Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-22T08:54:12.909Z Has data issue: false hasContentIssue false

Association between physical activity level and blood pressure: varied and graded mediating effects of obesity indices in schoolchildren

Published online by Cambridge University Press:  08 January 2020

Fatai A. Maruf*
Affiliation:
Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, Nnamdi Azikiwe University, Nnewi, Nigeria
Marufat O. Odetunde
Affiliation:
Department of Medical Rehabilitation, Faculty of Basic Medical Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
Prosper U. Okonkwo
Affiliation:
Department of Physiotherapy, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
*
Author for correspondence: F. A. Maruf, PhD, Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, Nnamdi Azikiwe University, Nnewi Campus, Nnewi, Nigeria. Tel: +234 8067437607; E-mail: mafaad@yahoo.com

Abstract

Objective:

To explore the mediating effects of adiposity indices in the association between physical activity level and blood pressure in a Nigerian schoolchildren population.

Materials and Methods:

One thousand five hundred and seventeen schoolchildren (714 males and 803 females) from randomly selected primary schools participated. Physical activity level, sum of skinfold thickness at three sites, waist circumference, body mass index, and blood pressure were measured using standardised procedures. The statistical significance of the mediating effects of adiposity indices was determined using Sobel Test.

Results:

Some obesity indices mediated the association between physical activity level and systolic blood pressure [males: waist circumference (t = 5.31; p < 0.001), skinfold thickness (t = 3.80; p < 0.001), and waist circumference/height (t = 2.21; p < 0.001); females: body mass index (t = 8.03; p < 0.001), waist circumference (t = 7.80; p < 0.001), and skinfold thickness (t = 5.94; p < 0.001)]. Similarly, some obesity indices mediated the prediction of diastolic blood pressure in females [males: body mass index (t = 1.95; p = 0.05), waist circumference (t = 2.65; p = 0.01), and skinfold thickness (t = 1.97; p = 0.05); females blood pressure: body mass index (t = 6.49; p < 0.001), waist circumference (t = 6.29; p < 0.001), skinfold thickness (t = 2.31; p = 0.02), and waist circumference/height (t = 2.59; p = 0.01)].

Conclusion:

The obesity indices that mediate the association between physical activity level and blood pressure vary, and their mediating effects are graded. While waist circumference and skinfold thickness exert the greatest mediating effects on the association in males, body mass index and waist circumference do in females.

