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Kiss O, Baker FC, Palovics R, Dooley EE, Pettee Gabriel K, Nagata JM. Using explainable machine learning and fitbit data to investigate predictors of adolescent obesity. Sci Rep 2024; 14:12563. [PMID: 38821981 PMCID: PMC11143310 DOI: 10.1038/s41598-024-60811-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 04/26/2024] [Indexed: 06/02/2024] Open
Abstract
Sociodemographic and lifestyle factors (sleep, physical activity, and sedentary behavior) may predict obesity risk in early adolescence; a critical period during the life course. Analyzing data from 2971 participants (M = 11.94, SD = 0.64 years) wearing Fitbit Charge HR 2 devices in the Adolescent Brain Cognitive Development (ABCD) Study, glass box machine learning models identified obesity predictors from Fitbit-derived measures of sleep, cardiovascular fitness, and sociodemographic status. Key predictors of obesity include identifying as Non-White race, low household income, later bedtime, short sleep duration, variable sleep timing, low daily step counts, and high heart rates (AUCMean = 0.726). Findings highlight the importance of inadequate sleep, physical inactivity, and socioeconomic disparities, for obesity risk. Results also show the clinical applicability of wearables for continuous monitoring of sleep and cardiovascular fitness in adolescents. Identifying the tipping points in the predictors of obesity risk can inform interventions and treatment strategies to reduce obesity rates in adolescents.
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Affiliation(s)
- Orsolya Kiss
- Center for Health Sciences, SRI International, 333 Ravenswood Ave, Menlo Park, CA, 94025, USA.
| | - Fiona C Baker
- Center for Health Sciences, SRI International, 333 Ravenswood Ave, Menlo Park, CA, 94025, USA
- School of Physiology, University of the Witwatersrand, Parktown, Johannesburg, South Africa
| | - Robert Palovics
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Erin E Dooley
- Department of Epidemiology, University of Alabama at Birmingham, 1665 University Boulevard, Birmingham, AL, 35233, USA
| | - Kelley Pettee Gabriel
- Department of Epidemiology, University of Alabama at Birmingham, 1665 University Boulevard, Birmingham, AL, 35233, USA
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
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Singh N, Jha NA, Kumar V. Urbanisation negatively impacts sleep health and mood in adolescents: a comparative study of female students from city and rural schools of North India. Sleep Biol Rhythms 2024; 22:279-289. [PMID: 38524164 PMCID: PMC10959891 DOI: 10.1007/s41105-023-00503-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 11/15/2023] [Indexed: 03/26/2024]
Abstract
This study investigated the impact of social settings on sleep, physical and mental health in female adolescents of North India (latitude 29.5 oN; longitude 77.5 oE). Using a battery of questionnaires, we compared the chronotype, sleep-wake pattern, sleep health (e.g. sleep quality, daytime sleepiness and fatigue) and mood (via depression, anxiety and stress symptoms) in female students (age 14-18 years) from rural (N = 719) and urban (N = 1033) schools separated by about 35 km, but families had almost similar socio-demographic details. The morning type was prevalent amongst rural, whilst the evening type was prevalent amongst urban students who also had access to smart phones, suggesting a possible greater use of the internet. There were greater negative sleep effects, daytime sleepiness, overall poor sleep quality, higher fatigue and anxiety levels in urban than the rural cohort. Interestingly, these measures also differed between school days and free days, suggesting an impact of the conflict between internal biological and social timings (= social jet lag). We also found a significant relationship between chronotype, internet addiction, mood-related parameters and measures of sleep health. Overall, these results suggest a possible impact of social settings on sleep health and mood-related behaviours in female adolescents.
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Affiliation(s)
- Nisha Singh
- IndoUS Center in Chronobiology, Department of Zoology, University of Delhi, Delhi, 110007 India
| | - Neelu Anand Jha
- Jindal School of Environment and Sustainability, O.P. Jindal Global University, Sonipat, Haryana 131001 India
| | - Vinod Kumar
- IndoUS Center in Chronobiology, Department of Zoology, University of Delhi, Delhi, 110007 India
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Wiltshire CN, Kouri N, Wanna CP, Minton ST, France JM, Reda MH, Davie W, Basarkod S, Winters S, Hinrichs R, Stenson AF, Jovanovic T. Resting heart rate associations with violence exposure and posttraumatic stress symptoms: sex differences in children. Biol Sex Differ 2024; 15:28. [PMID: 38549155 PMCID: PMC10976797 DOI: 10.1186/s13293-024-00606-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 03/18/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND Traumatic events experienced in childhood can lead to increased risk of cardiovascular disorders in adulthood. Black Americans are disproportionately affected, as they are at increased risk for experiencing childhood trauma and cardiovascular diseases in adulthood. One of the hypothesized mechanisms of this association is through long-lasting dysregulation of the autonomic nervous system, a hallmark physiological biomarker of posttraumatic stress disorder (PTSD), which is twice as prevalent in women compared to men. METHODS Ninety-one, majority Black American children, aged 9 were recruited to be a part of our longitudinal study of child development at research centers in Atlanta, GA and Detroit, MI. Resting HR was measured through a electrocardiogram (ECG) recording using the Biopac MP150. Self-report measures of violence exposure and PTSD symptoms were administered by research staff. RESULTS Children with more violence exposure reported increased PTSS as well as lower resting HR. Regression analysis showed evidence of sex modifying this relationship, (B = -0.64, p < 0.05), such that the association between resting HR and PTSS was stronger in girls than in boys. In our exploratory analysis with standard clinical cutoffs of resting HR, the normative HR group was found to significantly moderate the relationship between violence exposure and PTSS in boys, (B = -2.14, p < 0.01), but not girls (B = -0.94, p = 0.27). CONCLUSION In our sample of primarily Black urban children, we found that violence exposure was associated with slower, more adult-like HR, that girls showed greater PTSS associated with slower HR while boys did not, and that girls with lower than normative HR showed significantly higher PTSS compared to girls with normative HR. Our sample's demonstration of psychological consequences in addition to the physiological implications could provide new information about a psychobiological sequelae of violence exposure.
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Affiliation(s)
- Charis N Wiltshire
- Department of Psychiatry and Neurosciences, Wayne State University School of Medicine, 3901 Chrysler Service Dr, Detroit, MI, 48201, US.
- Department of Psychiatry, Emory University School of Medicine, 69 Jesse Hill Jr Dr. SE, 30303, Atlanta, GA, US.
| | - Nicole Kouri
- Department of Psychiatry and Neurosciences, Wayne State University School of Medicine, 3901 Chrysler Service Dr, Detroit, MI, 48201, US
| | - Cassandra P Wanna
- Department of Psychiatry and Neurosciences, Wayne State University School of Medicine, 3901 Chrysler Service Dr, Detroit, MI, 48201, US
| | - Sean T Minton
- Department of Psychiatry, Emory University School of Medicine, 69 Jesse Hill Jr Dr. SE, 30303, Atlanta, GA, US
| | - John M France
- Department of Psychiatry and Neurosciences, Wayne State University School of Medicine, 3901 Chrysler Service Dr, Detroit, MI, 48201, US
| | - Mariam H Reda
- Department of Psychiatry and Neurosciences, Wayne State University School of Medicine, 3901 Chrysler Service Dr, Detroit, MI, 48201, US
| | - William Davie
- Department of Psychiatry and Neurosciences, Wayne State University School of Medicine, 3901 Chrysler Service Dr, Detroit, MI, 48201, US
| | - Sattvik Basarkod
- Department of Psychiatry and Neurosciences, Wayne State University School of Medicine, 3901 Chrysler Service Dr, Detroit, MI, 48201, US
| | - Sterling Winters
- Department of Psychiatry and Neurosciences, Wayne State University School of Medicine, 3901 Chrysler Service Dr, Detroit, MI, 48201, US
| | - Rebecca Hinrichs
- Department of Psychiatry, Emory University School of Medicine, 69 Jesse Hill Jr Dr. SE, 30303, Atlanta, GA, US
| | - Anais F Stenson
- Department of Psychiatry and Neurosciences, Wayne State University School of Medicine, 3901 Chrysler Service Dr, Detroit, MI, 48201, US
| | - Tanja Jovanovic
- Department of Psychiatry and Neurosciences, Wayne State University School of Medicine, 3901 Chrysler Service Dr, Detroit, MI, 48201, US
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Zhao R, Li X, Wang J, Zhang L, Gao Z. Evaluation of physical fitness and health of young children aged between 3 and 6 based on cluster and factor analyses. BMC Public Health 2024; 24:420. [PMID: 38336673 PMCID: PMC10854155 DOI: 10.1186/s12889-024-17660-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 01/03/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND As life improves and sedentary time increases, young children's physical fitness gradually declines. METHODS Multi-stage stratified whole cluster sampling was utilized to sample 5584 preschoolers. Young infants' morphology, function, and quality were revealed using cluster and factor analysis. RESULTS The cluster analysis separated 3-6-year-olds into two genders: 1,551 men in group A "high physical fitness" 1,499 men in group B "low physical fitness"; 1,213 women in group A and 1,321 women in group B. Young children's fitness was measured by standing long jump(1.00), weight(1.00), and height(1.00). A cluster analysis of 3-4-year-olds classified them into three groups: 272 "muscular strength," 75 "average physical fitness," and 250 "low agility." Young children's health depends on weight (1.00), height (0.57), and chest circumference (0.54). A cluster analysis of the 4-5-year-olds classified them into two groups: 1070 "balance" and 806 "muscular strength." Young children's health depends on weight (1.00), height (0.74), and chest circumference (0.71). A cluster analysis of the 5-6-year-olds divided them into three groups: 1762 "high physical fitness," 384 "obese," and 105 "low physical fitness." Young children's physical health depends on BMI (1.00), weight (1.00), and chest circumference (1.00). Factor analysis demonstrated that muscle strength, body shape, cardiovascular variables, and physical fitness composite components affected young children's health. CONCLUSION Women should focus on motor function and strength, while men on flexibility. Male group B "low physical fitness" should focus on strength, motor function, and balance, whereas male group A "high physical fitness" should focus on flexibility. Then, female group A "high physical fitness" should emphasize variety.2) For 3-4-year-olds, group A "muscular strength" should focus on flexibility, and group C "low agility" on motor function. 3) For 4-5-year-olds, group A "balanced" should focus on strength and motor function; 4) For 5-6-year-olds, group B "obese" should emphasize weight loss, and group C "low fitness" should emphasize strength, motor function, and flexibility; 5) Young children's physical fitness depends on muscle strength, body shape, cardiovascular factors, and physical fitness composite.
