Diet, Overweight, Elevated Blood Pressure, and Acanthosis Nigricans Among K-9th Grade Native American Students

Abstract

Childhood overweight is associated with increased rates of hypertension (HTN) and acanthosis nigricans (AN), a known risk factor for diabetes. This cross-sectional study of predominantly Native American students examined relationships between diet and overweight, AN, and HTN among K-9th grade students. Eighty-six students completed a questionnaire regarding fruit and vegetable (F/V) consumption and physical activity (PA) behaviors. Anthropometric data, blood pressure (BP), and presence of AN were determined by trained screeners. Fifty-three percent of the Native American study participants were overweight or at-risk-for-overweight (BMI ≥85th percentile), while 35% of the non-Native American participants were overweight or at risk for overweight. At 60% vs. 35% respectively, the percentage of students either overweight or at risk for overweight was significantly higher (p=.02) among fourth through ninth graders compared with students in kindergarten through third grades. Fourteen percent were positive for AN, and 33% had either Pre-HTN or HTN (≥ 90th percentile) based on the first blood pressure reading. Analysis of variance results indicated that students with either pre-HTN or HTN had a significantly higher mean BMI (24.1 ± 8.0) vs. those with normal BP (20.4 ± 5.1; P=.012). BMI was positively correlated with AN (r=0.433, p=.01) such that all students positive for AN had a BMI ≥ 85th percentile (p=.001). Students who agreed with the Likert statement that they usually eat ≥5 F/V a day had a significantly lower mean systolic BP (107mmHg ± 17) vs. those who did not (123mmHg ± 17, P=.001). Regression results indicate that BMI and attitude toward the importance of fruit and vegetable consumption are independent predictors of systolic BP (p=.001). Results suggest that significant numbers of students in this sample are positive for AN, are overweight, and are at risk for hypertension and that more positive attitudes toward fruit and vegetable consumption are associated with lower blood pressure levels. Prevention programs to address these health problems are discussed.