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Sunda M, Gilic B, Vuletic PR, Pavlinovic V, Zenic N. Mediating Effects of the COVID-19 Pandemic on the Associations between Physical Activity and Physical Fitness; Cross-Sectional Study among High School Adolescents. J Funct Morphol Kinesiol 2023; 8:131. [PMID: 37754964 PMCID: PMC10531934 DOI: 10.3390/jfmk8030131] [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: 07/27/2023] [Revised: 08/22/2023] [Accepted: 08/30/2023] [Indexed: 09/28/2023] Open
Abstract
The COVID-19 pandemic and the imposed social distancing measures caused negative changes in physical activity levels (PALs) and physical fitness (PF) among adolescents, but the potential mediating effect of the pandemic on the association between PAL and PF is unknown. This study aimed to evaluate gender-specific associations between objectively measured PAL and indices of PF among high school adolescents during the period of the COVID-19 pandemic. The participants were 150 adolescents (101 females) aged 14-18 years; their anthropometrics were evaluated, and they were tested on PF (cardiorespiratory fitness (CRF; beep test), power (broad jump), flexibility (sit-and-reach test), and abdominal strength (sit-ups)) and PAL (using a pedometer for 7 days) during the pandemic period. A T-test was calculated to determine differences between genders. Associations between variables were evaluated using Pearson correlations. Additionally, multivariate taxonomic classification was used to sort participants into homogenous groups (clusters) according to their PF, and then analysis of variance (ANOVA) was performed to differentiate them according to PAL. For the total sample, PAL was correlated with CRF only (R = 0.25, p < 0.05), while gender-stratified correlations showed that PAL was significantly associated with CRF among girls only (R = 0.29, p < 0.05), which was additionally confirmed with multivariate cluster analysis and subsequent ANOVA. No association between PAL and PF was found for boys. The relatively low association between PAL and PF is most likely related to the mediating effect of the change in life circumstances during the COVID-19 pandemic, and limited applicability of pedometers in evaluating high-intensity PAL. Further studies in other age groups and environments are warranted.
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Affiliation(s)
- Mirela Sunda
- Faculty of Kinesiology, University of Zagreb, 10000 Zagreb, Croatia; (M.S.); (P.R.V.)
| | - Barbara Gilic
- Faculty of Kinesiology, University of Split, 21000 Split, Croatia; (B.G.); (V.P.)
| | - Petra Rajkovic Vuletic
- Faculty of Kinesiology, University of Zagreb, 10000 Zagreb, Croatia; (M.S.); (P.R.V.)
- Faculty of Kinesiology, University of Split, 21000 Split, Croatia; (B.G.); (V.P.)
| | - Vladimir Pavlinovic
- Faculty of Kinesiology, University of Split, 21000 Split, Croatia; (B.G.); (V.P.)
| | - Natasa Zenic
- Faculty of Kinesiology, University of Split, 21000 Split, Croatia; (B.G.); (V.P.)
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Martino F, Bassareo PP, Martino E, Romeo F, Calcaterra G, Perrone Filardi P, Indolfi C, Nodari S, Montemurro V, Guccione P, Salvo GD, Chessa M, Pedrinelli R, Mercuro G, Barillà F. Cardiovascular prevention in childhood: a consensus document of the Italian Society of Cardiology Working Group on Congenital Heart Disease and Cardiovascular Prevention in Paediatric Age. J Cardiovasc Med (Hagerstown) 2023; 24:492-505. [PMID: 37409595 DOI: 10.2459/jcm.0000000000001488] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
Cardiovascular diseases (CVD) may be manifested from a very early age. Genetic and environmental (epigenetic) factors interact to affect development and give rise to an abnormal phenotypical expression of genetic information, although not eliciting changes in the nucleotide sequence of DNA. It has been scientifically proven that increased oxidative stress (OS) caused by disease (overweight, obesity, diabetes), nutritional imbalances, unhealthy lifestyles (smoking, alcohol, substance abuse) in the mother during pregnancy may induce placental dysfunction, intrauterine growth restriction, prematurity, low birth weight, postnatal adiposity rebound, metabolic alterations and consequent onset of traditional cardiovascular risk factors. OS represents the cornerstone in the onset of atherosclerosis and manifestation of CVD following an extended asymptomatic period. OS activates platelets and monocytes eliciting the release of pro-inflammatory, pro-atherogenic and pro-oxidising substances resulting in endothelial dysfunction, decrease in flow-mediated arterial dilatation and increase in carotid intima-media thickness. The prevention of CVD is defined as primordial (aimed at preventing risk factors development), primary (aimed at early identification and treatment of risk factors), secondary (aimed at reducing risk of future events in patients who have already manifested a cardiovascular event), and tertiary (aimed at limiting the complex outcome of disease). Atherosclerosis prevention should be implemented as early as possible. Appropriate screening should be carried out to identify children at high risk who are apparently healthy and implement measures including dietary and lifestyle changes, addition of nutritional supplements and, lastly, pharmacological treatment if risk profiles fail to normalise. Reinstating endothelial function during the reversible stage of atherosclerosis is crucial.
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Affiliation(s)
- Francesco Martino
- Department of Internal Clinical, Anesthesiological and Cardiovascular Sciences, La Sapienza University, Rome, Italy
| | - Pier Paolo Bassareo
- University College of Dublin, School of Medicine, Mater Misericordiae University Hospital and Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Eliana Martino
- Department of Internal Clinical, Anesthesiological and Cardiovascular Sciences, La Sapienza University, Rome, Italy
| | | | | | | | - Ciro Indolfi
- Division of Cardiology, Research Centre for Cardiovascular Diseases, Magna Graecia University, Catanzaro
| | - Savina Nodari
- Department of Medical Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, ASST Spedali Civili, Brescia
| | | | - Paolo Guccione
- Department of Cardiology, Cardiac Surgery, Cardio-pulmonary Transplantation, IRCCS Bambino Gesu'Paediatric Hospital, Rome
| | - Giovanni Di Salvo
- Division of Paediatric Cardiology, Department of Women's and Children's Health, University of Padua, Padua
| | - Massimo Chessa
- ACHD UNIT, Pediatric and Adult Congenital Heart Centre, IRCCS-Policlinico San Donato, San Donato Milanese, Vita Salute San Raffaele University, Milan
| | - Roberto Pedrinelli
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa
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Kraav J, Tamme R, Remmel L, Mäestu E, Zagura M, Jürimäe J, Tillmann V. Arterial Structure in 18-Year-Old Males Is Dependent on Physical Activity at 12 Years and Cumulative Cardiorespiratory Fitness From Puberty to Late Adolescence. Pediatr Exerc Sci 2023; 35:144-154. [PMID: 36509088 DOI: 10.1123/pes.2022-0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 08/17/2022] [Accepted: 08/24/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE To evaluate the long-term effect of body composition, physical activity, and cardiorespiratory fitness (CRF) from puberty on arterial health in late adolescent males. METHODS The cumulative burden of physical activity (measured with accelerometer), CRF (VO2peak0.82), and body composition (body mass index, fat mass, and fat percentage) from puberty to late adolescence (sum of 4 time points from 12 to 18 y) was assessed in 102 males. Additional analysis on the first (T1) and last (T4) time points was performed. Intima-media thickness (IMT), carotid-femoral pulse wave velocity, and augmentation index adjusted to heart rate of 75 beats per minute (bpm) as dependent variables were measured at T4 and analyzed in multivariable regression models adjusted for known risk factors including maturation, blood pressure, and smoking habits. RESULTS T1 and cumulative body composition measures were independently associated with IMT, while cumulative (β = -0.011, P = .036) and T4 (β = -0.0.031, P = .001) CRF revealed independent associations with IMT. Individuals with moderate to vigorous physical activity >60 minutes per day at T1 showed relationship (β = -1.091, P = .026) with IMT independently of late adolescent physical activity. No significant relationship was present for arterial function. CONCLUSION Arterial structure in adolescent males is associated with physical activity at 12 years while relationship with CRF can be seen in late adolescence and cumulatively from puberty to late adolescence.
