Physical Activity and cardiovascular risk factors in children

Department of Exercise Epidemiology, Center for Research in Childhood Health, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark.
British Journal of Sports Medicine (Impact Factor: 5.03). 09/2011; 45(11):871-6. DOI: 10.1136/bjsports-2011-090333
Source: PubMed


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.

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    • "Secondly, current guidelines are based on self-report PA, which has numerous limitations, and do not include novel CVD risk markers as outcome measures. Andersen et al.[3]addressed these limitations via inclusion of objective PA data, and novel inflammatory markers. However, endothelial and diastolic dysfunction are yet to be included in such analyses despite the crucial role each plays in the development of CVDs[10], their strong prognostic capacity in predicting CV events[11,12], and clear associations with PA131415. "
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    ABSTRACT: Background: Physical activity reduces cardiovascular mortality and morbidity. The World Health Organisation (WHO) recommends children engage in 60 min daily moderate-to-vigorous physical activity (MVPA). The effect of compliance with this recommendation on childhood cardiovascular risk has not been empirically tested. To evaluate whether achieving recommendations results in reduced composite-cardiovascular risk score (CCVR) in children, and to examine if vigorous PA (VPA) has independent risk-reduction effects. Methods: PA was measured using accelerometry in 182 children (9-11 years). Subjects were grouped according to achievement of 60 min daily MVPA (active) or not (inactive). CCVR was calculated (sum of z-scores: DXA body fat %, blood pressure, VO2peak, flow mediated dilation, left ventricular diastolic function; CVR score ≥1SD indicated 'higher risk'). The cohort was further split into quintiles for VPA and odds ratios (OR) calculated for each quintile. Results: Active children (92 (53 boys)) undertook more MVPA (38 ± 11 min, P < 0.001), had greater VO2peak (4.5 ± 0.8 ml/kg/min P < 0.001), and lower fat % (3.9 ± 1.1 %, P < 0.001) than inactive. No difference were observed between active and inactive for CCVR or OR (P > 0.05). CCVR in the lowest VPA quintile was significantly greater than the highest quintile (3.9 ± 0.6, P < 0.05), and the OR was 4.7 times higher. Conclusion: Achievement of current guidelines has positive effects on body composition and cardiorespiratory fitness, but not CCVR. Vigorous physical activity appears to have beneficial effects on CVD risk, independent of moderate PA, implying a more prescriptive approach may be needed for future VPA guidelines.
    Preview · Article · Dec 2015 · BMC Public Health
    • "Sport injuries are also of economic concern as they lead to high direct and indirect costs contributing to the health-economic burden of public health (Collard et al., 2011). Increased physical activity and fitness levels have numerous health benefits (Ekblom & Astrand, 2000; Janssen & Leblanc, 2010; Andersen et al., 2011) and from a health-related perspective it is of interest to increase physical fitness levels in the general population . School settings may be both effective and universally applicable to increase activity and fitness levels in children and adolescents because physical education (PE) in schools is compulsory in most countries, and therefore includes the least active children (Kriemler et al., 2011). "
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    ABSTRACT: The aims of this study were to investigate if (A) injuries and (B) increased physical education (PE) influenced the development of physical fitness in schoolchildren. Simultaneously, to investigate if a possible PE effect was modified by sport participation outside school hours. This was a longitudinal controlled school-based study. Six schools with 270 min of PE (extra PE) and four schools with 90 min of PE were followed up for 2.5 years. In total, 1054 children were included for analysis (normal PE = 443, extra PE = 611). Development in fitness was analyzed using composite z-scores from six fitness tests measured four times. Information of injury and sport was derived from weekly automated mobile phone text messages surveying the presence of musculo-skeletal pain and organized sport participation. Injury and extra PE both influenced the development of physical fitness. Injury decreased development of physical fitness with -1.01 composite z-score units (95% CI: -1.57; -0.45). Extra PE increased physical fitness development with 0.80 (95% CI: 0.49; 1.10) composite z-score units. The influence of injury was not dependent on extra PE. No modifying effect was found by mean weekly sport participation outside school hours. In conclusion, extra PE had a positive effect, whereas injuries had a negative effect on physical fitness development in schoolchildren.
    No preview · Article · Dec 2015 · Scandinavian Journal of Medicine and Science in Sports
    • "Physical activity (PA) in developmental age has been associated with both physical and mental positive health changes, such as decreasing in cardiovascular risk factors [1], preventing metabolic diseases [2], improving quality of life [3], behavior [4], self-esteem [5], and mood [6]. Moreover, physical exercise by youths has been linked to improvement in cognition, learning and academic proficiency [7], through different possible neurobiological mechanisms: increased volume of cerebral blood flow and oxygen rate [8], modifications in hypothalamic-pituitaryadrenal axis hormonal release [9], and increase in neurotrophic factors (particularly in brain-derived neurotrophic factor, BDNF), which in turn have been hypothesized to determine the increase in white matter volume and connectivity [10]. "
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    ABSTRACT: Schools are an ideal setting to implement physical activity programs targeted at youths' learning and intellectual abilities, as exercise has been associated with improvement in cognitive skills and academic proficiency. A systematic review of the literature was performed to examine the effects of school-based physical activity interventions on academic achievement and cognitive outcomes. A search for relevant papers was carried out on PubMed/Medline, Scopus and Google Scholar. Only quasi-experimental and experimental studies were included, if focused on school-based physical activity interventions targeting 3 to 18 year-old healthy pupils, and designed to establish a relationship between exercise performed in a school setting and cognitive/academic performance. Thirty-one papers were retrieved by the search, reporting the findings of twenty-eight school-based physical activity interventions. Most of the included studies were published in the past five years. A large majority of the studies showed positive results in terms of academic achievement and, above all, cognitive skills. In the recent years, the number of studies on school-based physical interventions aimed to establish a relationship between physical activity performed in school setting and cognitive/academic outcomes significantly increased, as well as high quality assessments and designs. This review highlights the effectiveness of school-based physical activity interventions on academic achievement and, above all, on youths' cognitive performance. Some interesting findings come from studies assessing brain functional changes, from interventions targeting culturally diverse or low-income samples, and from interventions where physical activity is in the form of active videogames.
    No preview · Article · Nov 2015 · CNS & neurological disorders drug targets
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