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Affiliation(s)
- Rui Zhao
- School of Sports Medicine and Health, Chengdu Sport University, #2, Tiyuan Road, Wuhou District, Chengdu, 610041, China
| | - Xue Li
- School of Sports Medicine and Health, Chengdu Sport University, #2, Tiyuan Road, Wuhou District, Chengdu, 610041, China.
| | - Junwei Wang
- School of Sports Medicine and Health, Chengdu Sport University, #2, Tiyuan Road, Wuhou District, Chengdu, 610041, China
| | - Lanchuan Zhang
- School of Sports Medicine and Health, Chengdu Sport University, #2, Tiyuan Road, Wuhou District, Chengdu, 610041, China
| | - Zhanle Gao
- School of Sports Medicine and Health, Chengdu Sport University, #2, Tiyuan Road, Wuhou District, Chengdu, 610041, China
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Torres-Puebla G, Poblete P, Rodríguez-Núñez I, Báez C, Muñoz-Pareja M, Zenteno D. The cardiorespiratory response and physiological determinants of the 6-min handbike cycle test in healthy children: A cross-sectional study. Pediatr Pulmonol 2023; 58:1152-1159. [PMID: 36617493 DOI: 10.1002/ppul.26309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 01/05/2023] [Accepted: 01/05/2023] [Indexed: 01/10/2023]
Abstract
INTRODUCTION The submaximal tests are used to measure aerobic capacity and correlate with activities of daily living in chronic patients. The 6-min handbike cycle test (6mhct) was created for nonambulatory subjects, but there are no reference values to quantify and classify the cardiorespiratory fitness of children in this condition. OBJECTIVE(S) Generate 6mhct reference values and determine predictive variables in a population of Chilean children between 8 and 13 years old. MATERIALS AND METHODS Cross-sectional study. Sampling for convenience, stratified by age. Evaluation of anthropometric variables, handgrip strength, heart rate (HR), effort perception, and blood pressure were performed, then the 6mhct was applied. Descriptive statistics, Student's t test and Mann-Whitney U test, correlation coefficient, and regression equation were used to estimate the total revolutions by age, being significant p < 0.05. RESULTS Were evaluated 120 children homogeneously distributed by age. The total revolutions performed by boys and girls were 861.4 ± 102.9 and 771.8 ± 90.2, respectively (p < 0.001). There was a significant correlation between total revolutions and age (r = .52), weight (r = .29), height (r = .46), average UULL (length of the upper limb) length (r = .44), average handgrip strength (r = .53), peak HR (r = .67), recovery HR (r = .44), and HR reserve (r = .72). The regression equation was established. CONCLUSIONS These results can be used as preliminary reference values for the 6mhct in Chilean children from 8 to 13 years old. Handgrip strength, age, peak HR, and HR reserve influenced the performance of the 6mhct.
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Affiliation(s)
- Gerardo Torres-Puebla
- Children's Respiratory Rehabilitation Program, Pediatric Service, Guillermo Grant Benavente Hospital, Concepcion, Chile.,Master of Science Program in Cardiorespiratory Kinesiology, Departamento de Kinesiología, Facultad de Ciencias de la Salud, Universidad San Sebastián, Concepcion, Chile
| | - Pedro Poblete
- Master of Science Program in Cardiorespiratory Kinesiology, Departamento de Kinesiología, Facultad de Ciencias de la Salud, Universidad San Sebastián, Concepcion, Chile
| | - Iván Rodríguez-Núñez
- Departamento de Kinesiología, Facultad de Medicina, Universidad de Concepción, Concepcion, Chile
| | - Claudio Báez
- Master of Science Program in Cardiorespiratory Kinesiology, Departamento de Kinesiología, Facultad de Ciencias de la Salud, Universidad San Sebastián, Concepcion, Chile
| | - Maritza Muñoz-Pareja
- Departamento de Salud Pública, Facultad de Medicina, Universidad Católica de la Santísima Concepción, Concepcion, Chile
| | - Daniel Zenteno
- Children's Respiratory Rehabilitation Program, Pediatric Service, Guillermo Grant Benavente Hospital, Concepcion, Chile.,Departamento de Pediatría, Facultad de Medicina, Universidad de Concepción, Concepcion, Chile
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Silva Filho RCDS, Sasaki JE, Gordia AP, Andaki ACR. Effects of a Physical Exercise Program and Health Advice on Sedentary Behavior of Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1064. [PMID: 36673819 PMCID: PMC9859598 DOI: 10.3390/ijerph20021064] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/29/2022] [Accepted: 07/07/2022] [Indexed: 06/17/2023]
Abstract
Sedentary behavior (SB) is a risk factor for chronic non-communicable diseases. This study aimed to assess the effects of an extracurricular physical exercise program and health advice on SB in adolescents. This was a non-randomized experimental study involving 19 adolescents divided into an intervention group (IG) and a control group (CG), aged 13-16 years from a public school in a Brazilian municipality. SB was measured using self-reports and accelerometers. The intervention included physical exercise and health advice. Repeated measures analysis of variance with a significance level of α = 5% was used. There was a time*group interaction for the subscapular fold ((pre IG = 16.30 mm vs. CG = 13.44 mm, post IG = 14.00 mm vs. CG = 15.89 mm) p = 0.001), and VO2MAX ((pre IG = 32.75 mL/kg/min vs. CG = 30.66 mL/kg/min, post IG = 35.76 mL/kg/min vs. CG = 29.28 mL/kg/min) p = 0.008). The accelerometer showed significant differences between groups in the total SB ((pre IG = 647.49 min/day vs. CG = 535.24 min/day, post IG = 614.02 min/day vs. CG = 586.97 min/day) p = 0.045), with a significant decrease in the IG. In conclusion, an extracurricular physical exercise program and health advice was effective in reducing SB in adolescents.
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Affiliation(s)
| | - Jeffer Eidi Sasaki
- Postgraduate Program in Physical Education, Federal University of Triângulo Mineiro, Uberaba 38061-500, MG, Brazil
| | - Alex Pinheiro Gordia
- Teachers Training Center, Federal University of Recôncavo da Bahia, Amargosa 45300-000, BA, Brazil
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Association between clustering of cardiovascular risk factors and resting heart rate in Chinese population: a cross-sectional study. J Geriatr Cardiol 2022; 19:418-427. [PMID: 35845154 PMCID: PMC9248276 DOI: 10.11909/j.issn.1671-5411.2022.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Epidemiologic studies have explored the association between a single cardiovascular risk factor (CVRF) and resting heart rate (RHR), but the research on the relation of multiple risk factors with RHR remains scarce. This study aimed to explore the associations between CVRFs clustering and the risk of elevated RHR. METHODS In this cross-sectional study, adults aged 35-75 years from 31 provinces were recruited by the China PEACE Million Persons Projects from September 2015 to August 2020. We focused on seven risk factors: hypertension, diabetes mellitus, dyslipidemia, obesity, smoking, alcohol use, and low physical activity. Multivariate logistic regression was used to calculate odds ratios (OR) for elevated RHR (> 80 beats/min). RESULTS Among 1,045,405 participants, the mean age was 55.67 ± 9.86 years, and 60.4% of participants were women. The OR (95% CI) for elevated RHR for the groups with 1, 2, 3, 4 and ≥ 5 risk factor were 1.11 (1.08-1.13), 1.36 (1.33-1.39), 1.68 (1.64-1.72), 2.01 (1.96-2.07) and 2.58 (2.50-2.67), respectively (P trend < 0.001). The association between the CVRFs clustering number and elevated RHR was much more pronounced in young males than in other age-sex subgroups. Clusters comprising more metabolic risk factors were associated with a higher risk of elevated RHR than those comprising more behavioral risk factors. CONCLUSIONS There was a significant positive association between the CVRFs clustering number and the risk of elevated RHR, particularly in young males. Compared clusters comprising more behavioral risk factors, clusters comprising more metabolic risk factors were associated with a higher risk of elevated RHR. RHR may serve as an indicator of the cumulative effect of multiple risk factors.
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Lima NS, Krishna H, Gerber BS, Heffernan KS, Gump BB, Lefferts WK. Physical activity is associated with lower pulsatile stress but not carotid stiffness in children. J Hum Hypertens 2022; 36:263-270. [PMID: 33712711 PMCID: PMC8435042 DOI: 10.1038/s41371-021-00506-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 01/25/2021] [Accepted: 02/04/2021] [Indexed: 12/31/2022]
Abstract
The cardiovascular disease (CVD) process may begin early in life when accompanied by atherosclerotic risk factors. CVD risk factors in children are associated with stiffening of the large elastic arteries, a reflection of subclinical atherosclerosis. Physical activity is a preventative lifestyle strategy that may benefit arterial stiffness by attenuating the hemodynamic stress on the artery wall. This study examined the relations between physical activity, carotid pulsatile stress, and carotid stiffness in children. One hundred and forty children (9-11 yrs; 50.0% male, 57.9% African-American, 42.10% Caucasian, body mass index (BMI) 20.1 ± 4.7 kg/m2) participated in this study. Physical activity counts were measured using a wrist-worn accelerometer and averaged over 7 days. Carotid artery β-stiffness and pulse pressure (calibrated to brachial mean and diastolic pressure) were assessed as via ultrasound and tonometry, respectively. Pulsatile stress was calculated as the product of carotid pulse pressure and heart rate. Physical activity counts were correlated with pulsatile stress (r = -0.27), and BMI (r = -0.23), but were unrelated to carotid stiffness. In multivariate models, associations between physical activity counts and pulsatile stress remained (B = -1.3 [95%CI, -2.4, -0.2], β = -0.20, p < 0.05) after covariate adjustment for age, race, sex, pubertal stage, and BMI. Carotid pulsatile stress was related to regional carotid stiffness (r = 0.45, p < 0.05). These data suggest that higher levels of physical activity at young age are associated with lower hemodynamic stress in the carotid artery. Findings are discussed in the context of an inverse relationship between hemodynamic pulsatile stress and carotid stiffness in children.
