Associations between accelerometry measured physical activity and sedentary time and the metabolic syndrome: A meta-analysis of more than 6000 children and adolescents

Physical activity and its impact on cardiovascular health in pediatric kidney transplant recipients

BACKGROUND

Cardiovascular (CV) morbidity after kidney transplantation (KTx) in childhood is of increasing importance. In light of a high prevalence of CV risk factors, protective measures such as physical activity (PA) come into focus. Our aim was to comprehensively assess PA in pediatric KTx recipients and evaluate its impact on CV health.

METHODS

Forty-eight patients were assessed for frequency, duration, intensity, and setting of PA using the "Motorik-Modul" PA questionnaire. Walking-based activity was measured by accelerometer in a subgroup (n = 23). CV risk factors and subclinical CV organ damage were determined. The impact of PA on CV parameters was analyzed using linear regression models.

RESULTS

Fifty-two percent of pediatric KTx recipients did not reach WHO recommended PA level; 54% did not engage in PA with vigorous intensity (VPA). Twenty-nine percent indicated an extremely inactive lifestyle (< 120 min/week of moderate to vigorous intensity PA, MVPA). Compared to the healthy German KiGGS cohort, KTx recipients specifically lacked engagement in sport activities (KTx: 129 min/week; 95%CI, 97-162 vs. KiGGS, 242 min/week; 95%CI, 230-253). VPA was associated with lower systolic blood pressure (p = 0.024) and resting heart rate (p = 0.005), MVPA with fewer components of the post-transplant metabolic syndrome (p = 0.037), and better left ventricular diastolic function (p = 0.006).

CONCLUSIONS

A considerable lack of PA, especially VPA, exists in young KTx recipients. PA was positively associated with important parameters of CV health. While long-term CV protection through PA seems promising in pediatric KTx recipients, specific educational approaches are most likely needed to increase patients' engagement in sport activities.

Metabolic Derangement by Arsenic: a Review of the Mechanisms

Studies have implicated arsenic exposure in various pathological conditions, including metabolic disorders, which have become a global phenomenon, affecting developed, developing, and under-developed nations. Despite the huge risks associated with arsenic exposure, humans remain constantly exposed to it, especially through the consumption of contaminated water and food. This present study provides an in-depth insight into the mechanistic pathways involved in the metabolic derangement by arsenic. Compelling pieces of evidence demonstrate that arsenic induces metabolic disorders via multiple pathways. Apart from the initiation of oxidative stress and inflammation, arsenic prevents the phosphorylation of Akt at Ser473 and Thr308, leading to the inhibition of PDK-1/Akt insulin signaling, thereby reducing GLUT4 translocation through the activation of Nrf2. Also, arsenic downregulates mitochondrial deacetylase Sirt3, decreasing the ability of its associated transcription factor, FOXO3a, to bind to the agents that support the genes for manganese superoxide dismutase and PPARg co-activator (PGC)-1a. In addition, arsenic activates MAPKs, modulates p53/ Bcl-2 signaling, suppresses Mdm-2 and PARP, activates NLRP3 inflammasome and caspase-mediated apoptosis, and induces ER stress, and ox-mtDNA-dependent mitophagy and autophagy. More so, arsenic alters lipid metabolism by decreasing the presence of 3-hydroxy-e-methylglutaryl-CoA synthase 1 and carnitine O-octanoyl transferase (Crot) and increasing the presence of fatty acid-binding protein-3 mRNA. Furthermore, arsenic promotes atherosclerosis by inducing endothelial damage. This cascade of pathophysiological events promotes metabolic derangement. Although the pieces of evidence provided by this study are convincing, future studies evaluating the involvement of other likely mechanisms are important. Also, epidemiological studies might be necessary for the translation of most of the findings in animal models to humans.

The association between device-measured sitting time and cardiometabolic health risk factors in children

BACKGROUND

There is limited evidence of the associations between postural-derived sitting time, waist-worn derived sedentary time and children's health and the moderation effect of physical activity (PA). This study examined associations of children's device-measured sitting time with cardiometabolic health risk factors, including moderation by physical activity.

METHODS

Cross-sectional baseline data from children (mean-age 8.2 ± 0.5 years) in Melbourne, Australia (2010) participating in the TransformUs program were used. Children simultaneously wore an activPAL to assess sitting time and an ActiGraph GT3X to assess sedentary time and physical activity intensity. Cardiometabolic health risk factors included: adiposity (body mass index [BMI], waist circumference [WC]), systolic and diastolic blood pressure (SBP, DBP), high-density lipoprotein (HDL), low-density lipoprotein (LDL), cholesterol, triglycerides, fasting plasma glucose (FPG), serum insulin, and 25-hydroxyvitaminD (25[OH]D). Linear regression models (n = 71-113) assessed associations between sitting time with each health risk factor, adjusted for different PA intensities (i.e. light [LIPA], moderate-vigorous intensities [MVPA], separately on each model), age, sex, adiposity, and clustering by school. Interaction terms examined moderation. The analyses were repeated using device-measured sedentary time (i.e. ActiGraph GT3X) for comparison.

RESULTS

Sitting time was positively associated with SBP (b = 0.015; 95%CI: 0.004, 0.026), DBP (b = 0.012; 95%CI:0.004, 0.020), and FPG (b = 0.001; 95%CI: 0.000, 0.000), after adjusting for higher PA intensities. The association between sitting time and insulin (b = 0.003; 95%CI: 0.000, 0.006) was attenuated after adjusting for higher PA intensities. When the models were adjusted for LIPA and MVPA, there was a negative association with LDL (b=-0.001; 95%CI: -0.002, -0.000 and b=-0.001; 95%CI: -0.003, -0.000, respectively). There was a negative association of sedentary time with WCz (b=-0.003; 95%CI: -0.005, 0.000) and BMIz (b=-0.003; 95%CI: -0.006, -0.000) when the models were adjusted by MVPA. Sedentary time was positively associated with triglycerides (b = 0.001; 95%CI: 0.000, 0.001) but attenuated after adjusting for MVPA. No evidence of moderation effects was found.

CONCLUSIONS

Higher volumes of sitting and sedentary time were associated with some adverse associations on some cardiometabolic health risk factors in children. These associations were more evident when sitting time was the predictor. This suggests that reducing time spent sitting may benefit some cardiometabolic health outcomes, but future experimental research is needed to confirm causal relationships and identify the biological mechanisms that might be involved.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry: ACTRN12609000715279.

The bidirectional longitudinal association between academic performance and cardiovascular disease risk factors in adolescents

INTRODUCTION

The limited prior research examining the association between academic performance and cardiovascular disease (CVD) risk factors in youth did not explore the reciprocal association between these constructs, and analyzed CVD risk factors individually. Thus, the aim of the present study was to explore the bidirectional longitudinal association between clustered CVD risk score and academic performance in adolescents over a 24-month interval.

METHODS

A total of 237 adolescents (45.6% girls), aged 13.9 ± 0.3 years old at baseline, from DADOS (Deporte, ADOlescencia y Salud) study were included in this study. A clustered CVD risk score was created by calculating the mean age- and gender-standardized z-scores of waist circumference, systolic blood pressure, total cholesterol to high-density lipoprotein cholesterol ratio, triglycerides, homeostatic model assessment of insulin resistance, and cardiorespiratory fitness (inversed). Academic performance was assessed through the final academic grades and the test of educational abilities.

RESULTS

Our results showed that the clustered CVD risk score at baseline was not associated with academic performance 24 months later (all p > .05). Nevertheless, except for physical education, academic grades at baseline were inversely associated with clustered CVD risk score at follow-up in adolescents (β ranged from -0.140 to -0.102; all p < .05). No associations were found between academic abilities at baseline and clustered CVD risk score at follow-up (all p > .05).

CONCLUSION

Academic grades could help predict CVD risk 24 months later during adolescence. Education professionals should foster adolescents' academic performance not only to improve academic results but also to maximize future cardiovascular health benefits.

2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association

BACKGROUND

The American Heart Association (AHA), in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, nutrition, sleep, and obesity) and health factors (cholesterol, blood pressure, glucose control, and metabolic syndrome) that contribute to cardiovascular health. The AHA Heart Disease and Stroke Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, brain health, complications of pregnancy, kidney disease, congenital heart disease, rhythm disorders, sudden cardiac arrest, subclinical atherosclerosis, coronary heart disease, cardiomyopathy, heart failure, valvular disease, venous thromboembolism, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs).

METHODS

The AHA, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States and globally to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2024 AHA Statistical Update is the product of a full year's worth of effort in 2023 by dedicated volunteer clinicians and scientists, committed government professionals, and AHA staff members. The AHA strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year's edition includes additional global data, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains.

RESULTS

Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics.

CONCLUSIONS

The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.

How the COVID-19 pandemic and related school closures reduce physical activity among children and adolescents in the WHO European Region: a systematic review and meta-analysis

BACKGROUND

Emerging research suggests that physical activity among children and adolescents decreased during the COVID-19 pandemic. However, a differentiated overview of European youth is lacking. In particular, no systematic analysis has been conducted to date on the impact of heterogeneous pandemic restrictions and school closures within European countries, and with regard to potentially vulnerable groups.

METHODS

We searched seven databases and included studies for children and adolescents (≤ 19 years) of the WHO European Region that compared physical activity during the COVID-19 pandemic with a pre-pandemic baseline using validated measurement instruments. We used the Oxford Stringency Index and School Closure Index as indicators of restriction stringency. Screening for eligibility, data extraction, assessment of the study risk of bias (using the 'Risk of Bias in Non-randomized Studies - of Exposure' [ROBINS-E]) and certainty grading of evidence (using the GRADE approach), were all done in duplicate. Unpublished data was requested from study authors. Data were pooled in random effects models. An a priori protocol was published, reporting is carried out in accordance with the 'Preferred Reporting Items for Systematic Review and Meta-Analyses' (PRISMA) statement.

