Are adherence to the Mediterranean diet and siesta individually or jointly associated with blood pressure in Spanish adolescents? Results from the EHDLA study

Abstract

BackgroundBoth dietary and sleep patterns can influence both blood pressure levels and heart rate, but these associations have been understudied in adolescents. Furthermore, it is not known whether diet and sleep could exert a synergistic effect with respect to the maintenance of optimal BP levels in this population.ObjectiveTo investigate the relationship of blood pressure levels with the combination of higher adherence to the Mediterranean diet and the habit of siesta (daytime napping) in Spanish adolescents.MethodsA cross-sectional study was conducted with data obtained through personal interviews and physical examination from a representative sample of 1,378 adolescents (12–17 years of age) from the Valle de Ricote (Region of Murcia, Spain) selected using a simple random sampling technique. Adherence to the Mediterranean diet was assessed with the Mediterranean Diet Quality Index in Children and Adolescents, and the frequency and duration of siesta were self-reported. Objective measurements of systolic and diastolic blood pressure were obtained under standardized conditions. Statistical procedures were performed with SPSS software (v.25) and included logistic and generalized regression models adjusted for sex, age, socioeconomic status, body mass index, total energy intake, nighttime sleep duration, and moderate-to-vigorous physical activity.ResultsOf the 698 adolescents finally studied (mean age 13.9 ± 1.5 years; 56.2% female), 37.1% (n = 259) had high adherence to the Mediterranean diet and 19.6% (n = 137) reported frequent siesta. In the completely adjusted models, compared to adolescents with low Mediterranean diet adherence and no or infrequent siesta, those with high Mediterranean diet adherence and frequent siesta were less likely to have high-normal blood pressure or hypertension (odds ratio = 0.47; 95% confidence interval: 0.26, 0.88) and showed slightly lower systolic blood pressure (ß-coef. = −2.60; 95% CI: −5.18, −0.02).ConclusionGreater adherence to the Mediterranean diet and frequent siesta have a synergistic effect on maintaining lower blood pressure levels in adolescence. These findings reinforce that adherence to both Mediterranean lifestyle behaviors early in life may be an important strategy to prevent hypertension throughout adulthood.

Healthy eating index and muscle mass are associated stronger with blood pressure than muscle strength in adolescent girls living in urban area

“…Supporting our finding, a cross-sectional study of 1,378 Spanish adolescents (12–17 years of age) which examined the relationship between the Mediterranean diet, daytime sleep and BP reported a lower risk of high BP in high Mediterranean diet group if compared to those with low or moderate diet and the protective estimate is greater with those with habitual daytime sleep after adjusted by potential confounding (Tam et al , 2022). Other studies in the adult population also reported similar findings.…”

“…Good diet quality shares protective or lowering properties against hypertension due to its balanced nutritional composition derived from a variety of food sources that are rich in fiber and minerals which can reduce and control BP (Joshi et al , 2020). After all, complying with a healthy diet is one of the best strategies to modify the risk of hypertension (Tam et al , 2022).…”

“…Furthermore, although a study among adolescent girls in a rural area of Indonesia aged 15–19 years found low intake of micronutrients (vitamins and minerals) during the pandemic (Sari et al , 2022), eating patterns in adolescents living in an urban area is still limited. Adolescents with poor eating patterns are associated with a higher risk of hypertension (Tam et al , 2022).…”