Cardiovascular Health In Adolescents Research Articles

Association between Serum Vitamin D Concentrations and Life's Essential 8 score in American adolescents

IntroductionThis study sought to use the latest Life's Essential 8 scoring tool to obtain information on the relationship between serum vitamin D concentration and adolescent cardiovascular health (CVH).Material and methodsA total of 1,819 teenagers aged 16–19 were enrolled. Associations between serum vitamin D concentrations and CVH ratings were estimated using multiple linear regression and multinomial logistic regression methods, and the dose–response relationship was examined by restricted cubic spline analysis.ResultsAfter adjusting for all confounding factors, serum vitamin D concentrations were positively correlated with CVH scores (β=0.12; 95% CI: 0.09-0.14, p<0.001). Among the sex and race subgroups, the correlation was stronger in male, Mexican American and Non-Hispanic Black participants, with ORs of 1.05 (95% CI: 1.03-1.07), 1.06 (95% CI: 1.04-1.08), p=0.002), 1.07 (95% CI: 1.03-1.11), 1.09 (95% CI: 1.05-1.14), p=0.01, 1.04 (95% CI: 1.01-1.06), and 1.05 (95% CI: 1.02-1.09), p=0.01, respectively. Serum vitamin D concentrations had a nonlinear relationship with CVH ratings. CVH scores grew with serum vitamin D concentrations up to the inflection point (86 nmol/L) (β=0.17 (95% CI: 0.135-0.206, p<0.001). When serum vitamin D concentrations exceeded 86 nmol/L, CVH scores were not associated with serum vitamin D concentrations.ConclusionsThe study identifies a nonlinear relationship between serum vitamin D levels and CVH in US adolescents aged 16-19, with an inflection point at 86 nmol/L. These findings underscore the importance of vitamin D in adolescent cardiovascular health and suggest the need for targeted health strategies, particularly in high-risk groups such as male, Mexican American, and Non-Hispanic Black teenagers.

Association of physical activity and screen time with cardiovascular disease risk in the Adolescent Brain Cognitive Development Study

BackgroundAccording to the Physical Activity Guidelines Advisory Committee Scientific Report, limited evidence is available on sedentary behaviors (screen time) and their joint associations with physical activity (steps) for cardiovascular health in adolescence. The objective of this study was to identify joint associations of screen time and physical activity categories with cardiovascular disease (CVD) risk factors (blood pressure, hemoglobin A1c, cholesterol) in adolescence.MethodsThis study analyzed data from the Adolescent Brain Cognitive Development (ABCD) Study, comprising a diverse sample of 4,718 U.S. adolescents aged 10–15 years between 2018 and 2021. Steps were measured by a Fitbit wearable device and levels were categorized as low (1,000–6,000), medium (> 6,000–12,000), and high (> 12,000) averaged daily step counts. Self-reported recreational screen time hours per day were classified as low (0–4), medium (> 4–8), and high (> 8) hours per day. CVD risk factors including blood pressure, hemoglobin A1c, and cholesterol (total and HDL) were measured.ResultsThe analytical sample averaged 6.6 h of screen time per day and 9,722 steps per day. In models including both screen time and steps, the high screen time category was associated with a 4.27 higher diastolic blood pressure percentile (95% CI 1.83–6.73) and lower HDL cholesterol (B= -2.85, 95% CI -4.77 to -0.94 mg/dL) compared to the low screen time category. Medium (B = 3.68, 95% CI 1.24–6.11) and low (B = 7.64, 95% CI 4.07–11.20) step categories were associated with higher diastolic blood pressure percentile compared to the high step category. The medium step category was associated with lower HDL cholesterol (B= -1.99, 95% CI -3.80 to -0.19 mg/dL) compared to the high step category. Findings were similar when screen time and step counts were analyzed as continuous variables; higher continuous step count was additionally associated with lower total cholesterol (mg/dL).ConclusionsCombinations of low screen time and high steps were generally associated with favorable cardiovascular health markers including lower diastolic blood pressure and higher HDL cholesterol, which can inform future adolescent health guidelines.