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Affiliation(s)
- Juta Kraav
- Institute of Clinical Medicine, University of Tartu, Tartu,Estonia
| | - Reeli Tamme
- Institute of Clinical Medicine, University of Tartu, Tartu,Estonia
- Children's Clinic, Tartu University Hospital, Tartu,Estonia
| | - Liina Remmel
- Institute of Sports Sciences and Physiotherapy, University of Tartu, Tartu,Estonia
| | - Evelin Mäestu
- Institute of Sports Sciences and Physiotherapy, University of Tartu, Tartu,Estonia
| | - Maksim Zagura
- Department of Biochemistry, Centre of Excellence for Translational Medicine, University of Tartu, Tartu,Estonia
| | - Jaak Jürimäe
- Institute of Sports Sciences and Physiotherapy, University of Tartu, Tartu,Estonia
| | - Vallo Tillmann
- Institute of Clinical Medicine, University of Tartu, Tartu,Estonia
- Children's Clinic, Tartu University Hospital, Tartu,Estonia
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Videira-Silva A, Hetherington-Rauth M, Sardinha LB, Fonseca H. Combined high-intensity interval training as an obesity-management strategy for adolescents. Eur J Sport Sci 2023; 23:109-120. [PMID: 34663193 DOI: 10.1080/17461391.2021.1995508] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Effective and safe exercise protocols for obesity management in adolescents are imperative. This study aimed to analyse compliance, efficacy, and safety of combined high-intensity interval training circuit (HIIT) in the management of obesity (including overweight) in adolescents, compared to traditional training (TT). Data from 55 adolescents (47.3% girls) (TT n = 31; HIIT n = 24), aged 12-18 (mean age of 14.3 ± 1.7), with overweight and obesity (median BMI z-score of 2.95), were assessed at baseline and month 6 (Clinicaltrials.gov/NCT02941770). During the 6-month intervention, participants in both exercise groups attended two exercise sessions/week (60 min/session) along with a set of appointments with a paediatrician, nutritionist, and exercise physiologist. Forty-six participants completed the intervention (TT n = 23; HIIT n = 23). Exercise session attendance (≥80%) was significantly higher among HIIT participants (73.9 vs. 13.0%, p < .001). HIIT, but not TT, showed a significant decrease in BMI z-score (d = 0.40, p < .001), body fat mass (BFM, %) (d = 0.41, p = .001), and trunk fat mass (d = 0.56, p < .001), as well as a significant increase in muscle mass (MM, %) (d = 0.28, p = .001) between baseline and 6 months. According to generalized estimating equations, time-by-attendance interactions (instead of time-by group) were found in BMI z-score (β = 0.25, 95%CI: 0.17, 0.33), BFM (β = 2.29, 95%CI: 1.02, 3.56), trunk fat mass (β = 2.94, 95%CI: 1.70, 4.18), and MM (β = -1.16, 95%CI: -1.87, -0.45). No adverse events were reported during HIIT sessions. Although compliance may mediate the impact of an exercise protocol on health-related outcomes, HIIT showed to be safe, with higher compliance compared to TT, which may result in improved outcomes overtime.
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Affiliation(s)
- António Videira-Silva
- Faculty of Medicine, Pediatric University Clinic, University of Lisbon, Lisbon, Portugal
| | - Megan Hetherington-Rauth
- Faculty of Human Kinetics, Exercise and Health Laboratory, University of Lisbon, Lisbon, Portugal
| | - Luís B Sardinha
- Faculty of Human Kinetics, Exercise and Health Laboratory, University of Lisbon, Lisbon, Portugal
| | - Helena Fonseca
- Pediatric Obesity Clinic, Department of Pediatrics, Hospital de Santa Maria, Lisbon, Portugal.,Faculty of Medicine, Rheumatology Research Unit, Molecular Medicine Institute, University of Lisbon, Lisbon, Portugal
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Aragón-Vela J, Alcalá-Bejarano Carrillo J, Moreno-Racero A, Plaza-Diaz J. The Role of Molecular and Hormonal Factors in Obesity and the Effects of Physical Activity in Children. Int J Mol Sci 2022; 23:15413. [PMID: 36499740 PMCID: PMC9737554 DOI: 10.3390/ijms232315413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 11/27/2022] [Accepted: 12/05/2022] [Indexed: 12/13/2022] Open
Abstract
Obesity and overweight are defined as abnormal fat accumulations. Adipose tissue consists of more than merely adipocytes; each adipocyte is closely coupled with the extracellular matrix. Adipose tissue stores excess energy through expansion. Obesity is caused by the abnormal expansion of adipose tissue as a result of adipocyte hypertrophy and hyperplasia. The process of obesity is controlled by several molecules, such as integrins, kindlins, or matrix metalloproteinases. In children with obesity, metabolomics studies have provided insight into the existence of unique metabolic profiles. As a result of low-grade inflammation in the system, abnormalities were observed in several metabolites associated with lipid, carbohydrate, and amino acid pathways. In addition, obesity and related hormones, such as leptin, play an instrumental role in regulating food intake and contributing to childhood obesity. The World Health Organization states that physical activity benefits the heart, the body, and the mind. Several noncommunicable diseases, such as cardiovascular disease, cancer, and diabetes, can be prevented and managed through physical activity. In this work, we reviewed pediatric studies that examined the molecular and hormonal control of obesity and the influence of physical activity on children with obesity or overweight. The purpose of this review was to examine some orchestrators involved in this disease and how they are related to pediatric populations. A larger number of randomized clinical trials with larger sample sizes and long-term studies could lead to the discovery of new key molecules as well as the detection of significant factors in the coming years. In order to improve the health of the pediatric population, omics analyses and machine learning techniques can be combined in order to improve treatment decisions.
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Affiliation(s)
- Jerónimo Aragón-Vela
- Department of Health Sciences, Area of Physiology, Building B3, Campus s/n “Las Lagunillas”, University of Jaén, 23071 Jaén, Spain
| | - Jesús Alcalá-Bejarano Carrillo
- Department of Health, University of the Valley of Mexico, Robles 600, Tecnologico I, San Luis Potosí 78220, Mexico
- Research and Advances in Molecular and Cellular Immunology, Center of Biomedical Research, University of Granada, Avda, del Conocimiento s/n, 18016 Armilla, Spain
| | - Aurora Moreno-Racero
- Research and Advances in Molecular and Cellular Immunology, Center of Biomedical Research, University of Granada, Avda, del Conocimiento s/n, 18016 Armilla, Spain
| | - Julio Plaza-Diaz
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, 18071 Granada, Spain
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada
- Instituto de Investigación Biosanitaria IBS, Granada, Complejo Hospitalario Universitario de Granada, 18014 Granada, Spain
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Videira-Silva A, Sardinha LB, Fonseca H. Atherosclerosis Prevention in Adolescents with Obesity: The Role of Moderate-Vigorous Physical Activity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15537. [PMID: 36497620 PMCID: PMC9738804 DOI: 10.3390/ijerph192315537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/11/2022] [Accepted: 11/19/2022] [Indexed: 06/17/2023]
Abstract
Carotid intima-media thickness (cIMT) is a subclinical marker of atherosclerotic development, which is impaired in adolescents with obesity. This study aimed to analyze the impact of physical activity (PA), cardiorespiratory fitness (CRF), body mass index (BMI), and body composition changes on the cIMT of adolescents with obesity. Longitudinal data (6 months) from adolescents aged 12-18 years, with a BMI ≥97th percentile, previously recruited for the non-randomized controlled trial PAC-MAnO (Clinicaltrials.gov-NCT02941770) were analyzed using partial correlations controlling for sex and pubertal status and multiple regressions. A total of 105 adolescents (51.4% girls, 86.7% Caucasian), 14.8 ± 1.8 years old, with a BMI z-score of 3.09 ± 0.74 were included. Total body fat mass (TBFM) (F(1,91) = 23.11, p < 0.001), moderate-vigorous PA (MVPA) (F(1,91) = 7.93, p = 0.0006), and CRF (mL/kg/min) (F(1,90) = 19.18, p < 0.001) predicted cIMT variance with an R2 of 0.24, 0.09, and 0.23, respectively. MVPA changes showed a high correlation with CRF variation (r(91) = 0.0661, p < 0.001). This study suggests that although cIMT is impaired in overweight adolescents, improvements in TBFM, MVPA, and CRF are associated with cIMT improvement. Although both energy intake and MVPA may influence TBFM, MVPA plays the most relevant role in cIMT development due to its direct association with CRF.
