Printer Friendly

Variety of food intake measured with Food Intake Variety Questionnaire (FIVeQ) and nutritional status of Polish adolescents aged 13-15 years.


Assessment of the way of eating implies taking into account customary food consumption and contained therein nutrients. In nutritional epidemiology, traditional methods of examining the occurrence of disease relate to one or several nutrients or foods. Such approach does not fully reflect the complex relationship between nutrients and the diversity of nutrient intake and combining foods [1,2]. A comprehensive approach to food consumption can be achieved by using food intake questionnaires, for example Food Intake Variety Questionnaire (FIVeQ). Questionnaires contain a list of foods for which frequency of consumption is determined. They have a high level of reliability and repeatability, are practical, easy to use and inexpensive. Facilitate data analysis, because does not affect the usual food intake and minimize individual variation [3]. Qualitative assessment of food intake using a questionnaire may be less accurate compared to the 24-hour food intake interview, but it allows assessing dietary habits of the population, even from a single study [4]. Studied by FIVeQ eating habits affects the long-term health effects, allowing to define the relationship between nutrition and diet-related disease morbidity [3]. In order make questionnaire suitable for epidemiological studies, it should include a complete list of products that are consumed by the study population, thus taking into account different ethnic and age [5,6]. Based on the FIVeQ questionnaire used in this study Food Intake Variety Index (FIVeI) was developed.

To achieve proper nutritional status and complete coverage of macro- and micronutrient needs eating a variety of foods is essential. Preference for varied flavors should ultimately increase the range of food products and nutrients consumed as well as the likelihood that a well-balanced diet is achieved. Food variety also contributes to the psychological dimension of eating, since variety, both within and between meals, contributes to the pleasure of eating. Flavor differences between foods within the same food group might contribute to the overall variety within a meal [7,8]. Age 13-15 years is a period of high demand for nutrients; especially complete protein, calcium and iron, which should be provided with a variety of food groups. Increased consumption of milk and dairy products, a wide range of different vegetables, poultry, fish, legumes and cereal products, especially whole grain provide coverage of needs for nutrients and stable growth [9]. Monotonous food intake, especially high in processed products, enriched with sugar and hydrogenated fatty acids, contributes to strengthening of irregular eating habits and in the future could affect the occurrence of obesity, hypertension and atherosclerosis [10]. Another aspect is neophobia--aversion and uncertainty of trying and eating new foods, which can be observed during the third year of life. Habits of eating a variety of foods acquired before the neophobic phase track further on into childhood, adolescence and early adulthood [8]. Moreover, between the ages 11-17 occurs a decrease in neophobia. Due to these factors, adolescence is a period likely to induce changes in food behavior if the proper variety of food intake has been implemented since the early childhood [11].

It is estimated that hypertension affects about 3-3.5% of the total population of children and adolescents. However, the prevalence of hypertension increases with age and after puberty reaches up to 10% [12]. Occurring in childhood and during adolescence elevated BP (Blood pressure) track into adulthood causing adult hypertension [13,14]. In 2009, the European Society of Hypertension declared HT in children a major and growing health problem requiring organized strategies to address it [14].

The main objective of this study was to demonstrate the relationship between variety of food intake described with Food Intake Variety Index and nutritional status of Polish adolescents aged 13-15 years old. Additionally, blood pressure was measured and its values were also compared with FIVeI.


The study was conducted from October to December 2012 in Bydgoszcz, Poland, with the approval of the Bioethics Committee at the Ludwik Rydygier Collegium Medicum in Bydgoszcz (decision No. 102/2008). Participants of the study were adolescents aged 13-15 years from five lower secondary schools. Recruitment was performed on the basis of random selection of the individual, ensuring that all students had equal probability to participate in the study. However, the condition for participation in the study was to present a member of the research team written permission from a parent. Anthropometric measurements were performed in a classroom allocated by the director of the institution or the school nurse's office. The final number of subjects included in the study was 131 adolescents (52% boys, 48% girls, mean age 14.4 [+ or -] 0.9). Each study participant filled Food Intake Variety Questionnaire, with a help of a member of the research team if necessary.

Anthropometric Measurements

All anthropometric measurements were performed in accordance with the guidelines of the WHO (Geneva 1995) [15]. Subjects were measured and weighted in light outerwear. Normal value was considered as the average of two measurements. Body height was measured in standing position using the Martin anthropometer. The accuracy of measurement was 1 mm, the result was given in centimeters. Using an electronic scale, weight measurement was performed (accuracy 100g, result in kg). After obtaining values for height and weight the Body Mass Index was calculated according to the formula given by the World Health Organization. Using caliper, thickness of four skinfolds was measured: fold over the triceps, over the biceps, the lower angle of the scapula (subscapular skinfold) and above the iliac crest. Measurements were performed on the non-dominant side of the body (accuracy 0.1 mm, result in mm). Also, on the nondominant side of the body, using tape, arm circumference (AC) was measured (accuracy 0.1 cm, result in cm). After obtaining the values of AC and triceps skinfold, Arm Muscle Circumference (AMC) was calculated (cm). Next two measurements concerned waist and hip circumferences (accuracy 0.1 cm, result in cm). Measurements were taken using tape again, remembering to avoid too strong pressure on soft tissues. Determined girths allowed estimating Waist-Hip Ratio (WHR) and Waist-to-Height Ratio (WHtR). Using near-infrared technology Free Fat Mass (FFM, kg), Fat Mass (FM, kg) and Fat Mass Percentage (%FM) were assessed with body content analyzer FUTREX 6100 A/ZL. FUTREX is a portable equipment, which during measurement sends a safe, Near-Infrared Light beam into the biceps of the dominant arm. Body fat will absorb this light and lean mass will reflect the light. The light absorption is measured by the FUTREX to determine body composition [16]. FUTREX is a validated equipment with repeatability of measurement 0.3% [17,18]. The only known possible restriction on NIR is to avoid measurements on an extremely black tattooed location due to possible light absorption. NIR does not have any of the other restrictions that BIA instruments have (e.g.: time of food, alcohol consumption, use of hand cream, menstrual cycle, pacemakers, internal heart defibrillators) [19].

