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Bikomeye JC, Awoyinka I, Kwarteng JL, Beyer AM, Rine S, Beyer KMM. Disparities in Cardiovascular Disease-Related Outcomes Among Cancer Survivors in the United States: A Systematic Review of the Literature. Heart Lung Circ 2024; 33:576-604. [PMID: 38184426 PMCID: PMC11144115 DOI: 10.1016/j.hlc.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 10/31/2023] [Accepted: 11/02/2023] [Indexed: 01/08/2024]
Abstract
BACKGROUND Cancer and cardiovascular disease (CVD) are major causes of morbidity and mortality in the United States (US). Cancer survivors have increased risks for CVD and CVD-related mortality due to multiple factors including cancer treatment-related cardiotoxicity. Disparities are rooted in differential exposure to risk factors and social determinants of health (SDOH), including systemic racism. This review aimed to assess SDOH's role in disparities, document CVD-related disparities among US cancer survivors, and identify literature gaps for future research. METHODS Following the Peer Review of Electronic Search Strategies (PRESS) guidelines, MEDLINE, PsycINFO, and Scopus were searched on March 15, 2021, with an update conducted on September 26, 2023. Articles screening was performed using the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020, a pre-defined Population, Exposure, Comparison, Outcomes, and Settings (PECOS) framework, and the Rayyan platform. A modified version of the Newcastle-Ottawa Scale was used to assess the risk of bias, and RAW Graphs for alluvial charts. This review is registered with PROSPERO under ID #CRD42021236460. RESULTS Out of 7,719 retrieved articles, 24 were included, and discussed diverse SDOH that contribute to CVD-related disparities among cancer survivors. The 24 included studies had a large combined total sample size (n=7,704,645; median=19,707). While various disparities have been investigated, including rural-urban, sex, socioeconomic status, and age, a notable observation is that non-Hispanic Black cancer survivors experience disproportionately adverse CVD outcomes when compared to non-Hispanic White survivors. This underscores historical racism and discrimination against non-Hispanic Black individuals as fundamental drivers of CVD-related disparities. CONCLUSIONS Stakeholders should work to eliminate the root causes of disparities. Clinicians should increase screening for risk factors that exacerbate CVD-related disparities among cancer survivors. Researchers should prioritise the investigation of systemic factors driving disparities in cancer and CVD and develop innovative interventions to mitigate risk in cancer survivors.
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Affiliation(s)
- Jean C Bikomeye
- Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA; PhD Program in Public and Community Health, Division of Epidemiology & Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - Iwalola Awoyinka
- Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA; PhD Program in Public and Community Health, Division of Epidemiology & Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA; MCW Cancer Center, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Jamila L Kwarteng
- Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA; MCW Cancer Center, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Andreas M Beyer
- Department of Medicine and Physiology, Division of Cardiology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Sarah Rine
- Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA; PhD Program in Public and Community Health, Division of Epidemiology & Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Kirsten M M Beyer
- Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA; PhD Program in Public and Community Health, Division of Epidemiology & Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA; MCW Cancer Center, Medical College of Wisconsin, Milwaukee, WI, USA
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Cruz-Ávila HA, Ramírez-Alatriste F, Martínez-García M, Hernández-Lemus E. Comorbidity patterns in cardiovascular diseases: the role of life-stage and socioeconomic status. Front Cardiovasc Med 2024; 11:1215458. [PMID: 38414921 PMCID: PMC10897012 DOI: 10.3389/fcvm.2024.1215458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 01/29/2024] [Indexed: 02/29/2024] Open
Abstract
Cardiovascular diseases stand as a prominent global cause of mortality, their intricate origins often entwined with comorbidities and multimorbid conditions. Acknowledging the pivotal roles of age, sex, and social determinants of health in shaping the onset and progression of these diseases, our study delves into the nuanced interplay between life-stage, socioeconomic status, and comorbidity patterns within cardiovascular diseases. Leveraging data from a cross-sectional survey encompassing Mexican adults, we unearth a robust association between these variables and the prevalence of comorbidities linked to cardiovascular conditions. To foster a comprehensive understanding of multimorbidity patterns across diverse life-stages, we scrutinize an extensive dataset comprising 47,377 cases diagnosed with cardiovascular ailments at Mexico's national reference hospital. Extracting sociodemographic details, primary diagnoses prompting hospitalization, and additional conditions identified through ICD-10 codes, we unveil subtle yet significant associations and discuss pertinent specific cases. Our results underscore a noteworthy trend: younger patients of lower socioeconomic status exhibit a heightened likelihood of cardiovascular comorbidities compared to their older counterparts with a higher socioeconomic status. By empowering clinicians to discern non-evident comorbidities, our study aims to refine therapeutic designs. These findings offer profound insights into the intricate interplay among life-stage, socioeconomic status, and comorbidity patterns within cardiovascular diseases. Armed with data-supported approaches that account for these factors, clinical practices stand to be enhanced, and public health policies informed, ultimately advancing the prevention and management of cardiovascular disease in Mexico.
