CHAMPS study-DK Research Articles

Leisure-time sport and overuse injuries of extremities in children age 6–13, a 2.5 years prospective cohort study: the CHAMPS-study DK

ObjectivesIt is not known which sports are most likely to cause overuse injuries of the extremities in children. In this study, we report on the incidence of overuse injuries of...

Cross-sectional associations of objectively measured physical activity with brain-derived neurotrophic factor in adolescents

ObjectiveThe purpose of this study was to examine the associations between objectively measured physical activity and serum brain-derived neurotrophic factor (BDNF) in adolescents. MethodsCross-sectional analyses were performed using data from 415 adolescents who participated in the 2015 follow-up of the Childhood Health Activity and Motor Performance School Study Denmark (the CHAMPS-study DK). Physical activity was objectively measured by accelerometry monitors. Serum BDNF levels were analyzed using the Enzyme-linked immunosorbent assay (ELISA). Anthropometrics and pubertal status were measured using standardized procedures. ResultsWith adjustment for age, pubertal status and body mass index, mean physical activity (counts per minute) was negatively associated with serum BDNF in boys (P=0.013). Similarly, moderate-to-vigorous physical activity (MVPA) was negatively associated with serum BDNF in boys (P=0.035). In girls, mean physical activity and MVPA were not associated with serum BDNF. Without adjustment for wear time, sedentary time was not associated with serum BDNF in either sex. ConclusionThese findings indicate that higher physical activity is associated with lower serum BDNF in boys, but not in girls.

The Prospective Association of Organized Sports Participation With Cardiovascular Disease Risk in Children (the CHAMPS Study-DK)

ObjectiveTo investigate the prospective association of organized leisure-time sports participation with cardiovascular risk in children. MethodsStudents were recruited from 10 public primary schools. From July 2009 to October 2010, parents reported children's weekly organized leisure-time sports participation via text messaging. Clustered cardiovascular risk was estimated with a composite score comprising fasting serum triglyceride levels, homeostasis assessment model-estimated insulin resistance, total to high-density lipoprotein cholesterol ratio, and systolic blood pressure. Additional outcomes were body mass index categories and fasting serum insulin and glucose concentrations. Associations were explored with generalized estimating equations and reported with beta coefficients (β) and percent difference per weekly sports session or incidence rate ratios. All models were adjusted for baseline values and other potential confounders. ResultsIn total, 1197 children (53% female) with a mean age of 8.4±1.4 years were included. Participating in sports for 53 weeks was associated with lower clustered cardiovascular risk (β, −0.25; 95% CI, −0.41 to −0.10; percent difference, 3.2%; 95% CI, 5.2%-1.3%). Similar outcomes were observed for log homeostasis assessment model-estimated insulin resistance (β, −0.08; 95% CI, −0.12 to −0.04; percent difference, 3.4%; 5.1%-1.7%) and log insulin (β, −0.07; 95% CI, −0.11 to −0.04; percent difference, 2.6%; 95% CI, 4.0%-1.5%). Sports participation was associated with a 20% decreased risk of overweight/obesity (incidence rate ratio, 0.78; 95% CI, 0.64-0.96). ConclusionParticipating in organized leisure-time sports for approximately 1 year is associated with decreased clustered cardiovascular risk in children. These findings show that participating in youth sports may be an effective strategy to reduce cardiovascular risk in children.

Motor Performance as Predictor of Physical Activity in Children: The CHAMPS Study-DK.

Physical activity (PA) is associated with several health benefits in children, and PA habits developed in childhood tend to persist into adulthood. PA may be the foundation of a healthy lifestyle, and motor performance has been shown to be positively associated with PA in cross-sectional studies. The purpose of this study was to explore the longitudinal relation between motor performance and PA in a 3-yr follow-up study. Longitudinal analyses were performed using data from 673 participants (44% boys, 6-12 yr old) who had been included in the Childhood Health Activity and Motor Performance School study-DK. Baseline motor performance tests consisted of vertical jump, shuttle run, hand grip strength, backward balance, precision throw, and cardiovascular fitness. Composite z-scores were generated to express health-related fitness and performance-related fitness. PA was measured by accelerometer at baseline and at 3-yr follow-up and was expressed as a percentage of time in moderate-to-vigorous PA. Cardiovascular fitness, vertical jump, health-related fitness, and performance-related fitness showed significant positive associations with 3-yr follow-up measures of PA in both sexes. Furthermore, shuttle run showed significant inverse associations with follow-up measures of PA for both sexes. Cardiorespiratory fitness, shuttle run, vertical jump, health-related fitness, and performance-related fitness were significantly associated with time spent in moderate-to-vigorous PA at 3-yr follow-up. The clinical relevance of the results indicates that cardiorespiratory fitness and shuttle run in childhood may be important determinants of PA in adolescence.

Organized Sport Participation Is Associated with Higher Levels of Overall Health-Related Physical Activity in Children (CHAMPS Study-DK).

