An average of 60mins/day of moderate to vigorous physical activity from childhood through young adulthood was associated with worsening cardiac structural damage in youth: A 13-year longitudinal study

Abstract

Abstract Background Health guidelines have recommended that children and adolescents engage in moderate to vigorous physical activity (MVPA) of ≥60mins/day. However, there is no longitudinal evidence on the effect of ≥60mins/day of MVPA on cardiac health in the pediatric population. Purpose To investigate the longitudinal association of cumulative MVPA from childhood through young adulthood with cardiac structural changes. Methods From the Avon Longitudinal Study of Parents and Chidren (ALSPAC), UK birth cohort, 766 children aged 11 years who had at least two follow-up time-points accelerometer-measured light physical activity over 13 years follow-up, and complete cardiac structural measures at age 17 years clinic visit were included. MVPA was assessed with ActiGraph accelerometer worn for 4-7 days at the 11-, 15-, and 24-year clinic visits. Moderate to vigorous physical activity was categorized as <40 mins/day (reference), 40–<60mins/day, and ≥60mins/day. Echocardiography assessed left ventricular mass indexed for height2.7 (LVMI2.7) and relative wall thickness (RWT) at baseline and follow-up. Associations were examined using generalized linear mixed-effect models and adjusted for sex, and time-varying covariates measured at both baseline and follow-up such as age, insulin, high-sensitivity C-reactive protein, heart rate, systolic blood pressure, glucose, fat mass, lean mass, smoking status, family history of hypertension/diabetes/high cholesterol/vascular disease, socioeconomic status, triglyceride, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, sedentary time, and light PA. Results Among 766 children (mean [SD] age, 11.75 [0.24] years; 422 [55.0%] females]) males spent on average 64, 56, and 55mins/day in MVPA at ages 11, 15, and 24 years, respectively. Females spent an average of 47, 39, and 47mins/day in MVPA at ages 11, 15, and 24 years respectively. LVMI2.7 was significantly higher among males than females with an average difference of ∼4g/m2.7 both at ages 17 and 24 years but no significant sex differences in RWT. In a fully adjusted model, persistent ≥60mins/day of MVPA from ages 11–24 years was associated with higher LVMI2.7 (effect estimate 0.856g/m2.7 [CI 0.346 – 1.367] p=0.001) and higher RWT (0.013g/m2.7 [CI 0.010 – 0.017] p=0.003) at age 24 years in the total cohort. Each minute spent in MVPA from ages 11–24 years was associated with progressively increased changes in LVMI2.7 (0.010g/m2.7 [CI 0.002 – 0.019] p=0.016) but not increased RWT from ages 17–24 years. Each minute spent in MVPA from ages 11–24 years was associated with progressively increased changes in LVMI2.7 (0.049g/m2.7 [CI 0.037 – 0.061] p<0.0001) in males but not in females and increased RWT from ages 17 – 24 years in both males and females. Conclusion Persistent ≥60min/day of MVPA and each minute spent in MVPA during growth from childhood through young adulthood was associated with progressive ventricular concentric remodelling.