Physical activity and cardiovascular risk factors in children.
ABSTRACT A number of recent systematic reviews have resulted in changes in international recommendations for children's participation in physical activity (PA) for health. The World Health Authority (WHO) has recently released new recommendations. The WHO still recommends 60 min of moderate to vigorous physical activity (MVPA), but also emphasises that these minutes should be on top of everyday physical activities. Everyday physical activities total around 30 min of MVPA in the quintile of the least active children, which means that the new recommendations constitute more activity in total compared with earlier recommendations.
To summarise evidence justifying new PA recommendation for cardiovascular health in children.
The results of recent systematic reviews are discussed and supplemented with relevant literature not included in these reviews. PubMed was searched for the years 2006-2011 for additional topics not sufficiently covered by the reviews.
PA was associated with lower blood pressure and a healthier lipid blood profile in children. The association was stronger when a composite risk factor score was analysed, and the associations between physical fitness and cardiovascular disease (CVD) risk factors were even stronger. Muscle strength and endurance exercise each had an effect on blood lipids and insulin sensitivity even if the effect was smaller for muscle strength than for aerobic exercise. New evidence suggests possible effects of PA on C-reactive protein.
There is accumulating evidence that PA can have beneficial effects on the risk factors of CVD in children. Public health policy to promote PA in children, especially the most sedentary children, may be a key element to prevent the onset of CVD later in the children's lives.
- SourceAvailable from: Natalia Arias[Show abstract] [Hide abstract]
ABSTRACT: Background Studies that have examined the impact of a physical activity intervention on cardiometabolic risk factors have yielded conflicting results. The objective of this study was to assess the impact of a standardized physical activity program on adiposity and cardiometabolic risk factors in schoolchildren.Methods Cluster randomized trial study of 712 schoolchildren, 8¿10 years, from 20 public schools in the Province of Cuenca, Spain. The intervention (MOVI-2) consisted of play-based and non-competitive activities. MOVI-2 was conducted during two 90-minute sessions on weekdays and one 150-minute session on Saturday mornings every week between September 2010 and May 2011. We measured changes in adiposity (overweight/obesity prevalence, body mass index [BMI], triceps skinfold thickness [TST], body fat %, fat-free mass, waist circumference) and other cardiometabolic risk factors (LDL-cholesterol, triglycerides/HDL-cholesterol ratio, insulin, C-reactive protein and blood pressure). The analyses used mixed regression models to adjust for baseline covariates under cluster randomization.ResultsAmong girls, we found a reduction of adiposity in intervention versus control schools, with a decrease in TST (¿1.1 mm; 95% confidence interval [CI] -2.3 to ¿0.7), body fat % (¿0.9%; 95% CI ¿1.3 to ¿0.4), waist circumference (¿2.7 cm; 95% CI ¿4.5 to ¿0.9), and an increase in fat-free mass (0.3 kg; 95% CI 0.01 to 0.6). The intervention also led to lower serum LDL-cholesterol and insulin levels. Among boys, a reduction in waist circumference (¿1.4 cm; 95% CI ¿2.6 to ¿0.1; P¿=¿0.03), and an increase in fat-free mass (0.5 kg; 95% CI 0.2 to 0.9; P¿=¿0.003) was associated with the intervention versus control schools. The prevalence of overweight/obesity or underweight, BMI, and other cardiometabolic risk factors was not modified by the intervention. No important adverse events were registered.Conclusions An extracurricular intervention of non-competitive physical activity during an academic year, targeting all schoolchildren regardless of body weight, is a safe and effective measure to reduce adiposity in both genders and to improve cardiometabolic risk profile in girls.Trial registrationClinical trials NCT01277224.International Journal of Behavioral Nutrition and Physical Activity 12/2014; 11(1):154. · 3.68 Impact Factor
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ABSTRACT: This study presents a novel method to assess context-specific physical activity patterns using accelerometer and GPS. The method efficiency is investigated by providing descriptive results on the use of domains and subdomains, and assessing how much of children's and adolescents' daily activity time can be classified by these domains and subdomains. Four domains and 11 subdomains were defined as important contexts for child and adolescent behaviour. During weekdays (n=367) and weekend days (n=178) the majority of children and adolescents spent time in active transport, urban green space, clubs and sports facilities. Satisfactory method efficiency was found during weekdays. Natural experiments combined with objective assessment of context-specific behaviours hold the potential to create evidence on the effects of changes to the built environment on behaviour. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.Health & Place 12/2014; 31C:90-99. · 2.44 Impact Factor
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ABSTRACT: Background Effective lifestyle interventions are needed to prevent noncommunicable diseases in low- and middle-income countries. We analyzed the effects of a school-based health promotion intervention on physical fitness after 28 months and explored if the effect varied with important school characteristics. We also assessed effects on screen time, physical activity and BMI.Methods and resultsWe performed a cluster-randomized pair matched trial in schools in urban Ecuador. The intervention included an individual and environmental component tailored to the local context and resources. Primary outcomes were physical fitness (EUROFIT battery), screen time (questionnaires) and physical activity (accelerometers). Change in BMI was a secondary outcome. A total of 1440 grade 8 and 9 adolescents (intervention: n =¿700, 48.6%) and 20 schools (intervention: n =¿10, 50%) participated. Data of 1083 adolescents (intervention: n =¿550, 50.8%) from 20 schools were analyzed.The intervention increased vertical jump (mean effect 2.5 cm; 95%CI 0.8-4.2; P =¿0.01). Marginally insignificant, adolescents from the intervention group needed less time for speed shuttle run (intervention effect =¿¿0.8 s, 95%CI ¿1.58-0.07; P =¿0.05). The proportion of students achieving over 60 minutes of moderate-to-vigorous physical activity / day decreased over time with the change in proportion significantly less in the intervention schools (6 vs. 18 percentage points, P <¿0.01). The intervention effect on speed shuttle run was significant in larger schools while the effect on vertical jump was larger in mixed gender school compared to small and female schools. The proportion of schools that met the recommendations for physical activity increased with 37% in intervention schools with half-day schedule compared to the controls in the pair. No significant effects were found on screen time and BMI. Measurement of physical activity in a subsample was a limitation. No adverse effects were reported.ConclusionsA school-based intervention with an individual and environment component can improve physical fitness and can minimize the decline in physical activity levels from childhood into adolescence in urban Ecuador.Trial registrationClinicaltrials.gov identifier NCT01004367.International Journal of Behavioral Nutrition and Physical Activity 12/2014; 11(1):153. · 3.68 Impact Factor