IntroductionMany children fail to meet international guideline recommendations for health-related activity (≥60 minutes/day of moderate-to-vigorous physical activity [MVPA]), and intervention studies to date have reported negligible effects.ObjectiveExplore the associations of organized leisure-time sport participation with overall physical activity levels and health-related physical activity guideline concordance.MethodsThis prospective cohort study was nested in the Childhood Health, Activity, and Motor Performance School Study Denmark. Study participants were a representative sample of 1124 primary school students. Organized leisure-time sport participation was reported via text messaging and physical activity was objectively measured over seven days with accelerometry. Associations between sport participation and physical activity level were explored with multilevel mixed-effects regression models and reported with beta coefficients (b) and adjusted odds ratios (aOR).ResultsParticipants were 53% female, with mean(SD) age = 8.4(1.4) years. Boys were more active than girls (p<0.001), and physical activity levels and guideline concordance decreased with age (p<0.001). Soccer participation at any frequency was associated with greater overall MVPA (b[95% CI] = 0.66[0.20,1.13] to 2.44[1.44,3.44]). Depending on participation frequency, this equates to 5–20 minutes more MVPA on the average day and 3 to 15 fold increased odds of achieving recommended levels of health-related physical activity (aOR[95%CI] = 3.04[1.49,6.19] to 14.49[1.97,106.56]). Similar associations were identified among children playing handball at least twice per week. Relationships with other sports (gymnastics, basketball, volleyball) were inconsistent.ConclusionsMany children, particularly girls and those in higher grade levels do not adhere to health-related physical activity recommendations. Organized leisure-time sport participation may be a viable strategy to increase overall health-related physical activity levels and international guideline concordance in children.

The influence of anthropometry and body composition on children's bone health: the childhood health, activity and motor performance school (the CHAMPS) study, Denmark.

Overweight, physical inactivity and sedentary behaviour have become increasing problems during the past decade. Increased sedentary behaviour may change the body composition (BC) by increasing the fat mass relative to the lean mass (LM). These changes may influence bone health to describe how anthropometry and BC predict the development of the bone accruement. The longitudinal study is a part of The CHAMPS study-DK. Children were DXA scanned at baseline and at 2-year follow-up. BC (LM, BF %) and BMC, BMD and BA were measured. The relationship between bone traits, anthropometry and BC was analysed by multilevel regression analyses. Of the invited children, 742/800 (93%) accepted to participate. Of these, 682/742 (92%) participated at follow-up. Mean (range) of age at baseline was 9.5 years (7.7-12.1). Height, BMI, LM and BF % predicted bone mineral accrual and bone size positively and independently. Height and BMI are both positive predictors of bone accruement. LM is a more precise predictor of bone traits than BF % in both genders. The effects of height and BMI and LM on bone accruement are nearly identical in the two genders, while changes in BF % have different but positive effects on bone accretion in both boys and girls.

Do extra compulsory physical education lessons mean more physically active children--findings from the childhood health, activity, and motor performance school study Denmark (The CHAMPS-study DK).

BackgroundPrimarily, this study aims to examine whether children attending sports schools are more active than their counterpart attending normal schools. Secondary, the study aims to examine if physical activity (PA) levels in specific domains differ across school types. Finally, potential modifications by status of overweight/obesity and poor cardio-respiratory fitness are examined.MethodsParticipants were from the first part of the CHAMPS-study DK, which included approximately 1200 children attending the 0th – 6th grade. At the sports schools, the mandatory physical education (PE) program was increased from 2 to 6 weekly lessons over a 3-year period. Children attending normal schools were offered the standard 2 PE lessons. PA was assessed at two different occasions with the GT3X ActiGraph accelerometer, once during winter in 2009/10 and once during summer/fall in 2010. Leisure time organized sports participation was quantified by SMS track. Based on baseline values in 2008, we generated a high-BMI and a low-cardio-respiratory fitness for age and sex group variable.ResultsThere were no significant differences in PA levels during total time, PE, or recess between children attending sports schools and normal schools, respectively. However, children, especially boys, attending sports schools were more active during school time than children attending normal schools (girls: β=51, p=0.065; boys: β=113, p<0.001). However, in the leisure time during weekdays children who attended sports schools were less active (girls: β=-41, p=0.004; boys: β=-72, p<0.001) and less involved in leisure time organized sports participation (girls: β=-0.4, p=0.016; boys: β=-0.2, p=0.236) than children who attended normal schools. Examination of modification by baseline status of overweight/obesity and low cardio-respiratory fitness indicated that during PE low fit girls in particular were more active at sports schools.ConclusionNo differences were revealed in overall PA levels between children attending sports schools and normal schools. Sports schools children were more active than normal schools children during school time, but less active during leisure time. In girls, less organized sports participation at least partly explained the observed differences in PA levels during leisure time across school types. Baseline status of cardio-respiratory fitness modified school type differences in PA levels during PE in girls.Electronic supplementary materialThe online version of this article (doi:10.1186/s12966-014-0121-0) contains supplementary material, which is available to authorized users.