RESULTS

Of 14,897 non-duplicate records, 26 publications (n = 15,038 pre-pandemic, n = 13,041 during pandemic) met full inclusion criteria. Comparison before and during the COVID-19 pandemic revealed a significant reduction in total physical activity (standardized mean difference [SMD], -0.57 [95%CI, -0.95; -0.20]) and moderate-to-vigorous physical activity (SMD, -0.43 [95% CI, -0.75; -0.10]), corresponding to a decrease of 12 min per day (a 20% reduction of the WHO recommendation). A decrease in sporting activity was also recorded. Subgroup analyses suggested that middle childhood (aged 8-12) and adolescents were particularly affected by the decline. School closures were associated with a reduction in physical activity. The certainty of evidence for all outcomes was low.

CONCLUSIONS

A sharp decline in all forms of physical activity was recorded among European children and adolescents during the COVID-19 pandemic. This decline was higher during periods of school closure and mainly affected younger schoolchildren and adolescents. Immediate action by policy-makers and practitioners, as well as evidence-based public health strategies, are imperative in reversing this trend.

TRIAL REGISTRATION

PROSPERO: CRD42023395871.

Effect of physical activity levels on blood lipids, insulin resistance, and adipokines in children with obesity

PURPOSE

Our study was performed to observe children with obesity by using accelerometers and identify their differences in blood lipid levels, insulin resistance, and adipokines based on their physical activity levels.

METHODS

197 obese children were classified into three groups based on their physical activity levels over a period of 7 days, using the average counts per minute: Sedentary Time (ST), Light Physical Activity (LPA), and Moderate to Vigorous Intensity Physical Activity (MVPA). Blood lipids, including triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C), were analyzed. Insulin resistance was assessed using the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) formula. Adipokines, including leptin and resistin, were measured. Our results were obtained through one-way analysis of variance was employed, with Scheffe post-hoc analysis. The statistical significance level was set at p < 0.05 for all analyses.

RESULTS

Results showed that the levels of blood lipids (TG: p<0.001, TC: p<0.01, LDL-C: p<0.001, HDL-C: p< 0.05) and adipokines (Leptin, Resistin: p<0.01) of children who had obesity and maintained moderate to vigorous physical activity were healthier than those who engaged in ST or LPA. Specifically, children with obesity engaging in MVPA demonstrated blood lipid and adipokine levels that were normal or close to normal. However, no significant differences in insulin resistance were observed in all groups.

CONCLUSION

In summary, encouraging moderate to vigorous physical activity in children with obesity could help improve obesity indicators, such as blood lipids and adipokines.

Objective measured physical activity and metabolic syndrome score in children and adolescents: The UP&DOWN longitudinal study

INTRODUCTION

We aimed to analyze the cross-sectional and longitudinal association of physical activity (PA) levels and PA patterns with metabolic syndrome score (MetS) in children and adolescents.

METHODS

A total of 175 children (82 females) and 188 adolescents (95 females) were included. Objective PA levels and patterns were determined by accelerometry. MetS was computed from waist circumference, systolic blood pressure, triglycerides, high-density lipoprotein cholesterol, and glucose levels. Different linear regression models were implemented to examine the associations of PA with MetS.

RESULTS

Vigorous PA, moderate-vigorous PA, number of bouts per day in 10 min (N10), and total time in bouts per day in 10 min (T10) were negatively associated with MetS in male children and adolescents at cross-sectional level (β ranging from -0.005 to -0.164, all p < 0.05). Total time in bouts per day in 20 min in male children, and vigorous PA and N10 in female children were longitudinally and negatively associated with MetS (β ranging from -0.011 to -0.247, all p < 0.05).

CONCLUSIONS

Associations of PA and MetS were observed at cross-sectional level in males and longitudinally in female children. The associations in PA patterns were found when patterns were grouped into bouts of 10 min. Therefore, for future studies of PA with health markers in the pediatric population, it would be advisable to choose bouts of shorter duration.

Fatigue and Physical Activity Patterns in Children With Inflammatory Bowel Disease

OBJECTIVES

Fatigue is a common symptom in children with inflammatory bowel disease (IBD). Diagnostic tests to evaluate biological causes of fatigue commonly include markers of inflammation and hemoglobin (Hb), yet functional parameters have been inadequately studied in pediatric IBD. In this study, we compared fatigued and non-fatigued children with IBD from both a biological and functional point of view.

METHODS

A cross-sectional study of 104 pediatric IBD patients with mild to moderately active IBD was conducted. Fatigued children were defined as those with a Pediatric Quality of Life Inventory Multidimensional Fatigue Scale z score <-2.0. Non-fatigued children had a z score ≥-2.0. Disease-specific quality of life (measured with IMPACT-III score), C-reactive protein (CRP), fecal calprotectin (FC), hemoglobin z score (Hb z score), and physical activity tests including 6-minute walking distance z score (6MWD z score) and triaxial accelerometry (TA) were evaluated.

RESULTS

Fatigued children (n = 24) had a significant lower IMPACT-III score than non-fatigued children (n = 80). Hb z scores, CRP, FC, and 6MWD z scores were not significantly different between groups. TA was performed in 71 patients. Wear time validation requirements were met in only 31 patients. Fatigued patients spent significant shorter median time in moderate-to-vigorous activity than non-fatigued patients (18.3 vs 37.3 minutes per day, P = 0.008).

CONCLUSION

Biological parameters did not discriminate fatigued from non-fatigued patients. TA possibly distinguishes fatigued from non-fatigued patients; the potential association may provide a target for interventions to combat fatigue and improve quality of life.

Physical activity and physical fitness among children and adolescents after the onset of the COVID-19 pandemic in the WHO European Region: a systematic review protocol

INTRODUCTION

The implementation of COVID-19 pandemic-related restrictions resulted in limitations for physical activity (PA) opportunities, which may have initiated a longer-term behavioural change. The protocol describes the methodology for a planned systematic review that aims to summarise changes in PA and physical fitness (PF) in children and adolescents in the WHO European Region after the onset of the COVID-19 pandemic.

METHODS AND ANALYSIS

The protocol adheres to the 'Preferred Reporting Items for Systematic Review and Meta-Analysis for Protocols' (PRISMA-P) statement. Using a peer-reviewed search strategy according to the evidence-based checklist 'Peer Review of Electronic Search Strategies' (PRESS), we will perform a systematic literature search in seven databases. Inclusion criteria are all primary studies that gathered data on children and adolescents ≤19 years living in the WHO European Region and made a comparison to pre-pandemic data. Primary outcomes are PA and PF. We will assess the risk of bias with the 'Risk of Bias Instrument for Non-Randomized Studies of Exposures' (ROBINS-E). The 'Grading of Recommendations Assessment, Development and Evaluation' (GRADE) approach will be used for the evaluation of the certainty of evidence. Also, subgroup analyses will be performed (eg, for gender, age, stringency of pandemic restrictions).

ETHICS AND DISSEMINATION

Ethical approval is not required, as primary data will not be collected in this study. The results will be presented in a peer-reviewed publication and at congresses relevant to the research field.

PROSPERO REGISTRATION NUMBER

CRD42023395871.

Metabolic syndrome criteria and severity and carbon dioxide (CO2) emissions in an adult population

BACKGROUND

Metabolic syndrome (MetS) has become a growing risk factor of some non-communicable diseases. Increase of greenhouse gas emissions affects the planet.

AIMS

To assess the association between MetS severity and amount of carbon dioxide (CO₂) emitted in an adult population.

DESIGN

Cross-sectional study (n = 6646; 55-76-year-old-men; 60-75-year-old-women with MetS).

METHODS

Dietary habits were assessed using a pre-validated semi quantitative 143-item food frequency questionnaire. The amount of CO₂ emitted due to the production of food consumed by person and day was calculated using a European database, and the severity of the MetS was calculated with the MetS Severity Score.

RESULTS

Higher glycaemia levels were found in people with higher CO₂ emissions. The risk of having high severe MetS was related to high CO₂ emissions.

CONCLUSIONS

Low CO₂ emissions diet would help to reduce MetS severity. Advantages for both health and the environment were found following a more sustainable diet.

TRIAL REGISTRATION

ISRCTN, ISRCTN89898870 . Registered 05 September 2013.

Participating in a School-Integrated Daily Exercise Program Improves Motor Performance Significantly in School-Children

Children's sedentary time has increased, while daily physical activity and motor performance have decreased. We evaluated an integrated school-based exercise program by assessing changes in motor skills after one year and comparing these changes to children who did not participate. We included 303 children from five schools in this longitudinal study and assigned them either to the exercise group (EG; n = 183 with daily exercise program) or the waiting group (WG; n = 120). Motor skills were assessed at baseline and after one year. Mixed modeling was used to analyze inter-group differences of change in motor skills and to determine the effect of sex, age group, and weight status. EG improved more strongly than WG for sprint, side jumps (both p = 0.017), stand and reach (p = 0.012), and ergometry (p ≤ 0.001) when compared to WG. Girls improved more strongly in the sit-ups than boys, second graders more than fifth graders in the backwards balance and the ergometry, and non-overweight children more in the standing long jump than overweight children. The exercise program is effective in increasing motor skills and physical fitness. Girls were not disadvantaged, and overweight children profited as much as their non-overweight peers in all categories but one.

Heart Disease and Stroke Statistics-2023 Update: A Report From the American Heart Association

BACKGROUND

The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs).

