Biomedical subjects

H C Kemper

Publications and source records attributed to H C Kemper.

At least 55 records · Page 3Linked to original sources

PubMed1997

The longitudinal development of running economy in males and females aged between 13 and 27 years: the Amsterdam Growth and Health Study.

The purpose of this study was to describe the longitudinal development of running economy [defined as the oxygen uptake (VO2) at a submaximal running speed] in males and females from teenage to young adult age using data from the Amsterdam Growth and Health Study. Submaximal VO2 (in ml.kg-1.min-1) was measured in 84 males and 98 females while they ran on a treadmill at a constant speed of 8 km.h-1 for 6 min at three different treadmill slopes (0%, 2.5% and 5%). This test was carried out six times, on the same subjects at the ages of 13, 14, 15, 16, 21, and 27 years. The longitudinal development of running economy in males and females was analysed using a two-way analysis of variance for repeated measurements. At all three slopes, a significant decrease in VO2 with increasing age was found for both males and females, implying a significant increase in running economy for both sexes. Males showed significantly higher VO2 values than females at all ages measured and for all three slopes, suggesting that females have a significantly higher running economy than males. In order to make a better comparison of the VO2 of individuals of different sizes, allometric models were used; power function ratios were constructed in which body mass was expressed to an exponential power. Following this analysis the difference in submaximal VO2 and running economy between males and females appeared even larger.

Adolescent↗

PubMed1997

The relation between "long-term exposure" to lifestyle during youth and young adulthood and risk factors for cardiovascular disease at adult age.

PURPOSE: To investigate the relationship between lifestyle (dietary intake of macronutrients, smoking behavior, alcohol consumption and daily physical activity) from 13-29 years of age ("long-term exposure") and cardiovascular disease (CVD) risk factors (lipoprotein levels, blood pressure, body fatness, and body composition) at the age of 29 years. METHODS: The study was part of the Amsterdam Growth and Health Study, which began in 1977, and in which repeated measurements were carried out over a period of 17 years on 181 subjects (98 females and 83 males). RESULTS: "Long-term exposure" to smoking behavior was inversely related to high density lipoprotein cholesterol (HDL) levels (p = 0.02) and positively to the total cholesterol/HDL ratio (p = 0.05). Both smoking behavior and alcohol consumption were inversely related to blood pressure (p < 0.01). "Long-term exposure" to daily physical activity was inversely related to body fatness (p < 0.01), but for females positively to the waist/hip ratio (p < 0.01). No relationship was found between the dietary intake of macronutrients and the CVD risk factors. When "long-term exposure" was limited to adolescence (13-16 years of age) only the relationship between daily physical activity and the waist/hip ratio for females remained significant (p < 0.01). CONCLUSIONS: "Long-term" smoking behavior was related to a high risk profile regarding hypercholesterolemia, but to a low risk profile regarding blood pressure. The latter was also found for "long-term" alcohol consumption. "Long-term" daily physical activity was related to a low risk profile regarding body fatness; but for females, surprisingly, to a high risk profile regarding body fat distribution.

Adolescent↗

PubMed1997

A new approach to tracking of subjects at risk for hypercholesteremia over a period of 15 years: The Amsterdam Growth and Health Study.

Because 'traditional' tracking analyses have some drawbacks, this paper presents a new method, which is based on generalized estimating equations (GEE). The new method is illustrated with data from the Amsterdam Growth and Health Study. In this observational longitudinal study six repeated measurements were carried out on 181 subjects (initial age 13 years) over a period of 15 years. Tracking was assessed for total cholesterol (TC), high density lipoprotein (HDL) and the TC/HDL ratio by calculating the odds ratio (OR) for subjects at risk at the age of 13 years regarding the development of their risk status over a 15 year period. These ORs can be interpreted as tracking coefficients. Three methods were compared: percentage of subjects who maintain their position in a certain risk group (i.e. univariate logistic regression), multivariate logistic regression and GEE. The three methods differ in the possibility of using all available data in the analysis and in the possibility of adjusting for certain covariates. Based on this, the GEE-approach seemed to be the most appropriate to calculate tracking coefficients for subjects at risk. When the risk groups were defined according to objective (absolute) risk values, for TC the GEE-OR was 10.1 (95% confidence interval (CI) 5.0-21.9), for HDL 14.4 (95% CI 7.2-28.7) and for the TC/HDL ratio 25.5 (95% CI 11.5-56.8). It can be concluded that the GEE-approach is very suitable to assess tracking for subjects at risk.