To indicate correct and incorrect results during evaluation of body weight and body composition, standards of growth for children and youth developed by Palczewska and Niedzwiecka [20] were used. The percentages of young people with low (<10th percentile), or high (>90th percentile) values of examined somatic parameters were assigned.

Measurement of BP (systolic and diastolic) was made with electronic sphygmo-manometer. Participant sat calmly for 3 minutes before the measurement. Cuff of the sphygmo-manometer was put on a bare arm about 2-3 centimeters above the elbow, keeping in mind that arm of the study participant should be on the level of the heart [21]. Measurements were repeated twice and average value of these measurements was assumed as BP. By finding individual respondent's position on growth chart correctness of BP value was assessed (correct values between 10th-90th percentile) [22].

Food Intake Variety Questionnaire

Assessment of the way of eating was made using FIVeQ questionnaire developed by Ph.D. E. Niedzwiecka and Prof. L. Wadolowska from the Department of Human Nutrition, University of Warmia and Mazury in Olsztyn, Poland. FIVeQ questionnaire allows specifying the frequency of food consumption. Questionnaire is a validated and accurate tool to assess food variety [23,24] In this study, adolescents supplied information about the consumption of sixty-three food group products, which were divided into main food groups. Respondents answered yes/no questions, whether in the past seven days (last week) they ate more than proposed amounts of listed heat-treated food products (the amount "eaten from plate"). Quantities were defined as: "seven slices" for cereal products, "seven cups" for dairy and beverages, with the exception of wine (amount defined as 1 glass of wine--100 ml) and spirits (one shot of liquor--50 ml), for cold cuts and sausages "amount sufficient for one slice of bread well covered" (about 20 grams), "10 cubes" for chocolate, and for the rest of the food products " two tablespoons" e.g. groats, nuts, fish, and butter. When a person did not know a food product or did not remember whether ate it or not, the assumed answer was "no." FIVeQ provides information whether during the previous week food product was consumed in amounts greater than a very small quantity.

Food Intake Variety Index allows expressing variety of food consumption. It is calculated as the sum of food products consumed during the week, with the exception of alcohol (beer, wine and other spirits). Maximum index value is 60 products/week. Based on the obtained points it was possible to identify study participants with four FIVeI levels: inadequate (V1; <20 products/week), sufficient (V2; 20-29), good (V3; 30-39) and very good (V4; [greater than or equal to]40).

Statistical analysis

Statistical analysis was performed using STATISTICA StatSoft 10.0 PL. For the analysis, a non-parametric tests were used. Their choice was conditioned by failing to meet the basic assumptions of parametric tests, i.e. the compatibility of distributions of measured variables with normal distribution and homogeneity of variance. The compliance of distributions with normal distribution was verified with Shapiro-Wilk test while the equality of variances with Levene's test. To evaluate the differences in the average level of numerical characteristics of the two populations Mann-Whitney U test was used. This test can be calculated as the so-called exact test, which allows a fair comparison of data even from very small groups.

Differences in the average values of analyzed variables were determined by Kruskal-Wallis test. Sex and variety of food consumption were assumed as independent variables. Classified features were analyzed using the Pearson [chi.sup.2] test.

The level of statistical significance was set at p <0.05 (acceptable error of 5%); p <0.01 (acceptable error of 1%); p <0.001 (acceptable error of 0.1%).


Assessment of nutritional status

The assessment was made based on the results of selected anthropometric parameters (table 1). The level of significance at p <0.001 was found for thickness of skinfolds above the triceps, above the biceps, above the iliac crest, WHR, AMC, FFM, FM and %FM. Girls had higher values of the listed skinfolds, as well as for the subscapular skinfold (p <0.05). In addition, they had higher values of FM and %FM. Boys had higher values of body height, body weight and selected indexes--WHR, AMC and FFM. The level of significance at p <0.05 was also observed for waist circumference, which value was higher for boys. For other evaluated anthropometric parameters, no statistically significant difference was shown.

Blood pressure

Systolic and diastolic BP was analyzed while interpreting results for health status. Their median values and compliance with standards were evaluated. Statistically, significant differences were indicated between the results of systolic BP and gender (table 2). The median value for boys was 128.0 mmHg, for girls 121.0 mmHg. Values of diastolic BP were similar for both sexes (74.0; 58.0-153.0 mmHg).

Food Intake Variety Index

The median FIVel was 29.0 (min-max 13.0-56.0) products per week with a maximum of 60 (table 4). Differences in FIVeI levels according to gender were statistically significant (p <0.05).

Diet of 50% boys and 27% girls was defined as good. Nearly 11% of the respondents consumed monotonous diet, with a FIVel level inadequate (V1) and only 6% had a very good diet (V4).

Levels of FIVeI and nutritional status

Values of FIVeI showed that 57 adolescents had the variety of food consumption defined as sufficient, 51 as good, 15 as inadequate and 8 as very good (table 5). The highest body height achieved adolescents with level V4 (very good) and highest body weight with level V4 and V2 (very good and sufficient). Along with the increasing level of FIVeI decreased values of AMC and thickness of skinfold above the biceps, waist circumference, diastolic and systolic blood pressure (with the exception of level V4).

Values of the studied anthropometric parameters were within the normal range, referred to 10-90 percentile range (table 6). Increased body height (>90 percentile) had 7% of the examined adolescents from group V1, 23% from group V2, 14% from group V3 and 37% from group V4. Along with the increasing FIVeI level, decreased the number of underweight (<10 percentile) and overweight (>90 percentile) participants. Adolescents with FIVeI level V1 had the highest values of triceps and subscapular skinfolds. With the increase of FIVeI decreased the number of adolescents with BMI value above 90 percentile, which is used as a criterion for obesity. In the same manner decreased rates of WHR and AMC.

63% of adolescents had elevated systolic BP. 47% of participants assigned to group V1 had systolic BP within the normal range. Accurate blood pressure was observed in 60% of participants assigned to group V3 and V2. Most of the examined adolescents (67-80%) from groups V1-V4 had diastolic BP within the normal range. Elevated diastolic BP was least likely to be observed in adolescents with inadequate food variety intake.