An Age Study on Adopting Adult Hypertension Standards in Chinese Mature Children and Adolescents

Abstract OBJECTIVE To determine age cutoff values for the use of adult hypertension diagnostic criteria in children and adolescents, and to evaluate the consistency and screening effect of the adult criteria with the sex-, age-, and height-specific blood pressure reference (gold standard). METHODS A literature review and expert consultation were used to determine age cutoff value. In children above the cutoff age, the China Child and Adolescent Cardiovascular Health Survey was used to compare the consistency and screening effect between the adult criteria and the gold standard, and Beijing Blood Pressure Study was used to evaluate the predictive value of childhood hypertension diagnosed by adult criteria and gold criteria for hypertension and subclinical cardiovascular damage in adulthood. RESULTS (i) Adult criteria can be used to evaluate hypertension for children aged 16 and above. (ii) Among adolescents aged 16 and above, the adult standard has lower sensitivity (21.1%) but higher specificity (100.0%) compared with the gold standard, with a consensus rate of over 80.0%. And the predictive ability of the adult standard for subclinical cardiovascular health damage in adulthood is also similar to that of the gold standard. CONCLUSIONS Sixteen years can be used as a cutoff point for the adoption of adult hypertension diagnostic criteria in children, and it has a certain degree of simplicity and accuracy.

Effect of high-intensity interval training and moderate-intensity continuous training on cardiovascular risk factors in adolescents: Systematic review and meta-analysis of randomized controlled trials

BackgroundIn recent years, cardiovascular diseases in adolescents have become more serious. High intensity interval training (HIIT) and moderate intensity continuous training (MICT) have been shown to improve cardiovascular diseases in adolescents. Meta-analysis was conducted to compare the effects of HIIT and MICT on cardiovascular risk factors in adolescents. MethodsRandomised controlled trials of HIIT and MICT for cardiovascular risk factors in adolescents up to January 2023 were searched using authoritative databases such as CNKI, Web of Science, PubMed, and EBSCO. Data analysis was performed using Review Manage 5.4 and Stata 14.0. ResultsA total of 12 studies involving 468 participants, mean age 15.19±4.35, were included in the study. The findings showed that compared with MICT, HIIT reduced adolescents' body weight (SMD=-0.18, 95 %CI=-0.58, 0.21) and increased maximal oxygen uptake (SMD=0.56, 95 %CI=0.20, 0.93) and high-density lipoprotein (SMD=-0.47, 95 % CI=-1.11, 0.17), and improved systolic blood pressure (SMD=-0.35, 95 %CI=-0.78, 0.09), glucose (SMD=-1.53, 95 %CI=-2.93, -0.13), and insulin (SMD=-0.66, 95 % CI=-1.73, 0.41), p<0.05. HIIT and MICT improved BMI, fat mass, diastolic blood pressure, triglycerides, total cholesterol, and LDL, with no significant difference between these training types. ConclusionHIIT was better than MICT for improving cardiovascular health in adolescents, with better effects on body weight, BMI, fat mass, systolic blood pressure, diastolic blood pressure, maximal oxygen uptake, triglyceride, total cholesterol, LDL, HDL, glucose, and insulin levels.

The Impact of Regular Physical Activity on Lipid Profile and Cardiovaskular Health in Adolescents : A Literature Review

This literature review delves into the impact of regular physical activity on lipid profiles and cardiovascular health in adolescents, addressing the growing concern of sedentary lifestyles and unhealthy habits contributing to increased cardiovascular disease risks among teenagers. By systematically searching academic databases and scientific journals using relevant keywords, a selection of 8 articles was chosen for review after rigorous screening and eligibility assessment. The findings of the review underscore the significant relationship between physical activity, metabolic parameters, and cardiovascular risk factors in adolescents. Studies consistently highlight the benefits of regular physical activity in improving lipid profiles, insulin sensitivity, and overall cardiovascular parameters in this population. For instance, adolescents engaging in moderate to high-intensity physical activity demonstrated reduced risks of metabolic syndrome and improved insulin sensitivity. Lifestyle modifications encompassing increased physical activity and dietary changes were associated with positive alterations in lipid and glycemic profiles, particularly in high-risk pediatric individuals. Notably, regular vigorous-intensity physical activity was found to yield favorable cardiometabolic outcomes in adolescents with type 2 diabetes. In conclusion, the review emphasizes the critical role of regular physical activity in maintaining cardiovascular health and managing metabolic risk factors among adolescents. Participation in physical activity, particularly at moderate to high intensity, holds promise for significant improvements in lipid profiles and cardiovascular parameters. These findings underscore the importance of promoting active lifestyles among teenagers to prevent cardiovascular disease and enhance overall health outcomes.