Adolescent↗

PubMed1997

The association between dietary patterns and cardio vascular disease risk indicators in healthy youngsters: results covering fifteen years of longitudinal development.

OBJECTIVE: To examine longitudinal relationships between nutrition and risk indicators for cardio vascular diseases (CVD) during adolescence and young adulthood. DESIGN: A longitudinal study over fifteen years. SUBJECTS: 98 females and 84 males, from 13 to 27 years. METHODS: By means of six interviews dietary patterns were determined. Blood samples were analyzed for serum concentration of total cholesterol (TC), and high-density-lipoprotein (HDL), blood pressure, body fat and maximal aerobic power (VO2max) were determined. The longitudinal relations were analyzed with generalized estimation equations (GEE), a statistical technique in which relations at different time-points are tested simultaneously. RESULTS: Compared to Dutch recommendations six out of seven macro nutrients appear to be unfavorable with respect to CVD. Borderline or high CVD risk values are apparent at 27 y in more than 25% of the subjects with respect to percentage body fat and serum total cholesterol in both sexes. In males 40% or more show borderline hypertension. The 'univariate' longitudinal analyses showed significantly positive relations: (1) between the intake of animal protein, saturated fat (SFA), cholesterol (Cho1) and TC, and HDL; (2) between total energy intake (EN) and systolic blood pressure, and VO2max. Significantly negative associations were found: (1) between EN, poly-unsaturated fat (PUFA) and TC concentrations; (2) between EN and sum of four skinfolds (SSF). CONCLUSIONS: With increasing age, over a period of 15 y in both sexes the SFA and Cho1 intake relate significantly to the development of a negative CVD risk profile. The intake of PUFA relates positive to a CVD risk profile. The significantly negative relation between EN intake and body fat (SSF) is partly explained by the relation between EN and VO2max.

Adolescent↗

PubMed1997

Longitudinal development and tracking of calcium and dairy intake from teenager to adult.

OBJECTIVES: Because of growing interest in the potential role of calcium in preventive pediatric strategies against osteoporosis, the longitudinal development and tracking of calcium had a dairy intake from adolescence into adulthood was addressed. DESIGN: In the Amsterdam Growth and Health Study, a group of 84 males and 98 females were followed over a 15 y period from age 13-27 y. The calcium and dairy intake was assessed six times by a cross-check dietary history method. To assess tracking, two traditional approaches, interperiod correlation coefficients and percent of subjects who remained in the same quartile of calcium intake over time, and a new approach based on generalized estimating equations were used. RESULTS: The mean calcium intake was relatively high and increased over time (30%). The tracking of calcium and dairy intake from adolescence into adulthood was moderate in both sexes (for example the correlation for calcium was 0.43 in males and 0.38 in females). CONCLUSIONS: The predictability of calcium intake over time does not seem to be sufficiently strong to identify teenagers who are likely to maintain an inadequate calcium intake in adulthood. Therefore, the identification and treatment of subjects with a low calcium intake cannot be limited to the teenage period but should be extended into adulthood.

Adolescent↗

PubMed1997

The Amsterdam Growth and Health Longitudinal Study. The past (1976-1996) and future (1997-?).

This article presents an overview of the Amsterdam Growth and Health Longitudinal Study (AGAHLS). This study was started in the 1970s, following a whole sample of 500 healthy 13-year-old boys and girls from two secondary schools. During the school period (12-17 years) annual measurements were performed with respect to anthropometrics, physiological and psychological parameters, lifestyle characteristics (activity, diet, smoking) and health parameters. A multiple longitudinal design was applied with overlapping birth cohorts and a cross-sectional measured control group to monitor for confounding factors such as time of measurement, cohort, dropout and testing effects. Emphasis is also placed on measures that enhance adherence of the subjects. The follow-up was extended with repeated measurements at age 21, 26 and 28. This enabled us to analyze the data with respect to tracking characteristics of biological and lifestyle variables over a period of 15 years between adolescence and adulthood and also to investigate quasi-causal relationships between the effects of a healthy lifestyle and indicators for cardiovascular diseases (CVD). Also new methods such as measurement of atherosclerosis and osteoporosis will be added and related to longitudinal measurements of the same subjects in the past. The main results that were obtained in the past are summarized and research questions for the near future are explained.