Anthropometric measurements were used to assess the nutritional status of the study participants. Results of weight and body height obtained from this study were higher than those acquired by other researchers, although BMI index was similar to the results of other studies from Poland (Mdn=19.8 kg/[m.sup.2]) [25,26]. Noticeable were larger values of the studied parameters in boys compared to girls, with the exception of hip circumference and thickness of skinfolds. These disparities can be explained by puberty and fat accumulation in girls' bodies as a result of a development of secondary sexual characteristics. Measurements taken with FUTREX were used to assess body fat mass (FM), percentage of body fat mass (% FM) and free fat mass (FFM). Values of FM and % FM for the entire study group were similar to the results of other researchers (respectively 10.7 kg and 20.0%) and were higher for girls than boys [25,27]. Excessive body weight was indicated in 12% of examined adolescents. This is consistent with results of other Polish researchers [28]. According to BMI index 11% of respondents obtained values defining body weight deficiency (<10 percentile), and another 11% values defining overweight and obesity (>90 percentile). Results of the measurements vary depending on the region and differences become even stronger when comparing different countries. The tendency to be overweight among children and adolescents in Brazil is 18%, United Kingdom 18.4%, Portugal 18%, Italy 17.4%, USA 30% [29].

Obesity is a key determinant of elevated BP in children and adolescents. Along with the growing epidemic of obesity in the pediatric population their BP increases. In Poland, the percentage of children and adolescents with diagnosed hypertension is 515% [30]. To evaluate BP of adolescents, it is necessary to use growth charts and also take into account age, gender and body height. Correct values of BP on growth charts cover range lower than 90 percentile, 90-95 percentile signifies prehypertension and values above 95 percentile hypertension [31].

In adolescents, prehypertension can be diagnosed not only on the basis of mentioned before percentile ranges but also with its values (>120/80 mmHg) [32]. In this study, values of systolic BP differed according to gender (p<0.05). Comparing these values with growth charts, 60% of study participants had normal systolic BP, but as much as 38% (both boys and girls) had prehypertension (> 90 percentile). Incorrect values (> 90 percentile) of diastolic BP had 25% of the respondents and its median value for both sexes was 74.0 mm Hg. Common to many studies is the fact that boys have higher BP values than girls [33]. Comparing measurements of blood pressure in adolescents is difficult, due to the considerable regional diversity of its occurrence [30,34]. Always, also in this study, a possible measuring mistake should be taken into account. There are many measurement methods and recommended guidelines are constantly being improved [35]. Commonly studied is a predisposition to abdominal obesity measured with WHtR [greater than or equal to] 0.5 Chinese researchers found that among 38,810 students mean values for systolic and diastolic BP were significantly higher in those with WHtR ratio [greater than or equal to] 0.5. The study confirmed that WHtR ratio is positively correlated with BP in both children and adolescents [36]. In present study highest percentage of people (47%) with abnormal systolic BP (> 90 percentile) had FIVeQ level V1. The same level of variety was observed in 13% of adolescents with high WHtR values (>90 percentile). This may indicate a relationship between WHtR and BP. Elevated values of BP in childhood tend to remain on the same growth curve over time [13]. It becomes an essential approach to controlling BP from an early age. Elevated BP during childhood is an important contributor to increased cardiovascular risk in later life, such as atherosclerosis [37]. New guidelines emphasize the necessity for BP screening among children and adolescents aged 3-17 years during their annual preventive care visits. The main cause of this action is to reduce the prevalence of hypertension among children and adolescents by 10% [38].

The median value of FIVeI was 29.0 products/week and the variety of food intake was higher for boys than for girls (33.0 and 27.0 products/week respectively). Interpretation of the index for the entire study group indicates a sufficient variety of food intake (44%), with 50% of boys diversity defined as good, and 53% of girls as sufficient. The results are unsatisfactory and indicate irregularities in the diet of the young people. Varied daily diet in adolescents contributes to an adequate nutritional intake, is associated with lower risk of youth and adult obesity and is strongly related to the physical and cognitive development. Adolescence is a critical period in which poor dietary practices may contribute to an increased risk of chronic diseases in adulthood [39,40].

Moreover, increased consumption of junk food and snacks contribute to the development of obesity and hypertension among children [41].

On the basis of a simple analysis of the FIVeQ questionnaires, we found that youth with inadequate FIVeI level consumed less nuts, seeds and fish. Consumption of dairy products, refined and whole meal cereal products and water was strongly diversified. Regardless of the level of FIVeI all youth had low consumption of vegetable juices and legumes, and high consumption of products with high energy density: chocolate, salty snacks and fruit juices. Compared with other countries, a diet of French adolescents had high values of fat, saturated fatty acids and very high values of cholesterol. Using data obtained from the FFQ questionnaire researchers demonstrated a high intake of meat, cooked foods, yogurt, milk, bread, pasta, rice, cereals, potatoes, fruit, vegetables, sweet sodas, water, and low consumption of legumes, legumes, foods with reduced fat, oil, eggs, fish and cheese [4]. Analysis of FFQ filled by Belgian youth showed an increased intake of bread, vegetables, potatoes, fruit, soft drinks and alcoholic beverages, water, milk and dairy products, and reduced cereal, snacks, cheese, yellow and chocolate [42].

Results of anthropometric and blood pressure measurements were compared with four levels of FIVeI. Youth with highest body height was characterized with a very good variety of food intake; they also demonstrated the highest value of systolic BP. The lowest systolic BP had the shortest adolescents, with good food variety intake. It is well known that blood pressure is closely associated with body size (weight, height or body mass index) [43]. According to German Health Interview and Examination Survey on Children and Adolescents (KiGGS), it also increases with age [44].

Some studies indicated that weight and BMI index more closely correlates with BP levels than height [32,37,45]. A study from Mozambique, in which took part 2316 students (aged 6-18) showed that systolic and diastolic BP were significantly higher in subjects who were overweight. On the contrary, malnourished subjects had significantly lower systolic and diastolic BP compared to those with normal nutritional status [46].

In the present study, the direct relationship between body weight and BP was not tested. However, according to percentile ranges, the highest percentage of overweight and obese youth (20%) had an inadequate variety of food consumption, and this level of FIVeI (V1) obtained 47% adolescents with abnormal systolic BP. In case of underweight (<10 percentile), the highest percentage of youth (13%) also had inadequate FIVeI (V1) and at the same level of variety were 6% of people with reduced systolic BP, and 7% with lower diastolic BP.