Abstract 17653: Neighborhood Deprivation and Cardiovascular Health in US Adolescents, National Health and Nutrition Examination Survey 2007-2018

Introduction: AHA “Life’s Essential 8” scores cardiovascular health (CVH) as good, intermediate or poor based on diet, physical activity, sleep, tobacco exposure, cholesterol, blood pressure, blood glucose, and body mass index. CVH of the US population remains suboptimal, and the relationship between neighborhood deprivation and CVH in youth has not been fully explored. Hypothesis: We hypothesize that high neighborhood deprivation is associated with intermediate/poor CVH in adolescents. Methods: Using 2007-2018 National Health and Nutrition Examination Survey data, we examined the relationship between neighborhood deprivation index (NDI) and CVH status in adolescents. NDI was created from 2010 US Census data and reflects neighborhood level income, housing, education, and poverty status. Higher NDI indicates greater neighborhood deprivation. NDI values were divided into tertiles for analysis. We used proc survey logistic to assess the odds of poor/intermediate CVH status among youth living within high and intermediate compared to low deprivation communities. The model was adjusted for age, sex, ethnicity-race, household reference education and marital status, family poverty, rural vs urban residence and Citizenship status. All analyses were conducted using SAS 9.4, p&lt;0.05 . Results: We evaluated data from 3894 individuals, representative of 57,195,556 US adolescents 13 to 18 years of age. Most adolescents were non-Hispanic white (67%), male (51%), US Citizens (96%), mean age of 15 years, with an even distribution of youth living within low, intermediate and high deprivation neighborhoods (Table 1). We identified 31% greater odds of intermediate/poor CVH status among youth living within the most deprived communities (Table 2). Conclusions: Greater NDI associates with worse CVH in US adolescents. Public health initiatives should consider using NDI to tailor efforts in designing intervention strategies to preserve CVH status in US adolescents.

Hard Lessons From a School-Based Intervention to Improve Cardiovascular Health in Adolescence

Hard Lessons From a School-Based Intervention to Improve Cardiovascular Health in Adolescence

Prevalence of hypertension and its associations with body composition across Chinese and American children and adolescents.

The age of onset of hypertension (HTN) is decreasing, and obesity is a significant risk factor. The prevalence and racial disparities in pediatric HTN and the association between body composition and blood pressure are insufficiently studied. This study aimed to evaluate the prevalence of HTN in Chinese and American children and adolescents and to assess the relationship between various body composition indices and HTN. Seven thousand, five hundred and seventy-three Chinese and 6239 American children and adolescents aged 8-18years from the 2013-2015 China Child and Adolescent Cardiovascular Health study and the 2011-2018 National Health and Nutrition Examination Surveys were analyzed. Blood pressure and body composition (fat and muscle) were measured by trained staff. The crude prevalence and age-standardized prevalence rate (ASPR) of primary HTN and its subtypes [isolated systolic hypertension (ISH) and isolated diastolic hypertension (IDH)] were calculated based on 2017 American Academy of Pediatrics guidelines. Multivariable-adjusted linear regression coefficients and odds ratios (ORs) were calculated to assess the associations of body composition indicators with HTN, ISH and IDH. The ASPR of HTN was 18.5% in China (CN) and 4.6% in the United States (US), whereas the obesity prevalence was 7.4% and 18.6%, and the population attributable risk of HTN caused by overweight and obesity was higher in the US than in CN. Increased fat mass, muscle mass and body fat percentage mass were associated with a higher risk of HTN in both countries. The percent of muscle body mass had a protective effect on HTN and ISH in both countries [HTN (CN: OR= 0.83, 95% CI =0.78-0.88; US: OR= 0.72, 95% CI= 0.64-0.81); ISH (CN: OR= 0.87, 95% CI= 0.80-0.94; US: OR= 0.71, 95% CI= 0.62-0.81)], and the protective effect was more common among children and adolescents with high levels of physical activity. The burden of HTN in Chinese children and adolescents was substantial and much greater than that in the US, and the contribution of obesity to HTN was higher in the US than in CN. Augmenting the proportion of muscle mass in body composition has a protective effect against HTN in both populations. Optimizing body composition positively influences blood pressure in children and adolescents, particularly those with high-level physical activity. Video abstract (MP4 149982 KB).