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Affiliation(s)
- Antonio Videira-Silva
- Pediatric University Clinic, Faculty of Medicine, Universidade de Lisboa, 1649-035 Lisbon, Portugal
- CIDEFES (Centro de Investigação em Desporto, Educação Física, Exercício e Saúde), Universidade Lusófona, 1749-024 Lisbon, Portugal
| | - Luis B. Sardinha
- Exercise and Health Laboratory, CIPER, Faculty of Human Kinetics, Universidade de Lisboa, 1649-004 Lisbon, Portugal
| | - Helena Fonseca
- Pediatric University Clinic, Faculty of Medicine, Universidade de Lisboa, 1649-035 Lisbon, Portugal
- Pediatric Obesity Clinic, Department of Pediatrics, Hospital de Santa Maria, 1649-035 Lisbon, Portugal
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A Systematic Review of the Associations of Adiposity and Cardiorespiratory Fitness With Arterial Structure and Function in Nonclinical Children and Adolescents. Pediatr Exerc Sci 2022:1-12. [PMID: 36150705 DOI: 10.1123/pes.2022-0029] [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: 02/16/2022] [Revised: 08/02/2022] [Accepted: 08/07/2022] [Indexed: 11/07/2022]
Abstract
PURPOSE To summarize the evidence on associations of adiposity and cardiorespiratory fitness (CRF) with arterial structure and function in nonclinical children and adolescents. METHODS Two researchers conducted a search in 5 electronic databases in April 2022 to find studies in nonclinical youth (age 5-17.9 y) reporting multivariable associations. Studies were eligible if adiposity and/or CRF were used as the predictor and arterial structure and/or function was the outcome. The Quality Assessment Tool for Quantitative Studies was used to assess methodological quality for experimental studies, and a modified version was used for observational studies. RESULTS Ninety-nine studies (72.7% cross-sectional) were included. Ninety-four assessed associations between adiposity and arterial outcomes, most using overall body proportion (n = 71), abdominal (n = 52), or whole-body adiposity (n = 40). Most evidence was inconsistent or nonsignificant, but 59 studies suggested higher abdominal adiposity and worse body proportion were associated with adverse arterial outcomes. Twenty-one assessed associations between CRF and arterial outcomes, with findings inconsistent. Most evidence was rated weak in quality. CONCLUSION While high adiposity may contribute to poor arterial outcomes, evidence is limited regarding CRF. Future studies should disentangle these associations by studying youth with healthy adiposity but poor CRF, or vice versa, using longitudinal or experimental study designs.
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Julian V, Ring-Dimitriou S, Wyszyńska J, Mazur A, Matlosz P, Frelut ML, Erhardt E, Vlachopapadopoulou E, Forslund A, Boyland E, Weghuber D, Thivel D. There is a clinical need to consider the physical activity - sedentary pattern in children with obesity. Position paper of the European Childhood Obesity Group. ANNALS OF NUTRITION AND METABOLISM 2022; 78:236-241. [PMID: 35500549 DOI: 10.1159/000524570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 04/09/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION While international prevention guidelines recently advocated, in addition to moderate and vigorous physical activity (MVPA) guidelines, for a minimization of sedentary time (SED), recommendations remain to be developed for youths with obesity. METHODS A literature search was conducted in PubMed, the Cochrane Library plus the reference lists of selected articles for relevant publications in English, including original papers, systematic reviews, and meta-analyses, with search terms "sedentary behaviors" or "sedentary time" or "screen time" AND "children" or "adolescents" AND "obesity" or "adiposity" or "cardiometabolic risk" or "cardiometabolic disease". The results were summarized as a narrative review and presented to the scientific board of the European Childhood Obesity Group (ECOG) who then discussed their implication in clinical practice and proposed the position outlined in this paper. RESULTS SED and screen times are associated with adiposity and cardiometabolic risks independently of youths' physical activity level. Besides considering MVPA and SED times as separate variables, comprehensive studies have questioned the impact of different patterns of MVPA and SED levels. Although lower body adiposity and better cardiometabolic health are achieved among those with desirable movement behaviors patterns (i.e., more MVPA/less SED or active/not sedentary), youths with intermediate patterns (i.e., high MVPA/high SED and low MVPA/low SED, or active /sedentary and inactive/not sedentary) have been found to be associated with intermediate risks. CONCLUSION There is a need to decrease SED behaviors irrespective of MVPA and to consider PA-SED patterns in youths with obesity. The European Childhood Obesity Group (ECOG) encourages anti-obesity strategies targeting both physical activity (PA) and SED behaviors to support the shift from long periods of SED time, especially screen time, to daily routines incorporating bouts of PA. Stepwise or sequential approaches to movement behavior counseling might start with targeting SED at first to decrease cardiometabolic risks when implementing MVPA is not yet possible.
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Affiliation(s)
- Valérie Julian
- Department of Sport Medicine and Functional Explorations, University Teaching Hospital of Clermont-Ferrand, Diet and Musculoskeletal Health Team, Human Nutrition Research Center (CRNH), INRA, University of Clermont Auvergne, Clermont-Ferrand, France
- Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria
| | | | | | - Artur Mazur
- Medical Faculty, University of Rzeszow, Rzeszow, Poland
| | - Piotr Matlosz
- Medical Faculty, University of Rzeszow, Rzeszow, Poland
| | | | - Eva Erhardt
- Department of Pediatrics, University of Pécs, Pécs, Hungary
| | | | - Anders Forslund
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Emma Boyland
- Appetite and Obesity Research Group, Department of Psychology, University of Liverpool, Liverpool, United Kingdom
| | - Daniel Weghuber
- Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria
| | - David Thivel
- Laboratory of the Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P), Clermont Auvergne University, Clermont-Ferrand, France
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Physical Activity, Physical Fitness and the Sense of Coherence-Their Role in Body Acceptance among Polish Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165791. [PMID: 32785143 PMCID: PMC7460119 DOI: 10.3390/ijerph17165791] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 08/02/2020] [Accepted: 08/04/2020] [Indexed: 12/21/2022]
Abstract
The aim of the study was to investigate the protective role of physical activity (PA) and other health-related bio-psycho components (physical fitness, body composition, body perception and the sense of coherence (SOC)) in body acceptance. We searched for gender differences in those relationships. We investigated 231 adolescents aged 13-16 years from an urban area in Poland. We conducted objective measurements of height, weight, fat% and relative value of minute oxygen consumption. Questionnaires for PA, SOC Body Figure Perception and body acceptance were applied. Linear regression was used for analyzing determinants of body acceptance. We found that more physically active girls reported a less slim ideal vision of their figure (p < 0.05). Physical fitness is a better predictor of body acceptance than physical activity. In the final model, the sense of coherence, body mass index (BMI), and gender (being a boy) were also predictors of body acceptance (F(6,92) = 13.084, p < 0.0001). Gender differences were discussed in the present study. Fitness enhancing physical activity should be recommended for adolescents to achieve the protective psychosocial effect especially among girls. Physical activity on a daily basis brings positive results in a more adequate and reasonable body assessment and it can play a protective role in terms of mental wellbeing. Body satisfaction varies between genders and it is a more sensitive issue among girls than boys during adolescence.