For body height, weight, above triceps and subscapular skinfolds, arm circumference, BMI, WHR, AMC, systolic and diastolic blood pressure were defined percentile ranges according to gender and level of variety of food consumption. Overall, all parameters had the correct values within 10-90 percentile. With the increasing level of the variety of food consumption increased the percentage of youth with proper body weight and decreased under- and overweight. This dependence can be explained by previously mentioned preferred choice of food products (more fish and nuts in the diet) in V4 group, despite similar amounts of sweets and salty snacks. On the other hand, at level V1 percentage of people with shortage values of these parameters (<10 percentile) increased. This can be explained by incorrect dieting, which may include unhealthy eating practices such as an extreme restriction of overall caloric intake and/or eating only certain types of food contributing to monotonous diet [47].

Additionally dieting during adolescence is associated with unhealthy weight control behaviors, risky or healthful dieting behaviors (as fasting and excessive exercising, use of diet pills, vomiting) [48]. Weight control behaviors can progress into young adulthood and predict a higher BMI later in life [49]. The variety of food intake had no effect on BMI percentile ranges because of the lack of connection with body height.

As study limitations, we can denote a small study group, possible inaccuracy of blood pressure measurement due to using electronic sphygmomanometer and a possibility of obtaining some incorrect answers from variety of food intake questionnaire filled by study respondents, resulting from not remembering eating behaviors from previous week. The strengths of this study include using various and accurate anthropometric measurements, presence of a member of the research team at every stage of filling the Food Intake Variety Questionnaire and using standardized questionnaires.


Nutritional status of examined adolescents can be defined as good. Values of BMI, FM and %FM were similar to those obtained by other researchers. Overweight and obesity were observed in 11% of study participants as well as underweight. Determined using FIVeQ variety of food consumption was insufficient and needs improvement. However, there may be a positive influence of the variety of food consumption on body weight. BP was connected with high levels of FIVeI and body height. Alarming is that incorrect values of systolic BP (> 90 percentile) had 38% study participants and diastolic 25%. Further studies concerning blood pressure and a variety of food consumption are essential.

Conflicts of interest

The authors declare no conflicts of interest.

Financial disclosure

The authors declare no financial disclosure.


[1.] Newby PK, Hu FB, Rimm EB, Smith-Warner SA, Feskanich D, Sampson L, Willett WC. Reproducibility and validity of the Diet Quality Index Revised as assessed by use of a food-frequency questionnaire. Am J Clin Nutr. 2003 Nov;78(5):941-9.

[2.] Wong JE, Parnell WR, Howe AS, Black KE, Skidmore PM. Development and validation of a food-based diet quality index for New Zealand adolescents. BMC Public Health. 2013 Jun 8;13:562.-71.

[3.] Martinez MF, Philippi ST, Estima C, Leal G. Validity and reproducibility of a food frequency questionnaire to assess food group intake in adolescents. Cad Saude Publica. 2013 Sep;29 (9):1795-804.

[4.] Deschamps V, Lauzon-Guillain B, Lafay L, Borys JM, Charles MA, Romon M. Reproducibility and relative validity of a food-frequency questionnaire among French adults and adolescents. Eur J Clin Nutr. 2009 Feb;63 (2):282-91.

[5.] Papadopoulou SK, Barboukis V, Dalkiranis A, Hassapidou M, Petridou A, Mougios V. Validation of a questionnaire assessing food frequency and nutritional intake in Greek adolescents. Int J Food Sci Nutr. 2008 Mar;59 (2):148-54.

[6.] Araujo MC, Yokoo EM, Pereira RA. Validation and Calibration of a Semiquantitative Food Frequency Questionnaire Designed for Adolescents. J Am Diet Assoc. 2010 Aug;110 (8):1170-7.

[7.] Mennella JA, Nicklaus S, Jagolino AL, Yourshaw LM. Variety is the spice of life: strategies for promoting fruit and vegetable acceptance during infancy. Physiol Behav. 2008 Apr 22;94(1):29-38.

[8.] Nicklaus S. Development of food variety in children. Appetite. 2009 Feb;52(1):253-5.

[9.] Mesch CM, Stimming M, Foterek K, Hilbig A, Alexy U, Kersting M, Libuda L. Food variety in commercial and homemade complementary meals for infants in Germany. Market survey and dietary practice. Appetite. 2014 May; 76: 113-9.

[10.] Wanat G, Stolarczyk A, Grochowska-Niedworok E, Kardas M. Research on nutritional education and level of knowledge on a well-balanced diet of junior high school pupils. Hygeia Public Health. 2011;46(3):376-80. (Polish)

[11.] Nicklaus S, Boggio V, Chabanet C, Issanchou S. A prospective study of food variety seeking in childhood, adolescence and early adult life. Appetite. 2005 Jun;44(3):289-97.

[12.] Litwin M, Niemirska A. Primary hypertension and metabolic disorders in children and adolescents. Metabolic Disorders Forum. 2009;2(2):124-31. (Polish)

[13.] Ferrer M, Fernandez-Britto JE, Bacallao J, Perez H. Development of hypertension in a cohort of cuban adolescents. MeDICC Rev. 2015 Jan;17(1):41-7.

[14.] Lurbe E, Cifkova R, Cruickshank JK, Dillon M, Ferreira I, Invitti C, Kuznetsova T, Laurent S, Mancia G, Morales-Olivas F, Rascher W, Redon J, Schaefer F, Seeman T, Stergiou G, Wuhl E, Zanchetti A. Management of high blood pressure in children and adolescents: recommendations of the European Society of Hypertension. J Hypertens. 2009 Sep;27:1719-42.

[15.] Report of a WHO Expert Committee, WHO Technical Report Series 854. Physical status: The use and interpretation of anthropometry. 1995 Geneva. ISBN 92 4 120854 6, ISSN 05123054

[16.] Futrex-6100 Near-IR Body Composition and Fitness Analyzer: Use leaflet. 2007, Futrex, Inc.

[17.] Dotson C: Calibration of the FUTREX 6000 Body Composition Analyzers. Final Report. Futrex Inc. 1996.