0757 Associations between Objective Sleep Health and Cardiovascular Health in Adolescents with Type 1 Diabetes

Abstract Introduction Adolescents with type 1 diabetes (T1D) are at risk for early-onset cardiovascular disease due to increased arterial stiffness, decreased endothelial function, and early-stage hypertension compared to healthy peers. Poor sleep health has been associated with greater glycemic variability, increased insulin resistance, and poorer cardiovascular health; however, the relationship between sleep and vascular health has not been studied in adolescents with T1D. The aim of this study was to evaluate associations between objectively measured sleep and cardiovascular health in this population. We hypothesized that better sleep health would correlate with better cardiovascular health. Methods Twenty-four adolescents with T1D completed the study during the academic year. Sleep was monitored for one week at home with actigraphy. Watchpat-assessed apnea hypopnea index (AHI) and vascular measures were obtained during an overnight study visit. EndoPAT estimated reactive hyperemia index (RHI) and augmentation index (AI). Dynapulse measured systolic and diastolic blood pressure (SBP, DBP), mean arterial pressure (MAP), heart rate (HR), pulse wave velocity (PWV), and brachial distensibility and resistance (BrachD, BrachR). Correlations between sleep and vascular measures were examined. Results Participants were an average age of 15.5±1.1 years (54.2% female, 83.3% White non-Hispanic, BMI 58.8 ±25.8%ile, HbA1c 7.5±1.2%). Average school night (weekday) sleep duration was 6.7±0.8 hours and average sleep efficiency (SE) was 82.8±6.9%. The majority (87.5%) of participants slept less than the clinical recommendation of 8-10 hours per night. Worse actigraphy-estimated SE was associated with higher DBP (r=-0.52, p=0.02; mean= 59.2±6.7mmHg) and MAP (r=-0.46, p=0.04; mean= 79.5±7.5mmHg). Higher AHI was associated with higher BrachR (r=0.81, p&amp;lt; 0.001). No significant associations were identified between sleep variables and RHI, AI, HR, PWV, or BrachD (all p&amp;gt;0.05). Conclusion Poorer SE and higher AHI were associated with poorer indicators of vascular health in adolescents with T1D, consistent with prior literature linking poorer sleep health with risk factors for hypertension in adults with T1D. Further research is needed to determine if improving sleep can improve cardiovascular comorbidities in adolescents with T1D. Support (if any) JDRF 2-SRA-2019-848-S-B; JDRF 2-SRA-2022-1144-M-B; Ludeman Center for Women’s Health Research COVID-19 Relief Supplemental Grant; Colorado Clinical &amp; Translational Research Center Maternal &amp; Child Health Pilot Award; CTSA UL1 TR002535

Difference of glucose and lipid metabolism abnormalities and body fat between the Chinese and USA teenagers.

Comparing body fat and the effect of body fat on metabolic abnormalities in Chinese and USA teenagers may provide clues for the early prevention and control of cardiovascular disease (CVD). We aimed to compare the prevalence of glucose and lipid metabolism abnormalities, body fat amount and distribution, and the effect of body fat on glucose and lipid metabolism in Chinese and US teenagers. We included 5424 Chinese teenagers (48.5% male) from the China Child and Adolescent Cardiovascular Health (CCACH) study and 8704 USA teenagers (55.6% male) from the USA National Health and Nutrition Examination Survey (NHANES). Blood lipid, blood glucose, and body fat indicators were obtained using the same standardised measurements. The prevalence of dyslipidaemia in Chinese teenagers was of those in the USA (hypercholesterolaemia = 3.5% vs 7.4%; high low-density lipoprotein cholesterol (LDL-C) = 3.6% vs 5.0%; low high-density lipoprotein cholesterol (HDL-C) = 9.9% vs 14.3%; hypertriglyceridaemia = 3.7% vs 10.1%) (P < 0.05). However, with the increase in body mass index (BMI), the prevalence of high LDL-C increased more in Chinese than in US teenagers, even exceeding them in the obese group (2.7% in non-overweight to 9.7% in overweight group in China, P < 0.05; 3.5% in non-overweight to 6.5% in the obese group in the USA, P < 0.05). The prevalence of impaired fasting glucose was higher in China than in the USA (28.0% vs 17.5%, P < 0.05). Besides, Chinese adolescents are more likely to accumulate fat in the abdomen, and the per-unit fat increase would bring a higher risk of dyslipidaemia in Chinese boys than in USA boys. Dyslipidaemia was more prevalent in US teenagers than in Chinese teenagers, but with the increase in BMI, the prevalence of high LDL-C increased more in Chinese than in US teenagers. Impaired fasting glucose (IFG) was significantly more prevalent in China than in the USA. The unfavoured body fat and higher risk of body fat on metabolic disorders in Chinese teenagers suggest that Chinese teenagers should pay more attention to the adverse effect of body fat on metabolic abnormalities.

