Investigating the correlation between dominant food patterns and physical activity with the composition of blood lipids in children and adolescents living in Minodar region of Qazvin

Dissertation for Master of Health Sciences in Nutrition

Abstract

Introduction of the research indicates the prevalence of blood lipid disorders in childhood and adolescence. With regard to the formation of eating habits from childhood and adolescence and the impact on health or disease in adulthood, the present study was conducted with the aim of determining the correlation between dominant dietary patterns and the composition of blood fats in children and adolescents living in the Minodar region of Qazvin. Methodology In the present study, 321 adolescents aged 10 to 18 years were selected from the Metabolic Diseases Project in the Minodar region of Qazvin. Food intake was evaluated using a food frequency questionnaire and physical activity was evaluated using a 9-item questionnaire (Physical activity questionnaire in adolescent). To measure serum lipids, after 12 hours of fasting, venous blood samples were taken from all participants. Factor analysis method was used to identify the dominant dietary patterns and the correlation between the dominant dietary patterns and the composition of blood lipids was evaluated by the analysis of covariance method. Findings Out of the 301 adolescents examined, 154 (51.2%) were girls and 147 (48.8%) were boys with an average age of 15.08 ± 2.4 years. The prevalence of hypertriglyceridemia, hypercholesterolemia, high LDL cholesterol and low HDL cholesterol compared to the standard in this age group was 17.7, 5.1, 3.7 and 36% respectively. 67.1% of the samples had a normal body mass index and no significant difference was observed in terms of blood lipid composition (total cholesterol (P=0.813), triglycerides (P=0.313, LDL cholesterol (P=0.978), HDL cholesterol (P=0.114)) and BMI [1] (P=0.09) and fat intake (P=0.94) between girls and boys. While the amount of energy (P=0.012), protein (P=0.012) and carbohydrate intake (P=0.001) were significantly higher in boys than in girls, 31.1% of teenagers had a low level of physical activity, 44.6% had a moderate level of physical activity and 24.1% had a high level of physical activity, and the difference in the level of physical activity in both sexes was statistically significant and more in boys than in girls. (P=0.001). Using factor analysis method, it was found that the composition of blood fats and body mass index in the quartiles of all three dietary patterns were not significant (P>0.05). No relationship was observed between the level of physical activity and the composition of blood lipids (P>0.05).

Conclusion In this study, no significant relationship was observed between any of the three dietary patterns and physical activity with the composition of blood lipids. It is recommended to carry out future research with more samples to determine dietary patterns, physical fitness and blood fat status of adolescents and to carry out educational interventions.

key words dietary pattern, adolescents, fat, factor analysis

[1]

-1- statement Problem:

Habits are formed from a young age. The continuity and impact of eating habits on lifestyle in adulthood is another reason for the necessity of early lifestyle modification to prevent diseases of adulthood (Kelishadi, 2003). The basis of health is formed in childhood and optimal nutrition during this period is decisive in the process of natural growth and health of human body and mind in the future (Pourhashemi, 2008). Improving the quality of health care services and expanding immunization coverage and rapid changes in lifestyle, nutrition and physical activity have caused a change in the pattern of diseases and a rapid increase in chronic non-communicable diseases (Kelishad, 2010). Thus, the food pattern related to chronic diseases, which is usually formed before puberty and stabilizes with the onset of puberty, has a significant effect on the risk factors of chronic diseases such as obesity, cardiovascular diseases, hypertension, diabetes and cancer (Gharib, 2011).Atherosclerosis process starts from childhood and its severity is related to risk factors such as: high weight, blood fat composition, smoking, family history, blood pressure and diet composition (Kavey, 2011). Autopsy studies in children with sudden deaths showed that children with coronary artery disease risk factors (high cholesterol and triglycerides, high blood pressure, smoking) had atherosclerotic lesions (Couch, 2000). An increase in serum cholesterol, triglycerides, and low-density lipoprotein cholesterol (LDL-C) and a decrease in high-density lipoprotein cholesterol (HDL-C) are known as risk factors for cardiovascular diseases (CVD), and blood lipid composition disorders are closely related to other CVD risk factors, including obesity and hypertension, not only in adults but also in children (Yang, 2012). Although blood lipid composition disorder is one of the risk factors of cardiovascular diseases, there is little information about blood lipid composition and the prevalence of its disorders among Iranian children (Fesharakinia, 2008). A survey of 3148 Iranian children and adolescents aged 3 to 19 in 2001 showed that 31% of the studied population had cholesterol between 170 and 199 (mg/dl) and 16% had cholesterol above 200 mg/dl. Also, in 22% of the studied population, LDL-C was between 110 and 129 and in 17% it was above 130 mg/dL (Azizi, 2001). In another study, the percentiles of total cholesterol, low-density lipoprotein and triglycerides were higher, and the percentile of high-density lipoprotein was lower than the standard percentile for the age and gender of adolescents (Kelishadi, 2004). The findings of a study in 2008 in South Khorasan province on 1326 primary school students aged 7 to 12 years showed that the prevalence of low HDL cholesterol was 14.1%, the prevalence Hypertriglyceridemia was 5.4%, the prevalence of high LDL cholesterol was 1.4%, and the prevalence of hypercholesterolemia was 3% (Fesharakinia, 2008). Also, the prevalence of hypertriglyceridemia, hypercholesterolemia, and increased LDL cholesterol levels and decreased HDL cholesterol levels in adolescent girls aged 14 to 18 years in Tabriz city were 3%, 16.4%, 21.1%, and 54.7%, respectively. 50% of the people studied had HDL cholesterol below the 5th percentile (Ghodsi, 2004). A number of studies consider high LDL cholesterol and low HDL cholesterol, blood pressure, diabetes, obesity, and smoking as the strongest risk factors for CVD, and research indicates that some of these risk factors occur at a young age (Latifi, 2014). Inactivity is an independent risk factor for many cardiovascular diseases, diabetes, and osteoporosis Lipid disorders are known. Its effectiveness and benefits will be greater when sufficient physical activity is started before puberty and continues regularly, while the habit of physical activity is formed early in life (Kelishadi, 2001).

The World Health Organization recommends at least 60 minutes of moderate to high intensity physical activity for children and adolescents. In addition to the role of increasing HDL blood cholesterol in adolescents and children, physical activity improves the health of the cardiovascular system, respiratory system, weight control and anxiety reduction, avoiding risky behaviors such as alcohol and tobacco consumption. Inactivity endangers the health of teenagers and causes them to become isolated and depressed (Kazemi, 2011). In recent decades, the pattern of physical activity in teenagers has changed. These changes are the result of increasing the time spent watching TV and internet games and reducing the time spent on physical activity in schools and society. This has caused an increase in weight in school-age children (Mahan, 2011; Zaree, 2013).

The evidence of a study in Isfahan showed that 26.5% of teenage girls aged 11 to 18 had a sedentary lifestyle, and there was a relationship between the regular physical exercise of the teenager and the physical exercise of the mother, the level of the mother's education. In fact, physical activity, like many behavioral patterns, has a learning aspect, and the family as an arena for providing behavioral patterns can play an important role in this field, so identifying how this relationship is important to find suitable intervention solutions (Kazemi, 2011). In a study, it was shown that among students aged 6 to 18 in Iranian cities, the amount of watching TV and playing computer games was a total of 8.9 hours per day, which is very high (Ziaee, 2006).