[18.] Lambert EV, Will M, Micklesfield L, Noak es T, Lambert M. Validation of Near Infrared Reactance and Bioelectrical Impedance Techniques for Body Composition Measurement in Adolescents. Med Sci Sports. 2006;38(5):S310

[19.] Jones JD, Spears M. Body Composition Analysis Comparison of Bioelectrical Impedance Instruments versus Near-Infrared Instruments. Technical Note. 2014;46:1-14.

[20.] Palczewska I, Niedzwiecka Z. Indicators of somatic development of children and youth from Warsaw. Med Wieku Rozw. 2001;5/2:1-120. (Polish)

[21.] Petrie I, O'Brien E, Littler W, Sweit M. Recommendations on blood pressure measurement. British Hypertension Society. BMJ 1986 Sep 6;293(6547):611-5.

[22.] Krzyzaniak A. Blood pressure in children and adolescents (standards, monitoring, prevention). Wyd. Akademia Medyczna, Poznan 2004 (Polish)

[23.] Niedzwiedzka E., Wadolowska L. Accuracy analysis of the Food Intake Variety Questionnaire (FIVeQ). Reproducibility assessment among older people. Pakistan J. Nutr. 2008;7(3):426-435.

[24.] Wqdolowska L. Validation of Food Frequency Questionnaire--FFQ. Repeatability rating. Bromat. Chem Toksykol. 2005;1:27-33. (Polish)

[25.] Konstantynowicz J, Piotrowska-Jastrzebska J, Kaczmarski M, Klopotowski M, Motkowski R, Abramowicz P. Densitometric and anthropometric assessment of body fat in adolescents aged 13 to 19 years. Endocrynol Ped. 2008; 1(2):21-31. (Polish)

[26.] Goluch-Koniuszy Z, Friedrich M, Radziszewska M. Evaluation of nutrition mode and nutritional status and prohealth education of children during the period of pubertal spurt in the city of Szczecin. Rocz Panstw Zakl Hig. 2009;60(2): 143-49. (Polish)

[27.] Lange E, Gandziarek D, Tymolewska-Niebuda B. Body composition and selected eating habits of children aged 14-17 years. Bromat Chem Toksykol. 2011;3:389-97. (Polish)

[28.] Roszko-Kirpsza I, Olejnik B, Zalewska M, Marcinkiewicz S, Maciorkowska E. Selected dietary habits and nutritional status of children and adolescents of the Podlasie region. Probl Hig Epidemiol. 2011;92(4):799-805. (Polish)

[29.] Campagnolo PD, Vitolo MR, Gama CM, Stein AT. Prevalence of overweight and associated factors in southern Brazilian adolescents. Public Health. 2008 May;122(5):509-15.

[30.] Kowalska M, Krzych L, Siwik P, Zawiasa A, 2008. Determinants of hypertension in school-aged boys and girls in Silesia voivodeship. Arterial Hypertension. 2008;12(4):269-76.

[31.] Lurbe E, Cifkova R, Cruickshank JK, Dillon M, Ferreira I, Invitti C, Kuznetsova T, Laurent S, Mancia G, Morales-Olivas F, Rascher W, Redon J, Schaefer F, Seeman T, Stergiou G, Wuhl E, Zanchetti A. Management of high blood pressure in children and adolescents: recommendations of the European Society of Hypertension. J Hypertens. 2009 Sep;27:1719-42.

[32.] National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescent. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004 Aug;114(2 Suppl 4th Report):555-76.

[33.] de Moraes AC, Lacerda MB, Moreno LA, Horta BL, Carvalho HB. Prevalence of High Blood Pressure in 122,053 Adolescents: A Systematic Review and Meta-Regression. Medicine (Baltimore). 2014 Dec;(93)27:e232-41.

[34.] Krzyzaniak A. Blood pressure in children and adolescents (standards, monitoring, prevention). Wyd. Akademia Medyczna, Poznan 2004. (Polish)

[35.] Frese EM, Fick A, Sadowsky HS. Blood Pressure Measurement Guidelines for Physical Therapists. Cardiopulm Phys Ther J. 2011 Jun; 22(2):5-12.

[36.] Zhang YX, Zhang ZC, Xie L. Distribution curve of waist-to-height ratio and its association with blood pressure among children and adolescents: study in a large population in an eastern coastal province. Eur J Pediatr. 2014 Jul;173(7):879-85.

[37.] LA de Hoog M, van Eijsden M, Stronks K, Gemke RJ, Vrijkotte TG. Association between body size and blood pressure in children from different ethnic origins. Cardiovasc Diabetol. 2012 Nov 5;11:136-45.

[38.] George MG, Tong X, Wigington C, Gillespie C, Hong Y. Hypertension Screening in Children and Adolescents--National Ambulatory Medical Care Survey, National Hospital Ambulatory Medical Care Survey, and Medical Expenditure Panel Survey, United States, 2007-2010. MMWR Surveill Summ. 2014 Sep 12;63 Suppl 2:47-53.

[39.] Diethelm K, Huybrechts I, Moreno L, De Henauw S, Manios Y, Beghin L, Gonzalez-Gross M, Le Donne C, Cuenca-Garcia M, Castillo MJ, Widhalm K, Patterson E, Kersting M. Nutrient intake of European adolescents: results of the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) Study. Public Health Nutr. 2014 Mar;17(3):48697.

[40.] Adamo KB, Brett KE. Parental perceptions and childhood dietary quality. Matern Child Health J. 2014 May; 18(4):978-95.

[41.] Payab M, Kelishadi R, Qorbani M, Motlagh ME, Ranjbar SH, Ardalan G, Zahedi H, Chinian M, Asayesh H, Larijani B, Heshmat R. Association of junk food consumption with high blood pressure and obesity in Iranian children and adolescents: the CASPIAN-IV Study. J Pediatr (Rio J). 2015 Mar-Apr;91(2):196-205.

[42.] Vereecken CA, De Bourdeaudhuij I, Maes L. The HELENA online food frequency questionnaire: reproducibility and comparison with four 24-h recalls in Belgian-Flemish adolescents. Eur J Clin Nutr. 2010 May;64(5): 541-8.