Are obesity and physical fitness associated with cardiovascular disease risk in adolescents with Down syndrome? The longitudinal UP&DOWN study

ABSTRACT Introduction The aims of this study were to examine cross-sectional, and longitudinal association of different measures of obesity and physical fitness with cardiovascular disease (CVD) risk factors in adolescents with Down syndrome. Methods Longitudinal analysis included 90 adolescents with Down syndrome. Obesity and physical fitness were measured following the ALPHA battery. Blood pressure and blood samplings (glucose, total cholesterol, high-density lipoprotein cholesterol, and serum lipid triglycerides levels (mg/dl) were determinated. Results In cross-sectional analyses, obesity was positively associated with single CVD risk factors and CVD risk factor index (all p < .05). In the prospective analyses, obesity was not associated with single CVD risk factors, but components of physical fitness at baseline impact in some single CVD risk factors (all p < .05). Conclusion Obesity might be more strongly related to current cardiovascular-health, while components of physical fitness might be more related to future cardiovascular-health in adolescents with Down syndrome.

Ideal Cardiovascular Health in adolescents: Findings from Study of Cardiovascular Risks in Adolescents

Background and aimWe assessed the Ideal Cardiovascular Health (CVH) in Brazilian adolescents according to demographics and socioeconomic characteristics. Methods and resultsThis is a cross-sectional study with data from the Study of Cardiovascular Risks in Adolescents (ERICA), with a nationwide representative sample of 36,956 Brazilian adolescents, aged 12–17 years, enrolled in public and private schools. The CVH metrics considered were body mass index (BMI), physical activity, smoking, healthy diet score, blood pressure, fasting plasma glucose, and total cholesterol. The demographics and socioeconomic characteristics analyzed were sex, age, race/skin color, and type of school attended. The study design was considered, and the significant difference determined by the non-overlapping of 95% Confidence Interval. The mean ideal CVH score was 4.0, higher for females, adolescents aged 15–17 years, and students from private schools. The prevalence of ideal fasting plasma glucose was 96%, of non-smoking 95.6%, of ideal blood pressure 75.5%, of ideal BMI 73.2%, of ideal total cholesterol 55.4%, of ideal physical activity 45.2%, and only 0.5% had an ideal diet. The prevalence of ideal CVH metrics varied according to demographics and socioeconomic characteristics. ConclusionFemales, older adolescents, and students who attended private school had a better CVH. Demographics and socioeconomic characteristics were associated with CVH metrics. The low ideal proportions found for diet and physical activity are of concern and reinforce the need for food and nutritional educational actions designed to promote healthy behaviors in adolescence to prevent the development of cardiovascular diseases.

Longitudinal associations between specific types of emotional reactivity and psychological, physical health, and school adjustment.

Using a multimethod, multiinformant longitudinal design, we examined associations between specific forms of positive and negative emotional reactivity at age 5, children's effortful control (EC), emotion regulation, and social skills at age 7, and adolescent functioning across psychological, academic, and physical health domains at ages 15/16 (N = 383). We examined how distinct components of childhood emotional reactivity directly and indirectly predict domain-specific forms of adolescent adjustment, thereby identifying developmental pathways between specific types of emotional reactivity and adjustment above and beyond the propensity to express other forms of emotional reactivity. Age 5 high-intensity positivity was associated with lower age 7 EC and more adolescent risk-taking; age 5 low-intensity positivity was associated with better age 7 EC and adolescent cardiovascular health, providing evidence for the heterogeneity of positive emotional reactivity. Indirect effects indicated that children's age 7 social skills partially explain several associations between age 5 fear and anger reactivity and adolescent adjustment. Moreover, age 5 anger reactivity, low-, and high-intensity positivity were associated with adolescent adjustment via age 7 EC. The findings from this interdisciplinary, long-term longitudinal study have significant implications for prevention and intervention work aiming to understand the role of emotional reactivity in the etiology of adjustment and psychopathology.

