Ibadan study: Boys face higher blood pressure risk as diet fails to explain childhood hypertension

Dietary patterns alone may not explain elevated blood pressure among children and adolescents in Ibadan, even as boys were found to have 60 per cent higher odds of elevated diastolic blood pressure than girls, a new study has found.

The study, led by Dr M. D. Dairo, with Adedeji Abdulrahmon Alayande as the second author, examined 335 children and adolescents aged eight to 14 in selected urban and rural communities in Ibadan, Oyo State. It was published on August  edition of Discover Public Health.

The researchers found that male participants had 60 per cent higher odds of elevated diastolic blood pressure compared with females. They also identified three major dietary patterns: traditional/plant-based, sweetened beverage, and protein/Westernised.

However, none of the three dietary patterns showed a statistically significant association with elevated systolic or diastolic blood pressure.

The community-based study was conducted between May and November 2025 among children aged eight to 14 years in selected communities in Ibadan, covering four local government areas and 12 communities.

Dietary intake was assessed using a 47-item food-frequency questionnaire, while blood pressure was measured twice, five minutes apart, after participants had rested in a seated position.

The analysis was adjusted for age and sex but did not include potentially important variables such as body mass index, physical activity and pubertal stage.

The study found that increasing scores on the traditional/plant-based dietary pattern were associated with approximately 22 per cent higher odds of elevated diastolic blood pressure, but the association did not reach statistical significance.

Age, however, showed a significant association with elevated systolic blood pressure, with increasing age associated with approximately 16 per cent lower odds of elevated systolic blood pressure.

Alayande, who identified the research as a major component of his MSc thesis, said the findings suggest that dietary exposure may not produce immediately measurable blood-pressure changes during childhood and early adolescence.

In a public statement on the research, he noted that although the identified dietary patterns were not significantly associated with systolic or diastolic blood pressure, diastolic blood pressure showed a positive trend with the traditional/plant-based dietary pattern.

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He also highlighted the difference between male and female participants, noting that the higher risk observed among males “may reflect early sex differences in vascular tone and autonomic regulation”.

Alayande further suggested that the absence of a significant dietary association could mean that the cumulative effects of dietary patterns require prolonged exposure before clinically meaningful changes in blood pressure become apparent.

The researchers similarly suggested that developmental differences in vascular tone, autonomic regulation and hormonal changes during puberty could contribute to differences in blood pressure between boys and girls.

The researchers also raised an important question about what constitutes a “healthy” traditional diet.

Although the traditional/plant-based pattern contained fruits, vegetables and legumes, traditional Nigerian cooking can involve substantial sodium through seasoning cubes, soups and preserved foods.

They suggested that food preparation practices and the balance between sodium and potassium could potentially explain the positive trend observed between the traditional/plant-based pattern and diastolic blood pressure.

They stressed, however, that this remains a possible explanation rather than a finding established by the study.

According to the researchers, the findings add to concerns about the emergence of cardiovascular risk factors among Nigerian children and highlight the need to look beyond diet when assessing the causes of elevated blood pressure in young people.

Despite concerns over increasing consumption of sugary drinks and processed foods among children, the study found no statistically significant association between dietary pattern scores and systolic blood pressure.

The researchers also pointed out that the effects of dietary habits may accumulate over time and become more evident later in life.

They therefore called for longitudinal studies that follow children over several years and repeatedly assess dietary intake and blood pressure.

They also recommended that future research incorporate body composition, physical activity, pubertal development and broader cardiometabolic indicators.

The study, according to the authors, demonstrates the complexity of blood-pressure regulation among young Nigerians and the need for a broader approach to cardiovascular-risk prevention.