METHODS

The American Heart Association, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2023 Statistical Update is the product of a full year's worth of effort in 2022 by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. The American Heart Association strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year's edition includes additional COVID-19 (coronavirus disease 2019) publications, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains.

RESULTS

Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics.

CONCLUSIONS

The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.

Sedentary Behavior, Dietary Habits, and Cardiometabolic Risk in Physically Active Children and Adolescents

BACKGROUND

Sedentary behavior has been associated with several cardiometabolic risk factors during childhood. However, little is known about the impact of sedentary behavior on the health and eating habits of physically active children and adolescents.

OBJECTIVE

To evaluate the association between sedentary behavior and cardiometabolic risk factors and eating habits in physically active children and adolescents.

METHODS

This cross-sectional study was conducted, including 516 physically active children and adolescents (10 to 18 years old; both sexes) enrolled in the social project "Estação Conhecimento-Vale" were evaluated. Biochemical and lifestyle variables (questionnaire) were collected. Sedentary behavior was determined indirectly (questionnaire), by using sitting time ≥ 3 hours per day as a cutoff point. A p-value < 0.05 was considered statistically significant for all tests.

RESULTS

Sedentary behavior was not associated with overweight/obesity (odds ratio = 0.72 [95% confidence interval (CI): 0.325-1.389]), hypertriglyceridemia (odds ratio = 0.63 [95% CI: 0.306-1.297]), low HDL cholesterol (odds ratio = 0.57 [95% CI: 0.323-1.019]), or high non-HDL cholesterol (odds ratio = 0.63 [95% CI: 0.283-1.389]). However, children and adolescents with sedentary behavior were more likely to regularly consume food in front of the television (odds ratio = 1.96 [95% CI: 1.114-3.456]) and to consume at least one ultra-processed food per day (odds ratio = 2.42 [95% CI: 1.381-4.241]). In addition, they were less likely to consume fruit regularly (odds ratio = 0.52 [95% CI: 0.278-0.967]).

CONCLUSION

There was no association between sedentary behavior and cardiometabolic risk factors in physically active children and adolescents. However, sedentary behavior was associated with inadequate eating habits. Thus, we may suggest that the regular engagement in physical activity may attenuate the deleterious effects of sedentary behavior on the cardiometabolic parameters of children and adolescents.

Active school commuting in adolescents from 28 countries across Africa, the Americas, and Asia: a temporal trends study

BACKGROUND

Evidence examining trends in active school commuting among adolescents are mainly single-country studies, and principally focused on high-income countries. Thus, the present study aims to examine temporal trends in adolescents' active school commuting and to examine if there are differences in such trends by sex. We used nationally representative samples of 28 countries, which were predominantly low- and middle-income countries (LMICs), covering 5 different WHO regions.

METHODS

Data from the Global School-based Student Health Survey 2004-2017 were analyzed in 177,616 adolescents [mean (SD) age: 13.7 (1.0) years; 50.7% girls]. Active school commuting was self-reported (frequency of walking or riding a bike to and from school in the past 7 days). The prevalence and 95%CI of active school commuting (i.e., ≥ 3 days/week) was calculated for the overall sample and by sex for each survey. Crude linear trends in active school commuting were assessed by linear regression models. Interaction analyses were conducted to examine differing trends among boys and girls.

RESULTS

Trends in active school commuting were heterogeneous across countries, with results showing stable patterns for the majority (16/28), decreasing trends for some (7/28) and increasing trends over time for a few (5/28). The majority of countries showed no differences in active school commuting trends between girls and boys.

CONCLUSIONS

The quantification of changes in adolescents' active school commuting over time, together with a deeper understanding of local determinants for such behaviors will provide valuable evidence to inform the development of tailored and context-specific actions.

Effects of interrupting daily sedentary behavior on children's glucose metabolism: A 6-day randomized controlled trial

BACKGROUND

Metabolic disease risk in youth is influenced by sedentary behaviors. Acute in-lab studies show that, during a single day, interrupting a sedentary period with short bouts of physical activity improves glucometabolic outcomes.

OBJECTIVE

To determine if acutely improved glucose metabolism persists after multi-day interruptions of sitting with walking brief bouts. We hypothesized that children who underwent interrupting sitting on multiple days would demonstrate lower insulin area under the curve during an oral glucose tolerance test compared to uninterrupted sitting.

METHODS

Healthy, normoglycemic children (N = 109) ages 7-11 years were randomized to one of two conditions: Control (3 h of daily Uninterrupted Sitting) or Interrupted Sitting (3-min of moderate-intensity walking every 30 min for 3 h daily); with dietary intake controlled through provision of foodstuffs for the entire experiment. Participants attended six consecutive daily visits at a research ambulatory unit. The primary outcome was insulin area under the curve during the oral glucose tolerance test on day 6 during interrupted or uninterrupted sitting; secondary outcomes included glucose and c-peptide area under the curve, energy intake at a buffet meal on day 6, and free-living activity.

RESULTS

Among 93 children (42 uninterrupted sitting, 51 interrupted sitting), daily interrupted sitting resulted in 21% lower insulin (β = 0.102 CI:0.032-0.172, p = 0.005) and a 10% lower C-peptide (β = 0.043, CI:0.001-0.084, p = 0.045) area under the curve. Matsuda and Glucose Effectiveness Indices were also improved (p's < 0.05). There were no group differences in energy intake or expenditure.

CONCLUSIONS

Sustained behavioral change by interrupting sedentary behaviors is a promising intervention strategy for improving metabolic risk in children.

Development of the Children and Adolescents Physical Activity and Sedentary Questionnaire (CAPAS-Q): Psychometric Validity and Clinical Interpretation

BACKGROUND

Pediatricians' clinical practice and health interventions in youths require instruments with adequate psychometric properties to assess physical activity (PA), sedentary behaviors (SB), and their subdomains.

OBJECTIVE

To assess the psychometric properties of the Children and Adolescents Physical Activity and Sedentary-Questionnaire (CAPAS-Q) in healthy French children and adolescents.

METHODS

The CAPAS-Q has been developed through a rigorous collective procedure and consists of a 31 items self-administered questionnaire evaluating children's 7-day PA and SB dimensions and subdomains. Participants (n = 103, aged 8-18 years old) completed the questionnaire twice (7 days apart) and wore an ActiGraph GT3X&nbsp;+ accelerometer for 7 days. Anthropometric measurements and body composition were assessed.

RESULTS

Cronbach alpha for PA and SB dimensions were 0.71 and 0.68, respectively. Reproducibility was found moderate to good, with Lin's coefficients of 0.69 and 0.68 for PA and SB dimensions, respectively. Reproducibility was higher for adolescents compared to children. PA dimension was positively correlated with moderate PA, vigorous PA, moderate to vigorous PA, and total PA times and negatively correlated with SB time (p < 0.05). SB dimension and screen time were positively correlated with SB time and negatively correlated with LPA, MPA, MVPA, and total PA times (p < 0.05). Spearman correlation coefficients were fair to moderate, ranging between 0.23-0.45.

CONCLUSION

The CAPAS-Q proposes a reliable and valid evaluation of French children and adolescents' PA and SB, providing clinicians with potential intervention levels to improve youth movement behaviors.

A direct observation tool to measure interactions between shade, nature, and children's physical activity: SOPLAY-SN

BACKGROUND

Most physical activity (PA) during school occurs at recess; however, recess PA may be influenced by children's thermal comfort and interaction with nature, neither of which have concurrently been measured reliably in previous studies. This study tests the reliability of SOPLAY-SN, an adaption of the validated System for Observing Play and Leisure Activity in Youth (SOPLAY) to measure Shade and Nature (SN) alongside PA, and associations between children's PA and interaction with shade and nature during recess to highlight the utility of the tool.

METHODS

Interactions with shade and nature were measured using systematic direct observation at two playgrounds (primary-grade = ages 5-8, upper-grade = ages 9-12) during recess at an elementary school in Phoenix, Arizona (USA). Pairs conducted observations over four warm days (primary = 29-34 °C, upper-grade = 32-36 °C) in May 2021 (N = 179 scans). Intraclass correlation coefficients (ICC) were used to calculate inter-rater reliability. Mean counts, frequencies, and Kendall rank correlation coefficient tests were used to assess relations between PA level and interactions with shade and nature.

RESULTS

Reliability was good for sedentary behavior (ICC = 0.98); light PA (LPA; ICC = 0.80) and moderate-to-vigorous PA (MVPA; ICC = 0.94); shade interaction (ICC = 0.95); and nature interaction (ICC = 0.80) and average agreement was good (86% overall PA, 88% shade, 90% nature). Most (60%) primary-grade children were observed in the shade, with 64% under a covered play structure where children were mainly (47%) sedentary. Of the 11% of primary-grade students observed interacting with nature, 90% occurred in a grass field with trees. Among upper-grade children, 23% were observed in the shade with 53% in grass fields where 48% of play was light. Few (7%) upper-grade children were observed interacting with nature, with most instances (76%) in a grass field with trees. Among primary-grade children, shade was correlated with sedentary behavior (τ_b = 0.63, p < .05); LPA (τ_b = 0.39, p < .05); MVPA (τ_b = 0.56, p < .05); and nature interactions with sedentary behavior (τ_b = 0.16, p < .05). Among upper-grade children, shade was correlated with sedentary behavior (τ_b = 0.27, p < .05) and LPA (τ_b = 0.21, p < .05).

CONCLUSIONS

SOPLAY-SN is a reliable tool for measuring children's interaction with shade and nature and participation in PA. Understanding how shade and nature impact movement during recess can inform playground design for children's health and well-being.