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Staudt A, Stock K, Gande N, Bernar B, Hochmayr C, Pechlaner R, Kiechl SJ, Geiger R, Griesmacher A, Anliker M, Kiechl S, Kiechl-Kohlendorfer U, Knoflach M, Winder B, Reiter C, Burger C, Klingenschmid J, Marxer J, Asare M, Bock-Bartl M, Kothmayer M, Bohl M, Pircher M. Impact of lifestyle and cardiovascular risk factors on early atherosclerosis in a large cohort of healthy adolescents: The Early Vascular Ageing (EVA)-Tyrol Study. Atherosclerosis 2020; 305:26-33. [DOI: 10.1016/j.atherosclerosis.2020.05.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 05/12/2020] [Accepted: 05/20/2020] [Indexed: 12/17/2022]
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Lee J, Chen B, Kohl HW, Barlow CE, do Lee C, Radford NB, DeFina LF, Gabriel KP. The Association of Physical Activity With Carotid Intima Media Thickening in a Healthy Older Population: Cooper Center Longitudinal Study. J Aging Phys Act 2020; 28:448-454. [PMID: 31801110 PMCID: PMC7266725 DOI: 10.1123/japa.2019-0103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 09/30/2019] [Accepted: 10/01/2019] [Indexed: 11/18/2022]
Abstract
The purpose of this study was to examine the association between self-reported physical activity (PA) and mean common carotid artery intima-media thickness (CCA IMT) among older adults. The data are from 1,811 Cooper Center Longitudinal Study participants, who were aged ≥60 years, with no history of cardiovascular disease. A medical history questionnaire was used to assess PA. Carotid ultrasound was performed to measure CCA IMT and the presence of plaque and stenosis. Logistic regression models were constructed to estimate the association between PA and CCA IMT after adjustment for covariates. The participants were aged 69.2 ± 5.9 years, and the majority were male (73.3%) and White (96.7%). The odds ratio of abnormal thickening of CCA IMT was 0.72 (95% confidence interval [0.54, 0.96]) in physically active participants (≥500 metabolic equivalent·min/week) after adjustment for covariates. In the current study, meeting PA guidelines in older adulthood was associated with lower odds of abnormal thickening of CCA IMT.
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Königstein K, Klenk C, Appenzeller-Herzog C, Hinrichs T, Schmidt-Trucksäss A. Impact of sedentary behavior on large artery structure and function in children and adolescents: a systematic review. Eur J Pediatr 2020; 179:17-27. [PMID: 31773330 DOI: 10.1007/s00431-019-03497-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 10/03/2019] [Accepted: 10/03/2019] [Indexed: 01/25/2023]
Abstract
Sedentary behavior contributes to increased atherosclerotic risk in adults. Whether or not this can be extended to pediatric populations is unclear. This systematic review assessed associations of sedentary behavior with large artery structure and function in pediatric populations. MEDLINE, EMBASE, CENTRAL, and Web of Science were searched from the earliest available date to 31st of December 2018. Analyses of associations of sedentary behavior with large artery structure or function in a pediatric (sub-)population were included, adhering to the PRISMA guidelines. The protocol was published in advance on PROSPERO (CRD42018112996). Study quality and quality of evidence were analyzed using NHLBI Study Quality assessment tools and GRADE. Six observational studies found no association of exposure and outcome variables, and one had contradicting results. One intervention found reduced flow-mediated dilation after 3 h of uninterrupted sitting. Exposure and outcome measures were highly heterogeneous. Study quality was low to moderate. Quality of evidence was very low or low in the observational studies and high in the intervention.Conclusion: In pediatric populations, current evidence is limited and of low quality about how acute effects of sedentary behavior translate into early vascular aging and the long-term development of vascular dysfunction and atherosclerotic risk. Future studies should emphasize a careful choice of the adequate type and measurement site of a biomarker for large artery structure and function as well as conduct a detailed assessment of sedentary behavior patterns.Trial registration: PROSPERO Registration Number: CRD42018112996What is known: • An independent association of sedentary behavior and biomarkers of large artery structure and function has been demonstrated in adults. • In children, sedentary behavior is directly associated with classical cardiovascular risk factors like elevated blood glucose levels, insulin resistance, high blood pressure, obesity, and elevated blood lipids.What is new: • Currently, only few studies of low quality in children and adolescents provide limited evidence about how acute effects of sedentary behavior translate into early vascular aging and the long-term development of atherosclerosis. • The type and measurement site of vascular biomarker need to be chosen carefully, and a detailed assessment of sedentary behavior patterns is important to minimize the methodological bias.
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Affiliation(s)
- Karsten Königstein
- Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, Birsstr. 320 B, 4052, Basel, Switzerland.
| | - Christopher Klenk
- Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, Birsstr. 320 B, 4052, Basel, Switzerland
| | | | - Timo Hinrichs
- Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, Birsstr. 320 B, 4052, Basel, Switzerland
| | - Arno Schmidt-Trucksäss
- Department of Sport, Exercise and Health, Division Sports and Exercise Medicine, University of Basel, Birsstr. 320 B, 4052, Basel, Switzerland.
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Penha JTD, Gazolla FM, Carvalho CNDM, Madeira IR, Rodrigues‐Júnior F, Machado EDA, Sicuro FL, Farinatti P, Bouskela E, Collett‐Solberg PF. Physical fitness and activity, metabolic profile, adipokines and endothelial function in children. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2019. [DOI: 10.1016/j.jpedp.2018.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Penha JTD, Gazolla FM, Carvalho CNDM, Madeira IR, Rodrigues-Júnior F, Machado EDA, Sicuro FL, Farinatti P, Bouskela E, Collett-Solberg PF. Physical fitness and activity, metabolic profile, adipokines and endothelial function in children. J Pediatr (Rio J) 2019; 95:531-537. [PMID: 29856943 DOI: 10.1016/j.jped.2018.04.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 04/25/2018] [Accepted: 04/25/2018] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVES The prevalence of obesity is increasing. The aim of this study was to investigate if there is endothelial dysfunction in children with normal or excess weight, and whether the metabolic profile, adipokines, and endothelial dysfunction would be more strongly associated with physical fitness or with physical activity levels. METHOD Cross-sectional study involving children aged 5-12 years. The evaluation included venous occlusion plethysmography, serum levels of adiponectin, leptin and insulin, lipid profile, physical activity score (PAQ-C questionnaire), and physical fitness evaluation (Yo-Yo test). RESULTS A total of 62 children participated in this study. Based on the body mass index, 27 were eutrophic, 10 overweight and 25 obese. Triglycerides, LDL cholesterol, HOMA-IR, and leptin were higher in the obese and excess-weight groups compared to the eutrophic group (p<0.01). HDL cholesterol and adiponectin levels were higher in the eutrophic group compared to the obese and excess-weight groups (p<0.01). Flow-mediated vasodilation after hyperemia was higher in the eutrophic group in comparison to obese and excess-weight subjects (p<0.05). There was no difference in the physical activity levels among groups measured by PAQ-C. The Yo-Yo test was significantly associated with HDL cholesterol (rho=-0.41; p=0.01), and this association remained after adjusting for body mass index z-score (rho=0.28; p=0.03). CONCLUSION This study showed that endothelial dysfunction is already present in obese children, suggesting a predisposition to atherosclerotic disease. Moreover, HDL cholesterol levels were correlated with physical fitness, regardless of body mass index.