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Affiliation(s)
| | - Hema Krishna
- University of Illinois at Chicago, Chicago, IL, USA
| | - Ben S Gerber
- University of Illinois at Chicago, Chicago, IL, USA
| | | | | | - Wesley K Lefferts
- University of Illinois at Chicago, Chicago, IL, USA.
- Syracuse University, Syracuse, NY, USA.
- Iowa State University, Ames, IA, USA.
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Bi H, Zhang Y, Qin P, Wang C, Peng X, Chen H, Zhao D, Xu S, Wang L, Zhao P, Lou Y, Hu F. Association of Chinese Visceral Adiposity Index and Its Dynamic Change With Risk of Carotid Plaque in a Large Cohort in China. J Am Heart Assoc 2021; 11:e022633. [PMID: 34970911 PMCID: PMC9075187 DOI: 10.1161/jaha.121.022633] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background We aimed to evaluate the association between the Chinese visceral adiposity index (CVAI) and its dynamic change and risk of carotid plaque based on a large Chinese cohort. Methods and Results This cohort included 23 522 participants aged 20 to 80 years without elevated carotid intima‐media thickness and carotid plaque at baseline and who received at least 2 health checkups. CVAI was calculated at baseline and at every checkup. The dynamic change in CVAI was calculated by subtracting CVAI at baseline from that at the last follow‐up. Cox proportional hazard regression model was used to estimate hazard ratios (HRs) and 95% CIs. The restricted cubic spline was applied to model the dose‐response association between CVAI and carotid plaque risk. During the 82 621 person‐years of follow‐up, 5987 cases of carotid plaque developed (7.25/100 person‐years). We observed a significant positive correlation between CVAI and carotid plaque risk (HR, 1.53; 95% CI, 1.48–1.59 [P<0.001]) in a nonlinear dose‐response pattern (Pnonlinearity<0.001). The sensitivity analyses further confirmed the robustness of the results. The association was significant in all subgroup analyses stratified by sex, hypertension, and fatty liver disease except for the diabetes subgroup. The association between CVAI and carotid plaque risk was much higher in men than in women. No significant association was identified between change in CVAI and carotid plaque risk. Conclusions CVAI was positively associated with carotid plaque risk in a nonlinear dose‐response pattern in this study. Individuals should keep their CVAI within a normal level to prevent the development of carotid plaque.
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Affiliation(s)
- Haoran Bi
- Department of Epidemiology and Biostatistics School of Public Health Xuzhou Medical University Xuzhou Jiangsu People's Republic of China
| | - Yanyan Zhang
- Department of Biostatistics and Epidemiology School of Public Health Shenzhen University Health Science Center Shenzhen Guangdong People's Republic of China
| | - Pei Qin
- Department of Biostatistics and Epidemiology School of Public Health Shenzhen University Health Science Center Shenzhen Guangdong People's Republic of China
| | - Changyi Wang
- Department of Non-communicable Disease Prevention and Control Shenzhen Nanshan Center for Chronic Disease Shenzhen Guangdong People's Republic of China
| | - Xiaolin Peng
- Department of Non-communicable Disease Prevention and Control Shenzhen Nanshan Center for Chronic Disease Shenzhen Guangdong People's Republic of China
| | - Hongen Chen
- Department of Non-communicable Disease Prevention and Control Shenzhen Nanshan Center for Chronic Disease Shenzhen Guangdong People's Republic of China
| | - Dan Zhao
- Department of Non-communicable Disease Prevention and Control Shenzhen Nanshan Center for Chronic Disease Shenzhen Guangdong People's Republic of China
| | - Shan Xu
- Department of Non-communicable Disease Prevention and Control Shenzhen Nanshan Center for Chronic Disease Shenzhen Guangdong People's Republic of China
| | - Li Wang
- Department of Non-communicable Disease Prevention and Control Shenzhen Nanshan Center for Chronic Disease Shenzhen Guangdong People's Republic of China
| | - Ping Zhao
- Department of Health Management Beijing Xiaotangshan Hospital Beijing People's Republic of China
| | - Yanmei Lou
- Department of Health Management Beijing Xiaotangshan Hospital Beijing People's Republic of China
| | - Fulan Hu
- Department of Biostatistics and Epidemiology School of Public Health Shenzhen University Health Science Center Shenzhen Guangdong People's Republic of China
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Flores-Ramírez AG, Tovar-Villegas VI, Maharaj A, Garay-Sevilla ME, Figueroa A. Effects of L-Citrulline Supplementation and Aerobic Training on Vascular Function in Individuals with Obesity across the Lifespan. Nutrients 2021; 13:nu13092991. [PMID: 34578869 PMCID: PMC8466140 DOI: 10.3390/nu13092991] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 08/19/2021] [Accepted: 08/19/2021] [Indexed: 12/20/2022] Open
Abstract
Children with obesity are at higher risk for developing cardiometabolic diseases that once were considered health conditions of adults. Obesity is commonly associated with cardiometabolic risk factors such as dyslipidemia, hyperglycemia, hyperinsulinemia and hypertension that contribute to the development of endothelial dysfunction. Endothelial dysfunction, characterized by reduced nitric oxide (NO) production, precedes vascular abnormalities including atherosclerosis and arterial stiffness. Thus, early detection and treatment of cardiometabolic risk factors are necessary to prevent deleterious vascular consequences of obesity at an early age. Non-pharmacological interventions including L-Citrulline (L-Cit) supplementation and aerobic training stimulate endothelial NO mediated vasodilation, leading to improvements in organ perfusion, blood pressure, arterial stiffness, atherosclerosis and metabolic health (glucose control and lipid profile). Few studies suggest that the combination of L-Cit supplementation and exercise training can be an effective strategy to counteract the adverse effects of obesity on vascular function in older adults. Therefore, this review examined the efficacy of L-Cit supplementation and aerobic training interventions on vascular and metabolic parameters in obese individuals.
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Affiliation(s)
- Anaisa Genoveva Flores-Ramírez
- Department of Medical Science, Division of Health Science, University of Guanajuato, Campus León, León 37320, Mexico; (A.G.F.-R.); (V.I.T.-V.)
| | - Verónica Ivette Tovar-Villegas
- Department of Medical Science, Division of Health Science, University of Guanajuato, Campus León, León 37320, Mexico; (A.G.F.-R.); (V.I.T.-V.)
| | - Arun Maharaj
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX 79409, USA;
| | - Ma Eugenia Garay-Sevilla
- Department of Medical Science, Division of Health Science, University of Guanajuato, Campus León, León 37320, Mexico; (A.G.F.-R.); (V.I.T.-V.)
- Correspondence: (M.E.G.-S.); (A.F.)
| | - Arturo Figueroa
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX 79409, USA;
- Correspondence: (M.E.G.-S.); (A.F.)
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Farah BQ, Christofaro DGD, Andrade-Lima A, Germano-Soares AH, Tebar WR, Barros MVGD, Ritti-Dias RM. Sensitivity and Specificity of Cutoff Points of Resting Heart Rate from 6,794 Brazilian Adolescents: A Cross-Sectional Study. Arq Bras Cardiol 2021; 117:74-81. [PMID: 34320072 PMCID: PMC8294731 DOI: 10.36660/abc.20200111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 08/05/2020] [Indexed: 12/03/2022] Open
Abstract
Fundamento A frequência cardíaca em repouso (FCR) pode ser uma ferramenta útil de triagem para o risco cardiovascular. Porém, os pontos de corte para FCR nunca foram descritos em populações jovens. Objetivo Estabelecer os pontos de corte para FCR em adolescentes brasileiros e analisar se há associação entre pontos de corte e fatores de risco cardiovascular. Métodos A amostra foi composta por 6.794 adolescentes (de 10 a 19 anos). A pressão arterial e a FCR foram avaliadas por dispositivo oscilométrico. Também foram avaliados o índice de massa corporal e a circunferência da cintura. Foi adotada a curva ROC para analisar a sensibilidade e especificidade, e as associações de FCR elevada com os fatores de risco cardiovascular foram analisadas por regressão logística binária. Foi considerado estatisticamente significante um valor de p < 0,05 para todas as análises. Resultados Os valores médios da FCR eram mais altos entre os participantes de 10 a 14 anos do naqueles de 15 a 19 anos, em meninos (p < 0,001) e meninas (< 0,001). Os pontos de corte de FCR propostos para detecção de fatores de risco cardiovascular foram significativos para meninos de 10 a 14 (> 92 bpm) e de 15 a 19 anos (> 82 bpm) e para meninas de 15 a 19 anos (> 82 bpm) (p < 0,05 para todos), enquanto nenhum ponto de corte foi identificado para as meninas de 10 a 14 anos (p > 0,05). Os pontos de corte propostos para a FCR foram associados com obesidade abdominal, sobrepeso e pressão arterial elevada em meninos e meninas. Os pontos de corte da FCR foram associados ao conjunto de fatores de risco cardiovascular em adolescentes de 15 a 19 anos. Conclusões Os pontes de corte propostos para a FCR foram associados com os fatores de risco cardiovascular em adolescentes.