Acculturation, Physical Activity, and Metabolic Syndrome in Asian American Adults

INTRODUCTION

Asian Americans (AsAms) have a high prevalence of metabolic syndrome (MetS) and are one of the least physically active racial groups in America. The purpose of this study was to examine the relationship between MetS and moderate-to-vigorous physical activity (MVPA) among AsAm adults and whether acculturation modifies this relationship.

METHOD

Data were from 2,259 AsAms participating in the 2011-2016 National Health and Nutrition Examination Survey. Physical activity (PA) was self-reported as minutes of weekly MVPA. Acculturation included nativity, length of residency in America, and language preference. The International Diabetes Federation criteria was used to determine the presence of MetS.

RESULTS

About 64.4% of AsAms did not meet the PA recommendation (MVPA ≥150 min/week). The prevalence of MetS was 39.2%. The odds of having MetS were greater among AsAms who did not meet MVPA recommendations compared with those who did meet MVPA recommendations (odds ratio [OR] = 1.5, 95% confidence interval [CI] = [1.11, 2.07]). When stratified by acculturation, this association remained statistically significant in the groups who immigrated to America more than 15 years ago and who spoke English only.

CONCLUSION

MVPA reduces MetS risk in AsAm adults, especially among more acculturated AsAms. Culturally adapted programs are warranted to promote PA and adequate knowledge of disease prevention in this population.

Association between alanine aminotransferase as surrogate of fatty liver disease and physical activity and sedentary time in adolescents with obesity

To compare patterns of sedentary (SED) time (more sedentary, SED + vs less sedentary, SED-), moderate to vigorous physical activity (MVPA) time (more active, MVPA + vs less active, MVPA-), and combinations of behaviors (SED-/MVPA + , SED-/MVPA-, SED + /MVPA + , SED + /MVPA-) regarding nonalcoholic fatty liver diseases (NAFLD) markers. This cross-sectional study included 134 subjects (13.4 ± 2.2 years, body mass index (BMI) 98.9 ± 0.7 percentile, 48.5% females) who underwent 24-h/7-day accelerometry, anthropometric, and biochemical markers (alanine aminotransferase (ALT) as first criterion, and aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), AST/ALT ratio as secondary criteria). A subgroup of 39 patients underwent magnetic resonance imaging-liver fat content (MRI-LFC). Hepatic health was better in SED- (lower ALT, GGT, and MRI-LFC (p < 0.05), higher AST/ALT (p < 0.01)) vs SED + and in MVPA + (lower ALT (p < 0.05), higher AST/ALT (p < 0.01)) vs MVPA- groups after adjustment for age, gender, and Tanner stages. SED-/MVPA + group had the best hepatic health. SED-/MVPA- group had lower ALT and GGT and higher AST/ALT (p < 0.05) in comparison with SED + /MVPA + group independently of BMI. SED time was positively associated with biochemical (high ALT, low AST/ALT ratio) and imaging (high MRI-LFC) markers independently of MVPA. MVPA time was associated with biochemical markers (low ALT, high AST/ALT) but these associations were no longer significant after adjustment for SED time.

CONCLUSION

Lower SED time is associated with better hepatic health independently of MVPA. Reducing SED time might be a first step in the management of pediatric obesity NAFLD when increasing MVPA is not possible.

WHAT IS KNOWN

• MVPA and SED times are associated with cardiometabolic risks in youths with obesity. • The relationships between NAFLD markers and concomitant MVPA and SED times have not been studied in this population.

WHAT IS NEW

• Low SED time is associated with healthier liver enzyme profiles and LFC independent of MVPA. • While low SED/high MVPA is the more desirable pattern, low SED/low MVPA pattern would have healthier liver enzyme profile compared with high MVPA/high SED, independent of BMI, suggesting that reducing SED time irrespective of MVPA is needed to optimize liver health.

Influence of Maternal Exercise on Glucose and Lipid Metabolism in Offspring Stem Cells: ENHANCED by Mom

CONTEXT

Recent preclinical data suggest exercise during pregnancy can improve the metabolic phenotype not only of the mother, but of the developing offspring as well. However, investigations in human offspring are lacking.

OBJECTIVE

To characterize the effect of maternal aerobic exercise on the metabolic phenotype of the offspring's mesenchymal stem cells (MSCs).

DESIGN

Randomized controlled trial.

SETTING

Clinical research facility.

PATIENTS

Healthy female adults between 18 and 35 years of age and ≤ 16 weeks' gestation.

INTERVENTION

Mothers were randomized into 1 of 2 groups: aerobic exercise (AE, n = 10) or nonexercise control (CTRL, n = 10). The AE group completed 150 minutes of weekly moderate-intensity exercise, according to American College of Sports Medicine guidelines, during pregnancy, whereas controls attended stretching sessions.

MAIN OUTCOME MEASURES

Following delivery, MSCs were isolated from the umbilical cord of the offspring and metabolic tracer and immunoblotting experiments were completed in the undifferentiated (D0) or myogenically differentiated (D21) state.

RESULTS

AE-MSCs at D0 had an elevated fold-change over basal in insulin-stimulated glycogen synthesis and reduced nonoxidized glucose metabolite (NOGM) production (P ≤ 0.05). At D21, AE-MSCs had a significant elevation in glucose partitioning toward oxidation (oxidation/NOGM ratio) compared with CTRL (P ≤ 0.05). Immunoblot analysis revealed elevated complex I expression in the AE-MSCs at D21 (P ≤ 0.05). Basal and palmitate-stimulated lipid metabolism was similar between groups at D0 and D21.

CONCLUSIONS

These data provide evidence of a programmed metabolic phenotype in human offspring with maternal AE during pregnancy.

Sedentary time has a stronger impact on metabolic health than moderate to vigorous physical activity in adolescents with obesity: a cross-sectional analysis of the Beta-JUDO study

BACKGROUND

Relationships between movement-related behaviours and metabolic health remain underexplored in adolescents with obesity.

OBJECTIVES

To compare profiles of sedentary time (more sedentary, SED+ vs. less sedentary, SED-), moderate to vigorous physical activity (MVPA) time (more active, MVPA+ vs. less active, MVPA-) and combinations of behaviours (SED-/MVPA+, SED-/MVPA-, SED+/MVPA+, SED+/MVPA-) in regard to metabolic health.

METHODS

One hundred and thirty-four subjects (mean age 13.4 ± 2.2 yrs, mean body mass index [BMI] 98.9 ± 0.7 percentile, 48.5% females) underwent 24 h/7 day accelerometry, anthropometric, body composition, blood pressure (BP), lipid profile and insulin resistance (IR) assessments.

RESULTS

Metabolic health was better in SED- [lower fat mass (FM) percentage (p < 0.05), blood pressure (BP) (p < 0.05), homeostasis model assessment of insulin resistance (HOMA-IR) (p < 0.001) and metabolic syndrome risk score (MetScore) (p < 0.001), higher high-density lipoprotein-cholesterol (HDL-c) (p = 0.001)] vs. SED+ group and in MVPA+ [lower triglyceridemia (TG), (p < 0.05), HOMA-IR (p < 0.01) and MetScore (p < 0.001), higher HDL-c (p < 0.01)] vs. MVPA- group after adjustment with age, gender, maturation and BMI. SED-/MVPA+ group had the best metabolic health. While sedentary (p < 0.001) but also MVPA times (p < 0.001) were lower in SED-/MVPA- vs. SED+/MVPA+, SED-/MVPA- had lower FM percentage (p < 0.05), HOMA-IR (p < 0.01) and MetScore (p < 0.05) and higher HDL-c (p < 0.05), independently of BMI. Sedentary time was positively correlated with HOMA-IR and Metscore and negatively correlated with HDL-c after adjustment with MVPA (p < 0.05). MVPA was negatively correlated with HOMA-IR, BP and MetScore and positively correlated with HDL-c after adjustment with sedentary time (p < 0.05).

CONCLUSION

Lower sedentary time is associated with a better metabolic health independently of MVPA and might be a first step in the management of pediatric obesity when increasing MVPA is not possible.

Associations between children's physical literacy and well-being: is physical activity a mediator?

Background

Physical literacy (PL) is a multi-dimensional concept that provides a holistic understanding of movement and physical activity. PL contains an affective, a physical, and a cognitive domain, which together lay the foundation for the individual’s capacity and the tendency for participating in physical activities currently and throughout life. PL is increasingly regarded as a ‘cause of the causes’ to health promotion. Cross-sectional studies have shown associations between children’s PL, physical activity behaviours, and well-being. This study aims to examine the associations between Danish children’s PL and their physical and psychosocial well-being and whether the associations are mediated by moderate- to vigorous intensity physical activity (MVPA).

Methods

Cross-sectional data from Danish schoolchildren aged 7–13 years were collected in Jan-Dec 2020 in the Danish Assessment of Physical Literacy (DAPL) project. PL was assessed with the DAPL which measures the affective, cognitive, and physical domains of PL. MVPA (min/day) was measured with accelerometers (Axivity), psychosocial well-being was measured with The Strengths and Difficulties Questionnaire, and physical well-being was measured with the KIDSCREEN questionnaire. Structural equation models were constructed with PL and MVPA as predictors of physical well-being and four aspects of psychosocial well-being.

Results

A positive moderate association between PL and physical well-being, partly mediated by MVPA was observed. PL was positively associated with the positive aspects of psychosocial well-being and negatively associated with the negative aspects (behaviour problems). None of the associations between PL and aspects of psychosocial well-being were mediated by MVPA.

Conclusions

The study contributes to evidence on the link between PL, physical activity, and health outcomes. The study found beneficial relations between PL and physical and psychosocial well-being. MVPA mediated part of the relationship between PL and physical well-being but not psychosocial well-being.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13517-x.

