Which lifestyle parameters discriminate high- from low-risk participants for coronary heart disease risk factors. Longitudinal analysis covering adolescence and young adulthood

BACKGROUND: The purpose of this study was to analyse which lifestyle parameters (daily physical activity, dietary intake, smoking habits and alcohol consumption) discriminate between participants at high-risk and those at low-risk for coronary heart disease (CHD) [systolic and diastolic blood pressure (SBP/DBP), total serum cholesterol (TC), high-density lipoprotein cholesterol (HDL), the TC: HDL ratio, body fatness (sum of skinfolds [SSF]) and cardiopulmonary fitness (VO2-max)].

METHODS: The data were derived from the Amsterdam Growth and Health Study (AGHS); an observational longitudinal study in which six repeated measurements were carried out over a period of 15 years on 181 participants aged 13 years at entry to the study. To assess possible discriminating factors, generalized estimating equations were used. This method makes use of risk group changing behaviour over time by using all available longitudinal data.

RESULTS: For DBP no significant relationships were found; high risk for SBP was inversely related to smoking habits (OR=0.52; P<0.01). No significant relationships were found for TC; high risk for HDL was positively related to the intake of carbohydrates (OR=1.2; P=0.02) and to smoking habits (OR=1.6; P=0.04); high risk for the TC:HDL ratio was positively related to the intake of carbohydrates (OR=1.3; P=0.01). High risk for SSF was positively related to the intake of protein (OR=1.5; P<0.01) and smoking habits (OR=1.8; P=0.01) and inversely related to daily physical activity (OR=0.81; P=0.01). High risk for VO2-max was inversely related to daily physical activity (OR=0.67; P<0.01).

CONCLUSIONS: In the relative young and healthy population of the AGHS during adolescence and young adulthood, physical inactivity was the most important lifestyle parameter related to high risk for CHD.