Prospective association of adiposity and cardiorespiratory fitness with cardiovascular risk factors in healthy children

This study aimed to examine the prospective association of three different measures of adiposity and cardiorespiratory fitness (CRF) with 2-year change in cardiovascular disease (CVD) risk factors in children. Two-year longitudinal data in schoolchildren aged 7-11 years (n = 365-729) was used. Total body fat (TBF) from dual-energy x-ray absorptiometry, body mass index (BMI), waist circumference (WC), CRF, blood samples, and blood pressure were obtained in 2008 and 2010 in the Childhood Health, Activity, and Motor Performance School Study in Denmark (CHAMPS study-DK). Greater adiposity at baseline was associated with increased CVD risk factor levels at follow-up. The magnitudes of associations were similar regardless of adiposity measure [TBF%: β 0.30, 95% confidence interval (CI): 0.21-0.39; BMI: β 0.24, 95% CI: 0.14-0.33; WC: β 0.20, 95% CI: 0.10-0.31], and no evidence of nonlinear relationships was observed. We found less strong associations of CRF with increase in CVD risk factor levels after adjusting for adiposity; however, increasing CRF was still favorably associated with decrease in CVD risk factor levels among boys. Results suggest that any effort to shift the population distribution of adiposity downward would be valuable for early CVD prevention. The association of CRF with CVD risk factors was largely explained by adiposity, particularly among girls.

The intensity of physical activity influences bone mineral accrual in childhood: the childhood health, activity and motor performance school (the CHAMPS) study, Denmark

BackgroundStudies indicate genetic and lifestyle factors can contribute to optimal bone development. In particular, the intensity level of physical activity may have an impact on bone health. This study aims to assess the relationship between physical activity at different intensities and Bone Mineral Content (BMC), Bone Mineral Density (BMD) and Bone Area (BA) accretion.MethodsThis longitudinal study is a part of The CHAMPS study-DK. Whole-body DXA scans were performed at baseline and after two years follows up. BMC, BMD, and BA were measured. The total body less head (TBLH) values were used. Physical activity (PA) was recorded by accelerometers (ActiGraph, model GT3X). Percentages of different PA intensity levels were calculated and log odds of two intensity levels of activity relative to the third level were calculated. Multilevel regression analyses were used to assess the relationship between the categories of physical activity and bone traits.ResultsOf 800 invited children, 742 (93%) accepted to participate. Of these, 682/742 (92%) participated at follow up. Complete datasets were obtained in 602/742 (81%) children. Mean (range) of age was 11.5 years (9.7-13.9). PA at different intensity levels was for boys and girls respectively, sedentary 62% and 64%, low 29% for both genders and moderate to high 9% and 7% of the total time. Mean (range) BMC, BMD, and BA was 1179 g (563–2326), 0.84 g/cm2 (0.64-1.15) and 1393 cm2 (851–2164), respectively. Valid accelerometer data were obtained for a mean of 6.1 days, 13 hours per day.ConclusionsThere 7was a positive relationship between the log odds of moderate to high-level PA versus low level activity and BMC, BMD and BA. Children with an increased proportion of time in moderate to high-level activity as opposed to sedentary and low-level activity achieved positive effects on BMC, BMD and BA.

Study protocol. The Childhood Health, Activity, and Motor Performance School Study Denmark (The CHAMPS-study DK)

BackgroundAn increasingly passive life-style in the Western World has led to a rise in life-style related disorders. This is a major concern for all segments of society. The county council of the municipality of Svendborg in Denmark, created six Sport Schools with increased levels of suitable physical activities, which made it possible to study the health outcomes in these children whilst comparing them to children who attended the ‘normal’ schools of the region using the design of a “natural experiment”.MethodsChildren from the age of 6 till the age of 10, who accepted to be included in the monitoring process, were surveyed at baseline with questionnaires, physical examinations and physical and biological testing, including DXA scans. The physical examination and testing was repeated during the early stage of the study. Every week over the whole study period, the children will be followed with an automated mobile phone text message (SMS-Track) asking questions on their leisure time sports activities and the presence of any musculoskeletal problems. Children who report any such problems are monitored individually by health care personnel. Data are collected on demography, health habits and attitudes, physical characteristics, physical activity using accelerometers, motor performance, fitness, bone health, life-style disorders, injuries and musculoskeletal problems. Data collection will continue at least once a year until the children reach grade 9.DiscussionThis project is embedded in a local community, which set up the intervention (The Sport Schools) and thereafter invited researchers to provide documentation and evaluation. Sport schools are well matched with the ‘normal’ schools, making comparisons between these suitable. However, subgroups that would be specifically targeted in lifestyle intervention studies (such as the definitely obese) could be relatively small. Therefore, results specific to minority groups may be diluted. Nonetheless, the many rigorously collected data will make it possible to study, for example, the general effect that different levels of physical activity may have on various health conditions and on proxy measures of life-style conditions. Specifically, it will help answer the question on whether increased physical activity in school has a positive effect on health in children.