Dietary inflammatory index and metabolic syndrome in US children and adolescents: evidence from NHANES 2001-2018

Background

An increasing number of children and adolescents are affected by metabolic syndrome (MetS). Dietary inflammatory index (DII) was associated with MetS in adult population. This study aimed to determine the associations between DII scores, MetS, and MetS components among children and adolescents.

Methods

Data of children and adolescents in the National Health and Nutrition Examination Survey (NHANES) database 2001–2008 were obtained. DII was calculated for each participant based on the 24-h dietary recall interview. Univariate and multivariate logistic regression were conducted to determine the associations between DII, the other study variables and abnormal MetS components.

Results

A total of 5,656 US children and adolescents (mean age = 15.49) in the 2001–2018 NHANES database were included. After adjusting for all confounders in the multivariate analysis, the top DII quartile was significantly and independently associated with increased odds of high blood pressure (BP) (aOR = 2.27, 95% CI: 1.02–5.07) as compared with the lowest DII quartile. DII in quartile 2, 3 or 4 were not significantly associated with increased odds of MetS, high waist circumference (WC), low high density lipoprotein-cholesterol (HDL-c), triglyceride (TG) or fasting plasma glucose (FPG) as compared with the lowest quartile. In stratified analysis by recommended physical activity level for children and adolescents, no significant association was observed between higher DII and MetS.

Conclusions

Among US children and adolescents, high DII is associated with prevalent high BP but not MetS. The finding may contribute to future policymaking in promoting children’s health.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12986-022-00673-5.

Metabolic syndrome: Operational definitions and aerobic and resistance training benefits on physical and metabolic health in children and adolescents

BACKGROUND

The variation in parameters for childhood metabolic syndrome (MetS) has hindered the development of a consensus for the diagnostic criteria in this group. Despite these inconsistencies, it is accepted that exercise can ameliorate the deleterious effects of MetS. However, direct comparison between aerobic versus resistance exercise on MetS symptomology in adolescents is lacking.

AIM

Aim of this review was to discuss controversies associated with current MetS operation definitions in adolescents and present a review summarizing longitudinal studies relevant to the influence of aerobic and resistance training on children with MetS.

METHODS

Reviews of PubMed and Web of Science were conducted to identify literature focusing on the influence of aerobic and resistance training on children with MetS. Selected manuscripts featured longitudinal research only.

RESULTS

A universally accepted definition of MetS for the pediatric population has yet to be established. As such, consensus regarding diagnostic criteria for MetS among children is lacking despite the presence of various descriptions in the literature. Though studies support the importance of aerobic and resistance exercise to combat comorbidities associated with MetS, longitudinal studies investigating the benefits of each exercise type among adolescents are limited and inconsistent.

CONCLUSION

An improved understanding of the impact of aerobic and resistance training on children with MetS is clinically relevant because it may facilitate more appropriate exercise recommendations for children with MetS. Additional large cohort studies are warranted to determine optimal exercise type.

Joint associations of physical activity and sedentary time with adiposity during adolescence: ALSPAC

BACKGROUND

In developing evidence-based physical activity (PA) guidelines for youth, a knowledge gap exists regarding the health effects of sedentary time (SED). The aim of this study was to determine the joint associations of moderate- and vigorous-intensity PA (MVPA) and SED with adiposity during adolescence.

METHODS

The study sample was 2619 non-obese participants (56.7% female) from the UK Avon Longitudinal Study of Parents and Children. Accelerometer-measured MVPA and SED at age 11, 13, 15 years and self-reported TV viewing at age 13 and 16 years were used to create two exposure variables: six MVPA&SED combinations based on two MVPA patterns [≥60 (active) and <60 min/day (inactive)] and three SED patterns [≈25 (low), ≈30 (middle) and ≈35 min/h (high)] and six MVPA&TV combinations based on two MVPA patterns and three TV viewing patterns [<1-2 (low), 1-2 (middle) and >1-2 h/day (high)]. Adiposity was evaluated using fat mass index (FMI) at age 17 years.

RESULTS

SED was not significantly associated with FMI in either active or inactive adolescents. However, higher TV viewing was associated with higher FMI in both active [adjusted FMI = 4.53 vs. 5.09 (95% CI = 4.87, 5.33) for low TV vs. high TV] and inactive adolescents [adjusted FMI = 4.91 vs. 5.21 (95% CI = 5.02, 5.39) for low TV vs. high TV].

CONCLUSIONS

Higher TV viewing time, but not total SED, was prospectively associated with higher adiposity among both active and inactive adolescents, suggesting a specific sedentary behavior target for public health.

Childhood obesity prevention: what can be achieved?

PURPOSE OF REVIEW

Childhood obesity is a pandemic generating an enormous individual and socioeconomic burden worldwide. This narrative review summarizes recent evidence on successful and recommended prevention strategies according to age groups and different levels of interventions.

RECENT FINDINGS

Effective prevention of childhood obesity is feasible and most successful early in life up to preschool age, and it should include a multicomponent approach, integrating individuals, family and society. Trials that improve nutrition and/or enhance physical activity are the cornerstones of childhood obesity prevention on an individual level. However, their efficacy is determined by the combination of interventions for the target age group. Further, improving family support and sleep, as well as reducing screen time, lead to favourable results. Many research gaps remain, including a lack of effective interventions for high-risk groups.

SUMMARY

As a multifactorial condition, childhood obesity requires a multicomponent approach. Interventions should be developmental stage-specific and adjusted to the setting. Current research gaps need to be targeted by future trials, with a special focus on the benefit of the most vulnerable groups. From a systems response perspective, a paradigm shift from interventions focusing on the individual to approaches that target society as a whole is warranted.

What is the role of cardiorespiratory fitness and sedentary behavior in relationship between the genetic predisposition to obesity and cardiometabolic risk score?

Background

Genetic factors along with inadequate lifestyle habits are associated with the development of cardiometabolic alterations. Thus, the present study aimed to examine the role of sedentary behavior on the relationship between rs9939609 polymorphism (fat mass and obesity-associated gene-FTO) and cardiometabolic risk score according to cardiorespiratory fitness (CRF) levels in children and adolescents.

Methods

A cross-sectional study with 1215 children and adolescents (692 girls), aged between 6 and 17 years. Screen time as a marker of sedentary behavior was evaluated through a self-reported questionnaire and CRF was estimated using the 6-min walking and running test. The genotyping of the FTO rs9939609 polymorphism was performed using a real-time polymerase chain reaction. Clustered cardiometabolic risk score (cMetS) was calculated by summing z-scores of total cholesterol/high-density lipoprotein cholesterol ratio, triglycerides, glucose, systolic blood pressure, and waist circumference, and dividing it by five. Moderation analyses were tested using multiple linear regression models.

Results

The coefficient of the interaction term of FTO (rs9939609) and screen time indicated that screen time was a significant moderator on the relationship between FTO rs9939609 polymorphism and cMetS (p = 0.047) in children and adolescents classified with low CRF (β = 0.001; 95% CI = 0.001; 0.002). It was observed a significant association between genotype risk (AA) of FTO polymorphism and cMetS, in participants that spent more than 378 min a day in front of screen-based devices (β = 0.203; 95% CI = 0.000; 0.405). No interaction term was found for those with high CRF.

Conclusions

High sedentary behavior seems to influence the relationship between genetic predisposition to obesity and cardiometabolic risk factors in children and adolescents with low CRF.

Effects of Movement Behaviors on Overall Health and Appetite Control: Current Evidence and Perspectives in Children and Adolescents

PURPOSE OF REVIEW

To present the definitions and recommendations for movement behaviors in children and adolescents, including physical activity (PA), sedentary behaviors (SB), and sleep, and to provide an overview regarding their impact on health and obesity outcomes from childhood to adulthood, as well as interactions with appetite control.

RECENT FINDINGS

PA represents a variable proportion of daily energy expenditure and one can be active with high SB or vice versa. Studies have described movements across the whole day on a continuum from sleep to SB to varying intensities of PA. More PA, less SB (e.g., less screen time) and longer sleep are positively associated with indicators of physical health (e.g., lower BMI, adiposity, cardiometabolic risk) and cognitive development (e.g., motor skills, academic achievement). However, less than 10% of children currently meet recommendations for all three movement behaviors. Movement behaviors, adiposity, and related cardiometabolic diseases in childhood track into adolescence and adulthood. Furthermore, low PA/high SB profiles are associated with increased energy intake. Recent studies investigating energy balance regulation showed that desirable movement behavior profiles are associated with better appetite control and improved eating habits. Early identification of behavioral phenotypes and a comprehensive approach addressing all key behaviors that directly affect energy balance will allow for individual strategies to prevent or treat obesity and its comorbidities. Investigating exercise as a potential "corrector" of impaired appetite control offers a promising weight management approach.

Heart Disease and Stroke Statistics-2022 Update: A Report From the American Heart Association

BACKGROUND

The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs).

METHODS

The American Heart Association, through its Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update. The 2022 Statistical Update is the product of a full year's worth of effort by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. This year's edition includes data on the monitoring and benefits of cardiovascular health in the population and an enhanced focus on social determinants of health, adverse pregnancy outcomes, vascular contributions to brain health, and the global burden of cardiovascular disease and healthy life expectancy.

RESULTS

Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics.

CONCLUSIONS

The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.