Adolescent↗

PubMed1997

Rate of maturation during the teenage years: nutrient intake and physical activity between ages 12 and 22.

This longitudinal study evaluates the relationship of food intake and physical activity with biological maturation of 200 boys and girls during adolescence and young adulthood. The subjects were followed during 9 years from ages 12 to 22 years, with repeated measurements at ages 13, 14, 15, 16, and 21. Biological maturation was estimated four times between ages 12 and 17 as skeletal age by radiographs of the left hand and wrist. Daily nutritional intake (macro- and micronutrients) was assessed with a cross-checked dietary history method. Daily physical activity was assessed through structured interview, whereby average weekly time spent in activity was used to assign a weighted activity score. The 107 girls and 93 boys were divided into three maturity groups: early maturers, late maturers, and average maturers. It was concluded that in both sexes, late maturation seemed to coincide with a higher energetic food intake and a slightly higher activity pattern than early maturation during adolescence.

Adolescent↗

PubMed1997

The effects of a community-based pulmonary rehabilitation programme on exercise tolerance and quality of life: a randomized controlled trial.

The present multicentre study evaluates the differences in efficacy between a 3 month rehabilitation programme including drug treatment, and a 3 month control period of drug treatment only, for asthmatic patients and patients with chronic obstructive pulmonary disease (COPD). The programme was run by physiotherapists in eight local practices, and included exercise training, patient education, breathing retraining, evacuation of mucus, relaxation techniques, and recreational activities. In a randomized controlled trial with a cross-over design, the effects of rehabilitation were evaluated 3 and 6 months after baseline measurements in terms of exercise tolerance and quality of life (QOL). Exercise tolerance was assessed using submaximal cycle ergometer tests and 6 min walking tests. QOL was evaluated by means of the Chronic Respiratory Disease Questionnaire (CRDQ). After 3 months, the patients who started with rehabilitation showed significant improvements in endurance time (421 s) and cardiac frequency (6 beats.min-1) during cycling, walking distance (39 m), and total CRDQ score (17 points) compared to the control group. These improvements were still significant after 6 months. Additional analysis indicated that the asthmatic patients and the patients with COPD responded to rehabilitation in a similar way, with the exception that there was a greater improvement in walking distance for asthmatics. Improvements in exercise tolerance were not significantly correlated with improvements in QOL. Rehabilitation of patients with asthma or chronic obstructive pulmonary disease in local physiotherapy practices improves exercise tolerance and quality of life.

Adolescent↗

PubMed1996

Relation between the longitudinal development of lipoprotein levels and lifestyle parameters during adolescence and young adulthood.

The longitudinal relationship between serum levels of lipoproteins and lifestyle measures (e.g., intake of cholesterol, carbohydrates, saturated fatty acids [SFA], polyunsaturated fatty acids [PUFA], the PUFA/SFA (P:S) ratio, alcohol consumption, smoking behavior, and daily physical activity) was investigated over a period of 15 years in a cohort study (the Amsterdam Growth and Health Study). Members of the cohort were 13 years of age at commencement of the study and were 27 years old at termination. The unique feature of the study presented is that the longitudinal relations were analyzed with generalized estimating equations, a statistical technique in which the relations at different time-points are tested simultaneously. The development of the total serum cholesterol (TC) level was positively related to the intake of cholesterol and negatively to the P:S ratio. The development of high-density-lipoprotein cholesterol (HDL) level was positively related to alcohol consumption and daily physical activity and negatively to smoking behavior. The development of the TC:HDL ratio was negatively related to alcohol consumption and positively to both smoking behavior and carbohydrate intake.

Adolescent↗

PubMed1996

Identification of high-risk groups among maintenance workers in a steel company with respect to musculoskeletal symptoms and workload.

To determine priorities for ergonomic improvements in five maintenance departments of a steel company, a study was carried out to identify groups with a high prevalence of musculoskeletal problems or a high exposure to unfavourable musculoskeletal workload. All workers were asked to complete a standardized questionnaire on musculoskeletal symptoms and musculoskeletal workload. Response rate in the five departments varied between 60 and 80% (n = 436). Symptoms of low back and neck-shoulder (12-month prevalence rates of 53% and 36%, respectively) were most common, but not higher in comparison with a reference group of 396 non-sedentary workers. Self-reported exposure rates to physical and psychosocial loads as well as poor climatic conditions were comparable with the reference group; only exposure to vibration was higher. Significant differences were seen between the five departments as well as between task groups with the departments. Several task groups with relatively high symptom rates and high exposure levels could be identified. It is concluded that a questionnaire survey can constitute a valuable contribution to the selection of high-risk task groups that need ergonomic intervention.