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Affiliation(s)
- Jociene Terra da Penha
- Universidade do Estado do Rio de Janeiro (UERJ), Laboratório de Pesquisas Clínicas e Experimentais em Biologia Vascular (Biovasc), Rio de Janeiro, RJ, Brazil
| | - Fernanda Mussi Gazolla
- Universidade do Estado do Rio de Janeiro (UERJ), Faculdade de Ciências Médicas, Rio de Janeiro, RJ, Brazil
| | | | - Isabel Rey Madeira
- Universidade do Estado do Rio de Janeiro (UERJ), Laboratório de Pesquisas Clínicas e Experimentais em Biologia Vascular (Biovasc), Rio de Janeiro, RJ, Brazil
| | - Flávio Rodrigues-Júnior
- Universidade do Estado do Rio de Janeiro (UERJ), Laboratório de Pesquisas Clínicas e Experimentais em Biologia Vascular (Biovasc), Rio de Janeiro, RJ, Brazil
| | - Elisabeth de Amorim Machado
- Universidade do Estado do Rio de Janeiro (UERJ), Laboratório de Pesquisas Clínicas e Experimentais em Biologia Vascular (Biovasc), Rio de Janeiro, RJ, Brazil
| | - Fernando Lencastre Sicuro
- Universidade do Estado do Rio de Janeiro (UERJ), Laboratório de Pesquisas Clínicas e Experimentais em Biologia Vascular do Centro Biomédico (Biovasc), Rio de Janeiro, RJ, Brazil
| | - Paulo Farinatti
- Universidade do Estado do Rio de Janeiro (UERJ), Instituto de Educação Física e Desporto, Laboratório de Atividade Física e Promoção da Saúde (Labsau), Rio de Janeiro, RJ, Brazil
| | - Eliete Bouskela
- Universidade do Estado do Rio de Janeiro (UERJ), Laboratório de Pesquisas Clínicas e Experimentais em Biologia Vascular (Biovasc), Rio de Janeiro, RJ, Brazil
| | - Paulo Ferrez Collett-Solberg
- Universidade do Estado do Rio de Janeiro (UERJ), Laboratório de Pesquisas Clínicas e Experimentais em Biologia Vascular (Biovasc), Rio de Janeiro, RJ, Brazil; Universidade do Estado do Rio de Janeiro (UERJ), Faculdade de Ciências Médicas, Rio de Janeiro, RJ, Brazil.
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Martino F, Martino E, Versacci P, Niglio T, Zanoni C, Puddu PE. Lifestyle and awareness of cholesterol blood levels among 29159 community school children in Italy. Nutr Metab Cardiovasc Dis 2019; 29:802-807. [PMID: 31248716 DOI: 10.1016/j.numecd.2019.05.060] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 05/13/2019] [Accepted: 05/14/2019] [Indexed: 01/20/2023]
Abstract
BACKGROUND AND AIM Lifestyle habits including indoor and outdoor activities among community school children, adherence to the Mediterranean diet and awareness about total cholesterol blood levels represent determinant factors in cardiovascular disease (CVD) prevention. The aim of this study was to analyze the relationship between adherence to the Mediterranean diet, total cholesterol blood levels, body composition and hours per day spent in in-house or outdoor among 29,159 Italian 6-14 years-old community school children (50% boys). The KidMed questionnaire, modified to handle missing information on olive oil consumption, was used to assess the adherence to the Mediterranean diet among participants. METHODS AND RESULTS Associations between variables were tested according to 3 classes of the Mediterranean diet adherence score using analysis of variance. Participants with high adherence to Mediterranean diet were few (1%). Overall awareness of total cholesterol blood levels was low among children (4.5%), slightly higher among parents (26.2 and 24.1% in mothers and fathers, respectively). Among Mediterranean diet adherent children, BMI was significantly (p < 0.001) smaller than among the non-Mediterranean or intermediate adherent children as were the total hours spent per day watching television or playing with videogames (p < 0.001) whereas the hours/day in sport or outdoor activities were more (p < 0.001). These results were confirmed by multiple linear regression with KidMed scored 0 to 8 as dependent variable. CONCLUSION Although awareness of total cholesterol blood levels and adherence to the Mediterranean diet are rare among community school children, only among these a healthier lifestyle was practiced with a tendency to lower CVD risks. These results are important as the first sized experience of this type in Italy.
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Affiliation(s)
- Francesco Martino
- Sapienza University of Rome, Department of Pediatrics Gynecology and Obstetrics, 00161, Rome, Italy
| | - Eliana Martino
- Sapienza University of Rome, Department of Pediatrics Gynecology and Obstetrics, 00161, Rome, Italy
| | - Paolo Versacci
- Sapienza University of Rome, Department of Pediatrics Gynecology and Obstetrics, 00161, Rome, Italy
| | - Tarcisio Niglio
- Istituto Superiore di Sanità Presidenza - Servizio CCS, Viale Regina Elena 299, 00161 Rome, Italy
| | - Cristina Zanoni
- Sapienza University of Rome, Department of Pediatrics Gynecology and Obstetrics, 00161, Rome, Italy
| | - Paolo E Puddu
- Sapienza University of Rome, Department of Cardiovascular, Respiratory, Nephrological, Anesthesiologic and Geriatric Sciences, 00161, Rome, Italy; EA 4650, Signalisation, électrophysiologie et imagerie des lésions d'ischémie reperfusion myocardique, UNICAEN, 14000, Caen, France; Association for Cardiac Research, 00198, Rome, Italy.
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Palmer-Keenan DM, Bair K. Research to Support the Development of a Campaign to Increase Physical Activity Among Low-Income, Urban, Diverse, Inactive Teens. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2019; 51:703-710. [PMID: 30910316 DOI: 10.1016/j.jneb.2019.02.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 02/04/2019] [Accepted: 02/06/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To ascertain inactive teens' insights regarding the types of physical activities (PAs) they would be willing to do, and to inform a Supplemental Nutrition Assistance Program-Education PA social marketing campaign targeting this audience. DESIGN Formative, qualitative research via focus groups. SETTING Low-income, urban New Jersey areas between September, 2013 and April, 2014. PARTICIPANTS Low-income, urban, ethnically diverse, inactive teens. PHENOMENON OF INTEREST Teens' favored PAs and insights into how to develop a successful marketing campaign. ANALYSIS Edited audio-transcriptions were coded and a constant comparative analysis was employed to identify emergent themes. RESULTS Data from 5 focus groups' teens (n = 31), 58% of whom were Hispanic, 23% of whom were African American, and 19% of whom were of mixed race, revealed 3 themes. To be appealing, PAs (1) must be fun (eg, dancing, with friends and families) and (2) need to be comfortable (indoors, not sweaty, not physically competitive or embarrassing), and (3) they must be promoted by "cool" and relatable people (eg, teens like themselves or young comedians). CONCLUSIONS AND IMPLICATIONS Nutrition and health educators and social marketers may be well advised to consider the unique preferences of inactive teens to improve their PA levels. Additional research in varied geographic regions is advisable.
