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Cardiovascular risk indicators in adolescents: the Umeå youth study
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences. Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
1995 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Atherosclerotic cardiovascular diseases (CVD), particularly coronary heart disease (CHD) and cerebrovascular disease, are today major causes of death in the industrialised parts of the world. There are evidence to suggest that the atherosclerotic process starts in childhood, implying that preventive measures should be implemented already in children and adolescents.

The aim of this study was to examine CVD risk indicators and their determinants in healthy Swedish adolescents. The study population comprised 14- and 17-year-old boys and girls (n=1032), in the dty and surroundings of Umeå in northern Sweden.

Biochemical, anthropometric, and physiological parameters associated to CVD (s- lipoproteins and s-apolipoproteins, s-insulin, s-ferritin, anthropometric measurements, blood pressure, and physical fitness) were evaluated in relation to family history of CVD, weight and length at birth, infant feeding regimen, physical growth during infancy and childhood, current diet, physical activity, smoking, and educational level and occupation of the parents.

The main findings of the study were that, on average, total serum cholesterol (TC) values in boys and girls were at the same level as reported from other European countries. A family history of CVD, short duration of breast feeding, low attained height during infancy and childhood, high body mass index (BMI), and low physical fitness were all associated with an unfavourable serum lipid profile. The findings also showed that features typical of the insulin resistance syndrome are present already in adolescents. In boys, iron stores, estimated by serum ferritin, were related to BMI and physical fitness, in a similar way as well established CVD risk indicators. Compared to previous dietary studies in Sweden, mean relative (energy %) fat intake had decreased substantially although the mean relative intake of saturated fat was still rather high. For both boys and girls, reported relative energy intake (energy intake/estimated energy expenditure) decreased with increasing level of BMI. Furthermore, daily smoking was more common among adolescents from families with low socio-economic status (SES) but was most strongly associated to smoking in peers. Tobacco use was considerably higher among adolescents attending vocational programs at secondary high school as compared to theoretical programs. Daily smokers had a more unfavourable serum lipid profile compared to non-smokers. Low socio-economic status of the parents was related to higher BMI and low educational level to higher dietary fat intake in both boys and girls.

In conclusion, the findings of the study show that parameters linked to adult CVD when examined in adolescents, are related to family history, infant nutrition, previous physical growth, current body composition, physical fitness, physical activity, smoking, and social status and educational level of the parents.

Place, publisher, year, edition, pages
Umeå: Umeå Universitet , 1995. , 47 p.
Umeå University medical dissertations, ISSN 0346-6612 ; 448
Keyword [en]
Cardiovascular risk factors, adolescents, serum lipids, serum insulin, serum ferritin, anthropometry, blood pressure, physical fitness, physical activity, diet, smoking, socio-economic status
National Category
Public Health, Global Health, Social Medicine and Epidemiology
URN: urn:nbn:se:umu:diva-7540ISBN: 91-7191-100-6OAI: diva2:147211
Public defence
1995-12-08, Hörsal A, Samhällsvetarhuset, Umeå universitet, Umeå, 09:00
Available from: 2008-01-10 Created: 2008-01-10 Last updated: 2015-04-08Bibliographically approved
List of papers
1. Serum lipid values in adolescents are related to family history, infant feeding, and physical growth.
Open this publication in new window or tab >>Serum lipid values in adolescents are related to family history, infant feeding, and physical growth.
1995 (English)In: Atherosclerosis, ISSN 0021-9150, E-ISSN 1879-1484, Vol. 117, no 1, 1-13 p.Article in journal (Refereed) Published
Abstract [en]

Total serum cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglycerides (TG), apolipoprotein A-I (apo A-I), apolipoprotein B (apo B), and lipoprotein (a) (Lp(a)) were analysed in 879 14- and 17-year-old healthy adolescents (477 boys and 402 girls), and related to family history of cardiovascular disease, early feeding, weight and length at birth, and physical growth during infancy and childhood. Mean TC was significantly higher in girls than in boys (4.4 and 4.2 mmol/l, respectively, both age-groups together). High TC values ( > 5.2 mmol/l) were more prevalent in girls than in boys: 14% and 17% compared to 6% and 12% in 14- and 17-year-old girls and boys, respectively. Mean TC and LDL-C values were lower during mid-puberty in both boys and girls while, in boys but not in girls, mean HDL-C values decreased and TG values increased successively with increasing pubertal stage. Girls who were taking oral contraceptives had higher mean values of TC (4.91/4.39 mmol/l), TG (1.32/0.83 mmol/l), and apo B (0.89/0.73 g/l). Boys with a family history of early deaths ( < 55 years) from myocardial infarction and girls with a family history of cerebral haemorrhage/thrombosis in fathers had higher mean values of TC (4.55/4.17 and 5.03/4.40 mmol/l, for boys and girls, respectively), LDL-C (2.84/2.47 and 3.08/2.56 mmol/l), and apo B (0.73/0.70 and 0.86/0.73 g/l). Adolescents with short duration of breast feeding ( < 6 months), or early introduction of infant formula, had higher mean values of TC (4.29/4.14 mmol/l) and apo B (0.72/0.68 g/l). There were no significant correlations between serum lipid values and body weight or length at birth, but adolescents with high LDL-C (upper quartile) seemed to have lower attained heights during infancy and childhood. In conclusion, this study shows that serum lipids in adolescence are primarily related to age and sex but also to early determinants like family history of cardiovascular diseases, infant feeding, and early physical growth.