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Affiliation(s)
- Héctor A Cruz-Ávila
- Graduate Program in Complexity Sciences, Autonomous University of México City, México City, Mexico
- Immunology Department, National Institute of Cardiology 'Ignacio Chávez', México City, Mexico
| | | | - Mireya Martínez-García
- Immunology Department, National Institute of Cardiology 'Ignacio Chávez', México City, Mexico
| | - Enrique Hernández-Lemus
- Computational Genomics Division, National Institute of Genomic Medicine, México City, Mexico
- Center for Complexity Sciences, Universidad Nacional Autónoma de México, México City, Mexico
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Homeyer D, Memaran N, Kück M, Grams L, von der Born J, Bauer E, Schwalba M, Kerling A, von Maltzahn N, Albrecht A, Haverich A, Stiesch M, Melk A, Tegtbur U. Participating in a School-Integrated Daily Exercise Program Improves Motor Performance Significantly in School-Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4764. [PMID: 36981673 PMCID: PMC10048861 DOI: 10.3390/ijerph20064764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 03/03/2023] [Accepted: 03/07/2023] [Indexed: 06/18/2023]
Abstract
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.
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Affiliation(s)
- Denise Homeyer
- Department of Rehabilitation and Sports Medicine, Hannover Medical School, 30625 Hannover, Germany
| | - Nima Memaran
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, 30625 Hannover, Germany; (N.M.)
| | - Momme Kück
- Department of Rehabilitation and Sports Medicine, Hannover Medical School, 30625 Hannover, Germany
| | - Lena Grams
- Department of Rehabilitation and Sports Medicine, Hannover Medical School, 30625 Hannover, Germany
| | - Jeannine von der Born
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, 30625 Hannover, Germany; (N.M.)
| | - Elena Bauer
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, 30625 Hannover, Germany; (N.M.)
| | - Martina Schwalba
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, 30625 Hannover, Germany; (N.M.)
| | - Arno Kerling
- Department of Rehabilitation and Sports Medicine, Hannover Medical School, 30625 Hannover, Germany
| | - Nadine von Maltzahn
- Department for Dental Prosthodontics and Biomedical Materials Science, Center for Dentistry and Oral Medicine, Hannover Medical School, 30625 Hannover, Germany
| | - Alexander Albrecht
- Department of Rehabilitation and Sports Medicine, Hannover Medical School, 30625 Hannover, Germany
| | - Axel Haverich
- Department of Cardiothoracic, Transplantation, and Vascular Surgery, Hannover Medical School, 30625 Hannover, Germany
| | - Meike Stiesch
- Department for Dental Prosthodontics and Biomedical Materials Science, Center for Dentistry and Oral Medicine, Hannover Medical School, 30625 Hannover, Germany
| | - Anette Melk
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, 30625 Hannover, Germany; (N.M.)
| | - Uwe Tegtbur
- Department of Rehabilitation and Sports Medicine, Hannover Medical School, 30625 Hannover, Germany
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AlZahrani SG. Healthy Schools Framework in Saudi Arabia: A Narrative Review. INTERNATIONAL JOURNAL OF PHARMACEUTICAL RESEARCH AND ALLIED SCIENCES 2023. [DOI: 10.51847/lj2fbaa0vm] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Tong Z, Kong Z, Jia X, Zhang H, Zhang Y. Multiscale Impact of Environmental and Socio-Economic Factors on Low Physical Fitness among Chinese Adolescents and Regionalized Coping Strategies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192013504. [PMID: 36294085 PMCID: PMC9602530 DOI: 10.3390/ijerph192013504] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 10/16/2022] [Accepted: 10/17/2022] [Indexed: 05/26/2023]
Abstract
As low physical fitness in adolescents increases their risk of all-cause mortality in future adulthood as well as regional public health budgets, many scholars have studied the factors influencing physical fitness in adolescents. However, the spatial non-stationarity and scale between physical fitness and influencing factors in adolescents are often neglected. To rectify this situation, this study constructed a multi-scale geographically weighted regression model based on data from the China National Student Fitness Survey and the China Statistical Yearbook in 2018 to investigate the spatial patterns of factors influencing low physical fitness among adolescents. The results showed that the influencing factors for measuring the physical fitness of Chinese adolescents had significant spatial heterogeneity and multi-scale effects. The local R2 values were relatively low in the western region of China. Consideration should be given to increasing the lifestyle and ethnic and cultural characteristics of local residents when selecting influencing factors in the future. The physical fitness of men was mainly influenced by socio-economic factors, while that of women was influenced by natural environmental factors. According to the different spatial distribution patterns of MGWR, this study suggests that each region should develop regionalized strategies to cope with the low physical fitness of adolescents, including taking advantage of the natural environment to develop physical fitness promotion projects, accelerating the upgrading of industrial structures in the north-eastern and western regions, and the need to remain cautious of rapid urbanization in the east.