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Affiliation(s)
- Debra M Palmer-Keenan
- Department of Nutritional Sciences, Rutgers, the State University of New Jersey, New Brunswick, NJ.
| | - Kerry Bair
- Department of Nutritional Sciences, Rutgers, the State University of New Jersey, New Brunswick, NJ
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da Costa BGG, da Silva KS, Malheiros LEA, Minatto G, de Lima LRA, Petroski EL. Are adolescents really being sedentary or inactive when at school? An analysis of sedentary behaviour and physical activity bouts. Eur J Pediatr 2018; 177:1705-1710. [PMID: 30182218 DOI: 10.1007/s00431-018-3233-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 08/22/2018] [Accepted: 08/24/2018] [Indexed: 01/02/2023]
Abstract
This study analysed physical activity (PA) and sedentary behaviour (SB) performed in bouts during schooltime. Adolescents of two schools answered a questionnaire, had their height and weight measured and wore accelerometers during schooltime. Moderate-to-vigorous intensity PA was estimated in bouts of 2, 5 and 10 min, and SB in bouts of 5, 10, 30 and 60 min. Body mass index was calculated, and adolescents were classified as overweight or normal weight. Frequency, duration and volume of PA and SB were calculated for the whole sample and for those who performed at least one bout weekly. PA and SB differences between gender and weight status were tested using Mann-Whitney and t tests. A total of 415 adolescents (54% girls, 12.3 ± 1.3 years old, 34.6% overweight) performed 0.1 (± 0.2), 0.2 (± 0.5) and 0.4 (± 0.6) bouts of 10, 5 and 2 min of PA, and 10.6 (± 2.0), 6.0 (± 1.3), 1.1 (± 0.9) and 0.4 (± 0.5) bouts/day of 5, 10, 30 and 60 min of SB, respectively. Boys accumulated less SB and more PA in bouts. No differences were found for weight status.Conclusion: Adolescents hardly engaged in bouted PA and accumulated more SB in smaller bouts during schooltime. Bouted PA and SB were not associated with weight status. What is Known: • Adolescents are not engaging in enough PA and are accumulating large volumes of SB, which might negatively impact their health. • Schools play an important role in daily overall PA, with opportunities such as PE classes and recesses. But most classes are still undertaken in seated positions. What is New: • Adolescents hardly engage in bouted (> 10 m) PA when at school., and most SB is accumulated in short bouts (≤ 10m). • Weight status was not associated with bouted PA or SB at school.
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Affiliation(s)
- Bruno Gonçalves Galdino da Costa
- Center of Sports, Research Center in Physical Activity and Health, Federal University of Santa Catarina, Campus João David Ferreira Lima, Florianópolis, Santa Catarina, 88040-900, Brazil.
| | - Kelly Samara da Silva
- Center of Sports, Research Center in Physical Activity and Health, Federal University of Santa Catarina, Campus João David Ferreira Lima, Florianópolis, Santa Catarina, 88040-900, Brazil
| | - Luís Eduardo Argenta Malheiros
- Center of Sports, Research Center in Physical Activity and Health, Federal University of Santa Catarina, Campus João David Ferreira Lima, Florianópolis, Santa Catarina, 88040-900, Brazil
| | - Giseli Minatto
- Center of Sports, Research Center in Physical Activity and Health, Federal University of Santa Catarina, Campus João David Ferreira Lima, Florianópolis, Santa Catarina, 88040-900, Brazil
- Research Center in Kineanthropometry and Human Performance, Center of Sports, Federal University of Santa Catarina, Campus João David Ferreira Lima, Florianópolis, Santa Catarina, 88040-900, Brazil
| | - Luiz Rodrigo Augustemak de Lima
- Research Center in Kineanthropometry and Human Performance, Center of Sports, Federal University of Santa Catarina, Campus João David Ferreira Lima, Florianópolis, Santa Catarina, 88040-900, Brazil
| | - Edio Luiz Petroski
- Research Center in Kineanthropometry and Human Performance, Center of Sports, Federal University of Santa Catarina, Campus João David Ferreira Lima, Florianópolis, Santa Catarina, 88040-900, Brazil
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Changes in muscular fitness and its association with blood pressure in adolescents. Eur J Pediatr 2018; 177:1101-1109. [PMID: 29740692 DOI: 10.1007/s00431-018-3164-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 04/20/2018] [Accepted: 04/25/2018] [Indexed: 01/02/2023]
Abstract
The aims of this study were to examine the longitudinal association between muscular fitness (MF) and blood pressure (BP) 2 years later, and to determine whether changes in MF over a 2-year period were associated with BP at follow-up, in adolescents. The sample comprised 734 youths (349 girls) aged from 12 to 18 years. MF was assessed with the standing long jump and handgrip tests. Socioeconomic status, pubertal stage, waist circumference, resting BP, and cardiorespiratory fitness were measured according to standard procedures. Regression analyses showed a significant inverse association between MF at baseline and systolic BP (β = - 0.072; p = 0.032) and rate pressure product (β = - 0.124; p < 0.001) at follow-up, after adjustments for age, sex, height, pubertal stage, and socioeconomic status. However, when analyses were further adjusted for waist circumference and cardiorespiratory fitness, these associations did not remain significant. Adolescents with persistently high and increasing MF exhibited the lowest levels of diastolic BP (F(3, 721) = 3.814, p = 0.018) and systolic BP (F(3, 721) = 3.908, p = 0.014) when compared to those with persistent low MF after adjustment for age, sex, height, socioeconomic status, cardiorespiratory fitness, and waist circumference.Conclusion: This study suggests that persistent greater and increasing MF in youth are associated with lower levels of BP across the adolescence. What is Known: • Currently, there is a growing interest on the health benefits of muscular fitness. • Cross-sectional studies have identified an association between muscular fitness and blood pressure in adolescents. What is New: • Changes in muscular fitness during adolescence were associated with systolic and diastolic BP over a 2-year period. • Adolescents with persistently low muscular fitness exhibited the highest levels of diastolic and systolic BP.
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Building a response criterion for pediatric multidisciplinary obesity intervention success based on combined benefits. Eur J Pediatr 2018; 177:1-12. [PMID: 29556792 DOI: 10.1007/s00431-018-3115-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 02/09/2018] [Indexed: 10/17/2022]
Abstract
UNLABELLED To propose a response criterion for analyzing the intervention success by verifying patient outcomes after a multidisciplinary obesity treatment program in Brazilian children and adolescents. Obese children and adolescents (n = 103) completed a 16-week multidisciplinary intervention (IG) and were compared to the control group (CG) (n = 66). A cluster of parameters (e.g. total domain of HRQoL; BMI z-score; cardiorespiratory fitness; body mass; waist circumference; fat mass; lean mass) were measured pre and post-intervention, and the sum of the median percentage variation and the percentile 25 and 75 were used from IG and CG to determine the responsiveness to the program. We are proposing four ranges in which children and adolescents may be classified after the intervention: (1) CG percentile 50 values or lower are considered non-responsive to the intervention, (2) values greater than CG percentile 50 but lower than IG percentile 50 are considered slightly responsive, (3) values greater than IG percentile 50 but lower than IG percentile 75 were considered as moderately responsive, and (4) values greater than IG percentile 75 were considered very responsive. CONCLUSIONS This criterion may serve as a complementary tool that can be employed to monitor the response to this model of multidisciplinary intervention. What is Known: • The effectiveness of multidisciplinary obesity interventions is usually determined by comparing changes in selected outcomes in the intervention versus versus control group. • There is no consensus about what should be assessed before and after the intervention program, which makes difficult to compare different programs and to determine their rate of responsiveness. What is New: • This study proposes a response criteria to pediatric obesity interventions following a similar model compared to ours based on key variables that presents low cost and high applicability in different settings.