[43.] Zhang YX, Zhao JS, Chu ZH, Wang LS. The association between components of height and blood pressure among children and adolescents in Shandong, China. Int J Cardiol. 2015 Mar 1;182:18-9.

[44.] Neuhauser HK, Thamm M, Ellert U, Hense HW, Rosario AS. Blood pressure percentiles by age and height from nonoverweight children and adolescents in Germany. Pediatrics. 2011 Apr;127(4):e978-88.

[45.] Ma J, Wang Z, Dong B, Song Y, Hu P, Zhang B. Quantifying the relationships of blood pressure with weight, height and body mass index in Chinese children and adolescents. J Paediatr Child Health. 2012 May;48(5):413-8.

[46.] Prista A, Maia JA, Damasceno A, Beunen G. Anthropometric indicators of nutritional status: implications for fitness, activity, and health in school-age children and adolescents from Maputo, Mozam-bique. Am J Clin Nutr. 2003 Apr;77(4):952-9.

[47.] Moy J, Petrie TA, Dockendorff S, Greenleaf C, Martin S. Dieting, exercise, and intuitive eating among early adolescents. Eat Behav. 2013 Dec;14 (4):529-32.

[48.] Enriquez E, Duncan GE, Schur EA. Age at dieting onset, body mass index, and dieting practices. A twin study. Appetite 2013 Dec;71:301-6.

[49.] Larson NI, Neumark-Sztainer D, Story M. Weight control behaviors and dietary intake among adolescents and young adults: longitudinal findings from Project EAT. J Am Diet Assoc. 2009 Nov; 109(11):1869-77.

Jaroch A. (1,2) *, Nowak D. (1), Kedziora-Kornatowska K. (2)

(1.) Faculty of Health Sciences, Department and Institute of Nutrition and Dietetics, Nicolaus Copernicus University in Torun, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Poland

(2.) Faculty of Health Sciences, Department and Clinic of Geriatrics, Nicolaus Copernicus University in Torun, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Poland

* Corresponding author:

Alina Jaroch

3 Debowa street, 85-626 Bydgoszcz, Poland

Tel.: +48796528980; e-mail:

Received: 10.08.2015

Accepted: 01.10.2015
Table 1. Results of selected anthropometric parameters

                                  All groups
                                    N = 131              Boys
Parameters                                              N = 68

                                           Mdn; Min-Max

Body height [cm]                    167.1;              170.1;
                                  143.0-188.6         143.0-188.6
Body weight [kg]                55.6; 34.1-94.5     57.0; 37.7-94.5
Thickness of skinfolds [mm]:
  * above the triceps           11.6; 4.4-26.0       9.4; 4.4-24.3
  * above the biceps             5.5; 2.0-20.7       4.6; 2.0-16.8
  * subscapular                  9.5; 4.9-35.2       8.1; 4.9-35.2
  * above the iliac crest       10.0; 4.4-32.8       8.1; 4.4-31.7
Circuits [cm]:
  * arm                         24.2; 18.5-33.4     24.8; 19.5-32.4
  * waist                       66.8; 55.1-96.1     68.4; 56.0-96.1
  * hips                       90.2; 68.5-112.0    87.8; 76.8-106.5
BMI [kg/[m.sup.2]]              19.8; 15.2-30.5     20.0; 15.2-30.5
WHR                             0.75; 0.64-0.92     0.78; 0.72-0.92
WHtR                            0.40; 0.34-0.54     0.41; 0.34-0.54
AMC [cm]                        20.4; 15.7-27.6     21.6; 16.8-27.6
Body composition made with
  * FFM [kg]                    43.7; 29.1-70.5     48.9; 32.4-70.5
  * FM [kg]                     10.7; 3.1-29.8       7.2; 3.1-26.0
  * %FM [%]                     20.0; 5.9-36.7      13.4; 5.9-27.8


Parameters                          N = 63            p

                                     Mdn; Min-Max

Body height [cm]                    164.4;
                                  147.9-181.2       <0.01
Body weight [kg]                53.3; 34.1-82.5      ns
Thickness of skinfolds [mm]:
  * above the triceps           13.1; 4.8-26.0     <0.001
  * above the biceps             7.0; 3.0-20.7     <0.001
  * subscapular                 11.2; 5.2-33.8      <0.01
  * above the iliac crest       12.0; 4.6-32.8     <0.001
Circuits [cm]:
  * arm                         24.0; 18.5-33.4      ns
  * waist                       65.5; 55.1-83.1     <0.01
  * hips                       91.6; 68.5-112.0     <0.05
BMI [kg/[m.sup.2]]              19.7; 15.3-30.0      ns
WHR                             0.72; 0.64-0.91    <0.001
WHtR                            0.40; 0.34-0.50      ns
AMC [cm]                        19.8; 15.7-26.1    <0.001
Body composition made with
  * FFM [kg]                    40.2; 29.1-53.1    <0.001
  * FM [kg]                     12.7; 5.0-29.8     <0.001
  * %FM [%]                     24.3; 14.6-36.7    <0.001

N--number, p-level of significance (p < 0.05, p < 0.01, p < 0.001),
Mdn-Median, Min-Max-Range minimum to maximum values, ns--differences
not significant, BMI-Body Mass Index, WHR-Waist-Hip Ratio, WHtR-
Waist-to-Height Ratio, AMC-Arm Muscle Circumference, FFM-Fat-free
Mass, FM-Fat Mass, %FM-Fat Mass Percentage

Table 2. Values of blood pressure

       Parameters             All groups
                                N = 131              Boys
                                                    N = 68

Systolic blood pressure    125.0; 95.0-175.0   128.0; 99.0-175.0
[mmHgl, Mdn; Min-Max

Diastolic blood pressure   74.0; 58.0-153.0    74.0; 58.0-153.0
[mmHg], Mdn; Min-Max

                                 Girls           p
                                N =  63

Systolic blood pressure    121.0; 95.0-159.0   <0.01
[mmHgl, Mdn; Min-Max

Diastolic blood pressure   74.0; 58.0-123.0     ns
[mmHg], Mdn; Min-Max

N--number, p-level of significance (p < 0.01), ns--differences not
significant Mdn-Median, Min-Max-Range minimum to maximum values
Connection between BP and percentile ranges was also assessed (table
3). 60% of respondents had values of systolic BP within the normal
range (10-90 percentile). 72% of respondents had correct values of
systolic BP. Elevated systolic BP (above 90 percentile) was found in
38% of boys and girls, and diastolic in 24% of boys and 27% girls.

