Nutrition Transition, Family History and Hypertension: Investigating the Association of Dietary Patterns, Obesity, and Mothers' Blood Pressure with Raised Blood Pressure among 6–19-Year-Olds in Southwestern Nigeria

Abstract

Background: Hypertension is on the increase among children and adolescents globally, including low- and middle-income countries (LMICs). While studies in high-income countries (HICs) have reported family history, obesity, diet and physical activity as risk factors for childhood and adolescent hypertension, there is limited data on the subject in LMICs including Nigeria. This study therefore investigated the relationship between dietary patterns, obesity, mothers' blood pressure and raised blood pressure (RBP) among adolescents in southwestern Nigeria.

Methods: This was a cross-sectional study carried out among 1185 school-aged children and adolescents (i.e. 6–19-year-olds) and their mothers in Osun State, southwestern Nigeria. Respondents were selected using a five-stage multi-stage sampling technique, and data were collected using pretested structured questionnaires. Anthropometry, blood pressure, and nutrition status were assessed using standard protocols. The guideline for screening high blood pressure (BP) in children and adolescents by the American Academy of Pediatrics was used to define RBP, which was the outcome variable. Dietary patterns and mothers' raised blood pressure (main explanatory variables) were defined using principal component analysis and the World Health Organization's BP classification respectively. A five-model multi-variable regression analysis was used to investigate the associations and control for possible confounders. All analyses were done using STATA with the level of significance set at p ≤0.05.

Results: The mean age of the respondents (the children) is 10.77 ± 3.45 years with a Male:Female ratio of 1:1.14. The overall prevalence rate of RBP among the 6–19-year-olds was 20.1%. After adjusting for all possible confounders (Model 4), RBP had statistically significant associations with meat and poultry dietary pattern (OR: 1.9; p=0.004; 95% CI: 1.2, 3.1) and mother's SBP (OR: 1.9; p=0.004; 95% CI: 1.2, 3.1). Participants with high adherence to meat and poultry dietary pattern and those whose mothers had raised SBP had 90% higher odds of having raised blood pressure compared to the others.

Conclusions: RBP among children 6–19 years had positive statistically significant associations with meat and poultry dominated dietary pattern and raised systolic blood pressure in their mothers. Efforts should be made to address RBP in Nigerian children and adolescents through targeted interventions.