Fitness, fatness, body movement, and diet in adolescents: clustering and associations with elevated blood pressure

BACKGROUND: The study of clusters of risk factors for elevated blood pressure (EBP) among adolescents from low-middle-income countries has received little research attention. The objective of the study was to identify clusters of EBP precursors (i.e., overweight, physical fitness, risk diet, and body movement) and to analyze its associations with EBP. METHODS: This a cross-sectional study conducted in a sample of 965 secondary schools' students aged between 12 and 17 years-old from Colombia. Measurements included blood pressure, sociodemographic information, and four EBP precursors: Overweight, body movement, risk diet, and physical fitness. Cluster analysis was applied with the two-step method to identify the patterns of EBP precursors, and logistic regression models were used to analyze the association between clusters and EBP. RESULTS: Findings indicate that EBP was present in 28.9% of the students, approximately 20% of adolescents had desirable profile (normal weight, normal-high physical fitness, low-risk diet, and middle-high body movement), and 16% of them had the four EBP precursors. The cluster solution revealed five clusters, formed according to the accumulation of EBP precursors, this is, characterized by having zero, one (low body movement), two (low body movement and high-risk diet), three (low body movement, high risk diet, and low fitness), or four (low body movement, high risk diet, low fitness, and overweight) EBP precursors. The cluster with four EBP precursors had a higher risk of having EBP. CONCLUSIONS: According to these findings, it is necessary to implement programs that simultaneously address multiple health-related behaviors to promote health in adolescents.