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Affiliation(s)
- Breno Quintella Farah
- Programa de Pós-Graduação em Educação Física da Universidade Federal de Pernambuco, Recife, PE - Brasil
| | | | | | | | | | | | - Raphael Mendes Ritti-Dias
- Universidade Nove de Julho - Programa de Pós-Graduação em Ciências da Reabilitação, São Paulo, SP - Brasil
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12
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Farah BQ, Christofaro DGD, Andrade-Lima A, Saraiva BTC, de Barros MVG, do Prado WL, Ritti-Dias RM. Association between sedentary recreational time and cardiac autonomic modulation in adolescent boys: cross-sectional study. SPORT SCIENCES FOR HEALTH 2020. [DOI: 10.1007/s11332-020-00641-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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13
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Saraiva BTC, Pinto RZ, Oliveira CB, Zanuto EF, Scarabottolo CC, Delfino LD, Suetake VYB, Gil FCS, Christofaro DGD. Continuity of physical activity practice from childhood to adolescence is associated with lower neck pain in both sexes and lower back pain in girls. J Back Musculoskelet Rehabil 2020; 33:269-275. [PMID: 31403935 DOI: 10.3233/bmr-181136] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND The literature on physical activity practice through sports as a protective factor for back pain in adolescents is conflicting. However, few studies have aimed to verify if continuity of the practice of physical activity from childhood to adolescence may be related to lower chances of back pain in adolescents. OBJECTIVES The objective of this study was to analyze the association between physical activity practice from childhood to adolescence and back pain in adolescents. METHODS The random sample was composed of 870 adolescents with a mean age of 13.7 ± 2.0 years. The continuity of physical activity practice was assessed through the continuity of sports practice from childhood to adolescence. Pain in the neck and low back were evaluated through a questionnaire. RESULTS The prevalence of neck pain and low back pain in boys was 17.5% and in girls was 20.9% for neck pain and 21.9% for low back pain. Physical activity practice during childhood to adolescence was a protective factor for neck pain (OR = 0.57 [CI = 0.35-0.94]) and low back pain (OR = 0.53 [CI = 0.33-0.86]) in girls and neck pain in boys (OR = 0.52 [CI = 0.30-0.90]), even after adjusting for confounding factors. CONCLUSION Girls with physical activity practice during childhood to adolescence were less likely to develop neck pain and back pain when compared to girls who did not maintain practice of physical activity. Similar results were observed in boys considering neck pain.
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Affiliation(s)
| | - Rafael Z Pinto
- Department of Physiotherapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Edner Fernando Zanuto
- Postgraduate Program in Physiotherapy, Universidade Estadual Paulista, Presidente Prudente, SP, Brazil
| | | | - Leandro Dragueta Delfino
- Postgraduate Program in Motricity Science, Universidade Estadual Paulista, Presidente Prudente, SP, Brazil
| | | | | | - Diego Giulliano Destro Christofaro
- Postgraduate Program in Motricity Science, Universidade Estadual Paulista, Presidente Prudente, SP, Brazil.,Postgraduate Program in Physiotherapy, Universidade Estadual Paulista, Presidente Prudente, SP, Brazil
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14
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Torres W, Cayres-Santos SU, Urban JB, de Moraes-Chagas LG, Christofaro DGD, Turi-Lynch BC, Codogno JS, Fernandes RA. Participation in Non-professional Sports and Cardiovascular Outcomes Among Adolescents: ABCD Growth Study. Matern Child Health J 2020. [DOI: https:/doi.org/10.1007/s10995-020-02919-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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15
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Torres W, Cayres-Santos SU, Urban JB, de Moraes-Chagas LG, Christofaro DGD, Turi-Lynch BC, Codogno JS, Fernandes RA. Participation in Non-professional Sports and Cardiovascular Outcomes Among Adolescents: ABCD Growth Study. Matern Child Health J 2020; 24:787-795. [PMID: 32323117 DOI: 10.1007/s10995-020-02919-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVES Sports are an important way to improve health during adolescence. However, it is still unclear whether the association between sports, blood pressure, and metabolic profile could be affected by sex, biological maturation, and trunk fatness. The aim of this study was to analyze the association between sports participation and the cluster of cardiovascular markers among adolescents of both sexes. METHODS A cross-sectional study involving 285 adolescents aged from 11 to 17 years of age (202 boys and 83 girls). Cardiovascular variables were composed of systolic blood pressure (SBP), diastolic blood pressure (DBP), resting heart rate (RHR), and carotid (CIMT) and femoral (FIMT) intima-media thickness, which were used to calculate the CardiovascularZ score. Sports participation was assessed through a face-to-face interview. Age of peak height velocity (APHV) was used as a covariate. RESULTS Among girls, the group engaged in sports presented lower values of RHR (sport: - 0.344 [95% CI - 0.650 to - 0.037] versus non-sport: 0.540 [95% CI 0.125 to 0.954]) and CardiovascularZ score (sport: - 0.585 [95% CI - 1.329 to 0.159] versus non-sport: 0.879 [95% CI - 0.127 to 1.884]), explaining 12.2% and 6.1% of all variance, respectively. Among boys, the group engaged in sports presented lower values of DBP (sport: - 0.158 [95% CI - 0.335 to 0.018] versus non-sport: 0.160 [95% CI - 0.091 to 0.412]) and FIMT (sport: - 0.128 [95% CI - 0.300 to - 0.044] versus non-sport: 0.211 [95% CI - 0.032 to 0.454]), explaining 2.2% and 2.6% of all variance, respectively. CONCLUSIONS FOR PRACTICE Adolescents engaged in sports presented healthier cardiovascular parameters, and sports participation seems to affect cardiovascular health differently in boys and girls.
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Affiliation(s)
- Wésley Torres
- Laboratory of InVestigation in Exercise - LIVE, Department of Physical Education, São Paulo State University (UNESP), Roberto Simonsen Street, 305, Presidente Prudente, São Paulo, 19060900, Brazil.
| | - Suziane Ungari Cayres-Santos
- Laboratory of InVestigation in Exercise - LIVE, Department of Physical Education, São Paulo State University (UNESP), Roberto Simonsen Street, 305, Presidente Prudente, São Paulo, 19060900, Brazil
| | - Jacqueline Bexiga Urban
- Laboratory of InVestigation in Exercise - LIVE, Department of Physical Education, São Paulo State University (UNESP), Roberto Simonsen Street, 305, Presidente Prudente, São Paulo, 19060900, Brazil
| | - Lucas Gabriel de Moraes-Chagas
- Laboratory of InVestigation in Exercise - LIVE, Department of Physical Education, São Paulo State University (UNESP), Roberto Simonsen Street, 305, Presidente Prudente, São Paulo, 19060900, Brazil
| | - Diego Giulliano Destro Christofaro
- Laboratory of InVestigation in Exercise - LIVE, Department of Physical Education, São Paulo State University (UNESP), Roberto Simonsen Street, 305, Presidente Prudente, São Paulo, 19060900, Brazil
| | - Bruna Camilo Turi-Lynch
- Laboratory of InVestigation in Exercise - LIVE, Department of Physical Education, São Paulo State University (UNESP), Roberto Simonsen Street, 305, Presidente Prudente, São Paulo, 19060900, Brazil
| | - Jamile Sanches Codogno
- Laboratory of InVestigation in Exercise - LIVE, Department of Physical Education, São Paulo State University (UNESP), Roberto Simonsen Street, 305, Presidente Prudente, São Paulo, 19060900, Brazil
| | - Rômulo Araújo Fernandes
- Laboratory of InVestigation in Exercise - LIVE, Department of Physical Education, São Paulo State University (UNESP), Roberto Simonsen Street, 305, Presidente Prudente, São Paulo, 19060900, Brazil
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Torres W, Cayres-Santos SU, Urban JB, de Moraes-Chagas LG, Christofaro DGD, Turi-Lynch BC, Codogno JS, Fernandes RA. Participation in Non-professional Sports and Cardiovascular Outcomes Among Adolescents: ABCD Growth Study. Matern Child Health J 2020. [DOI: https://doi.org/10.1007/s10995-020-02919-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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17
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Zanuto EF, Ritti-Dias RM, Tebar WR, Scarabottolo CC, Delfino LD, Casonatto J, Vanderlei LCM, Christofaro DGD. Is physical activity associated with resting heart rate in boys and girls? A representative study controlled for confounders. J Pediatr (Rio J) 2020; 96:247-254. [PMID: 30521767 PMCID: PMC9432037 DOI: 10.1016/j.jped.2018.10.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 09/27/2018] [Accepted: 10/01/2018] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE Investigate the relationship between different domains of physical activity and resting heart rate (RHR) in boys and girls. METHOD The sample included 1011 adolescents, aged between 10 and 17 years. RHR was measured by a heart rate monitor and physical activity was assessed in total and in three different domains (school, occupational, and sports practice) by a questionnaire. Anthropometry was directly obtained for body mass index and central fat. Ethnicity, sedentary behavior, and smoking habits were self-reported and used to adjust the analysis, through hierarchical linear regression. RESULTS Total physical activity was associated with low RHR in boys (β=-0.52; 95% CI: -0.92, -0.12) and girls (β=-0.67; 95% CI: -1.07, -0.28). Although sporting physical activities were associated with low RHR in both boys (β=-0.58; 95% CI: -1.05, -0.11) and girls (β=-0.87; 95% CI: -1.34, -0.39), occupational physical activity was related to low RHR only in boys (β=-1.56; 95% CI: -2.99, -0.14). CONCLUSION The practice of physical activity in the sport practice domain and total physical activity were related to low RHR in both sexes, while occupational physical activities were associated with RHR only in boys.