Type
Original Article
Copyright
© Cambridge University Press 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Waghmare, L, Shrivastav, T, Khatib, Net al.The cross-sectional study of anthropometric parameters in young healthy individuals having parental history of hypertension. Int J Med Public Health 2012; 2: 3843.Google Scholar
Reich, A, Muller, G, Gelbrich, G, Deustcher, K, Godicke, R, Kiess, W.Obesity and blood pressure-results from the examination of 2365 school children in Germany. Int J Obes Relat Metab Disord 2003; 27: 14591464.CrossRefGoogle ScholarPubMed
Thompson, M, Dana, T, Bougatos, C, Blazina, I, Norris, SL.Screening for hypertension in children and adolescents to prevent cardiovascular disease. Pediatrics 2013; 131: 490525.CrossRefGoogle ScholarPubMed
Mistra, A, Khurana, L.Obesity and the metabolic syndrome in developing countries. J Clin Edocrinol Metab 2008; 93: S9S30.CrossRefGoogle Scholar
So, HK, Sung, RY, Li, AM, et al.Higher exercise frequency associated with lower blood pressure in Hong Kong adolescents: a population-based study. J Hum Hypertens 2010; 24: 646651.CrossRefGoogle Scholar
Chobanian, AV, Bakris, GL, Black, HR, et al.The seventh report of the joint committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7. JAMA 2003; 289: 25602572.CrossRefGoogle ScholarPubMed
Dubbert, PM, Carithers, T, Sumner, AE, et al.Obesity, physical inactivity, and risk for cardiovascular disease. Am J Med Sci 2003; 324: 116126.CrossRefGoogle Scholar
Fang, J, Wylie-Rosett, J, Cohen, HW, Kaplan, RC, Alderman, MH.Exercise, body mass index, caloric intake, and cardiovascular mortality. Am J Prev Med 2003; 25: 283289.CrossRefGoogle ScholarPubMed
Hu, G, Barengo, NC, Tuomilehto, J, Lakka, TA, Nissinen, A, Jousilahti, P.Relationship of physical activity and body mass index to the risk of hypertension: a prospective study in Finland. Hypertension 2004; 43: 2530.CrossRefGoogle ScholarPubMed
Gidding, SS.Measuring children’s blood pressure matters. Circulation 2008; 117: 31633164.CrossRefGoogle ScholarPubMed
Willett, WC, Dietz, WH, Colditz, GA.Guidelines for healthy weight. N Engl J Med 1999; 341: 427434.CrossRefGoogle ScholarPubMed
Cook, NR, Gillman, MW, Rosner, BA, Taylor, JO, Hennekens, CH.Prediction of young adult’s blood pressure from childhood blood pressure, height, and weight. J Clin Epidemiol 1997; 50: 571579.CrossRefGoogle Scholar
World Health Report: reducing risks, promoting healthy life. Geneva, World Health Organization; 2002. http://www.who.int/whr/2002/. Accessed November 05, 2013.Google Scholar
Becque, MD, Katch, VL, Roccini, AP, Marks, CR, Moorehead, C.Coronary risk incidence of obese adolescents: reduction by exercise plus diet intervention. Pediatrics 1988; 8: 605612.Google Scholar
World Health Organization: The Challenge of Obesity in the WHO European Region and the Strategies for Response. Branca F, Nikogosian H, Lobstein T (eds). Copenhagen: WHO; 2007. http://www.euro.who.int/./E89858.pdf Accessed November 04, 2013.Google Scholar
Katzmarzyk, PT, Srinivasan, SR, Chen, W, Malina, RM, Bouchard, C, Berenson, GS.Body mass index, waist circumference and clustering of cardiovascular disease risk factors in biracial sample of children and adolescents. Pediatrics 2004; 114: e198e205.CrossRefGoogle ScholarPubMed
Sorof, JM, Lai, D, Turner, J, Poffenbarger, T, Portman, RJ.Overweight, ethnicity, and prevalence of hypertension in school-aged children. Pediatrics 2004; 113: 475482.CrossRefGoogle ScholarPubMed
Goel, R, Misra, A, Angarwal, SK, Vikram, N.Correlates of hypertension among urban Asian Indian adolescents. Arch Dis Child 2010; 95: 992997.CrossRefGoogle ScholarPubMed
Ke, L, Brock, KE, Cant, RV, Li, Y, Morrell, SL.The relationship between obesity and blood pressure differs by ethnicity in Sidney schoolchildren. Am J Hum Hypertens 2009; 22: 5258.CrossRefGoogle Scholar
Leung, LCK, Sung, RYT, So, H-K, et al.Prevalence and risk factors for hypertension in Hong Kong Chinese adolescents: waist circumference predicts hypertension, exercise decreases risk. Arch Dis Child 2011; 96: 804809.CrossRefGoogle Scholar
Maffeis, C, Pietrobelli, A, Grezzani, A, Provera, S, Tato, L.Waist circumference and cardiovascular risk factors in prepubertal children. Obes Res 2001; 9: 179187.CrossRefGoogle ScholarPubMed
Riberio, J, Guerra, S, Pinto, A, Oliveira, J, Duarte, J, Mota, J.Overweight and obesity in children and adolescents: relationship with blood pressure, and physical activity. Ann Hum Biol 2003; 30: 203213.CrossRefGoogle Scholar