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Videira-Silva A, Sardinha L, Fonseca H. Effect of a Physical Activity Consultation in the Management of Adolescent Overweight (the PAC-MAnO project): study rationale, design and methods. BMJ Paediatr Open 2018; 2:e000214. [PMID: 30094347 PMCID: PMC6069927 DOI: 10.1136/bmjpo-2017-000214] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 01/30/2018] [Accepted: 02/15/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Adolescent overweight is a major public health concern, as it is associated with several short-run and long-run adverse health outcomes. Inappropriate health behaviours may be at the front of this epidemic. There is widespread need for new strategies that may positively influence dietary and physical activity behaviours. This trial (NCT02941770) was designed to investigate the impact of a physical activity consultation, based on motivational interview technique, on physical activity behaviour and weight status among overweight adolescents followed at a tertiary paediatric care centre. METHODS/DESIGN This is an ongoing non-randomised controlled clinical trial with a 6-month duration and follow-up at month 12. It is expected to be concluded in December 2018. Adolescents (n=129) aged 12-18 with a body mass index ≥p85 are recruited and allocated into three groups: (1) control group: standard care (paediatric and nutrition consultations, n=43); (2) experimental group I: standard care plus physical activity consultation (n=43); and (3) experimental group II: exposure to two sessions/week of structured physical exercise, in addition to the standard care plus physical activity consultations (n=43). Sample size was calculated according to power analysis. Participants undergo a set of socioeconomic, anthropometric, body composition, clinical and behavioural (dietary and physical activity) assessments. DISCUSSION Adolescence is a critical period for the acquisition of a healthy lifestyle. The promotion of an active lifestyle may influence adolescents' weight status and further prevent multiple comorbidities. The findings of our study will provide further understanding on the impact of a physical activity consultation on physical activity behaviour and weight reduction/maintenance among overweight adolescents. TRIAL REGISTRATION NUMBER NCT02941770.
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Affiliation(s)
- Antonio Videira-Silva
- Pediatric University Clinic, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Luís Sardinha
- Exercise and Health Laboratory, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
| | - Helena Fonseca
- Pediatric Obesity Clinic, Department of Pediatrics, Hospital de Santa Maria, Lisbon, Portugal.,Rheumatology Research Unit, Molecular Medicine Institute, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
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Breakfast habits, dairy product consumption, physical activity, and their associations with body mass index in children aged 6-18. Eur J Pediatr 2017; 176:1251-1257. [PMID: 28799014 DOI: 10.1007/s00431-017-2976-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 04/30/2017] [Accepted: 07/27/2017] [Indexed: 10/19/2022]
Abstract
UNLABELLED The purpose of this study was to determine breakfast habits, dairy product consumption, and physical activity and their relations with body mass index (BMI) in schoolchildren and adolescents. This cross-sectional, school-based study was performed with children aged 6-18 years. Height and weight were measured, and a BMI z-score was calculated for each child. Breakfast consumption frequency, intake of milk and other dairy products, physical activity habits, and mothers' employment status were assessed via a self-report questionnaire. Multiple linear regression analysis was used to estimate the association between these habits and BMI z-scores. Seven thousand one hundred sixteen children were included, 3445 (48.4%) female, with a mean age of 11.7 ± 2.7 years (5.8-18.9). Of these, 62.6% had breakfast every day. Boys ate breakfast daily significantly more often than girls (64.5 and 60.7%, respectively; p < 0.001). The percentage of children eating breakfast daily decreased with age (79.1% at 6-11 vs. 52.1% at 12-18 years, p < 0.001). Sixty-four (0.9%) children consumed no dairy products. Milk intake was negatively and significantly associated with BMI z-score (β = - 0.103, p < 0.001). Cheese consumption and the mother being employed were positively and significantly associated with BMI z-score (β = 0.517, p < 0.001, and β = 0.172, p < 0.001, respectively). Children engaging in physical activity had higher BMI z-score values than others (0.22 ± 0.01 vs. 0.12 ± 0.02, p < 0.001). Prevalence of overweight/obese was higher among children of working mothers compared to those of unemployed mothers (respectively, 29.3, 23.3%, p < 0.001). CONCLUSIONS Skipping breakfast was associated with overweight/obesity in schoolchildren and adolescents, while milk consumption exhibited a protective effect. What is known? • Dietary interventions should be incorporated into a multidisciplinary strategy for obesity prevention. • Most studies of habitual physical activity in children suggest that the overweight and obese children are less active. What is new? • Milk consumption seems to have a protective effect against overweight/obesity, irrespective of yogurt or cheese consumption. • Children engaging in greater physical activity had higher body mass index values than others.
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Videira-Silva A, Fonseca H. The effect of a physical activity consultation on body mass index z-score of overweight adolescents: results from a pediatric outpatient obesity clinic. Eur J Pediatr 2017; 176:655-660. [PMID: 28275861 DOI: 10.1007/s00431-017-2892-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 02/22/2017] [Accepted: 03/01/2017] [Indexed: 11/30/2022]
Abstract
UNLABELLED Physical activity (PA) is recognized as having many health benefits. Despite of all the efforts, the majority of the overweight adolescents still present low levels of PA. PA consultation can be a cost-effective way of enhancing PA and improve weight status among overweight adolescents. The main aim of this study was to analyze whether adolescents attending a PA consultation in a clinical setting show more therapeutic success at 6 months, based on body mass index (BMI) z-score and waist circumference (WC), compared to those only followed by the pediatrician and nutritionist. Clinical records from 396 patients were analyzed: PA consultation (PAc) group, n = 198; standard consultation (STc) group, n = 198. Baseline differences between groups were analyzed using chi-square and independent sample t tests. Changes within groups and between groups were analyzed using paired sample t tests and independent sample t tests, respectively. Patients in both groups decreased their BMI z-score. The PAc has shown a higher decrease in the BMI z-score (PAc -0.12, p < 0.0001; STc -0.05, p < 0.0001). The WC of the PAc group has increased 2.2 cm less than the one of the STc group (p < 0.005). The difference in waist-to-height ratio between the PAc and STc groups was of 0.015 (p < 0.005), showing a trend to decrease in the PAc group (-0.005, p = 172). CONCLUSION Although the success of adolescent obesity management cannot be based only on BMI, a PA consultation on the top of the traditional pediatric and nutrition interventions may further improve the BMI z-score outcome at 6 months. What is Known: • Physical activity (PA) plays an important role in weight management. However, most adolescents, in particular those who are overweight, present low levels of PA. • There is no consensus whether PA counseling influences PA behavior. What is New: • A PA consultation (a structured form of PA counseling) as part of a multidisciplinary team may further be useful for weight management of overweight adolescents followed at the clinical setting, compared to the traditional approach including only the pediatric and nutrition consultations. • Waist-to-height ratio may be more suitable than waist circumference per se to track changes in abdominal adiposity among adolescents who are still growing.