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Affiliation(s)
- Edner F Zanuto
- Universidade Estadual Paulista, Departamento de Educação Física, Presidente Prudente, SP, Brazil
| | - Raphael M Ritti-Dias
- Universidade Nove de Julho, Departamento de Ciências da Reabilitação, São Paulo, SP, Brazil
| | - William R Tebar
- Universidade Estadual Paulista, Programa de Pós-graduação em Ciências do Movimento, Departamento de Educação Física, Presidente Prudente, SP, Brazil
| | - Catarina C Scarabottolo
- Universidade Estadual Paulista, Programa de Pós-graduação em Ciências do Movimento, Departamento de Educação Física, Presidente Prudente, SP, Brazil
| | - Leandro D Delfino
- Universidade Estadual Paulista, Departamento de Educação Física, Presidente Prudente, SP, Brazil
| | - Juliano Casonatto
- Universidade Norte do Paraná, Departamento de Educação Física, Londrina, PR, Brazil
| | - Luiz Carlos M Vanderlei
- Universidade Estadual Paulista, Departamento de Fisioterapia, Presidente Prudente, SP, Brazil
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18
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Zanuto EF, Ritti‐Dias RM, Tebar WR, Scarabottolo CC, Delfino LD, Casonatto J, Vanderlei LCM, Christofaro DGD. Is physical activity associated with resting heart rate in boys and girls? A representative study controlled for confounders. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2020. [DOI: 10.1016/j.jpedp.2019.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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19
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da Silva MR, Waclawovsky G, Perin L, Camboim I, Eibel B, Lehnen AM. Effects of high-intensity interval training on endothelial function, lipid profile, body composition and physical fitness in normal-weight and overweight-obese adolescents: A clinical trial. Physiol Behav 2019; 213:112728. [PMID: 31676260 DOI: 10.1016/j.physbeh.2019.112728] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 10/16/2019] [Accepted: 10/26/2019] [Indexed: 12/15/2022]
Abstract
Endothelium-aggressive factors are associated with the development of atherosclerosis. Exercise training can either prevent or attenuate this process, but little is known about the effects of high-intensity interval training (HIIT) in adolescents. Thus, we assessed the effects of HIIT on endothelial function, lipid profile, body composition and physical fitness in normal-weight and overweight-obese adolescents. Thirty-eight participants aged 14-17 years who were physically inactive (IPAq) were divided in two groups: normal weight (NW, n = 13) and overweight-obese (OW, n = 25). Body composition, lipid profile, physical fitness and endothelial function (flow-mediated dilation, FMD) were assessed before and after undergoing the study protocol consisting of 12-week HIIT (∼15 min) + sport activities (30 min, 3×/week) + no diet. The differences were tested by GEE, Bonferroni post-hoc, p < 0.05. There were no changes in body composition after training period, but the OW group showed a reduction in waist (4.8 cm; p = 0.044) and abdominal circumference (3.7 cm; p = 0.049). We found improved physical fitness (cardiorespiratory endurance, explosive strength, abdominal muscle endurance and flexibility) in both groups. Lower endothelial function was found in the OW compared to NW (p = 0.042) at baseline. FMD increased (p < 0.001) in both groups from baseline (NW Δ4.1%; Cohen's effect size 0.64; OW Δ4.5%; Cohen's effect size 0.73) with no significant difference between the groups. In conclusion, a HIIT program even without any dietary changes can improve physical fitness and endothelial function among adolescents. These findings are clinically relevant because they support a reduction in endothelial damage that precedes the development of atherosclerosis.
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Affiliation(s)
- Marcondes Ramos da Silva
- Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia, Av. Princesa Isabel, 395, Santana, 90620-001 Porto Alegre, RS, Brazil
| | - Gustavo Waclawovsky
- Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia, Av. Princesa Isabel, 395, Santana, 90620-001 Porto Alegre, RS, Brazil
| | - Lisiane Perin
- Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia, Av. Princesa Isabel, 395, Santana, 90620-001 Porto Alegre, RS, Brazil
| | - Isadora Camboim
- Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia, Av. Princesa Isabel, 395, Santana, 90620-001 Porto Alegre, RS, Brazil; Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
| | - Bruna Eibel
- Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia, Av. Princesa Isabel, 395, Santana, 90620-001 Porto Alegre, RS, Brazil
| | - Alexandre Machado Lehnen
- Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia, Av. Princesa Isabel, 395, Santana, 90620-001 Porto Alegre, RS, Brazil.
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Cutoffs of Short-Term Heart Rate Variability Parameters in Brazilian Adolescents Male. Pediatr Cardiol 2018; 39:1397-1403. [PMID: 29766226 DOI: 10.1007/s00246-018-1909-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Accepted: 05/09/2018] [Indexed: 01/08/2023]
Abstract
A low heart rate variability (HRV) has been associated with cardiovascular risk factors in adolescents. However, no cut-off points are known for HRV parameters in this age group, making it difficult to use in clinical practice. Thus, the aims of the current study were to establish cutoffs of HRV parameters and to examine their association with cardiovascular risk in Brazilian adolescents male. For this reason, this cross-sectional study included 1152 adolescent boys (16.6 ± 1.2 years old). HRV measures of time (SD of all RR intervals, root mean square of the squared differences between adjacent normal RR intervals, and the percentage of adjacent intervals over 50 ms), frequency domains [low (LF) and high (HF) frequency], and Poincaré plot (SD1, SD2 and SD1/SD2 ratio) were assessed. Cardiovascular risk was assessed by sum of abdominal obesity, high blood pressure, overweight, and low physical activity level. The proposed cutoffs showed moderate to high sensitivity, specificity, and area under curve values (p < 0.05). HRV frequency parameters were statistically superior when compared to time-domain and Poincaré plot parameters. The binary logistic regression analysis indicated that all proposed HRV cutoffs were independently associated with a clustering of cardiovascular risk factors, with greater magnitude of HF and SD1/SD2 ratio (two or more risk factors: OR = 3.59 and 95% CI 1.76-7.34). In conclusion, proposed HRV cutoffs have moderate to high sensitivity in detecting of the cardiovascular risk factor and HRV frequency-domain were better discriminants of cardiovascular risk than time-domain and Poincaré plot parameters.
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21
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Childhood dietary trajectories and adolescent cardiovascular phenotypes: Australian community-based longitudinal study. Public Health Nutr 2018; 21:2642-2653. [PMID: 29947308 DOI: 10.1017/s1368980018001398] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE With the intention to inform future public health initiatives, we aimed to determine the extent to which typical childhood dietary trajectories predict adolescent cardiovascular phenotypes. DESIGN Longitudinal study. Exposure was determined by a 4 d food diary repeated over eight waves (ages 4-15 years), coded by Australian Dietary Guidelines and summed into a continuous diet score (0-14). Outcomes were adolescent (Wave 8, age 15 years) blood pressure, resting heart rate, pulse wave velocity, carotid intima-media thickness, retinal arteriole-to-venule ratio. Latent class analysis identified 'typical' dietary trajectories from childhood to adolescence. Adjusted linear regression models assessed relationships between trajectories and cardiovascular outcomes, adjusted for a priori potential confounders. SETTING Community sample, Melbourne, Australia. SUBJECTS Children (n 188) followed from age 4 to 15 years. RESULTS Four dietary trajectories were identified: unhealthy (8 %); moderately unhealthy (25 %); moderately healthy (46 %); healthy (21 %). There was little evidence that vascular phenotypes associated with the trajectories. However, resting heart rate (beats/min) increased (β; 95 % CI) across the healthy (reference), moderately healthy (4·1; -0·6, 8·9; P=0·08), moderately unhealthy (4·5; -0·7, 9·7; P=0·09) and unhealthy (10·5; 2·9, 18·0; P=0·01) trajectories. CONCLUSIONS Decade-long dietary trajectories did not appear to influence macro- or microvascular structure or stiffness by mid-adolescence, but were associated with resting heart rate, suggesting an early-life window for prevention. Larger studies are needed to confirm these findings, the threshold of diet quality associated with these physiological changes and whether functional changes in heart rate are followed by phenotypic change.
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Hu J, Teng CG, Chu GP, Han D, Fu H, Zhou YK, Wang Q, Wang B, Shen H, Liu F, Yang HB. Effects of resting heart rate on blood pressure and hypertension in Chinese children: findings from blood pressure surveillance program. Clin Exp Hypertens 2018; 41:1-7. [PMID: 29553835 DOI: 10.1080/10641963.2018.1451537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 02/28/2018] [Accepted: 03/07/2018] [Indexed: 01/13/2023]
Abstract
The purpose of this study was to analyze the association between resting heart rate (RHR) and prevalence of hypertension in Chinese children and to identify if this association was mediated by body mass index (BMI). The data of 5445 children who participated in the Blood Pressure Surveillance Program (2011-2017) were analyzed in this study. Children were divided into four groups according to quartiles of RHR in boys and girls, respectively. Compared to those in the first quartile, boys and girls in the fourth quartile were 3.06 (95% CI 2.12, 4.41) and 4.94 (95% CI 3.21, 7.61) times more likely to have hypertension, respectively. Meanwhile, every 10 beats per minute (bpm) increase in RHR was associated with a 41% (95% CI 1.27, 1.56) and 66% (95% CI 1.49, 1.85) greater risk of hypertension in boys and girls, respectively. There were no significant interactions between RHR and BMI on the prevalence of hypertension. This study confirms the existence of a relationship between elevated RHR and increased risk of hypertension in children, independent of BMI. An elevated RHR could be considered as a risk factor for the risk assessment of hypertension, no matter from a clinical setting or a public health perspective.