Adult↗

PubMed1996

Development and tracking of central patterns of subcutaneous fat in adolescence and adulthood: the Amsterdam Growth and Health Study.

BACKGROUND: A central pattern of body fat is recognized as a risk indicator of cardiovascular diseases in adulthood. The development of this body fat pattern from childhood into adulthood however, remains to be explored. METHODS: The development of two trunk skinfolds (subscapular; supra-iliac), two extremity skinfolds (biceps; triceps), and three trunk-extremity skinfold ratios for males (n = 71) and females (n = 84), were described over a period of 17 years from 13 to 29 years of age. In addition, tracking of the skinfolds and the skinfold ratios was investigated over this period. Data for this study came from the Amsterdam Growth and Health Study, an ongoing longitudinal study in the Netherlands that started in 1977. RESULTS: In adolescence, a decrease was seen in extremity skinfolds for men but not for women. For both sexes, the trunk skinfolds increased over the entire period of study. An increase was found in trunk-extremity skinfold ratios in males, but not in females. Tracking coefficients, calculated as Pearson correlation coefficients between the initial measurement and subsequent measurements, were about 0.4 for the single skinfolds between 13 and 29 years of age for both men and women. For the skinfold ratios, these correlation coefficients were about 0.55. Longitudinal tracking coefficients, measuring the association between the initial measurement and all follow-up data simultaneously, were about 0.65 for both men and women. CONCLUSIONS: A central pattern of body fat, mainly seen in males, seems to start in adolescence. From a preventive point of view, tracking coefficients were too low to be of predictive value. In order to conclude that the roots of a central pattern of body fat are in adolescence, careful search for determinants of change of this body fat pattern is needed.

Adipose Tissue↗

PubMed1996

Relative validity of 16-year recall of calcium intake by a dairy questionnaire in young Dutch adults.

Assessing past calcium intake in studies of osteoporosis is of major importance because calcium intake during young adulthood is thought to influence bone mass in later life. However, uncertainty exists about the accuracy of retrospectively reported calcium intake. We therefore evaluated whether a dairy questionnaire estimating calcium intake only from dairy products is a valid method to assess the retrospectively reported calcium intake of 29-year old Dutch males and females 8 and 16 y previously. This was examined in 166 subjects by comparing their original calcium intake reported in 1977 and 1985 by a cross-check dietary history method, with their 1977 and 1985 calcium intake values recalled in 1993 by the dairy questionnaire. The overestimation of the retrospectively reported calcium intake compared with the original intake (11-33%) suggests that the dairy questionnaire is a relatively poor tool to assess the absolute calcium intake of young adults 8 and 16 y ago. Based on the agreement statistics, the dairy questionnaire is a reasonably valid instrument to rank subjects according to their retrospective calcium intake. However, the reporting of the retrospective calcium intake appears to have been influenced by the current calcium intakes reported at the age of 29 y. Nevertheless, the retrospective calcium intake appears to be a better indicator of the original intake than the current intake because the subjects markedly increased their calcium intake over the 16-y period.

Adolescent↗

PubMed1996

Repeatability and relative validity of two physical activity questionnaires in elderly women.

In a population of 33 women aged 51-71 yr, two physical activity questionnaires (a modified Baecke questionnaire and the pre-EPIC questionnaire) were tested for repeatability (5 and 11 months). For assessment of relative validity, the questionnaires were compared with a physical activity diary (12 d) as the main reference method, a single 24-h Caltrac accelerometer score, and energy intake estimated from a 24-h dietary recall repeated 12 times. Repeatability of the questionnaires at 5 months was 0.82 (Baecke) and 0.42 (pre-EPIC), at 11 months 0.73 and 0.60, respectively. Correlation with the activity diary was 0.51 for the Baecke and 0.64 for the pre-EPIC questionnaire. Correlation with the Caltrac was 0.22 for both questionnaires, and with energy intake -0.21 and 0.43, respectively. Factor analysis suggested that the questionnaires and the diary measured a common aspect of activity, which could be interpreted as "reported normal physical activity." Women who reported sweating or breathlessness during the past week scored significantly higher only on the Baecke questionnaire. It was concluded that the two questionnaires seemed to be able to rank older women according to physical activity in epidemiological studies.