Differences in Physical Fitness and Body Composition Between Active and Sedentary Adolescents: A Systematic Review and Meta-Analysis

Previous research analyzing the differences in physical fitness and body composition between active and sedentary adolescents aged 12-16 has not provided conclusive results. For this reason, a systematic review with meta-analysis was conducted to provide an overview of the results obtained to date. The objectives of this systematic review and meta-analysis were to investigate the differences in the physical fitness and body composition of adolescents who engaged in daily physical activity and those who were inactive. A search in PubMed, EBSCO, and Web of Sciences databases was performed. A total of 13,884 articles were reviewed and 11 were included in the meta-analysis. In the physical fitness performance, significantly higher values in cardiorespiratory fitness, hamstring and lower back flexibility, sit-ups and upper limb resistance were found in active compared to the inactive participants. In body composition, the inactive group showed significantly higher values in variables related to body fat, mainly in body fat percentage, fat mass and fat mass index compared to the active group. The results revealed that maintaining an active lifestyle through physical activity is a determining factor in improving the physical fitness and body composition of adolescents aged 12-16 years. The study design of the systematic review was previously registered in PROSPERO with code CRD42021241975. https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=241975 .

Research on User Experience of Sports Smart Bracelet Based on Fuzzy Comprehensive Appraisal and SSA-BP Neural Network

Due to the marked increase in the prevalence of overweight and obesity worldwide and an environment leading to a series of chronic diseases, physical exercise is an important way to prevent chronic diseases. Additionally, a good exercise smart bracelet can bring convenience to physical exercise. Quick and accurate evaluation of smart sports bracelets has become a hot topic and draws attention from both academic researchers and public society. In the literature, the analytic hierarchy process (AHP) and entropy weight method (EWM) were used to obtain the weights from both subjective and objective perspectives, which were integrated by the comprehensive weighting method, and furthermore the performance of sports smart bracelet was evaluated through fuzzy comprehensive evaluation. Also, to avoid complex weight calculations caused by the comprehensive weighting method, machine learning methods are used to model the structure and contribute to the comprehensive evaluation process. However, few studies have investigated all previous elements in the comprehensive evaluation process. In this study, we consider all previous parts when evaluating smart sports bracelets. In particular, we use the sparrow search algorithm (SSA) to optimize the backpropagation (BP) neural network for constructing the comprehensive score prediction model of the sports smart bracelet. Results show that the sparrow search algorithm-optimized backpropagation (SSA-BP) neural network model has good predictive ability and can quickly obtain evaluation results on the premise of effectively ensuring the accuracy of the evaluation results.

Device-measured physical activity and cardiovascular disease risk in adolescent childhood cancer survivors. A physical activity in childhood cancer survivors (PACCS) study

OBJECTIVES

We aimed to compare cardiovascular disease (CVD) risk factors in childhood cancer survivors (CCS) with age- and sex-stratified reference material and examine the association between physical activity (PA) intensities and CVD risk factors in CCS.

MATERIALS AND METHODS

Within the cross-sectional, multicenter Physical Activity in Childhood Cancer Survivors (PACCS) study, we collected data on CVD risk factors [VO_2-peak (mL⋅kg^-1⋅min^-1), body mass index (BMI, kg/m²), systolic blood pressure (SBP, mmHg), and total-cholesterol/HDL-cholesterol (Total/HDL)] among CCS aged 9-18 years. CVD risk factors were compared to references with immediate t-tests. We transformed CVD risk factors into z-scores based on international references and generated an individual CVD risk score: [inverse ZVO_2-peak + Z _BMI + Z _SBP + Z _Total/HDL )/4]. Multivariable mixed linear regression models were used to analyze the associations between device-measured PA intensities and CVD risk factors.

RESULTS

We included 157 CCS aged on average 13.4 years at inclusion and 8.2 years from diagnosis. Male CCS had lower VO_2-peak compared to references (45.4 vs. 49.4 mL⋅kg^-1⋅min^-1, P = 0.001), higher diastolic BP (67 vs. 63 mmHg, P < 0.001), lower HDL (1.35 vs. 1.44 mmol/L, P = 0.012), as well as a tendency to higher CVD risk score (z-score=0.14 vs. 0.00, P = .075). Female CCS' CVD risk factors were comparable to references. Vigorous-intensity PA (VPA) was associated with CVD risk factors. A 10-min increase in VPA was associated with higher VO_2-peak (β = 4.9, 95% CI, 2.1-7.7), lower Total/HDL (β = -0.3, 95% CI, -0.6 to -0.1) and a lower CVD risk score (β = -0.4, 95% CI, -0.6 to -0.2).

CONCLUSION

Male adolescent CCS had less favorable values of CVD risk factors compared to references. VPA in adolescent CCS is associated with clinically meaningful favorable values of CVD risk factors.

Study on Dynamic Progression and Risk Assessment of Metabolic Syndrome Based on Multi-State Markov Model

AIM

Metabolic syndrome (MetS) coexists with the occurrence and even death of cardiovascular disease and diabetes mellitus. It is essential to study the factors in the dynamic progression of MetS in the interest of prevention and control.

PURPOSE

The aim of this study was to analyze the dynamic progression of Mets and explore the potential factors influencing the progression or reversal of MetS.

PATIENTS AND METHODS

This study involved 5581 individuals from two waves of the China Health and Retirement Longitudinal Study: 2011 and 2015. A multistate Markov model containing 4 states (free of metabolic disorder (FMD), mild metabolic disorder (MMD), severe metabolic disorder (SMD) and MetS) was adopted to study the dynamic progression of MetS and its influencing factors.

RESULTS

After follow-up, a total of 2862 cases (50.28% of the total number) had disease state transition. The intensity of transition from MetS to SMD is the same as that from SMD to MMD, and is greater than that from MMD to Mets (0.06 vs 0.05). For the MetS state, a mean of 1/0.08=12.5 years was spent in the MetS state before recovery. The exercise, smoke, drink, BMI level, hyperuricemia had statistically significant effects on progression of MetS status (P<0.05). The obesity or overweight, little exercise, smoke, drink and hyperuricemia increased the risk of forward progression of MetS disease status. There were significant nonmodifiable (age, gender) and modifiable factors (exercise, drink, BMI level, or high HbA1c) associated with reversion of MetS state.

CONCLUSION

The likelihood of progression from MMD to MetS is less likely than that of reversion from MetS to SMD and SMD to MMD. Old females were more resistant to recover from worse states than males. Prevention and intervention measures should be adopted early when MMD or SMD onset occurs.

Association between Metabolic Syndrome Diagnosis and the Physical Activity-Sedentary Profile of Adolescents with Obesity: A Complementary Analysis of the Beta-JUDO Study

Metabolic syndrome (MetS) is highly prevalent in children and adolescents with obesity and places them at an increased risk of cardiovascular-related diseases. However, the associations between objectively measured movement-related behaviors and MetS diagnosis remain unexplored in youths with obesity. The aim was to compare profiles of sedentary (SED) time (more sedentary, SED+ vs. less sedentary, SED−), moderate to vigorous physical activity (MVPA) time (more active, MVPA+ vs. less active, MVPA−) and combinations of behaviors (SED−/MVPA+, SED−/MVPA−, SED+/MVPA+, SED+/MVPA−) regarding the MetS diagnosis. One hundred and thirty-four adolescents with obesity (13.4 ± 2.2 years) underwent 24 h/7 day accelerometry, waist circumference (WC), blood pressure (BP), high-density lipoprotein-cholesterol (HDL-c), triglycerides (TG) and insulin-resistance (IR) assessments. Cumulative cardiometabolic risk was assessed by using (i) MetS status (usual dichotomic definition) and (ii) cardiometabolic risk z-score (MetScore, mean of standardized WC, BP, IR, TG and inverted HDL-c). SED− vs. SED+ and MVPA+ vs. MVPA− had lower MetS (p < 0.01 and p < 0.001) and MetScore (p < 0.001). SED−/MVPA+ had the lowest risk. While SED and MVPA times were lower in SED−/MVPA− vs. SED+/MVPA+ (p < 0.001), MetScore was lower in SED−/MVPA− independently of body mass index (BMI) (p < 0.05). MVPA, but not SED, time was independently associated with MetS diagnosis (p < 0.05). Both MVPA (p < 0.01) and SED times (p < 0.05) were associated with MetScore independently of each other. A higher MVPA and lower SED time are associated with lower cumulative cardiometabolic risk.

Differences of Sedentary Behavior, Physical Activity, and Metabolic Syndrome Severity Among Metabolic Syndrome Clusters

Background: Sedentary behavior (SB), physical activity (PA), and metabolic syndrome (MetS) are risk indicators for cardiometabolic diseases. Novel methods for researching MetS by the 16 unique clusters (i.e., WC+FBG+BP) and as a continuous severity z-score (MetS-Z) have emerged. This study examined how SB, PA, and MetS-Z differed among MetS clusters and SB and PA differences by MetS-Z tertiles. Methods: Using 2015-2016 National Health and Nutritional Examination Survey (NHANES) data, participants with MetS (N = 792) were identified. Subsequently, sex-, race-, and ethnicity-specific MetS-Z were calculated. SB and PA differences were compared between MetS clusters and MetS-Z tertiles. Additionally, MetS-Z was compared between MetS clusters. Results: The WC+FBG+BP MetS cluster was prevalent among 23.80% of participants (95% CIs, 18.41-30.18) and the overall mean MetS-Z was 1.16 (1.08-1.24). Participants reported over 6 daily hours of SB (393.41 minutes⋅day-1 [370.07-416.75]). The TRI+FBG+BP+HDL MetS cluster had less SB than the WC+TRI+FBG+HDL, WC+TRI+HDL, and WC+FBG+BP MetS clusters. PA did not differ between MetS clusters and no differences in SB or PA between MetS-Z tertiles. Conclusions: Limited differences in SB and PA were observed. Participants with 4 or more MetS criteria had worse MetS-Z. Efforts should support replacing SB with PA to improve cardiometabolic health.