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Affiliation(s)
- Jia Hu
- a Suzhou Center for Disease Prevention and Control , Suzhou , Jiangsu , China
| | - Chen-Gang Teng
- a Suzhou Center for Disease Prevention and Control , Suzhou , Jiangsu , China
| | - Guang-Ping Chu
- b Health Center for Women and Children of Gusu District , Suzhou , Jiangsu , China
| | - Di Han
- a Suzhou Center for Disease Prevention and Control , Suzhou , Jiangsu , China
| | - Han Fu
- c Xi'an Center for Disease Control and Prevention , Xi'an , Shaanxi , China
| | - Yi-Kai Zhou
- d MOE Key Lab of Environment and Health , Institute of Environmental Medicine, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology , Wuhan , Hubei , China
| | - Qi Wang
- e Department of Epidemiology and Biostatistics, School of Public Health , Tongji Medical College, Huazhong University of Science and Technology , Wuhan , Hubei , China
| | - Bo Wang
- a Suzhou Center for Disease Prevention and Control , Suzhou , Jiangsu , China
| | - Hui Shen
- a Suzhou Center for Disease Prevention and Control , Suzhou , Jiangsu , China
| | - Fang Liu
- a Suzhou Center for Disease Prevention and Control , Suzhou , Jiangsu , China
| | - Hai-Bing Yang
- a Suzhou Center for Disease Prevention and Control , Suzhou , Jiangsu , China
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Farah BQ, Andrade-Lima A, Germano-Soares AH, Christofaro DGD, de Barros MVG, do Prado WL, Ritti-Dias RM. Physical Activity and Heart Rate Variability in Adolescents with Abdominal Obesity. Pediatr Cardiol 2018; 39:466-472. [PMID: 29164276 DOI: 10.1007/s00246-017-1775-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 11/13/2017] [Indexed: 12/16/2022]
Abstract
Physical activity is a protective factor for autonomic dysfunction. However, whether this occurs in adolescents with abdominal obesity is still unclear. Thus, the aim of this study was to analyze the association between physical activity and heart rate variability (HRV) in adolescents with and without abdominal obesity. This cross-sectional study included 1152 boys (age: 17 ± 1 years). HRV measures of time (root mean square of the squared differences between adjacent normal RR intervals-RMSSD and the percentage of adjacent intervals over 50 ms-PNN50) and frequency domains (balance sympathetic-vagal-LF/HF) were evaluated, as well as total physical activity, commuting physical activity, leisure-time physical activity, and abdominal obesity. All physical activity domains were associated with better RMSSD, PNN50, and LF/HF in normal weight adolescents (p < 0.05), whereas in adolescents with abdominal obesity only leisure-time physical activity was associated with better PNN50 (b = 0.174, p = 0.035) independent of age, period of the day, body mass index, and blood pressure. In conclusion, higher leisure-time physical activity, but not total and commuting physical activity levels, was associated with improved HRV in adolescents with abdominal obesity.
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Affiliation(s)
| | - Aluísio Andrade-Lima
- Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo, Av. Professor Melo Moraes, 65, São Paulo, SP, 05508-030, Brazil.
| | | | - Diego Giulliano Destro Christofaro
- Laboratory of Investigation in Exercise - LIVE, Department of Physical Education, University of Paulista State (UNESP), São Paulo, SP, Brazil
| | - Mauro Virgílio Gomes de Barros
- Associate Graduate Program in Physical Education, University of Pernambuco, Recife, PE, Brazil.,Adolescent Health, University of Pernambuco, Camaragibe, PE, Brazil
| | - Wagner Luiz do Prado
- Department of Human Movement Sciences, Federal University of São Paulo, Santos, Brazil
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Christofaro DGD, Farah BQ, Vanderlei LCM, Delfino LD, Tebar WR, Barros MVGD, Ritti-Dias RM. Analysis of different anthropometric indicators in the detection of high blood pressure in school adolescents: a cross-sectional study with 8295 adolescents. Braz J Phys Ther 2017; 22:49-54. [PMID: 29169996 PMCID: PMC5816077 DOI: 10.1016/j.bjpt.2017.10.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 05/17/2017] [Accepted: 07/24/2017] [Indexed: 11/24/2022] Open
Abstract
Overweight adolescents classified in any of three anthropometric indices have more HBP. The sensitivity of the indicators was low and the specificity was high in detecting HBP. Parents must be aware that high BMI, WC or WTHR are highly associated with HBP.
Background High blood pressure is strongly associated with obesity in different populations. However, it is unclear whether different anthropometric indicators of obesity can satisfactorily predict high blood pressure in the school setting. Objectives This study evaluated the sensitivity and specificity of body mass index, waist circumference, and waist to height ratio in the detection of high blood pressure in adolescents. Methods The sample consisted of 8295 adolescents aged 10–17 years. Weight was measured using a digital scale, height with a stadiometer, and waist circumference using a tape measure. Blood pressure was measured by an automatic blood pressure measuring device. ROC curves were used for the analysis of sensitivity and specificity of the three anthropometric indices in identifying high blood pressure. Binary Logistic Regression was used to assess the association of body mass index, waist circumference, and waist to height ratio with high blood pressure. Results Low values of sensitivity were observed for body mass index (0.35), waist circumference (0.37), and waist to height ratio (0.31) and high values of specificity for body mass index (0.86), waist circumference (0.82), and waist to height ratio (0.83) in the detection of high blood pressure. An association was observed between adolescents classified with high body mass index (OR = 3.57 [95% CI = 3.10–4.10]), waist cirumference (OR = 3.24 [95% CI = 2.83–3.72]), and waist to height ratio (OR = 2.94 [95% CI = 2.54–3.40]) with high blood pressure. Conclusions Body mass index, waist circumference, and waist to height ratio presented low sensitivity to identify adolescents with high blood pressure. However, adolescents classified with high body mass index, waist circumference, and waist to height ratio demonstrated a high association of presenting high blood pressure.
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Affiliation(s)
- Diego G D Christofaro
- Universidade Estadual Paulista (UNESP), Department of Physical Education, Presidente Prudente, SP, Brazil.
| | - Breno Q Farah
- Universidade de Pernambuco (UPE), Department of Physical Education, Recife, PE, Brazil
| | - Luiz Carlos M Vanderlei
- Universidade Estadual Paulista (UNESP), Department of Physical Therapy, Presidente Prudente, SP, Brazil
| | - Leandro D Delfino
- Universidade Estadual Paulista (UNESP), Department of Physical Education, Presidente Prudente, SP, Brazil
| | - William R Tebar
- Universidade Estadual Paulista (UNESP), Department of Physical Education, Presidente Prudente, SP, Brazil
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da Silva CF, Burgos MS, da Silva PT, Burgos LT, Welser L, Sehn AP, Horta JA, de Mello ED, Reuter CP. Relationship between Cardiometabolic Parameters and Elevated Resting and Effort Heart Rate in Schoolchildren. Arq Bras Cardiol 2017; 109:191-198. [PMID: 28746520 PMCID: PMC5586225 DOI: 10.5935/abc.20170103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 02/07/2017] [Accepted: 03/03/2017] [Indexed: 11/20/2022] Open
Abstract
Background Little has been studied on heart rate and its relationship with metabolic disorders. Objective To identify possible association between heart rate (HR) and metabolic disorders in children and adolescents. Methods This cross-sectional study evaluated 2.098 subjects, aged between 7 and 17 years. The variables evaluated were: HR, systolic (SBP) and diastolic blood pressure (DBP), pulse pressure (PP), double-product (DP), myocardial oxygen consumption (mVO2), lipids, glucose and uric acid levels, body mass index (BMI) and waist circumference (WC). The values of HR at rest and effort were divided into quartiles. The association between continuous values of HR and cardiometabolic indicators was tested by linear regression. Results LDL cholesterol presented a significantly higher mean (p = 0.003) in schoolchildren with resting HR greater or equal to 91 bpm, compared to students with less than 75 bpm. Compared with the quartiles of effort HR, SBP, DBP, glucose and uric acid presented high values when HR was greater or equal than 185 bpm. SBP, glucose and HDL cholesterol demonstrated a significant association with resting HR. Uric acid was observed as a predictor of increased effort HR. Conclusion Schoolchildren with a higher resting HR have higher mean of LDL cholesterol. For effort HR, there was an increase in blood pressure, glucose and uric acid levels. Uric acid has been shown to be a predictor of elevated effort HR.
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Affiliation(s)
| | | | | | | | - Letícia Welser
- Universidade de Santa Cruz do Sul (UNISC), Santa Cruz do Sul, RS -
Brazil
| | - Ana Paula Sehn
- Universidade de Santa Cruz do Sul (UNISC), Santa Cruz do Sul, RS -
Brazil
| | - Jorge André Horta
- Universidade de Santa Cruz do Sul (UNISC), Santa Cruz do Sul, RS -
Brazil
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Resting Heart Rate Percentiles and Associated Factors in Children and Adolescents. J Pediatr 2017; 187:174-181.e3. [PMID: 28600156 DOI: 10.1016/j.jpeds.2017.05.021] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Revised: 04/03/2017] [Accepted: 05/05/2017] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To present population-based resting heart rate (RHR) percentiles and associated factors in children and adolescents. STUDY DESIGN Standardized RHR measurements with an oscillometric device were obtained from 3- to 17-year-olds who participated in the German Health Interview and Examination Survey for Children and Adolescents (n = 11 986). Age- and sex-specific RHR percentiles were derived using flexible age-dependent modeling. Linear regression was used to test associations of RHR and associated factors. RESULTS RHR decreased with age and mean RHR was on average 3.0 beats per minute (bpm) higher in girls than in boys (P < .01). The 95th RHR-KiGGS-percentile (P95) in boys and girls are up to 10 bpm lower than P95 based on pooled heterogeneous international studies and more similar to percentiles based on population data from NHANES (higher or lower by ≤5 bpm, depending on age). Factors independently associated with RHR in both sexes were age, SBP and height in children aged 3-10 years; and age, systolic blood pressure, and high aerobic fitness in adolescents aged 11-17 years. In girls, we further found an association between RHR and underweight (OR 3.3 and 4.7 for underweight girls aged 3-10 and 11-17, respectively, compared with normal weight girls). Associations between RHR and aerobic fitness, physical activity, and media use were stronger in boys than in girls. CONCLUSION This study provides population-based RHR percentiles and evidence for sex-dependent associations of cardiovascular risk factors with RHR in children and adolescents, many of which are lifestyle related.
