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Identifying Cardiovascular Risk Profiles Clusters among Mediterranean Adolescents across Seven Countries

Department of Health Systems Management, School of Health Sciences, Ariel University, Ariel 4076405, Israel
Program in Gerontology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheeva 8855630, Israel
Department of Developmental Psychology, University of Sevilla, 41004 Sevilla, Spain
School of Education, Bar Ilan University, Ramat Gan 5290002, Israel
Sleep Medicine Center—CENC, 1070-068 Lisbon, Portugal
Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal
Comprehensive Health Research Center (CHRC), Nova Medical School, Universidade Nova de Lisboa, 1160-056 Lisbon, Portugal
Divisions of Pediatric Endocrinology and Adolescent, Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul 34452, Turkey
Faculty of Social & Community Sciences, Ruppin Academic Center, Emek Heffer 4025000, Israel
Department of Nursing, Faculty of Health Science, Ariel University, Ariel 4076405, Israel
CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, 1499-002 Lisbon, Portugal
Physical Activity for Health Research Cluster, Department of Physical Education and Sport Sciences, University of Limerick, V94 T9PX Limerick, Ireland
School of Educational Sciences and Psychology, University of Eastern Finland, 80100 Joensuu, Finland
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Academic Editors: Daniela Pierannunzio, Silvia Ciardullo and Paola Nardone
Healthcare 2022, 10(2), 268;
Received: 4 January 2022 / Revised: 24 January 2022 / Accepted: 26 January 2022 / Published: 29 January 2022
(This article belongs to the Special Issue Child and Adolescent Health: Challenges and Perspectives)
Cardiovascular diseases (CVDs) are the number one cause of death globally and are partially due to the inability to control modifiable lifestyle risk factors. The aim of this study was to analyze the profiles of adolescents from seven Mediterranean countries (Greece, Israel, Italy, Macedonia, Malta, Portugal, Spain) according to their modifiable lifestyle risk factors for CVD (overweight/obesity, physical activity, smoking, alcohol consumption). The sample consisted of 26,110 adolescents (52.3% girls) aged 11, 13, and 15 years who participated in the Health Behavior in School-aged Children (HBSC) survey in 2018 across the seven countries. Sociodemographic characteristics (sex, age, country of residence, socioeconomic status) and CVD modifiable lifestyle risk factors (overweight/obesity, physical activity, smoking, alcohol consumption) were recorded. A two-step cluster analysis, one-way analysis of variance, and chi-square test were performed. Four different cluster groups were identified: two low-risk groups (64.46%), with risk among those with low physical activity levels; moderate-risk group (14.83%), with two risk factors (unhealthy weight and low physical activity level); and a high-risk group (20.7%), which presented risk in all modifiable lifestyle risk factors. Older adolescents reported a higher likelihood of being in the high-risk group. Given that the adolescence period constitutes an important time for interventions aimed at CVD prevention, identifying profiles of moderate- and high-risk adolescents is crucial. View Full-Text
Keywords: lifestyle behavior; cardiovascular risk factors; youth; cluster analysis lifestyle behavior; cardiovascular risk factors; youth; cluster analysis
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MDPI and ACS Style

Tesler, R.; Barak, S.; Reges, O.; Moreno-Maldonado, C.; Maor, R.; Gaspar, T.; Ercan, O.; Sela, Y.; Green, G.; Zigdon, A.; Marques, A.; Ng, K.; Harel-Fisch, Y. Identifying Cardiovascular Risk Profiles Clusters among Mediterranean Adolescents across Seven Countries. Healthcare 2022, 10, 268.

AMA Style

Tesler R, Barak S, Reges O, Moreno-Maldonado C, Maor R, Gaspar T, Ercan O, Sela Y, Green G, Zigdon A, Marques A, Ng K, Harel-Fisch Y. Identifying Cardiovascular Risk Profiles Clusters among Mediterranean Adolescents across Seven Countries. Healthcare. 2022; 10(2):268.

Chicago/Turabian Style

Tesler, Riki, Sharon Barak, Orna Reges, Concepción Moreno-Maldonado, Rotem Maor, Tânia Gaspar, Oya Ercan, Yael Sela, Gizell Green, Avi Zigdon, Adilson Marques, Kwok Ng, and Yossi Harel-Fisch. 2022. "Identifying Cardiovascular Risk Profiles Clusters among Mediterranean Adolescents across Seven Countries" Healthcare 10, no. 2: 268.

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