Abstract
BackgroundLower levels of physical activity (PA) and sedentary behaviour (SB) have been associated with increased cardiometabolic risk among children. However, little is known about the independent and combined associations of PA and SB as well as different types of these behaviours with cardiometabolic risk in children. We therefore investigated these relationships among children.MethodsThe subjects were a population sample of 468 children 6–8 years of age. PA and SB were assessed by a questionnaire administered by parents and validated by a monitor combining heart rate and accelerometry measurements. We assessed body fat percentage, waist circumference, blood glucose, serum insulin, plasma lipids and lipoproteins and blood pressure and calculated a cardiometabolic risk score using population-specific Z-scores and a formula waist circumference + insulin + glucose + triglycerides - HDL cholesterol + mean of systolic and diastolic blood pressure. We analysed data using multivariate linear regression models.ResultsTotal PA was inversely associated with the cardiometabolic risk score (β = -0.135, p = 0.004), body fat percentage (β = -0.155, p < 0.001), insulin (β = -0.099, p = 0.034), triglycerides (β = -0.166, p < 0.001), VLDL triglycerides (β = -0.230, p < 0.001), VLDL cholesterol (β = -0.168, p = 0.001), LDL cholesterol (β = -0.094, p = 0.046) and HDL triglycerides (β = -0.149, p = 0.004) and directly related to HDL cholesterol (β = 0.144, p = 0.002) adjusted for age and gender. Unstructured PA was inversely associated with the cardiometabolic risk score (β = -0.123, p = 0.010), body fat percentage (β = -0.099, p = 0.027), insulin (β = -0.108, p = 0.021), triglycerides (β = -0.144, p = 0.002), VLDL triglycerides (β = -0.233, p < 0.001) and VLDL cholesterol (β = -0.199, p < 0.001) and directly related to HDL cholesterol (β = 0.126, p = 0.008). Watching TV and videos was directly related to the cardiometabolic risk score (β = 0.135, p = 0.003), body fat percentage (β = 0.090, p = 0.039), waist circumference (β = 0.097, p = 0.033) and systolic blood pressure (β = 0.096, p = 0.039). Resting was directly associated with the cardiometabolic risk score (β = 0.092, p = 0.049), triglycerides (β = 0.131, p = 0.005), VLDL triglycerides (β = 0.134, p = 0.009), VLDL cholesterol (β = 0.147, p = 0.004) and LDL cholesterol (β = 0.105, p = 0.023). Other types of PA and SB had less consistent associations with cardiometabolic risk factors.ConclusionsThe results of our study emphasise increasing total and unstructured PA and decreasing watching TV and videos and other sedentary behaviours to reduce cardiometabolic risk among children.Trial registrationClinicalTrials.gov Identifier: NCT01803776.
Highlights
Lower levels of physical activity (PA) and sedentary behaviour (SB) have been associated with increased cardiometabolic risk among children
Total PA was inversely associated with the cardiometabolic risk score (β = −0.135, p = 0.004), body fat percentage (β = −0.155, p < 0.001), insulin (β = −0.099, p = 0.034), triglycerides (β = −0.166, p < 0.001), Very low-density lipoprotein (VLDL) triglycerides (β = −0.230, p < 0.001), VLDL cholesterol (β = −0.168, p = 0.001), low-density lipoprotein (LDL) cholesterol (β = −0.094, p = 0.046) and high-density lipoprotein (HDL) triglycerides (β = −0.149, p = 0.004) and directly related to HDL cholesterol (β = 0.144, p = 0.002) adjusted for age and gender
Unstructured PA was inversely associated with the cardiometabolic risk score (β = −0.123, p = 0.010), body fat percentage (β = −0.099, p = 0.027), insulin (β = −0.108, p = 0.021), triglycerides (β = −0.144, p = 0.002), VLDL triglycerides (β = −0.233, p < 0.001) and VLDL cholesterol (β = −0.199, p < 0.001) and directly related to HDL cholesterol (β = 0.126, p = 0.008)
Summary
Lower levels of physical activity (PA) and sedentary behaviour (SB) have been associated with increased cardiometabolic risk among children. Little is known about the independent and combined associations of PA and SB as well as different types of these behaviours with cardiometabolic risk in children. The epidemic of childhood obesity has increased the prevalence of paediatric metabolic syndrome [4,5,6]. Overweight and obesity track from childhood into adulthood and are associated with an increased risk of metabolic syndrome, type 2 diabetes and cardiovascular disease in adulthood [7,8]. Studies among children or adolescents have often employed composite cardiometabolic risk scores that have been calculated using the features of metabolic syndrome as continuous variables [12,13,14,15]
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