Greek adolescents, fitness, fatness, fat intake, activity, and coronary heart disease risk.

BACKGROUND: A dramatic increase in adult mortality rates from coronary heart disease (CHD) in Greece, accompanied by increased prevalence of CHD risk factors in children, has been documented. However, there is controversy about the independent effects of certain lifestyle parameters on primary CHD risk factors. AIMS AND METHODS: To examine the association between CHD risk factors (HDL-C, LDL-C, HDL-C/TC, triglycerides, systolic and diastolic blood pressure) and lifestyle parameters (fitness, fatness, fat intake, and physical activity) in 210 12-year old Greek pupils. RESULTS: Correcting for the fixed factors of gender and maturation, analyses of covariance (ANCOVA) with backward elimination of the lifestyle covariates revealed significant associations between three CHD risk factors (HDL-C, HDL-C/TC, systolic blood pressure) and physical activity levels. In contrast, the covariates aerobic fitness, fatness and fat intake failed to reach significance with any of the CHD risk factors. CONCLUSIONS: In Greek schoolchildren, primary CHD risk factors are mainly associated with physical activity levels, independently of fitness, fatness, and/or fat intake. Prevention strategies should concentrate on enhancing physical activity early in life, if the increased prevalence of Greek adult CHD mortality is to be diminished.