Association Between a Physical Activity Vital Sign and Cardiometabolic Disease in High-Risk Patients

The Benefits of Physical Activity for People with Obesity, Independent of Weight Loss: A Systematic Review

Purposeful weight loss continues to be the primary focus for treating obesity. However, this strategy appears to be inadequate as obesity rates continue to rise and a myriad of benefits of physical activity that affect multiple health outcomes related to obesity and associated comorbidities are not integrated into treatment strategies. There are emerging correlational data in individuals with obesity that demonstrate physical activity can be beneficial to many critical health markers, independent of weight loss or changes in BMI. This systematic review investigates interventional studies that examine health markers, independent of weight loss, in individuals with obesity. Fourteen studies were identified that utilized a variety of physical activity interventions with primary endpoints that included cellular, metabolic, systemic and brain health outcomes. The review of the literature demonstrates that for individuals with obesity, there are both small-scale and large-scale physiologic benefits that occur with increased physical activity of various modalities. Focusing on these benefits, rather than a narrow focus of weight loss alone, may increase physical activity behavior and health for individuals with obesity.

Associations Between the Physical Activity Vital Sign and Cardiometabolic Risk Factors in High-Risk Youth and Adolescents

BACKGROUND

The physical activity vital sign (PAVS) is a simple, validated tool for assessing physical activity in adults that has not been previously studied in pediatrics.

HYPOTHESIS

Reported physical activity utilizing the PAVS in pediatric patients should vary according to known associations with physical activity, such as age, sex, blood pressure, and body mass index (BMI).

STUDY DESIGN

Cross-sectional study.

LEVEL OF EVIDENCE

Level 3.

METHODS

All patients within a family medicine residency clinic were assessed via the PAVS from October 1, 2015, to October 31, 2016, including 255 consecutive pediatric patients aged 5 to 18 years. Associations were examined between PAVS, age, sex, blood pressure, and BMI using 1-way analysis of variance.

RESULTS

The average PAVS reported for youth (5-11 years) was 384.9 ± 218.1 minutes per week, with 69.5% reporting sufficient physical activity (≥300 minutes per week). Adolescents (12-18 years) reported a mean PAVS of 278.3 ± 199.6 minutes per week, with 51.1% reporting sufficient physical activity. Physical activity was lower in older participants (P < 0.0001) and was higher in male patients (P < 0.03). Higher BMI was associated with lower PAVS (P < 0.005), while lower systolic blood pressure was associated with a greater number of days per week of physical activity (P < 0.005).

CONCLUSION

The PAVS successfully identifies accepted associations between age, sex, and BMI in a pediatric population.

CLINICAL RELEVANCE

The correlation of the PAVS with age, sex, BMI, and blood pressure may inform future strategies to address and prevent cardiometabolic disease in pediatric patients.