Performance of different adiposity measures for predicting left ventricular remodeling in Chinese hypertensive youth

There is no consistent conclusion on which adiposity measure is best to predict cardiovascular risk factors in youth. The present study aims to assess the performance of body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) in predicting abnormal left ventricular structure in Chinese hypertensive youth. A total of 1180 youth aged 6–17 years with hypertension from the China Child and Adolescent Cardiovascular Health Study were included in this study. Logistic regression model, receiver operator characteristic (ROC) curve analysis and net reclassification improvement (NRI) method were used to assess performance of BMI, WC, and WHtR in predicting left ventricular hypertrophy (LVH) and left ventricular geometry (LVG). A 1-standard deviation increment in any of three indexes in predicting LVH and LVG were similar, e.g., with the odds ratios and 95% confidence intervals of 1.34 (1.16–1.55), 1.25 (1.08–1.45) and 1.40 (1.20–1.62), respectively. In addition, ROC analysis and NRI method confirmed the similar performance of three adiposity indexes in predicting LVH and LVG. In conclusion, BMI, WC and WHtR had similar performance in predicting abnormal left ventricular structure in Chinese hypertensive youth, but all three indexes had limited value in prediction. WHtR is a simple and convenient adiposity index for screening youth at high risk of target organ damage.

Exercise dose on hepatic fat and cardiovascular health in adolescents with excess of adiposity.

The HEPAFIT study was aimed at examining the impact of a 6-month physical education intervention, considering various levels of exercise intensity, on hepatic fat and cardiometabolic health outcomes in adolescents with excess adiposity. Adolescents (n=120), 11-17 years with excess adiposity by body fat >30%, were randomly assigned to one of the following 4 groups for 6months: (1) standard physical education lessons, control (CTRL); (2) high-intensity physical education (HIPE); (3) low-to-moderate intensity physical education (LIPE) and (4) combined HIPE and LIPE (PLUS). The primary outcome was hepatic fat content measured by vibration-controlled transient elastography (controlled attenuation parameter [CAP]). Secondary outcomes were traditional cardiovascular health markers (body composition, serum lipids, aminotransferases and health-related physical fitness components). Adjusted mixed effects linear models revealed a significant decrease in CAP levels in HIPE (-20.02 dB/m, p<0.0001) (p=0.001 vs. CTRL group) and PLUS (-16.25 dB/m, p=0.005) groups. Body fat decreased in the HIPE (-2.88%, p < 0.001) (p=0.001 vs. CTRL group) and LIPE (-1.26%, p=0.022) groups. The physical fitness components were increased in the HIPE and PLUS group relative to the baseline (p < 0.05), and the HIPE group showed a reduction in the total cholesterol and low-density lipoprotein cholesterol (LDL-C) levels (p < 0.05). Implementation of a 6-month physical education exercise program, particularly high-intensity or combined high and low-intensity, improves hepatic fat storage and significantly reduces cardiometabolic markers in adolescents with excess of adiposity. Interventions involving supervised physical exercise may help to improve metabolism and fat deposition at the hepatic level, thus preventing the development of non-alcoholic fatty liver disease in adolescents.

Abstract P035: Early Neurodevelopment Related Variables And Cardiovascular Health: Findings From The Multidimensional Assessment Of Preschoolers Study

Background: Cardiovascular health (CVH) declines with age starting in early childhood. Neurodevelopmental health (NDH) measures, such as executive function, in early childhood have been associated with subsequent behavioral and lifestyle outcomes; however, little is known about the association of NDH measures in early life with CVH during childhood. Objective: To assess the association of preschool NDH with CVH in later childhood/early adolescence. Methods: Among participants from the Multidimensional Assessment of Preschoolers Study (MAPS), we defined 3 neurodevelopment domains at baseline (ages 3-7 years): executive functioning, developmental functioning, and emotion and behavior regulation (each as a z-score of its component surveys and direct assessment). At the tween follow-up wave (ages 9-14 years), MAPS participants completed a CVH examination including assessment of physical activity, diet, blood pressure, and BMI defined as favorable vs unfavorable CVH metrics according to AHA recommendations. Multivariate logistic regression models were used to assess the association of each NDH domain with favorable/unfavorable CVH metrics at follow up. Models were adjusted for age, race, gender, and poverty. Results: We included 229 SES-diverse children (46.2% boys; 52% living in poverty at baseline; mean baseline age 4.7 yr; mean follow-up age: 11.3 yr). At follow-up, there were 179 (78.2%) children with favorable CVH and 50 (21.8%) children with unfavorable CVH. Better performance on all 3 NDH domains at baseline was demonstrated among children with favorable CVH at follow-up compared to those with unfavorable CVH, with mean z-score of 0.04 among those with favorable CVH compared to -0.15 among those with unfavorable CVH for executive functioning (p&lt;0.001), 0.02 compared to -0.07 for developmental functioning (p=0.004), and 0.02 compared to -0.06 for emotion and behavior regulation (p=0.027). After adjustment, associations between executive functioning, developmental functioning, and emotion/behavior regulation and favorable CVH were attenuated to non-significance {OR (95% CI): 1.21 (0.80-1.81), 1.03 (0.64-1.67), 1.08 (0.73-1.59), respectively}. Conclusions: These findings suggest a possible association between neurodevelopmental domains and CVH, although findings were not significant after adjustment. The heterogeneity of the sample may have obscured effects and the moderating role of the environment may elucidate explanatory pathways. More research with larger sample sizes is needed to better understand the impact of early-life NDH with adolescent CVH.