Association of change in the school travel mode with changes in different physical activity intensities and sedentary time: A International Children's Accelerometry Database Study

Our aim was to assess the association between changes in active travel to school and changes in different intensities of physical activity (i.e. moderate - MPA and vigorous - VPA) and time spent sedentary (SED) among adolescents and assess the moderating effect of children's sex, age and weight status. Data from six cohort studies in the International Children's Accelerometry Database were used (4108 adolescents aged 10-13y at baseline, with 1.9±0.7y of follow-up). Participants self-reported travel mode to school at baseline and follow-up. Mutually exclusive categories of change were created using passive (e.g. by car) or active (cycling or walking) forms of transport (active/active, passive/active, active/passive, passive/passive). Multilevel linear regression analyses assessed associations with change in accelerometer-assessed time spent MPA, VPA and SED, adjusting for potential confounders. The moderation of sex, age and weight status was tested though the inclusion of interaction terms in the regression models. Relative to those remaining in active travel (active/active), participants classified as passive/active increased VPA (B: 2.23 min/d; 95%CI: 0.97-3.48), while active/passive (MPA: -5.38min/d; -6.77 to -3.98; VPA: -2.92min/d; -4.06 to -1.78) and passive/passive (MPA: -4.53min/d; -5.55 to -3.50; VPA: -2.84min/d; -3.68 to -2.01) decreased MPA and VPA. There were no associations with SED. An interaction was observed, age group moderated the association with change in VPA: among 12-13y-olds a greater increase in VPA was observed for the passive/active group compared to active/active. Promoting active travel to school can be a strategy to attenuate the decline in physical activity through adolescence.

Independent and joint association of physical activity and sedentary behavior on all-cause mortality

Backgrounds:

Physical activity (PA) and sedentary behavior (SB) have been associated with mortality, while the joint association with mortality is rarely reported among Chinese population. We aimed to examine the independent and joint association of PA and SB with all-cause mortality in southern China.

Methods:

A cohort of 12,608 China Hypertension Survey participants aged ≥35 years were enrolled in 2013 to 2014, with a follow-up period of 5.4 years. Baseline self-reported PA and SB were collected via the questionnaire. Kaplan–Meier curves (log-rank test) and Cox proportional hazards regression were performed to evaluate the associations of PA and SB on all-cause mortality.

Results:

A total of 11,744 eligible participants were included in the analysis. Over an average of 5.4 years of follow-up, 796 deaths occurred. The risk of all-cause mortality was lower among participants with high PA than those with low to moderate level (5.2% vs. 8.9%; hazards ratio [HR]: 0.75, 95% confidence interval [CI]: 0.61–0.87). Participants with SB ≥ 6 h had a higher risk of all-cause mortality than those with SB <6 h (7.8% vs. 6.0%; HR: 1.37, 95% CI: 1.17–1.61). Participants with prolonged SB (≥6 h) and inadequate PA (low to moderate) had a higher risk of all-cause mortality compared to those with SB < 6 h and high PA (11.2% vs. 4.9%; HR: 1.67, 95% CI: 1.35–2.06). Even in the participants with high PA, prolonged SB (≥6 h) was still associated with the higher risk of all-cause mortality compared with SB < 6 h (7.0% vs. 4.9%; HR: 1.33, 95% CI: 1.12–1.56).

Conclusions:

Among Chinese population, PA and SB have a joint association with the risk of all-cause mortality. Participants with inadequate PA and prolonged SB had the highest risk of all-cause mortality compared with others.

Daily physical activity patterns in children and adolescents with inflammatory bowel disease

BACKGROUND

The aim of this study was to assess PA patterns among children and adolescents with inflammatory bowel disease (IBD).

METHODS

Sixty participants with IBD (42 Crohn's disease [CD], 10 ulcerative colitis [UC], and 8 IBD-unclassified [IBD-U], 30 male patients) in remission (n = 45) or with mild disease (n = 15) were compared with 60 healthy age- and sex-matched controls. Each participant wore a triaxial accelerometer during 4 consecutive days for objective daily PA quantification.

RESULTS

Overall, there was no significant difference in daily PA patterns between patients with IBD and healthy controls, with 31.7% of patients with IBD and 38.3% of healthy controls fulfilling the recommendation of 60 min of moderate-to-vigorous physical activity (MVPA) daily (NS). Male patients with IBD spent significantly less time in MVPA compared with matched healthy controls (mean difference, 16.2 min day^-1; p < 0.05). No difference was observed for female patients with IBD. No difference in sedentary pattern between male patients with IBD and controls was found.

CONCLUSIONS

Children and adolescents with inactive or mildly active IBD have similar PA patterns compared with healthy controls, except for male patients who have reduced moderate-to-vigorous PA. By far, most patients with IBD do not fulfill the MVPA recommendations for health benefits.

IMPACT

There is few data on PA patterns in pediatric patients with IBD. Methodological issues to assess PA limit the strengths of these studies. Pediatric IBD patients with inactive or mildly active IBD have similar physical activity patterns compared with healthy controls, except for male patients who have reduced moderate-to-vigorous PA. Most patients with IBD do not fulfill the MVPA recommendations for health benefits.

Metabolic syndrome and its components are associated with thyroid volume in adolescents

OBJECTIVE

To explore the association between metabolic syndrome (MetS) and its component and thyroid volume in Chinese adolescents, and to compare the detection rate of MetS under the three different diagnostic criteria.

METHODS

A total of 1097 school students (610 males and 487 females, ages 12-15 years) were enrolled. All the participants underwent physical examination, biochemical test, and thyroid gland ultrasonography. The thyroid volume of normal, overweight and obese group was compared. We also analyzed the association between the number of MetS components and thyroid volume. Linear and multiple linear regression were applied to explore the association between metabolic parameters and thyroid volume.

RESULTS

The thyroid volume of the males in overweight (t = 3.784, P < 0.001) and obese group (t = 5.068, P < 0.001) was significantly larger than that in normal group; the thyroid volume of the females in overweight group (t = 4.627,P < 0.001) was significantly larger than that of normal group. As the number of MetS components increased, the thyroid volume also increased significantly (F = 10.64, P < 0.01). Height, weight, body mass index (BMI), waist circumference, hip circumference, systolic blood pressure, fasting insulin, homeostasis model assessment of insulin resistance (HOMA-IR), uric acid and triglyceride were all positively associated with thyroid volume in the adolescents (P all < 0.001). Meanwhile, there was a negative association between high-density lipoprotein cholesterol (HDL-C) and thyroid volume (P < 0.001). According to multiple linear regression, waist circumference (β = 0.029, 95 %CI: 0.015 ~ 0.042; P < 0.01) and waist height ratio (β = 3.317, 95 %CI: 1.661 ~ 4.973; P < 0.01) were predict factors of thyroid volume. No statistical difference was found in the detection rates of metabolic syndrome under the three diagnostic criteria.

CONCLUSIONS

Overweight, obesity and metabolic syndrome was associated with adolescent thyroid volume. Central obesity may be an independent risk factor for thyroid enlargement in adolescents.

Physical activity and sitting time prior to and during COVID-19 lockdown in Austrian high-school students

The COVID-19 pandemic has led in many countries to the implementation of policies that mandate social distancing and movement restrictions. While these measures are warranted in order to minimize the spread of the virus they may have detrimental effects on various behaviors, including physical activity (PA). The present study examined PA and sitting time in 14 to18-year-old Austrian high school students prior to and during the second COVID-19 lockdown in Austria. Data was collected via an online questionnaire during fall/winter 2020/21. Questions were based on the International Physical Activity Questionnaire, which examined frequency and duration of PA and sitting time. A total of 221 high school students provided valid data. Participants reported significantly lower moderate and vigorous PA during the lockdown while sitting time increased (p < 0.01). The frequency of walking (days/week) also decreased during COVID-19 lockdown, which also contributed to a significant decline in total walking time (p < 0.01). Further, the decline in PA was more pronounced in boys, while girls reported a greater decline in walking. These differences were due to higher PA and walking in boys and girls, respectively, prior to the lockdown. During the lockdown sex differences in PA and sitting time were limited. Taken together, these results highlight the impact of COVID-19 policies on PA in adolescents and emphasize the importance to promote an active lifestyle even in times of home confinement.

Eating Speed, Physical Activity, and Cardiorespiratory Fitness Are Independent Predictors of Metabolic Syndrome in Korean University Students

Background: Little is known regarding the role of eating quickly, physical inactivity, and poor cardiorespiratory fitness (CRF) in assessing the onset of metabolic syndrome (Mets) in Korean young adults. Objectives: This study examined the association between the three risk factors and Mets in 1891 Korean university students (30% female) aged 18–29 years. Methods: Eating speed (slow vs. fast) and physical activity (active vs. inactive) were assessed with a standardized questionnaire. Maximal oxygen uptake as an indicator of CRF was assessed with graded exercise testing. Components of Mets were waist circumference, systolic and diastolic blood pressures, fasting blood glucose (FBG), triglycerides (TG), and high-density lipoprotein cholesterol (HDLC). Results: All the three exposures were positively associated with abdominal obesity, elevated blood pressures, elevated FBG, elevated TG, and decreased HDLC. Logistic regression analysis showed that the odds ratio (OR) of Mets was incremental in the order of physical inactivity (odds ratio, OR = 1.666; 95% confidence interval, CI = 1.024–2.708; p = 0.040), fast eating (OR = 1.687; 95% CI = 1.094–2.601; p = 0.018), and poor CRF (OR = 5.378; 95% CI = 3.475–8.325; p < 0.001). Conclusions: The current findings suggest that a multifaceted intervention targeting at promotion of physical activity and CRF in concert with healthy eating behaviors should be implemented as a preventive strategy against Mets in Korean university students.

