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J Pediatr. 2017 Mar;182:114-119.e2. doi: 10.1016/j.jpeds.2016.11.005. Epub 2016 Nov 29.

Obesity as a Mediator between Cardiorespiratory Fitness and Blood Pressure in Preschoolers.

Author information

1
Social and Health Care Research Center, University of Castilla-La Mancha, Cuenca, Spain.
2
Social and Health Care Research Center, University of Castilla-La Mancha, Cuenca, Spain; School of Education, University of Castilla-La Mancha, Ciudad Real, Spain.
3
School of Nursing and Physiotherapy, University of Castilla-La Mancha, Toledo, Spain.
4
Social and Health Care Research Center, University of Castilla-La Mancha, Cuenca, Spain; Faculty of Health Sciences, Autonomous University of Chile, Talca, Chile. Electronic address: Vicente.Martinez@uclm.es.

Abstract

OBJECTIVES:

To analyze the relationships between body mass index (BMI), cardiorespiratory fitness (CRF), and blood pressure (BP), and to examine whether obesity acts as a mediator between fitness and BP in children.

STUDY DESIGN:

A cross-sectional analysis using a population-based sample of 1604 school children aged 4-7 years attending 21 schools from the provinces of Ciudad Real and Cuenca, Spain, was undertaken. Data on anthropometric variables, BP measurements, and CRF were collected. The relationships between body composition (BMI, percent body fat, and waist circumference), CRF, and mean arterial pressure was estimated using Pearson correlation coefficients. ANCOVA tested the differences in BP measurements by categories of BMI and CRF, controlling for different sets of confounders. The PROCESS macro developed by Preacher and Hayes was used for mediation analysis.

RESULTS:

BP values were significantly higher in school children with excess weight and poorer CRF. In addition, BMI acts as a full mediator in the association between CRF and mean arterial pressure in boys at 62.28% (z = -5.433; P ≤ .001) and a partial mediator in girls at 35.24% (z = -5.246; P ≤ .001).

CONCLUSIONS:

BMI mediates the relationship between CRF and mean arterial pressure. These findings highlight the importance of maintaining a healthy weight for the prevention of high BP levels in childhood.

TRIAL REGISTRATION:

ClinicalTrials.gov: NCT01971840.

KEYWORDS:

blood pressure; cardiorespiratory fitness; children; mediation analysis; obesity

PMID:
27912924
DOI:
10.1016/j.jpeds.2016.11.005
[Indexed for MEDLINE]
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