Reference centiles for evaluating total body fat development and fat distribution by dual-energy x-ray absorptiometry among children and adolescents aged 3–18 years

The rise in the prevalence of childhood obesity has increased the demand for accurately evaluating body fatness in pediatric population. The aim of this study was to provide a series of sex- and age-specific body fat reference centiles for evaluating total body fat development and fat distribution in Chinese children and adolescents using dual-energy x-ray absorptiometry (DXA). A nationwide sample of Chinese children and adolescents aged 3-18 years (n=12,790) was drawn from a cross-sectional survey of the China Child and Adolescent Cardiovascular Health study (2013-2019). Fat measurements, including total fat mass index (FMI), total body fat percentage (BF%), regional FMI, trunk to leg (T/L) fat ratio and android to gynoid (A/G) fat ratio, were derived from whole body DXA scans. Sex- and age-specific centiles were estimated using the lambda-mu-sigma method and then compared with values derived from the US National Health and Nutrition Examination Survey (1999-2004) and Korean National Health and Nutrition Examination Survey (2008-2011). During early childhood, almost all body fat parameters decreased with age, except an increase in A/G ratio. After 7 years onward, drastic upward trends of total FMI and BF% were exhibited in boys till 10 years, followed by opposite downward trends during 11-14 years; while sustained increase of FMI was shown in girls across ages accompanied by relatively constant BF% levels. Meanwhile, steady increases were noticed for A/G ratio and T/L ratio, which were more pronounced in boys. In addition, the proposed body fat references were much lower than the US but similar to Koreans despite of subtle differences. This is the first study to present a set of DXA-based body fat reference for Chinese children and adolescents aged 3-18 years. The new reference provides clinicians and researchers a useful tool for assessing body fat development and distribution patterns throughout early childhood and adolescence.

Évaluation de la condition physique durant l’enfance dans le nord de la France : le programme Diagnoform

BackgroundA high level of physical fitness is associated with cardiovascular health in adolescents. We describe change in physical fitness levels assessed at two time points over 3 years. MethodsThe study presents a longitudinal design, with the first phase data collection at 8 years and the second phase carried out at 11 years. A total of 516 children (254 boys) aged to 7.7±0.4 years (in 2010) and 10.9±0.4 years (in 2010) and 10.9 ± 0.4 years (in 2013) participated to the study. Cardiorespiratory fitness, muscular strength, speed, and agility were assessed in this study. For each physical fitness test, determination of the situation (in terms of percentiles) of each child in 2010 and then in 2013 compared to national standards. The 2010 and 2013 percentiles are then compared using the Wilcoxon signed rank test. ResultsMuscular strength, agility and cardiorespiratory fitness decrease in both sex (p<0.01). A significant decrease was also found for all physical fitness components in normal weight children (p<0.05). For normal weight children in 2010 who became overweight or obese in 2013, there was a significant decrease in scores of cardiorespiratory fitness and agility tests (p<0.05). For overweight children in 2010 becoming from to normal weight status in 2013, only the agility test decreased significantly (p<0.05). Children being overweight or obese in 2010 and remaining in 2013, had a significant decrease in their physical fitness levels (p<0.05). ConclusionsOur results indicate that the physical fitness of French youth decrease between childhood and early adolescence. Developing and introducing a health promotion curriculum in the French schools is suggested to improve health and physical fitness.