Table 3. Distribution of values of blood pressure according to
percentile ranges of the examined adolescents

Parameters/ scopes         All groups
                             N = 131       Boys      Girls       p
                                          N = 68     N = 63

Systolic blood pressure                                         ns
< 10 percentile               2 (2)       2 (1)      2 (1)
10-90 percentile             60 (79)     60 (41)    60 (38)
> 90 percentile              38 (50)     38 (26)    38 (24)

Diastolic blood pressure                                        ns
< 10 percentile               3 (4)       4 (3)      2 (1)
10-90 percentile             72 (94)     72 (49)    71 (45)
> 90 percentile              25 (33)     24 (16)    27 (17)

N--number, p-level of significance (p < 0.05), ns--differences not
significant, x-average value, SD-standard deviation

Table 4. Variety of food consumption

                               All groups
Parameters                      N = 131      Boys       Girls      p
                                            N = 68     N = 63

FIVeI (max 60 products/week),    29.0;       33.0;      27.0;    <0.05
Mdn; Min-Max                   13.0-56.0   14.0-48.0  13.0-56.0
Variety of food intake,                                           ns
% of population
  V1                            11 (15)      9 (6)     14 (9)
  V2                            44 (57)     35 (24)    53 (33)
  V3                            39 (51)     50 (34)    27 (17)
  V4                             6 (8)       6 (4)      6 (4)

N--number, p-level of significance (p <0.05), ns--differences not
significant, FIVel-Food Intake Variety Index Mdn-Median, Min-Max-
Range minimum to maximum values, V1-variety of food consumption--
inadequate, V2-variety sufficient, V3-variety good, V4-variety very
good, ()--number in brackets

Table 5. Values of somatic parameters and blood pressure of examined
adolescents, depending on the variety of food consumption

                               All groups
Parameters                      N = 131

                              Mdn; Min-Max

Body height [cm]                 167.1;
Body weight [kg]                 55.6;
Thickness of skinfolds [mm]:
  above the triceps          11.6; 4.4-26.0
  above the biceps           5.5; 2.0-20.7
  subscapular                9.5; 4.9-35.2
  above the iliac            10.0; 4.4-32.8
Circuits [cm]:
    arm                          24.2;
    waist                        66.8;
    hips                      90.2; 68.5-
BMI [kg/[m.sup.2]]          19.8; 15.2-30.5

WHR                         0.75; 0.64-0.92

WHtR                        0.40; 0.34-0.54

AMC [cm]                    20.4; 15.7-27.6

Body composition
made with                   43.7; 29.1-70.5
FUTREX:                      10.7; 3.1-29.8
    * FFM [kg]               20.0; 5.9-36.7
    * FM [kg]
    * %FM
Systolic blood                125.0; 95.0-
pressure [mmHg]                  175.0
Diastolic blood               74.0; 58.0-
pressure [mmHg]                  153.0

                                Variety of food consumption

                                   V1                 V2
Parameters                       N = 15             N = 57

Body height [cm]                 165.1;             167.7;
                              151.6-173.4        147.9-188.6
Body weight [kg]                 53.3;              56.2;
                               36.4-81.1          34.1-92.2
Thickness of skinfolds [mm]:
  above the triceps          10.0; 5.0-23.3     12.9; 5.2-26.0
  above the biceps           5.8; 2.8-18.3      5.6; 2.8-20.7
  subscapular                9.1; 5.6-33.8      10.2; 5.2-31.7
  above the iliac            9.1; 4.9-32.8      10.7; 4.6-30.0
Circuits [cm]:
    arm                          24.7;              24.8;
                               18.6-33.4          18.5-31.8
    waist                        67.3;              66.9;
                               55.1-82.9          55.4-92.8
    hips                    89.2; 77.3-109.0   93.0; 75.6-112.0

BMI [kg/[m.sup.2]]          19.3; 15.7-30.0    20.0; 15.2-30.5

WHR                         0.76; 0.65-0.84    0.74; 0.66-0.88

WHtR                        0.40; 0.34-0.50    0.41; 0.35-0.53

AMC [cm]                    21.5; 15.7-26.1    20.4; 16.2-26.3

Body composition
made with                   44.4; 29.5-51.3    44.9; 29.1-70.5
FUTREX:                      10.6; 3.9-29.8     11.8; 3.7-29.4
    * FFM [kg]               20.7; 7.7-36.7     22.2; 8.5-35.7
    * FM [kg]
    * %FM
Systolic blood                125.5; 95.0-      125.0; 100.0-
pressure [mmHg]                  144.0              154.0
Diastolic blood             74.0; 65.0-84.0    74.0; 58.0-116.0
pressure [mmHg]

                               Variety of food consumption

                                   V3                V4
Parameters                       N = 51            N = 8          p

Body height [cm]                 164.6;            168.6;        ns
                              143.0-183.0       153.3-182.8
Body weight [kg]                 53.0;             57.0;         ns
                               40.3-94.5         44.0-63.8
Thickness of skinfolds [mm]:
  above the triceps          10.7; 5.4-23.5    10.8; 4.4-24.3    ns
  above the biceps           5.0; 2.4-16.8     7.0; 2.0-11.2     ns
  subscapular                8.8; 4.9-35.2     8.1; 5.2-15.0     ns
  above the iliac            9.6; 4.4-31.7     9.5; 4.6-19.8     ns
Circuits [cm]:
    arm                          24.0;             24.1;         ns
                                19.1-32.         21.3-26.3
    waist                        65.0;             67.2;
                               57.4-96.1         56.2-73.6
    hips                    89.5; 77.5-106.5    89.3; 68.5-      ns
BMI [kg/[m.sup.2]]          19.7; 15.3-28.8     19.4; 16.6-      ns
WHR                         0.75; 0.65-0.92     0.75; 0.64-      ns
WHtR                        0.40; 0.34-0.54     0.39; 0.34-      ns
AMC [cm]                    20.2; 16.3-27.6     20.0; 17.3-      ns
Body composition
made with                   43.3; 33.2-68.5     47.0; 31.9-      ns
FUTREX:                      9.5; 3.1-26.0          55.7        ns ns
    * FFM [kg]               18.5; 6.5-31.6    10.7; 3.4-14.3
    * FM [kg]                                  18.5; 5.9-29.2
    * %FM
Systolic blood                123.0; 99.0-     128.0; 104.0-     ns
pressure [mmHg]                  159.0             175.0
Diastolic blood             73.0; 58.0-123.0    77.0; 65.0-      ns
pressure [mmHg]                                    153.0

