Effects of clustering of multiple lifestyle-related behaviors on blood pressure in adolescents from two observational studies

Backgroud Several lifestyle-related behaviors are associated with cardiovascular health outcomes in adolescents. To examine the associations between clustered lifestyle-related behaviors and blood pressure (BP) levels in adolescents. Methods Participants were recruited by multistage random cluster in two cross-sectional studies; one conducted in 2006 and 2007 in ten cities from nine European countries: Athens and Heraklion in Greece, Dortmund in Germany, Ghent in Belgium, Lille in France, Pecs in Hungary, Rome in Italy, Stockholm in Sweden, Vienna in Austria, and Zaragoza in Spain; and another conducted in 2007 one city in Brazil (Maringa/PR). Systolic BP (SBP) and diastolic BP (DBP) (outcomes) and clustered behaviors (weekly consumption of fruits and vegetables, weekly consumption of sugar-sweetened beverages, sleep duration, screen time and physical activity) were analyzed. Results The Healthy Eating cluster was negatively associated with DBP in European girls, β = − 2.46 (− 4.62; − 0.30), and with SBP in Brazilian boys, β = − 2.79 (− 3.10; − 0.15). Furthermore, the Unhealthy Eating cluster was associated with increased SBP in European girls, β = 4.54 (1.29; 7.79), and in Brazilian boys, β = 4.10 (0.80; 7.40). Conclusion The Healthy Eating cluster was associated with lower blood pressure, whereas the Unhealthy Eating cluster was associated with increased SBP in adolescents.