Aged↗

PubMed1996

Subject-related risk factors for sports injuries: a 1-yr prospective study in young adults.

The purpose of this study was to investigate the importance of subject-related risk factors for sports injuries, taking exposure time into account. At baseline in 182 healthy males and females (27 yr) the following subject-related risk factors were assessed: body mass index (BMI), maximal oxygen uptake (direct treadmill measurement), seven aspects of neuromotor fitness (MOPER fitness test), strength of the hamstring and quadriceps muscles (CYBEX), having sustained a sports injury in the 12 months preceding the baseline measurement ("previous injury"), and 16 psychological and psychosocial factors (measured with 8 standard, valid, and reliable questionnaires). For 1 yr, subjects were asked to make daily entries on a monthly log concerning all sports activities exceeding an intensity of 4 MET and all sustained sport injuries. Completed logs were returned by 139 subjects (75 males and 64 females). Fifty-one injuries were registered in 41 subjects. The overall incidence rate (IR) was 3.7 sports injuries per 1000 h of sports participation (95% confidence interval 2.8-4.9). For various subcategories, the following IR per 1000 h of sports participation were calculated: contact sports IR = 11.0 (95% CI 7.4-16.3); noncontact sports IR = 2.3% (95% CI 1.6-3.3); competition IR = 13.4 (95% CI 8.7-20.6); and training IR = 2.8 (95% CI 1.6-5.1). Data were analyzed by stepwise multiple logistic regression. The following five variables were independent and significant (P < 0.05) predictors of risk in sustaining a sport injury: dominance (odds ratio (OR) = 1.71; 95% CI = 1.44-2.03), vital exhaustion (OR = 1.85; CI = 1.22-2.86), stressful life events (OR = 1.84; 95% CI = 1.10-311); these ORs were calculated for an increase of 10% of the range of obtained scores, starting at minimum value. For total sporting time, the OR was calculated by taking the group with a total sporting time below the median (4050 h) as a reference (OR = 6.87; 95% CI = 2.09-22.55). For previous injury, subjects that had not sustained a sports injury in the 12 months preceding the baseline measurements served as a reference for the calculation of the OR (OR = 9.41; 95% CI = 2.80-31.58). These findings confirm that both exposure time and previous injury are more important predictors of sports injuries than psychological, psychosocial, physiological, and anthropometrical factors.

Adult↗

PubMed1996

Relation between the longitudinal development of lipoprotein levels and biological parameters during adolescence and young adulthood in Amsterdam, The Netherlands.

STUDY OBJECTIVES: To analyse the relation between the longitudinal development of total serum cholesterol (TC), high density lipoprotein cholesterol (HDL), and the TC/ HDL ratio and the longitudinal development of the biological parameters body fatness (SSF), lean body mass (LBM), and cardiopulmonary fitness (VO2-max). The relations were analysed with generalised estimating equations (GEE). SETTING: The relations were investigated with data from the Amsterdam growth and health study, a longitudinal study in which six measurements were carried out within a period of 15 years. PARTICIPANTS: Altogether 98 females and 84 males aged 13 years at the start of the study. MAIN RESULTS: Adjusted for lifestyle and other biological parameters, the longitudinal development of TC was inversely related to the development of LBM (standardised regression coefficient beta = -0.27; p < or = 0.01) and positively to SSF (beta males = 0.32; p < or = 0.01 and beta females = 0.15; p < or = 0.01). HDL was inversely related to LBM (beta = -0.26; p < or = 0.01) and positively to VO2-max (beta = 0.08; p < or = 0.05). The TC/HDL ratio was positively related to SSF (beta males = 0.39; p < or = 0.01 and beta females = 0.13; p < or = 0.01) and inversely to VO2-max (beta = -0.09; p < or = 0.05). CONCLUSIONS: The longitudinal analyses showed that body fatness was related to a high risk profile with respect to hypercholesterolaemia, and cardiopulmonary fitness to a low risk profile. Furthermore, it was shown that using body mass index as an indicator of body fatness in relation to lipoprotein values, has some important drawbacks.

