Andersen LB, Harro M, Sardinha LB, Froberg K, Ekelund U, Brage S et al.. Physical activity and clustered cardiovascular risk in children: a cross sectional study (The European Youth Heart Study). Lancet 368, 299-304

Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.
The Lancet (Impact Factor: 45.22). 08/2006; 368(9532):299-304. DOI: 10.1016/S0140-6736(06)69075-2
Source: PubMed


Atherosclerosis develops from early childhood; physical activity could positively affect this process. This study's aim was to assess the associations of objectively measured physical activity with clustering of cardiovascular disease risk factors in children and derive guidelines on the basis of this analysis.
We did a cross-sectional study of 1732 randomly selected 9-year-old and 15-year-old school children from Denmark, Estonia, and Portugal. Risk factors included in the composite risk factor score (mean of Z scores) were systolic blood pressure, triglyceride, total cholesterol/HDL ratio, insulin resistance, sum of four skinfolds, and aerobic fitness. Individuals with a risk score above 1 SD of the composite variable were defined as being at risk. Physical activity was assessed by accelerometry.
Odds ratios for having clustered risk for ascending quintiles of physical activity (counts per min; cpm) were 3.29 (95% CI 1.96-5.52), 3.13 (1.87-5.25), 2.51 (1.47-4.26), and 2.03 (1.18-3.50), respectively, compared with the most active quintile. The first to the third quintile of physical activity had a raised risk in all analyses. The mean time spent above 2000 cpm in the fourth quintile was 116 min per day in 9-year-old and 88 min per day in 15-year-old children.
Physical activity levels should be higher than the current international guidelines of at least 1 h per day of physical activity of at least moderate intensity to prevent clustering of cardiovascular disease risk factors.

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    • "Secondarily, it plays an important role in reducing the risk of suffering from non-transmissible diseases such as cardiopathy, diabetes or even cancer (Andersen et al., 2006). Furthermore, PA directly acts on obesity by reducing the Body Mass Index (BMI), which is an indicator of obesity and overweight. "
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    ABSTRACT: Objectives. This study aims to analyse physical activity (PA) levels of high school and university students; to estimate their perception of built environment with regard to physical PA; and to assess the relation between PA and built environment. Methods. A sociological cross-sectional study with non-experimental design was applied. The International Physical Activity Questionnaire and the Built Environment Characteristics Questionnaire were filled in by a sample of 1.862 students from high schools and the university in Granada, Spain. Results. High school students were significantly more active than university students, the latter reaching insufficient levels of PA. Nevertheless, they consider Granada as a good context for carrying out outdoor exercise. No relations were found between PA levels and built environment. Conclusion. The discrepant outcomes for PA levels and perceived built environment suggest the need of interventions focused on making youth aware of the possibilities that an environment provides to them for exercising. Consequently, environment could have an impact on their health at the same time as youth learn to respect it.
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    • "Statistical analysis was performed in IBM SPSS Statistics 22 and Stata 12 (meta- analysis). Common estimates were calculated using random effect meta-analysis [13]. Analysis was progressed by the following steps. "
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    ABSTRACT: The aim of the study was to test the performance of a new definition of metabolic syndrome (MetS), which better describes metabolic dysfunction in children. Methods. 15,794 youths aged 6-18 years participated. Mean z-score for CVD risk factors was calculated. Sensitivity analyses were performed to evaluate which parameters best described the metabolic dysfunction by analysing the score against independent variables not included in the score. Results. More youth had clustering of CVD risk factors (>6.2%) compared to the number selected by existing MetS definitions (International Diabetes Federation (IDF) < 1%). Waist circumference and BMI were interchangeable, but using insulin resistance homeostasis model assessment (HOMA) instead of fasting glucose increased the score. The continuous MetS score was increased when cardiorespiratory fitness (CRF) and leptin were included. A mean z-score of 0.40-0.85 indicated borderline and above 0.85 indicated clustering of risk factors. A noninvasive risk score based on adiposity and CRF showed sensitivity and specificity of 0.85 and an area under the curve of 0.92 against IDF definition of MetS. Conclusions. Diagnosis for MetS in youth can be improved by using continuous variables for risk factors and by including CRF and leptin.
    Full-text · Article · May 2015 · Journal of Diabetes Research
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    • "Several studies concluded that low levels of PA and high levels of SB have been associated with increased overall cardio-metabolic risk [10] [11] [12] [13] and overweight [14] [15] among children. Some of them have analyzed the associations between PA and single cardiovascular diseases risk factors [13] [14] [16], and have shown that these associations are often very weak. "
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    ABSTRACT: Background/Objective: Increased physical activity (PA) and decreased sedentary behaviors (SB) may have beneficial effects on cardio-metabolic risk in adolescents. The aim of this study was to examine the associations between independent/combined effects of PA and SB with individual/clustered cardio-metabolic risk factors. Methods: A sample of 769 adolescents (12.5-17.5 years) from the HELENA cross-sectional study (Healthy Lifestyle in Europe by Nutrition in Adolescence) and with valid data on metabolic risk factors were included. Results: Concerning moderate-to-vigorous-PA (MVPA) and vigorous-PA (VPA), measured with accelerometers, girls tended to do more MVPA (36%) and VPA (114%) than boys. Unadjusted analyses show a positive association between “PA≥60min/d; SB≥2h” and the ratio TC/HDL-c (β= 0.27; 95%CI 0.01 to 0.52; p<0.05), and a negative association between “MVPA≥60min/d; SB<2h” with the ∑4Skinfolds (β=-0.32; 95%CI -0.61 to -0.02; p<0.05). Moreover, “SB≥2h/d” was associated with increased cardio-metabolic risk (PR 1.59; 95%CI 1.05 to 2.39; p<0.05), while “PA≥60min/d; SB<2h” had a protective effect against cardio-metabolic risk (PR 0.48; 95%CI 0.25 to 0.91; p<0.05). After adjustment for potential confounders, a positive association between SB and ∑4Skinfolds was shown (β= 0.28; 95%CI 0.04 to 0.53; p<0.05). Furthermore, VO2max (mL/Kg/min) tend to increase in those participants who do higher VPA and less SB (p=0.042), and there was a protective effect of “VPA≥30min/d; SB<2h” against cardio-metabolic risk (PR 0.24; 95%CI 0.07 to 0.85; p<0.05). Conclusion: The current study suggests that adolescents should be encouraged to decrease sedentary lifestyle and increase physical activity, especially vigorous physical activity, in order to reduce cardio-metabolic risk.
    Full-text · Article · Mar 2015 · International Journal of Cardiology
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