Obese children had the highest values for systolic and diastolic blood pressure. Increased levels of blood pressure are associated with other parameters of obesity, such as the circumference of the waist and hip. Early preventive measurements in childhood are necessary, and appropriate intervention appears to be effective.

Keywords

Hypertensionpreventionwaist circumference
Type
Original Article
Information
Cardiology in the Young , Volume 15 , Issue 3 , June 2005 , pp. 291 - 298
Copyright
© 2005 Cambridge University Press

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References

Allison DB, Fontaine KR, Manson JE, Stevens J, VanItallie TB. Annual deaths attributable to obesity in the United States. JAMA 1999; 282: 1530–1538.Google Scholar
American Heart Association 1998; statistical Supplement (online) http://www.amhrt.org/scientific/Hsstats98/08rsk/ct.html
Kavey REW, Daniels SR, Lauer RM, Atkins DL, Hayman LL, Taubert K. American Heart Association Guidelines for primary prevention of atherosclerotic cardiovascular disease beginning in childhood. Circulation 2003; 107: 1562–1566.Google Scholar
Berenson GS, Srinivasan SR, Bao W, Newman WP III, Tracy RE, Wattigney WA. Association between multiple cardiovasc risk factors and atherosclerosis in children and young adults. N Engl J Med 1998; 338: 1650–1656.Google Scholar
Mahoney LT, Burns TL, Stanford W. Coronary risk factors measured in childhood and young adult life are associated with coronary artery calcification in young adults: the Muscatine Study. J Am Coll Cardiol 1996; 27: 277–284.Google Scholar
McGill HC, McMahan CA, Malcolm GT, Oalmann MC, Strong JP. Relation of glycohemoglobin and adiposity to atherosclerosis in youth. Arterioscler Thromb Vasc Biol 1995; 15: 431–440.Google Scholar
Muntner P, He J, Cutler JA, Wildman RP, Whelton PK. Trends in blood pressure among children and adolescents. JAMA 2004; 291: 2107–2113.Google Scholar
Freedman DS, Dietz WH, Srinivasan SR, Berenson GS. The relation of overweight to cardiovascular risk factors among children and adolescents: the Bogalusa Heart Study. Pediatrics 1999; 103: 1175–1182.Google Scholar
Wabitsch M. Obese children and adolescents in Germany. A call for action. Bundesgesundheitsblatt 2004; 47: 251–255.Google Scholar
Power C, Lake JC, Cole TJ. Measurement and long-term healthy risks of children and adolescents fatness. Int J Obes 1997; 21: 507–526.Google Scholar
Freedman DS, Kettel Khan S, Dietz WH, Srinivasan SR, Berenson GS. Relationship of childhood obesity to coronary heart disease risk factors in adulthood: The Bogalusa Heart Study. Pediatrics 2001; 108: 712–718.Google Scholar
Lauer RM, Connor WE, Leaverton PE. Coronary heart disease risk factors in school children: the Muscatine Study. J Pediatrics 1975; 86: 697–706.Google Scholar
Campbell K, Waters E, O'Meara S, Kelly S, Summerbell C. Interventions for preventing obesity in children. Cochrane Database Syst Rev 2002; 2: CD001871.Google Scholar
Harrell JS, Gansky SA, McMurray RG, Bangdiwala SI, Frauman AC, Bradley CB. School-based interventions improve heart health in children with multiple cardiovascular disease risk factors. Pediatrics 1998; 102: 371–380.Google Scholar
Kromeyer-Hauschild K, Wabitsch M, Kunze D, et al. Perzentile für den Body mass Index für das Kindes- und Jugendalter unter Heranziehung verschiedener deutscher Stichproben. Monatsschr Kinderheilkd 2001; 8: 807–818.Google Scholar
Rascher W. Hypertonie bei Kindern: Wann ist sie zu behandeln? Management Hypertonie 2001; www.paritaet.org/hochdruckliga/nr102001.htmGoogle Scholar
De Man SA, Andre JL, Bachmann HJ, et al. Blood pressure in childhood: pooled findings of six European studies. J Hypertens 1991; 9: 109–114.Google Scholar
Weisser B, Düsing R, Mengden T. Arterial hypertension – individual risk stratification and therapeutic targets. DMW 2001; 126: 1235–1241.Google Scholar
Graf C. Das CHILT-Projekt. Dtsch Z Spomed 2003; 54: 247.Google Scholar
Graf C, Koch B, Kretschmann-Kandel E, et al. Correlation between BMI, leisure habits and motor abilities in childhood (CHILT-Project). Int J Obes 2004; 28: 22–26.Google Scholar
Arbeitsgemeinschaft Adipositas im Kindes- und Jugendalter. Leitlinien. Konsensuskonferenz 18.10.2003.
Bachmann H, Horacek U, Leowsky M, Hirche H. Blood pressure in children and adolescents aged 4–18. Correlation of blood pressure values with age, sex, body height, body weight and skinfold thickness (Essen blood pressure study). Monatsschr Kinderheilkd 1987; 135: 128–134.Google Scholar
Al-Sendi AM, Shetty P, Musaiger AO, Myatt M. Relationship between body composition and blood pressure in Bahrani adolescents. Br J Nutr 2003; 90: 837–844.Google Scholar
Chadha S, Tandom R, Shekhawat S, Gopinath N. An epidemiological study of blood pressure in school children (5–14 years) in Delhi. Indian Heart J 1999; 51: 178–182.Google Scholar
Kalker U, Hovels O, Kolbe-Saborowski H. Obese children and adolescents. Waist-hip ratio and cardiovascular disease. Monatsschr Kinderheild 1993; 141: 36–41.Google Scholar
Mast M, Körtzinger I, König E, Mueller MJ. Gender differences in fat mass of 5–7-year-old children. Int J Obes 1998; 22: 878–884.Google Scholar
Weststrate JA, Deurenberg P, van Tinteren H. Indices of body fat distribution and adiposity in Dutch children from birth to 18 years of age. Int J Obes 1989; 13: 465–477.Google Scholar
Flynn JT. Evaluation and management of hypertension in childhood. Prog Pediatr Cardiol 2001; 12: 177–188.Google Scholar
Soergel M, Kirschstein M, Busch C, et al. Oscillometric twenty-four-hour blood pressure values in healthy children and adolescents: a multicenter study including 1141 subjects. J Pediatr 1997; 130: 178–184.Google Scholar
Pescatello LS, Franklin BA, Fagard R, Farquhar WB, Kelley GA, Ray CA; American College of Sports Medicine. American College of Sports Medicine position stand. Exercise and hypertension. Med Sci Sports Exerc 2004; 36: 533–553.Google Scholar
Hansen HS, Froberg K, Hyldebrandt N, Nielsen JR. A controlled study of eight month of physical training and reduction of blood pressure in children: the Odense schoolchild study. BMJ 1991; 303: 682–685.Google Scholar
Webber LS, Osganian SK, Feldman HA, et al. Cardiovascular risk factors among children after a 2½ year intervention – the CATCH Study. Prev Med 1996; 25: 432–441.Google Scholar