Abstract
Given the dramatic increase in childhood obesity over the last decades, we wanted to assess the relationship between childhood obesity and multiple risk factors in a representative population of schoolchildren. METHODS: 535 children in 1 st and 5th grade (6–13y) from randomly selected socio-ethnic diverse public schools in Switzerland were investigated. Assessment included questionnaires, anthropometry, accelerometry, fitness testing and in 68% of children fasting blood samples (insulin, glucose, highly sensitive C-reactive protein (hs-CRP)). The independent association of fitness and insulin resistance (HOMA-IR) or low-grade chronic inflammation (hs-CRP) was assessed using partial correlation analyses. The association between overweight and obesity (BMI percentiles), cardiopulmonary fitness (20m shuttle run), physical activity (accelerometers, counts/day), television (TV) use, daily sleep length, nutritional habits (food frequency questionnaires), parental BMI and educational level, birth weight, age, sex and Tanner stages was assessed using multiple logistic regression. RESULTS: The prevalence of overweight and obesity was 15% and 11%, respectively. Sweetened carbonated drinks were consumed 2.4 ± 2.1 times/wk. 20% of children ate fast foods more than 5 times/wk, but only 23% went to a fast food restaurant more than once a month. They watched TV for 85±102 min/d. Even after controlling for age, sex, pubertal stage and BMI, increased hs-CRP and HOMA-IR were negatively correlated with fitness (r= −0.22, p<0.0001 andr= −0.12, p<0.05). In multiple logistic regression analyses, being obese or overweight was positively associated with maternal overweight and TV time and negatively with fitness and physical activity (p<0.0001, n=284), but not with nutritional habits. CONCLUSION: In Swiss children decreased fitness is associated with novel and traditional cardiovascular risk factors independent of BMI. Overweight and obesity are mainly associated with decreased fitness and physical activity, and with maternal overweight and increased TV use. Thus, preventive strategies to increase physical activity and fitness and to decrease inactivity and overweight are of utmost importance to improve the health of children.
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