urn:nbn:se:umu:diva-45431 (URN)8546746 (PubMedID)
Available from: 2011-07-04 Created: 2011-07-04 Last updated: 2015-03-16
2. Sex differences in iron stores of adolescents: what is normal?
Open this publication in new window or tab >>Sex differences in iron stores of adolescents: what is normal?
1995 (English)In: Journal of Pediatric Gastroenterology and Nutrition - JPGN, ISSN 0277-2116, E-ISSN 1536-4801, Vol. 20, no 2, 215-24 p.Article in journal (Refereed) Published
Abstract [en]

We evaluated iron status and its determinants in healthy adolescents. Fasting morning blood samples from a school-based cross-sectional study were analyzed for serum ferritin (SF), serum iron, total iron-binding capacity, and circulating transferrin receptors. Physical development, chronic disease, medication, dietary intake, and physical activity were assessed using clinical examination, questionnaires, and 7-day records. The risk of having low serum ferritin values was estimated using bivariate and multivariate regression. Subjects were 867 healthy Swedish adolescents, 14- and 17-year-olds (472 boys and 395 girls). SF values increased with pubertal stage in boys but not in girls. Five percent of the boys and 15% of the girls had SF values < 12 micrograms/L. Of the 17-year-old boys, 7% compared to 1% of the 17-year-old girls had SF values > 100 micrograms/L. Forty-one percent of cases with SF values > 12 micrograms/L had serum iron values < 15 microM, and 22% had transferrin saturation values < 16%. Mean total iron intakes of the boys were high [1.6 times recommended daily allowance (RDA)] and mean intakes of the girls were adequate (0.9 times RDA). Low heme iron intakes increased the risk of low iron stores (< 12 micrograms/L) in girls but not in boys. Total iron intake or other dietary factors, physical development, or level of physical activity did not influence the risk of low SF. The findings of this study suggest that the differences in iron status between boys and girls in adolescence results primarily from biological differences other than menstrual bleeding or insufficient iron intake. Furthermore, the results question the role of SF as an indicator of iron deficiency in adolescence, in particular if age and sex are not taken into consideration. We suggest that different reference values for SF, including the cut-off limit for low SF, adjusted for age and sex, should be considered. The high iron intakes and corresponding high SF values found in the older boys are noticeable in light of the possible negative health consequences of iron overload.

urn:nbn:se:umu:diva-45434 (URN)7714689 (PubMedID)
Available from: 2011-07-04 Created: 2011-07-04 Last updated: 2015-03-16
3. Dietary changes in Swedish adolescents.
Open this publication in new window or tab >>Dietary changes in Swedish adolescents.
1993 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 82, no 5, 472-80 p.Article in journal (Refereed) Published
Abstract [en]

A school-based dietary survey, using seven-day records, was performed in two cohorts of Swedish adolescents; 14- and 17-year-olds. The study comprised 366 boys and 365 girls. When compared to previous studies in Sweden, a striking finding was a decrease in dietary fat intake and an increase in carbohydrate intake. However, the relative intake of saturated fat had not changed (15% of total energy). The dietary change was mainly due to an increased consumption of cereal products. There were no major differences in dietary habits or nutrient density of the food between the two age groups, or between boys and girls. The mean intakes of protein, fat and carbohydrate, expressed as a percentage of the total energy intake, were 15, 33 and 52%, respectively. The mean intakes of vitamins and minerals were low only for selenium. The boys had a high iron intake (1.5 and 1.7 times the recommended intake for 14- and 17-year-olds, respectively) while the mean iron intake for girls was 0.9 times the recommended dietary allowances in both age groups. The intake of dietary salt was higher in boys than in girls (7.7 g and 9.0 g per day in 14- and 17-year-old boys, respectively, and 5.8 g per day in both 14- and 17-year-old girls). In a long-term health perspective, this positive change in nutrient intake in adolescents may contribute to a reduction in the incidence of diet-related diseases in Sweden.(ABSTRACT TRUNCATED AT 250 WORDS)

urn:nbn:se:umu:diva-45435 (URN)8518525 (PubMedID)
Available from: 2011-07-04 Created: 2011-07-04 Last updated: 2015-03-16

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