Ideal cardiovascular health in adolescents and young adults is associated with alexithymia over two decades later: Findings from the cardiovascular risk in Young Finns Study: Department: Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland

We evaluated the association of cardiovascular health in adolescence and young adulthood with alexithymia 25 years later. The study sample (n = 1122) participated in evaluations conducted in 1986 (baseline) and in 2011−2012 (T2). Baseline health factors and behaviors were assessed utilizing seven ideal cardiovascular health metrics (ICH index) including blood pressure, cholesterol and glucose levels, smoking, physical activity, body-mass-index, and diet. The stability of the ICH index was evaluated with corresponding assessments in 2007 (T1). At T2, alexithymia was measured with the 20-item Toronto Alexithymia Scale (TAS-20). The main analyses were conducted using ANCOVA and adjusted for depression, age, and present social and lifestyle factors. TAS-20 subscales, Difficulty Identifying Feelings (DIF), Difficulty Describing Feelings (DDF), and Externally Oriented Thinking, were analyzed separately. The ICH index was significantly associated with the TAS-20 total score, as well as both with DIF and DDF. A less ideal cardiovascular health was associated with higher alexithymia scores. However, regarding the separate factors, only the association between non-ideal dietary habits and DIF was significant in the multivariate analyses. The baseline ICH index score was stable from baseline to T1. We conclude that non-ideal cardiovascular lifestyle habits in adolescence and young adulthood are significantly associated with later alexithymia.

Developmental characteristics on body composition in Chinese urban children and adolescents aged 3-17 years old

Objective: To describe the body composition related developmental characteristics in Chinese children and adolescents aged 3-17 years. Methods: Data were obtained from the 'China Child and Adolescent Cardiovascular Health (CCACH) cross-sectional survey' in 2015, which including seven cities. Questionnaire survey, anthropometric measurements were carried out with body composition also measured, using the Hologic Discovery Dual Energy X-ray Absorptiometry (DXA) scanner. BMI, fat mass percentage (FMP), fat mass index (FMI) and fat free mass index (FFMI) were calculated. SAS 9.4 and SPSS 20.0 softwares were used for data analysis. Results: A total of 10 867 participants aged 3-17 years were involved in this study, including 5 512 boys (50.7%). FMP in boys decreased obviously between 10-15 years old[β=-1.811 (95%CI: -1.987 - -1.635)]. FMP in girls decreased between 3-7 years old[β=-0.896 (95%CI: -1.100 - -0.691)] and increased obviously between 12-15 years old [β=0.989 (95%CI: 0.753-1.224)]. In general, FMP in girls were higher than that in boys in every age group, except for the 9 and 10 years old groups ( all P<0.05). FFMI of boys was higher than that in girls at all ages. Differences on FFMI were getting bigger between boys and girls in the 11 years old group and above. FMI increased with age [boys: β=0.033 (95%CI: 0.018-0.048); girls: β=0.192 (95%CI: 0.181-0.204)] and intersected between genders. Adiposity rebound age was earlier in the obese group than that in both overweight and normal weight groups. FMI in normal weight boys decreased with age and remained lower than 5 kg/m(2), while FMI in overweight [β=0.114 (95%CI: 0.091-0.136)] and obese [β=0.211 (95%CI: 0.176-0.245)] boys increased with age. FMP in boys decreased with age from 10 years old in all weight status groups [normal weight: β=-0.836 (95%CI: -0.924 - -0.748); overweight: β=-1.090 (95%CI: -1.269 - -0.910); obese: β=-1.144 (95%CI: -1.321- -0.967)]. BMI, FFMI, FMI in girls changed with age similarly in all weight status groups and increased from 8 years old[normal weight: β=0.174 (95%CI: 0.165- 0.182); overweight: β=0.325 (95%CI: 0.304-0.346); obesity: β=0.447 (95%CI: 0.406-0.488)]. Changes in FMP in girls increased significantly with age after 12 years old [normal weight: β=0.963 (95%CI: 0.851-1.074); overweight: β=0.910 (95%CI: 0.695-1.125); obesity: β=0.895 (95%CI: 0.569-1.221)]. In total, correlation indexes of BMI and FMI were strong (boys: r=0.767; girls: r=0.873) and were different in various weight status groups. Conclusions: The growth chart of BMI presented inconsistently with the different developmental characteristics of body fat, and gender. Measurement on body composition needs to be developed for children and adolescents to give more precisely assessment on growth and development of children.