Ethnic variation in cardiovascular disease risk factors among children andyoung adults - Findings from the Third National Health and Nutrition Examination Survey, 1988-1994

Context Knowledge about ethnic differences in cardiovascular disease (CVD) risk factors among children and young adults from national samples is limit ed. Objective To evaluate ethnic differences in CVD risk factors, the age at wh ich differences were first apparent, and whether differences remained after accounting for socioeconomic status (SES). Design Third National Health and Nutrition Examination Survey, 1988-1994, Setting Eighty-nine mobile examination centers, Participants A total of 2769 black, 2854 Mexican American, and 2063 white ( non-Hispanic) children and young adults aged 6 to 24 years. Main Outcome Measures Ethnicity and household level of education (SES) in r elation to body mass index (BMI), percentage of energy from dietary fat, ci garette smoking, systolic blood pressure, glycosylated hemoglobin (HbA(1c)) , and non-high-density lipoprotein cholesterol (non-HDL-C [the difference b etween total cholesterol and HDL-C]). Results The BMI levels were significantly higher for black and Mexican Amer ican girls than for white girls, with ethnic differences evident by the age of 6 to 9 years (a difference of approximately 0.5 BMI units) and widening thereafter (a difference of >2 BMI units among 18- to 24-year-olds). Perce ntages of energy from dietary fat paralleled these findings and were also s ignificantly higher for black than for white boys. Blood pressure levels we re higher for black girls than for white girls in every age group, and glyc osylated hemoglobin levels were highest for black and Mexican American girl s and boys in every age group. In contrast, smoking prevalence was highest for white girls and boys, especially for those from low-SES homes (77% of y oung men and 61% of young women, aged 18-24 years, from low-SES homes were current smokers). All ethnic differences remained significant after account ing for SES and age. Conclusion These findings show strong ethnic differences in CVD risk factor s among youths of comparable age and SES from a large national sample. The differences highlight the need for heart disease prevention programs to beg in early in childhood and continue throughout young adulthood to reduce the risk of atherosclerosis.