Physical activity and cardiometabolic health in adolescents with type 2 diabetes: a cross-sectional study

INTRODUCTION

Youth living with type 2 diabetes display increased risk of cardiovascular disease (CVD). It is unclear if regular physical activity (PA) modifies this risk.

RESEARCH DESIGN AND METHODS

We compared CVD risk factors in a cross-sectional study of 164 youth with type 2 diabetes stratified according to weekly vigorous-intensity PA. Outcomes were hemoglobin A1c (HbA1c), ambulatory blood pressure (BP; ambulatory 24-hour readings), plasma lipoproteins, and albuminuria. The main exposure, vigorous-intensity PA, was quantified with the Adolescent Physical Activity Recall Questionnaire.

RESULTS

Youth were 15±3 years, and 78% lived rurally and 68% were female, with a mean body mass index (BMI) Z-score of 2.4±1.1 and a mean HbA1c of 9.6% ±2.6%. Youth who participated in regular vigorous-intensity PA (40%; n=67) achieved nearly twice the dose of PA than peers who did not (62 vs 34 metabolic equivalent score-hour/week, p=0.001). After adjusting for duration of diabetes, BMI Z-score, sex, and smoking, youth who engaged in vigorous-intensity PA displayed lower HbA1c (9.1% vs 9.9%, p=0.052), diastolic BP (70 mm Hg vs 73 mm Hg, p=0.002), diastolic load (20% vs 26%, p=0.023), and mean arterial pressure (87.3 mm Hg vs 90.3 mm Hg, p<0.01), compared with youth who did not. Compared with youth who did not participate in regular vigorous-intensity PA, those who did also displayed lower odds of albuminuria after adjusting for duration of diabetes, sex, smoking, rural residence, and BMI Z-score (adjusted OR: 0.40, 95% CI 0.19 to 0.84).

CONCLUSIONS

Among youth with type 2 diabetes, participation in vigorous-intensity PA is associated with lower CVD risk.

Is device-measured vigorous physical activity associated with health-related outcomes in children and adolescents? A systematic review and meta-analysis

OBJECTIVE

This study sought to analyze the prospective association between vigorous-intensity physical activity (VPA) and health-related outcomes in children and adolescents.

METHODS

Studies reporting associations between device-measured VPA and health-related factors in children and adolescents aged 3-18 years were identified through database searches (MEDLINE, EMBASE, and SPORTDiscus). Correlation coefficients were pooled if outcomes were reported by at least 3 studies, using DerSimonian-Laird random effects models.

RESULTS

Data from 23 studies including 13,674 participants were pooled using random effects models. Significant associations were found between VPA at baseline and overall adiposity (r = -0.09, 95% confidence interval (95%CI): -0.15 to -0.03; p = 0.002; I² = 89.8%), cardiometabolic risk score (r = -0.13, 95%CI: -0.24 to -0.02, p = 0.020; I² = 69.6%), cardiorespiratory fitness (r = 0.25, 95%CI: 0.15-0.35; p < 0.001; I² = 57.2%), and total body bone mineral density (r = 0.16, 95%CI: 0.06 to 0.25; p = 0.001; I² = 0%).

CONCLUSION

VPA seems to be negatively related to adiposity and cardiometabolic risk score and positively related to cardiorespiratory fitness and total body bone mineral density among children and adolescents at follow-up. Therefore, our findings support the need to strengthen physical activity recommendations regarding VPA due to its health benefits in children and adolescents.

Metabolic syndrome in Thai adolescents and associated factors: the Thai National Health Examination Survey V (NHES V)

Background

Presence of metabolic syndrome (MetS) in early life may influence cardiovascular outcome later in adulthood. There is limited data regarding MetS among Thai adolescents. This study aimed to estimate the prevalence of MetS and related factors in Thai adolescents.

Methods

Data on MetS components of 1934 Thai adolescents aged 10–16 years were obtained from the 5th National Health Examination Survey. Age at first screen time exposure, duration of screen time, frequency of food intake and physical activities were collected from interviews. MetS was defined according to 3 definitions: International Diabetes Federation (IDF), Cook’s, and de Ferranti’s.

Results

The prevalence of MetS was 4.1% by IDF, 8.0% by Cook’s, and 16.8% by de Ferranti’s definition. The overall prevalence was higher in male (19.0%) than female adolescents (15.3%). The most common MetS components composition among Thai adolescents was high waist circumference with high serum triglyceride and low HDL-cholesterol (40.0% for IDF, 22.6% for Cook’s and 43.5% for de Ferranti’s definition). Exposure to screen media during the first 2 years of life had a 1.3- fold increased odds of MetS by 1 out of 3 definitions (OR 1.30, 95% CI. 1.01–1.68). Duration of physical activity associated with decreased odds of MetS by Cook’s definition (OR 0.96, 95% CI. 0.92–0.99).

Conclusions

The prevalence of MetS among Thai adolescents was higher than previously reported by other studies. Screen media exposure during the first 2 years of life should be discouraged and measures to promote physical activity among children and adolescents should be strengthen.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10728-6.

Adherence to the 24-hour movement guidelines and adiposity in a cohort of at risk youth: A longitudinal analysis

BACKGROUND

The 24-hour movement guidelines provide recommendations for physical activity, screen time and sleep duration for children.

OBJECTIVES

Describe adherence to the guidelines and their cross-sectional and longitudinal associations with adiposity from childhood to adolescence.

METHODS

Data are from the QUALITY Cohort. Children were followed at 8 to 10 years (childhood; n = 630), 10 to 12 years (early adolescence; n = 564) and 15 to 17 years (adolescence; n = 377). Physical activity, screen time, and sleep duration were measured by accelerometry and questionnaires. Body mass index z-scores (zBMI), waist circumference, waist-to-height ratio and percent body fat were based on clinical measurements. Multiple linear regressions estimated associations.

RESULTS

In childhood, early adolescence and adolescence, 14%, 6%, and 0% of participants met the 24-hour movement guidelines, respectively. Meeting fewer guideline components was cross-sectionally associated with higher adiposity at each visit. Meeting fewer guideline components in childhood was longitudinally associated with higher adiposity at later visits. For example, those meeting none of the guideline components (vs all) in childhood had a 1.66 SD (95% CI: 0.42, 2.89) higher zBMI in early adolescence.

CONCLUSION

Few participants met the guidelines. Not meeting the guidelines in childhood is associated with higher adiposity 2 and 7 years later. Interventions are needed to increase adherence to the 24-hour movement guidelines across childhood and adolescence.

Bi-directional prospective associations between sedentary time, physical activity and adiposity in 10-year old Norwegian children

There is an adverse cross-sectional association between sedentary time, physical activity (PA) and adiposity, but weak and inconsistent estimates raise question to the direction of associations. The present study aims to examine whether the prospective association between sedentary time, different PA intensities and indicators of adiposity is bi-directional. The Active Smarter Kids Study obtained data from 869 ten-year-old children with valid measurements for sedentary time, PA, and adiposity at baseline and follow-up. Time spent sedentary and PA was measured by accelerometry, adiposity was assessed by three different measures: body mass index (BMI), waist circumference (WC) and sum of four skinfolds (S4SF). Neither overall PA nor time spent sedentary predicted lower BMI or WC at follow-up, but the time spent in moderate-and-vigorous PA (MVPA) and vigorous PA (VPA) predicted lower S4SF at follow-up among boys (MVPA β - 0.066 [95% CI -0.105, -0.027] p = 0.001). Baseline BMI and WC predicted less overall PA, MVPA and VPA in boys. All adiposity measures predicted more time spent sedentary at follow-up in boys. The results suggest that overall PA and sedentary time do not predict future adiposity. Baseline adiposity may rather predict more sedentary time and less higher intensity activity.

Sex-based differences in and risk factors for metabolic syndrome in adults aged 40 years and above in Northeast China: Results from the cross-sectional China national stroke screening survey

OBJECTIVES

Low levels of income and education are risk factors for metabolic syndrome in the population of Northeast China, which has a high incidence of metabolic syndrome and cardiovascular diseases. This study aimed to determine sex-based differences associated with the prevalence of and risk factors for metabolic syndrome among people older than 40 years in Northeast China; this has not been previously investigated.

DESIGN

This study analysed a portion of the large sample data of the national cross-sectional screening of China from 2016. Metabolic syndrome was defined as the presence of any three of the following five risk factors: abnormal waist circumference; high levels of triglycerides, high-density lipoprotein cholesterol or fasting plasma glucose; and elevated blood pressure. Multiple regression analysis was used to investigate sex-based differences in the prevalence of, and risk factors for metabolic syndrome.

SETTING

The study was conducted in Dehui City, Jilin Province, China.

PARTICIPANTS

A total of 4052 participants with complete questionnaire information and laboratory examination results were included.

RESULTS

The prevalence of metabolic syndrome was 50.1% overall (38.4% in men and 57.9% in women; p<0.001). High body mass index and hip circumference were associated with metabolic syndrome in both sexes. In addition, physical inactivity (OR and 95% CI 1.44 (1.06 to 1.97); p=0.022) in men and advanced age (OR and 95% CI 1.54 (1.15 to 2.04); p=0.003) in women were factors associated with metabolic syndrome. Women with junior high school education or above and living in rural areas were less likely to have metabolic syndrome. For men, education and rural or urban living had no association with metabolic syndrome.

CONCLUSIONS

The risk factors for metabolic syndrome have similarities and differences in different sexes; thus, the prevention and treatment of metabolic syndrome should be based on these sex differences.