Table 6. Distribution of values of anthropometric parameters and blood
pressure according to percentile ranges and Food Intake Variety Index
of the examined adolescents

                                                Food Intake
                                               Variety Index
                                 All group
Parameters/ scopes               N  = 131      V1        V2
                                             N = 15    N = 57
Body height
  < 10 percentile                 12 (15)     7 (1)    10 (6)
  10-90 percentile                70 (92)    86 (13)   67 (38)
  > 90 percentile                 18 (24)     7 (1)    23 (13)
Body weight
  < 10 percentile                 8 (10)     13 (2)     7 (4)
  10-90 percentile               80 (105)    67 (10)   75 (43)
  > 90 percentile                 12 (16)    20 (3)    18 (10)
Above the triceps skinfold
  < 10 percentile                  6 (8)     13 (2)     7 (4)
  10-90 percentile               76 (100)    67 (10)   74 (42)
  > 90 percentile                 18 (23)    20 (3)    19 (11)
Subscapular skinfold thickness
  < 10 percentile                  3 (4)      0 (0)     3 (2)
  10-90 percentile                74 (97)    73 (11)   72 (41)
  > 90 percentile                 23 (30)    27 (4)    25 (14)
Arm circumference
  < 10 percentile                 8 (10)     13 (2)     7 (4)
  10-90 percentile               80 (105)    67 (10)   75 (43)
  > 90 percentile                 12 (16)    20 (3)    18 (10)
  < 10 percentile                 11 (15)     7 (1)    14 (8)
  10-90 percentile               78 (102)    80 (12)   72 (41)
  > 90 percentile                 11 (14)    13 (2)    14 (8)
  < 10 percentile                 17 (22)    13 (2)    18 (10)
  10-90 percentile               78 (102)    74 (11)   77 (44)
  > 90 percentile                  5 (7)     13 (2)     5 (3)
  < 10 percentile                 13 (17)     6 (1)    16 (9)
  10-90 percentile                75 (98)    67 (10)   70 (40)
  > 90 percentile                 12 (16)    27 (4)    14 (8)
Systolic blood pressure
  < 10 percentile                  2 (2)      6 (1)     2 (1)
  10-90 percentile                60 (79)    47 (7)    67 (38)
  > 90 percentile                 38 (50)    47 (7)    31 (18)
Diastolic blood pressure
  < 10 percentile                  3 (4)      7 (1)     5 (3)
  10-90 percentile                72 (94)    80 (12)   67 (38)
  > 90 percentile                 25 (33)    13 (2)    28 (16)

                                    Food Intake
                                   Variety Index

Parameters/ scopes                 V3        V4       p
                                 N = 51     N = 8
Body height                                          ns
  < 10 percentile                16 (8)     0 (0)
  10-90 percentile               70 (36)   63 (5)
  > 90 percentile                14 (7)    37 (3)
Body weight                                          ns
  < 10 percentile                 8 (4)     0 (0)
  10-90 percentile               86 (44)   100 (8)
  > 90 percentile                 6 (3)     0 (0)
Above the triceps skinfold                           ns
  < 10 percentile                 2 (1)    13 (1)
  10-90 percentile               82 (42)   74 (6)
  > 90 percentile                16 (8)    13 (1)
Subscapular skinfold thickness                       ns
  < 10 percentile                 4 (2)     0 (0)
  10-90 percentile               74 (38)   88 (7)
  > 90 percentile                22 (11)   12 (1)
Arm circumference                                    ns
  < 10 percentile                 8 (4)     0 (0)
  10-90 percentile               86 (44)   100 (8)
  > 90 percentile                 6 (3)     0 (0)
BMI                                                  ns
  < 10 percentile                 8 (4)    25 (2)
  10-90 percentile               84 (43)   75 (6)
  > 90 percentile                 8 (4)     0 (0)
WHtR                                                 ns
  < 10 percentile                14 (7)    37 (3)
  10-90 percentile               82 (42)   63 (5)
  > 90 percentile                 4 (2)     0 (0)
AMC                                                  ns
  < 10 percentile                14 (7)     0 (0)
  10-90 percentile               78 (40)   100 (8)
  > 90 percentile                 8 (4)     0 (0)
Systolic blood pressure                              ns
  < 10 percentile                 0 (0)     0 (0)
  10-90 percentile               61 (31)   37 (3)
  > 90 percentile                39 (20)   63 (5)
Diastolic blood pressure                             ns
  < 10 percentile                 0 (0)     0 (0)
  10-90 percentile               75 (38)   75 (6)
  > 90 percentile                25 (13)   25 (2)

N--number, V1-variety of food consumption--inadequate, V2-variety
sufficient, V3-variety good, V4-variety very good, p-level of
significance (p <0.05), ns--differences not significant, BMI-Body Mass
Index, WHR-Waist-Hip Ratio, WHtR-Waist-to-Height Ratio, AMC-Arm Muscle
COPYRIGHT 2015 Medical University of Bialystok
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 2015 Gale, Cengage Learning. All rights reserved.

Article Details
Printer friendly Cite/link Email Feedback
Author:Jaroch, A.; Nowak, D.; Kedziora-Kornatowska, K.
Publication:Progress in Health Sciences
Article Type:Report
Geographic Code:4EXPO
Date:Dec 1, 2015
Previous Article:How dose walking exercise affect serum lipids in underweight female adults?
Next Article:Role of quality in healthcare service provision process.

Terms of use | Privacy policy | Copyright © 2018 Farlex, Inc. | Feedback | For webmasters