Adolescent↗

PubMed1996

The role of antioxidant vitamins and enzymes in the prevention of exercise-induced muscle damage.

A growing amount of evidence indicates that free radicals play an important role as mediators of skeletal muscle damage and inflammation after strenuous exercise. It has been postulated that the generation of oxygen free radicals is increased during exercise as a result of increases in mitochondrial oxygen consumption and electron transport flux, inducing lipid peroxidation. The literature suggests that dietary antioxidants are able to detoxify the peroxides produced during exercise, which could otherwise result in lipid peroxidation, and that they are capable of scavenging peroxyl radicals and therefore may prevent muscle damage. Endogenous antioxidant enzymes also play a protective role in the process of lipid peroxidation. The studies reviewed (rodent and human) show significant increases of malondialdehyde (a product of lipid peroxidation) after exercise to exhaustion, and also favourable changes in plasma antioxidant levels and in antioxidant enzyme activity. In trained individuals and trained rats, the antioxidant enzyme activity increases markedly. In this way, the increased oxidative stress induced by exercise is compromised by increased antioxidant activity, preventing lipid peroxidation. Human studies have shown that dietary supplementation with antioxidant vitamins has favourable effects on lipid peroxidation after exercise. Although several points of discussion still exist, the question whether antioxidant vitamins and antioxidant enzymes play a protective role in exercise-induced muscle damage can be answered affirmatively. The human studies reviewed indicate that antioxidant vitamin supplementation can be recommended to individuals performing regular heavy exercise. Moreover, trained individuals have an advantage compared with untrained individuals, as training results in increased activity of several major antioxidant enzymes and overall antioxidant status. However, future studies are needed in order to be able to give more specific information and recommendations on this topic.

Animals↗

PubMed1996

Biological maturation and the distribution of subcutaneous fat from adolescence into adulthood: the Amsterdam Growth and Health Study.

OBJECTIVE: To analyze differences in the development of a trunk-oriented fat distribution pattern between 13 and 27 years of age in individuals who either matured rapidly or slowly in adolescence. DESIGN: Longitudinal, observational, four annual measurements between 1977 and 1980 and additional measurements in 1985 and 1991. SUBJECTS: 79 boys, 98 girls, health Caucasian schoolchildren, classified as rapidly, normally or slowly maturing. MEASUREMENTS: biceps, triceps, subscapular, suprailiac skinfolds resulting in two skinfold ratios, body mass index, skeletal age, peak height velocity (for boys only), age at menarche. RESULTS: No statistically significant differences were found between rapidly and slowly maturing boys and girls, based on the skeletal age or the peak height velocity. Girls with a relatively early menarche showed significant higher mean skinfold ratios between 13 and 27 years of age than girls with a relatively late menarche. CONCLUSION: Skeletal maturation of boys and girls and peak height velocity (only measured in boys) are not associated with a trunk-oriented fat distribution pattern between 13 and 27 years of age. Only a relatively early menarche in girls seems to be associated with a trunk-oriented fat distribution pattern from adolescence into adulthood.

Adipose Tissue↗

PubMed1995

[The longitudinal development of smoking behavior in men and women between 13 and 27 years and the relationship with biological risk factors for cardiovascular diseases].

OBJECTIVE: To describe the longitudinal development of smoking behaviour from adolescence (age 13 years) into young adulthood (age 27 years) and to analyse the longitudinal relationship between smoking behaviour and biological risk factors for cardiovascular disease. DESIGN: Longitudinal. SETTING: Amsterdam school children. METHODS: This study was carried out as part of the Amsterdam Growth and Health Study, an observational longitudinal study. Six measurements were carried out over a period of 15 years in 84 males and 98 females, and included a questionnaire regarding smoking behaviour and blood analysis for cholesterol parameters. Tracking analysis and generalized estimating equations analysis were used. RESULTS: Both the percentage of smokers and the amount of tobacco smoked by smokers increased until the age of 21 years. After that smoking behaviour remained more or less stable in males and decreased slightly in females (period effect). Between 16 and 21 years half the number of persons tried to stop smoking but failed to succeed. The development of smoking behaviour appeared to be related to low systolic blood pressure and to development of a negative risk profile regarding hypercholesterolaemia (i.e. low high-density lipoprotein (HDL) cholesterol and high ratio of total cholesterol and HDL cholesterol). There was no relationship between smoking and the amount of subcutaneous fat.

Adolescent↗