Savva, SC, Tornaritis, M, Savva, ME, et al.Waist circumference and waist to height ratio are better predictors of cardiovascular disease risk factors in children than body mass index. Int J Obes 2000; 24: 14531458.CrossRefGoogle ScholarPubMed
Gaya, AR, Alves, A, Aires, L, Martins, CL, Ribeiro, JC, Mota, J.Association between times spent in sedentary, moderate to vigorous physical activity, body mass index, cardio-respiratory fitness and blood pressure. Ann Hum Biol 2009; 36: 379387.CrossRefGoogle Scholar
Leary, SD, Ness, AR, Smith, GD, et al.Physical activity and blood pressure in childhood: findings from a population-based study. Hypertension 2008; 51: 9298.CrossRefGoogle ScholarPubMed
Akor, F, Okolo, SN, Okolo, AA.Blood pressure and anthropometric measurements in healthy primary school entrants in Jos, Nigeria. South Afr J Child Health 2010; 4: 4245.Google Scholar
Arazi, H, Hoseini, R, Behrozi, A.A comparison of body fat and blood pressure between physical education and non-physical education major male students. Physic Educ Sport 2012; 10: 127134.Google Scholar
Moselagkomo, VK, Toriola, AL, Shaw, BS, Goon, DT, Akinyemi, O.Body mass index, overweight, and blood pressure among adolescent school children in Limpopo province, South Africa. Rev Paul Pediatr 2012; 30: 562569.Google Scholar
Akinpelu, AO, Oyewole, OO, Oritogun, KS.Relationship between cardio-respiratory fitness and blood pressure of Nigerian adolescents. Nigerian J Med Rehab 2007; 12: 15.Google Scholar
Maximova, K, O’Loughlin, J, Paradis, G, Hanley, JA, Lynch, J.Declines in physical activity and higher systolic blood pressure in adolescence. Am J Epidemiol. 2009; 170: 10841094.CrossRefGoogle ScholarPubMed
Sebanjo, IO, Oshikoya, KA.Physical activity and body mass index of school children and adolescents in Abeokuta, Southwest Nigeria. World J Pediatr 2010; 6: 217222.CrossRefGoogle Scholar
Kowalski, KC, Crocker, PRE, Domen, RM. The physical activity questionnaire for older children (PAQ-C) and adolescents (PAQ-A) manual. 2004.Google Scholar
Crocker, PRE, Bailey, DA, Faulkner, RA, Kowalski, KC, McGrath, R.Measuring general level of physical activity: preliminary evidence for the physical activity questionnaire for older children. Med Sci Sports Exerc 1997; 29: 13441349.CrossRefGoogle Scholar
Kowalski, KC, Crocker, PRE, Faulkner, RA.Validation of physical activity questionnaire for older children. Pediatr Exerc Sci 1997; 9: 174186.CrossRefGoogle Scholar
Cole, TJ, Bellizzi, MC, Flegal, M, Dietz, W.Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 2000; 320: 16.CrossRefGoogle ScholarPubMed
Revelas, A, Tahmazidis, O.Defining hypertension in children. South Afr Family Pract 2012; 54: 100105.CrossRefGoogle Scholar
Armstrong, N, Bray, S.Physical activity pattern defined by continuous heart rate monitoring. Arch Dis Child 1991; 66: 245247.CrossRefGoogle Scholar
Babinska, K, Kovacs, L, Janko, V, Dallos, T, Feber, J.Association between obesity and severity of ambulatory hypertension in children and adolescents. J Am Soc Hypertens 2012; 6: 356363.CrossRefGoogle ScholarPubMed
World Health Organization. Preventing and managing the global epidemic. Report of WHO Consultation on Obesity (WHO Technical Report Series 894). Geneva. 2000. http://www.who.int/./who_TRS_894/ Accessed November 04, 2013.Google Scholar
Kimm, SY, Glynn, NW, Orbazanek, Eet al.Relations between the changes in physical activity and body mass index during adolescence: a multicentre longitudinal study. Lancet 2005; 366: 301307.CrossRefGoogle Scholar
Andersen, LB, Harro, M, Sardinha, LB, et al.Physical activity and clustered cardiovascular risk in children; a cross-sectional study (The European Youth Heart Study). Lancet 2006; 368: 299304.CrossRefGoogle Scholar
Munger, RG, Prineas, RJ, Gomez-Marin, O.Persistent elevation of blood pressure among children with a family history of hypertension: the Minneapolis blood pressure study. J Hypertens 1988; 6:647653.CrossRefGoogle ScholarPubMed
Savitha, MR, Krishnamurthy, B, Fatthepur, SS, Yashwanth Kumar, AM, Khan, MA.Essential hypertension in early and mid-adolescence. Indian J Pediatr 2007; 74: 10071011.CrossRefGoogle ScholarPubMed
Ng, VWS, Kong, APS, Choi, KC, et al.BMI and waist circumference in predicting cardiovascular risk factors clustering in Chinese adolescents. Obesity 2007; 15: 494.CrossRefGoogle ScholarPubMed