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Affiliation(s)
- A Videira-Silva
- Lisbon Academic Medical Centre (CAML), Lisbon, Portugal. .,Pediatric Obesity Clinic, Department of Pediatrics, Hospital de Santa Maria, Lisbon, Portugal.
| | - H Fonseca
- Pediatric Obesity Clinic, Department of Pediatrics, Hospital de Santa Maria, Lisbon, Portugal.,Rheumatology Research Unit, Molecular Medicine Institute, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
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Fernström M, Fernberg U, Eliason G, Hurtig-Wennlöf A. Aerobic fitness is associated with low cardiovascular disease risk: the impact of lifestyle on early risk factors for atherosclerosis in young healthy Swedish individuals - the Lifestyle, Biomarker, and Atherosclerosis study. Vasc Health Risk Manag 2017; 13:91-99. [PMID: 28352184 PMCID: PMC5358957 DOI: 10.2147/vhrm.s125966] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The progression of cardiovascular disease (CVD) and atherosclerosis is slow and develops over decades. In the cross-sectional Swedish Lifestyle, Biomarker, and Atherosclerosis study, 834 young, self-reported healthy adults aged 18.0-25.9 years have been studied to identify early risk factors for atherosclerosis. PURPOSE The aims of this study were to 1) assess selected cardiometabolic biomarkers, carotid intima-media thickness (cIMT) as a marker of subclinical atherosclerosis, and lifestyle-related indicators (food habits, handgrip strength, and oxygen uptake, VO2 max); 2) analyze the associations between cIMT and lifestyle factors; and 3) identify subjects at risk of CVD using a risk score and to compare the characteristics of subjects with and without risk of CVD. METHOD Blood samples were taken in a fasting state, and food habits were reported through a questionnaire. cIMT was measured by ultrasound, and VO2 max was measured by ergometer bike test. The risk score was calculated according to Wildman. RESULT cIMT (mean ± standard deviation) was 0.50±0.06 mm, and VO2 max values were 37.8±8.5 and 42.9±9.9 mL/kg/min, in women and men, respectively. No correlation was found between aerobic fitness expressed as VO2 max (mL/kg/min) and cIMT. Using Wildman's definition, 12% of the subjects were classified as being at risk of CVD, and 15% had homeostasis model assessment of insulin resistance. A total of 35% of women and 25% of men had lower high-density lipoprotein cholesterol than recommended. Food habits did not differ between those at risk and those not at risk. However, aerobic fitness measured as VO2 max (mL/kg/min) differed; 47% of the subjects at risk had low aerobic fitness compared to 23% of the nonrisk subjects (P<0.001). CONCLUSION High aerobic fitness is associated with low CVD risk in Swedish young adults. The high prevalence of young adults observed with unfavorable levels of high-density lipoprotein cholesterol and homeostasis model assessment of insulin resistance raises concerns about future CVD risk.
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Affiliation(s)
- Maria Fernström
- Department of Medical Diagnostics, Medical Faculty, School of Health Sciences
| | - Ulrika Fernberg
- Medical Faculty, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Gabriella Eliason
- Department of Medical Diagnostics, Medical Faculty, School of Health Sciences
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Júdice PB, Silva AM, Berria J, Petroski EL, Ekelund U, Sardinha LB. Sedentary patterns, physical activity and health-related physical fitness in youth: a cross-sectional study. Int J Behav Nutr Phys Act 2017; 14:25. [PMID: 28259140 PMCID: PMC5336686 DOI: 10.1186/s12966-017-0481-3] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 02/21/2017] [Indexed: 01/13/2023] Open
Abstract
Background Strong evidence indicates that moderate-vigorous physical activity (MVPA) is positively associated with fitness in youth, independent of total sedentary-time. Sedentary-time appears negatively associated with fitness only when it replaces MVPA. However, whether different sedentary-patterns affect health-related fitness is unknown. Methods The associations between MVPA and sedentary-patterns with physical fitness were examined in 2698 youths (1262 boys) aged 13.4 ± 2.28 years. Sedentary-time (counts · minute−1 < 100) and PA were objectively measured by accelerometry. Each break (≥100 counts · min−1 < 2295) in sedentary-time and the frequency of daily bouts in non-prolonged (<30 min) and prolonged (≥30 min) sedentary-time were determined. The FITNESSGRAM® test battery was used to assess fitness. A standardized fitness composite-score (z-score) was calculated by summing the individual z-scores of the five tests adjusted to age and sex. Results Positive associations between MVPA and fitness were observed in both boys (β = 0.013, 95% CI: 0.005; 0.021) and girls (β = 0.014, 95% CI: 0.006; 0.022), independent of sedentary-patterns. Modest associations were found for the breaks in sedentary-time with fitness (β = 0.026, 95% CI: 0.009; 0.042), independent of total sedentary-time and MVPA in boys. In girls, non-prolonged sedentary bouts were positively associated with fitness (β = 0.014, 95% CI: 0.003; 0.024), independent of total sedentary-time and MVPA. Conclusions These results reinforce that, independent of the time and patterns of sedentary behavior, MVPA is consistently associated with fitness in youth. Modest and inconsistent associations were found for sedentary behaviors. Breaking-up sedentary-time in boys and non-prolonged sedentary bouts in girls were positively associated with fitness, independent of total sedentary-time and MVPA. In order to enhance youth’s fitness, public health recommendations should primarily target MVPA, still, suggestion to reduce and break-up sedentary-time may also be considered.
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Affiliation(s)
- Pedro B Júdice
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, Cruz-Quebrada, Lisbon, 1499-002, Portugal
| | - Analiza M Silva
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, Cruz-Quebrada, Lisbon, 1499-002, Portugal
| | - Juliane Berria
- Graduate in Physical Education Program, Kinanthropometry Center and Human Performance, Federal University of Santa Catarina, Santa Catarina, Brazil
| | - Edio L Petroski
- Graduate in Physical Education Program, Kinanthropometry Center and Human Performance, Federal University of Santa Catarina, Santa Catarina, Brazil
| | - Ulf Ekelund
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway.,MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Luís B Sardinha
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, Cruz-Quebrada, Lisbon, 1499-002, Portugal.
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Effect of water- versus land-based exercise training as a component of a multidisciplinary intervention program for overweight and obese adolescents. Physiol Behav 2016; 165:365-73. [DOI: 10.1016/j.physbeh.2016.08.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 08/01/2016] [Accepted: 08/17/2016] [Indexed: 11/19/2022]
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Cayres SU, Agostinete RR, de Moura Mello Antunes B, Lira FS, Fernandes RA. Impact of physical exercise/activity on vascular structure and inflammation in pediatric populations: A literature review. J SPEC PEDIATR NURS 2016; 21:99-108. [PMID: 27250102 DOI: 10.1111/jspn.12149] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 04/07/2016] [Accepted: 04/25/2016] [Indexed: 02/02/2023]
Abstract
PURPOSE To describe the effects of physical exercise/activity on the vascular architecture of children and adolescents, as well as to identify the effects of inflammation and sedentary behaviors on this relationship. METHODS Potentially relevant articles were identified in the databases MEDLINE and PubMed covering the period from 2000 to 2015. No language restrictions were applied. RESULTS Thirteen articles were found that included obese boys and girls in their samples (aged 9-19). Six interventional studies assessed inflammation and in five of these, physical exercise decreased inflammation. In 10 studies, vascular architecture was affected by physical exercise/activity. CONCLUSIONS The impact of physical exercise on vascular architecture and inflammation seems relevant, but has been mainly investigated in obese groups. PRACTICAL IMPLICATIONS Health professionals should act together in organized interventions in schools, targeting the promotion of higher physical activity levels in children and adolescents.
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Affiliation(s)
- Suziane Ungari Cayres
- Suziane Ungari Cayres, MSc, is PhD Student in Post-Graduate Program in Movement Sciences, São Paulo State University, Rio Claro, São Paulo, Brazil
| | - Ricardo Ribeiro Agostinete
- Ricardo Ribeiro Agostinete is Master's Degree Student in the Post-Graduate Program in Physiotherapy, São Paulo State University, Presidente Prudente, São Paulo, Brazil
| | - Barbara de Moura Mello Antunes
- Barbara de Moura Mello Antunes, MSc, is PhD Student in the Post-Graduate Program in Movement Sciences, São Paulo State University, Rio Claro, São Paulo, Brazil
| | - Fabio Santos Lira
- Fabio Santos de Lira, PhD, is Assistant Professor, Exercise and Immunometabolism Research Group, Department of Physical Education, São Paulo State University, UNESP, Presidente Prudente, São Paulo, Brazil
| | - Rômulo Araújo Fernandes
- Romulo Araújo Fernandes, PhD, is Assistant Professor, Laboratory of Investigation in Exercise, Department of Physical Education, Sao Paulo State University, São Paulo, Brazil
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