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Hu J, Shen H, Chu GP, Fu H, Huang FF, Zheng YM, Han D, Zhou YK, Wang Q, Wang B, Teng CG, Liu F, Yang HB. Association of elevated resting pulse rate with increased risk of hypertension development in children: A prospective study in Suzhou, China. Medicine (Baltimore) 2017; 96:e7696. [PMID: 28796052 PMCID: PMC5556218 DOI: 10.1097/md.0000000000007696] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Elevated resting heart rate (RHR) or resting pulse rate (RPR) is associated with increased risk of hypertension development. However, information is limited to adults. The purpose of this study is to analyze this association among Chinese children in a prospective design. METHODS A total of 4861 children who participated in the Blood Pressure Surveillance Program (2011-2017) were selected in this research. To investigate the association between RPR and hypertension development, children were divided into 4 groups according to the quartiles of RPR at baseline. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using logistic regression model. RESULTS Over a mean follow-up of 3.0 ± 0.1 years, there were 384 cases of incident hypertension. Compared to boys and girls in the 1st quartile, those in the 4th quartile were 1.73 (95% CI 1.13, 2.65), 2.22 (95% CI 1.43, 3.45) times more likely to have hypertension, respectively. Every 10 bpm increase in RPR was associated with a 26% greater risk of hypertension development in boys (OR: 1.26; 95% CI 1.10, 1.44), while this risk was 1.28 (95% CI 1.13, 1.44) in girls. Baseline blood pressure (BP) and body mass index (BMI) did not have significant interactions with RPR on risk of hypertension development. CONCLUSION This study confirms the relationship between elevated RPR and increased risk of hypertension development in children, independent of confounders including baseline BP and BMI. An elevated RPR could be considered as a risk factor for the assessment of hypertension, no matter from a clinical setting or a public health perspective.
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Affiliation(s)
- Jia Hu
- Suzhou Center for Disease Prevention and Control
| | - Hui Shen
- Suzhou Center for Disease Prevention and Control
| | - Guang-Ping Chu
- Health Center for Women and Children of Gusu District, Suzhou, Jiangsu
| | - Han Fu
- Xi’an Center for Disease Control and Prevention, Xi’an, Shaanxi Province
| | | | | | - Di Han
- Suzhou Center for Disease Prevention and Control
| | - Yi-Kai Zhou
- MOE Key Lab of Environment and Health, Institute of Environmental Medicine
| | - Qi Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Bo Wang
- Suzhou Center for Disease Prevention and Control
| | | | - Fang Liu
- Suzhou Center for Disease Prevention and Control
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Cardiovascular Risk Factors in Adolescents With Celiac Disease: A Cross-sectional Population-Based Study. J Pediatr Gastroenterol Nutr 2017; 65:190-194. [PMID: 27906796 DOI: 10.1097/mpg.0000000000001487] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Recent data have shown that adults with celiac disease (CD) may have a higher prevalence of risk factors for cardiovascular disease (CVD) compared with the general population. Thus, we aimed to investigate the association of CD with CVD risk factors at late adolescence in a cross-sectional population-based study. METHODS A total of 2,001,353 Jewish Israeli adolescents who underwent a general health examination at median age of 17.1 years from 1988 to 2015 were included. Covariate data included demographic measures, blood pressure (BP), resting heart rate, and risk factors associated with CVD. RESULTS Overall, 10,566 cases of CD were identified (0.53%). Multivariate analysis showed that mean diastolic BP was significantly lower in subjects with CD (men: 72.0±8.7 vs 70.4 ± 8.5, P < 0.0001; women: 70.0 ± 8.3 vs 69.0 ± 8.2, P < 0.0001), whereas systolic BP did not differ between groups. Resting heart rate was higher in CD cases (an absolute difference of 0.4 beats per minute, P < 0.0001). The proportions of overweight and obese subjects were significantly lower in CD cases. Noninsulin-dependent diabetes mellitus (relative risk [RR], 4.1; 95% confidence interval [CI] 2.8-5.7), hypercoagulability (RR, 2.6; 95% CI 1.5-4.5), and hyperlipidemia (RR, 1.9; 95% CI 1.2-3) were significantly more common in subjects with CD. CONCLUSIONS At the age of 17 years, the prevalence of risk factors for CVD is higher in subjects with CD compared with the general population. There is, however, neither increase in BP nor increase in overweight and obesity rates.
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Regis MF, Oliveira LMFTD, Santos ARMD, Leonidio ADCR, Diniz PRB, Freitas CMSMD. Urban versus rural lifestyle in adolescents: associations between environment, physical activity levels and sedentary behavior. EINSTEIN-SAO PAULO 2017; 14:461-467. [PMID: 28076591 PMCID: PMC5221370 DOI: 10.1590/s1679-45082016ao3788] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 10/25/2016] [Indexed: 11/21/2022] Open
Abstract
Objective To analyze the levels of physical activity and sedentary behavior in adolescents living in urban and rural areas. Methods An epidemiological, cross-section study with quantitative design, carried out at the regional level. The sample comprised 6,234 students aged 14 to 19 years, selected using random cluster sampling. The χ2 test and binary logistic regression were used in the analysis. Results A total of 74.5% of adolescents lived in urban areas. After adjustment, rural residents spent less time watching television (odds ratio - OR: 0.45; 95% confidence interval - 95%CI: 0.39-0.52), using a computer and/or playing video games (OR: 0.30; 95%CI: 0.22-0.42), or sitting down (OR: 0.66; 95%CI: 0.54-0.80); chose passive leisure less often (OR: 0.83; 95%IC: 0.72-0.95) and were less likely to be classified as insufficiently active (OR: 0.88; 95%IC: 0.78-0.99) when compared to urban residents, regardless of sex or age. The fact that adolescents living in rural areas who did not work were more likely to be classified as insufficiently active (OR: 2.59; 95%CI: 2.07-3.24) emphasized the significant role of occupation in physical activity levels in this group. Conclusion Adolescents living in rural areas were less exposed to the sedentary behaviors, chose more active leisure, and had higher levels of physical activity. Place of residence and occupation may play a major role in youth lifestyle. Objetivo Analisar os níveis de atividade física e o comportamento sedentário em adolescentes das áreas urbanas e rurais. Métodos Estudo epidemiológico, transversal, com abordagem quantitativa e abrangência estadual, cuja amostra foi constituída por 6.234 estudantes (14 a 19 anos), selecionados por meio de uma estratégia de amostragem aleatória de conglomerados. As análises foram realizadas por meio do teste χ2 e da regressão logística binária. Resultados Na amostra, 74,5% dos adolescentes eram residentes em área urbana. Após o ajuste, constatou-se que os adolescentes oriundos da área rural usavam menos televisão (odds ratio - OR: 0,45; intervalo de confiança de 95% - IC95%: 0,39-0,52), computador e/ou videogame (OR: 0,30; IC95%: 0,22-0,42), passavam menos tempo sentados (OR: 0,66; IC95%: 0,54-0,80), optaram menos pelo lazer passivo (OR: 0,83; IC95%: 0,72-0,95) e tinham menos chances de serem classificados como insuficientes ativos (OR: 0,88; IC95%: 0,78-0,99), quando comparados àqueles que residiam na área urbana, independentemente do sexo e da idade. Os adolescentes da área rural que não trabalhavam apresentaram mais chances de serem classificados como insuficientemente ativos (OR: 2,59; IC95%: 2,07-3,24), mostrando que a ocupação tinha um papel importante no nível de atividade física deste grupo. Conclusão Os adolescentes residentes na área rural estiveram menos expostos aos comportamentos sedentários, optaram mais por um lazer ativo e apresentaram um melhor nível de atividade física, podendo a zona de domicílio e a ocupação influenciar no estilo de vida deles.
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de Oliveira LMFT, da Silva AO, Diniz PRB, Farah BQ, Pirauá ALT, de Lima Neto AJ, Feitosa WMDN, Tassitano RM, Ritti-Dias RM. The number of visits and blood pressure measurements influence the prevalence of high blood pressure in adolescents. ACTA ACUST UNITED AC 2017; 11:343-349. [PMID: 28457829 DOI: 10.1016/j.jash.2017.04.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Revised: 03/16/2017] [Accepted: 04/04/2017] [Indexed: 11/18/2022]
Abstract
The aim of this study was to analyze the influence of the number of visits and the number of blood pressure (BP) measurements on the prevalence of high blood pressure (HBP) in adolescents. A cross-sectional epidemiologic study with 481 adolescents (14-19 years old) selected using a random cluster sampling strategy. We measured the BP three times in a first visit. Adolescents with HBP performed subsequent visits. The final calculation of BP followed four strategies: the 1st measure, mean of 1st and 2nd measurements, mean of all three measurements, and averaging the 2nd and 3rd measurements. The prevalence of HBP in the first and second visits was 6.4% and 1.9%, and the prevalence of hypertension (after three visits) was 1.7%. The prevalence of HBP varied from 8.6%-18.6% for boys and 4.6%-9.2% for girls, using the average 2nd and 3rd measurements and the 1st measurement, respectively. In all strategies, HBP and hypertension were more prevalent in boys and students attending the nocturnal shift. The number of visits and number of measurements affect the prevalence of HBP and hypertension in adolescents. Thus, clinicians and researchers should consider these aspects when assessing BP in adolescents aged 14-19 years old.
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Affiliation(s)
- Luciano Machado Ferreira Tenório de Oliveira
- Department of Physical Education, Centro Universitário Tabosa de Almeida-Asces-Unita, Caruaru, PE, Brazil; Department of Physical Education, Research Group of Health and Sport-GPESE, Caruaru, PE, Brazil; Department of Physical Education, Telehealth Unit, Clinic's Hospital, Recife, PE, Brazil; Department of Physical Education, Federal University of Pernambuco, Recife, PE, Brazil.
| | - Alison Oliveira da Silva
- Department of Physical Education, Centro Universitário Tabosa de Almeida-Asces-Unita, Caruaru, PE, Brazil; Department of Physical Education, Research Group of Health and Sport-GPESE, Caruaru, PE, Brazil; Department of Physical Education, University of Pernambuco, Recife, PE, Brazil
| | - Paula Rejane Beserra Diniz
- Department of Physical Education, Telehealth Unit, Clinic's Hospital, Recife, PE, Brazil; Department of Physical Education, Federal University of Pernambuco, Recife, PE, Brazil; Department of Internal Medicine, Federal University of Pernambuco, Recife, PE, Brazil
| | - Breno Quintella Farah
- Department of Physical Education, Centro Universitário Tabosa de Almeida-Asces-Unita, Caruaru, PE, Brazil; Department of Physical Education, Research Group of Health and Sport-GPESE, Caruaru, PE, Brazil; Department of Physical Education, University of Pernambuco, Recife, PE, Brazil
| | - André Luiz Torres Pirauá
- Department of Physical Education, Centro Universitário Tabosa de Almeida-Asces-Unita, Caruaru, PE, Brazil; Department of Physical Education, Research Group of Health and Sport-GPESE, Caruaru, PE, Brazil; Department of Physical Education, University of Pernambuco, Recife, PE, Brazil
| | - Antônio José de Lima Neto
- Department of Physical Education, Centro Universitário Tabosa de Almeida-Asces-Unita, Caruaru, PE, Brazil; Department of Physical Education, Research Group of Health and Sport-GPESE, Caruaru, PE, Brazil
| | | | | | - Raphael M Ritti-Dias
- Department of Physical Education, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
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Costa RDO, Silva JP, Lacerda EM, Dias R, Pezolato VA, Silva CAD, Krinski K, Correia MADV, Cieslak F. Overweight effect on spirometric parameters in adolescents undergoing exercise. EINSTEIN-SAO PAULO 2017; 14:190-5. [PMID: 27462892 PMCID: PMC4943352 DOI: 10.1590/s1679-45082016ao3612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 03/08/2016] [Indexed: 05/29/2023] Open
Abstract
Objective To evaluate effects of overweight on spirometric parameters in adolescents who underwent bronchial provocation test for exercise. Methods We included 71 male adolescents. The diagnosis of asthma was done based on participants’ clinical history and on the International Study Questionnaire Asthma and Allergies in Childhood, and the diagnosis of obesity was based on body mass index above 95th percentile. The bronchospasm induced by exercise was assessed using the run-walk test on a treadmill for eight minutes. The decrease in forced expiratory volume in one second > or equal to 10% before exercise was considered positive, and to calculate the intensity in exercise-induced bronchospasm we measured the maximum percentage of forced expiratory volume in one second and above the curve area. Data analysis was carried out using the Mann-Whitney U test and Friedman test (ANOVA), followed by Wilcoxon test (p<0.05). In addition, we used Fisher’s exact test to analyze the exercise-induced bronchospasm frequency. Results Significant differences were observed among obese adolescents in exercise-induced bronchospasm frequency (p=0,013) and in relation to time required for recovery after exercise (p=0,007). Conclusion Overweight can influence the increase in the exercise-induced bronchospasm frequency in non-asthmatic adolescents compared with eutrophic adolescents.
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Affiliation(s)
| | | | | | - Rodrigo Dias
- Universidade Metodista de Piracicaba, Piracicaba, SP, Brazil
| | | | | | - Kleverton Krinski
- Universidade Federal do Vale do São Francisco, Petrolina, PE, Brazil
| | | | - Fabrício Cieslak
- Universidade Federal do Vale do São Francisco, Petrolina, PE, Brazil
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Poulimeneas D, Grammatikopoulou MG, Dimitrakopoulos L, Kotsias E, Gerothanasi D, Kiranas ER, Tsigga M. Regional differences in the prevalence of underweight, overweight and obesity among 13-year-old adolescents in Greece. Int J Pediatr Adolesc Med 2016; 3:153-161. [PMID: 30805486 PMCID: PMC6372457 DOI: 10.1016/j.ijpam.2016.06.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 06/12/2016] [Accepted: 06/14/2016] [Indexed: 11/18/2022]
Abstract
Background and objectives To assess regional differences in the weight status and abdominal obesity among 13-year-old Greek adolescents. Design and setting Cross-sectional, nationwide study in Greece. Patients and methods A representative sample of 4833 13-year-old adolescents (50.7% boys) was recruited throughout the nine regional districts of Greece from 2010 to 2012. Basic anthropometry measurements (weight, height, and waist circumference) were obtained. Abdominal obesity and weight status were assessed according to the International Obesity Task Force criteria. Results The majority of the sample had a healthy body weight (60.3%), 4.1% were underweight, 27.2% were overweight, and 8.5% were obese. For boys, the highest prevalence of underweight was recorded in Epirus, normal body weight on the Ionian Islands, overweight in Central Greece and Macedonia, and obesity on the Ionian Islands. Among girls, the highest underweight prevalence was on the Ionian Islands, normal body weight in Macedonia, overweight in Central Greece and Macedonia, and obesity in Crete. Abdominal obesity affected 12.9% of the sample, with the greatest prevalence among Cretan boys and Thracian girls. Additionally, residing on the Greek islands was associated with a higher prevalence of central adiposity. Conclusion Greek 13-year-old adolescents who are subjected to geographical changes exhibit high obesity and abdominal obesity rates. This study provides evidence to design regionally tailored interventions that aim to tackle and prevent the disease among the nine regional districts in Greece.
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Affiliation(s)
- Dimitrios Poulimeneas
- Department of Nutrition & Dietetics, Alexander Technological Educational Institute, Sindos, Thessaloniki, Greece
| | - Maria G. Grammatikopoulou
- Department of Nutrition & Dietetics, Alexander Technological Educational Institute, Sindos, Thessaloniki, Greece
- Corresponding author. Department of Nutrition & Dietetics, Alexander Technological Educational Institute, Sindos PO Box 141, Thessaloniki, GR57400, Greece. Tel.: +30 2310013584.
| | | | - Emma Kotsias
- Department of Nutrition & Dietetics, Alexander Technological Educational Institute, Sindos, Thessaloniki, Greece
| | - Dina Gerothanasi
- Department of Nutrition & Dietetics, Alexander Technological Educational Institute, Sindos, Thessaloniki, Greece
| | - Efstratios R. Kiranas
- Department of Nutrition & Dietetics, Alexander Technological Educational Institute, Sindos, Thessaloniki, Greece
| | - Maria Tsigga
- Department of Nutrition & Dietetics, Alexander Technological Educational Institute, Sindos, Thessaloniki, Greece
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Saner C, Simonetti GD, Wühl E, Mullis PE, Janner M. Circadian and ultradian cardiovascular rhythmicity in obese children. Eur J Pediatr 2016; 175:1031-8. [PMID: 27240757 DOI: 10.1007/s00431-016-2736-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Revised: 04/21/2016] [Accepted: 05/16/2016] [Indexed: 10/21/2022]
Abstract
UNLABELLED Altered circadian and ultradian blood pressure (BP) and heart rate (HR) rhythmicity have been described in diseases with increased cardiovascular risk. We analyzed cardiovascular rhythmicity in obese children. BP and HR rhythmicity was assessed with Fourier analysis from 24-h ambulatory BP measurements in 75 obese children and compared with an age- and gender-matched, lean healthy reference group of 150 subjects. Multivariate regression analysis was applied to identify significant independent factors explaining variability of rhythmicity. Prevalence of 24- and 6-h BP rhythmicity in the obese group was lower (p = 0.03 and p = 0.02), whereas the prevalence of HR rhythmicity was comparable in both groups. Excluding hypertensive participants, the results remained similar. Twenty-four-hour BP and HR acrophase were delayed in obese children (p = 0.004, p < 0.0001), 24-h BP amplitude did not differ (p = 0.07), and 24-h HR amplitude was blunted (p = < 0.0001). BP Mesor in the obese group was higher (p = 0.02); HR Mesor did not differ (p = 0.1). Multivariate regression analysis failed to identify a single anthropometric or blood pressure parameter explaining the variability of BP and HR rhythmicity. CONCLUSION Prevalence and parameters of circadian and ultradian BP and HR rhythmicity in obese children are altered compared to a healthy reference group, independent of preexisting hypertension. WHAT IS KNOWN • Altered cardiovascular rhythmicity has been described in children with different diseases such as primary hypertension or chronic renal failure. What is New: • This study reveals altered cardiovascular rhythmicity in obese children compared to an age and gender-matched healthy reference group independent from preexisting hypertension.
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Affiliation(s)
- Christoph Saner
- University Children's Hospital UKBB, Spitalstrasse 33, CH-4056, Basel, Switzerland
| | - Giacomo D Simonetti
- Division of Pediatric Nephrology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 15, CH-3010, Bern, Switzerland. .,Pediatric Department of Southern Switzerland, Via Ospedale, CH-6500, Bellinzona, Switzerland.
| | - Elke Wühl
- Center for Pediatrics and Adolescent Medicine, University of Heidelberg, Im Neuenheimer Feld 430, D-69120, Heidelberg, Germany
| | - Primus E Mullis
- Division of Pediatric Endocrinology, Diabetology and Metabolism, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 15, CH- 3010, Bern, Switzerland
| | - Marco Janner
- Division of Pediatric Endocrinology, Diabetology and Metabolism, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 15, CH- 3010, Bern, Switzerland
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