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Affiliation(s)
- Zihan Tong
- Key Laboratory of Exercise and Physical Fitness, Ministry of Education, Beijing Sport University, Beijing 100084, China
| | - Zhenxing Kong
- Key Laboratory of Exercise and Physical Fitness, Ministry of Education, Beijing Sport University, Beijing 100084, China
| | - Xiao Jia
- Key Laboratory of Exercise and Physical Fitness, Ministry of Education, Beijing Sport University, Beijing 100084, China
| | - Hanyue Zhang
- Institute of Physical Education, Northeast Normal University, Changchun 130024, China
| | - Yimin Zhang
- Key Laboratory of Exercise and Physical Fitness, Ministry of Education, Beijing Sport University, Beijing 100084, China
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Alaqil AI, Petushek EJ, Gautam YR, Pfeiffer KA, Carlson JJ. Determining independence and associations among various cardiovascular disease risk factors in 9-12 years old school-children: a cross sectional study. BMC Public Health 2022; 22:1639. [PMID: 36042444 PMCID: PMC9426011 DOI: 10.1186/s12889-022-14035-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 08/09/2022] [Indexed: 11/13/2022] Open
Abstract
Background Cardiovascular disease (CVD) risk assessment of children typically includes evaluating multiple CVD risk factors some of which tend to correlate each other. However, in older children and young adolescents, there are little data on the level of independence of CVD risk factors. The purpose of this study was to examine the relationships among various CVD risk factors to determine the level of independence of each risk factor in a sample of 5th-grade public school students. Method A cross-sectional analysis of 1525 children (856 girls and 669 boys; age: 9-12 years) who participated in baseline CVD risk assessment for the (S)Partners for Heart Health program from 2010 - 2018. Thirteen CVD risk factor variables were used in the analysis and included blood lipids [low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol (TC), and triglycerides], resting systolic and diastolic blood pressure (BP); anthropometrics [height, weight, body mass index (BMI), % body fat, waist circumference (WC)]. Additionally, acanthosis nigricans (a marker insulin resistance and diabetes), and cardiorespiratory fitness (VO2 ml/kg) was estimated using the PACER. Descriptive statistics, bivariate Pearson correlations, and principal component analysis were used to determine the relationships among these variables and the independence. Results Parallel analysis indicated two components should be extracted. Among the two components extracted, WC, % body fat, and BMI loaded highest on component 1, which explained 34% of the total variance. Systolic BP and diastolic BP loaded predominantly on component 2 and accounted for 17% of the variance. Cardiorespiratory fitness, acanthosis nigricans, HDL, and triglycerides loaded highest on the first component (loadings between 0.42 and 0.57) but still suggest some non-shared variance with this component. Low-density lipoprotein had low loadings on each component. Factor loadings were stable across sex. Conclusion Among the various CVD risk indicators, measures of adiposity loaded highest on the component that explained the largest proportion of variability in the data reinforcing the importance of assessing adiposity in CVD risk assessment. In addition, blood pressure loaded highest on the second component, suggesting their relative independence when assessing CVD risk. The data also provide support and rationale for determining what CVD risk factors to include- based on resource needs. For example, researchers or public health programs may choose to assess WC instead of lipid profile for cardiovascular related problems if ease of assessment and cost are considerations.
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Affiliation(s)
- Abdulrahman I Alaqil
- Department of Physical Education, College of Education, King Faisal University, Al-Ahsa, 31982, Saudi Arabia.,Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej, 55, 5230, Odense, Denmark
| | - Erich J Petushek
- Department of Cognitive and Learning Sciences, Michigan Technological University, 1400 Townsend Drive, Houghton, MI, 49931, USA. .,Health Research Institute, Michigan Technological University, 1400 Townsend Drive, Houghton, MI, 49931, USA.
| | - Yuba R Gautam
- School of Health and Human Performance, College of Health Science and Professional Studies, Northern Michigan University, 1401 Presque Isle Ave, Marquette, MI, 49855, USA
| | - Karin A Pfeiffer
- Department of Kinesiology, Michigan State University, 308W Circle Dr, East Lansing, MI, 48824, USA
| | - Joseph J Carlson
- Department of Radiology, Division of Sports and Cardiovascular Nutrition, Michigan State University, East Lansing, MI, USA
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Schmidt T, Pawlowski CS, Kerr J, Schipperijn J. Investigating the WHAT and WHY on older adults' use of neighborhood open spaces following an environmental intervention. Transl Behav Med 2021; 11:582-596. [PMID: 32044982 DOI: 10.1093/tbm/ibaa004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Using neighborhood open spaces (NOS) may be an easy way for older adults to maintain healthy aging through physical activity and social interaction. Little is known about older adults' use of NOS, their preferences, and barriers to using them. This paper presents older adults' use of NOS in a deprived neighborhood before and after an intervention and factors promoting or inhibiting their use using convergent mixed methods design. Participatory research was employed involving older adults in the intervention. The System for Observing Play and Recreation in Communities was used to observe older adults' use of 13 NOS in spring 2017 (baseline) and spring 2018 (follow-up). Ten interviews were conducted in 2018 to identify barriers and facilitators for using NOS. Two NOS had a pavilion built and, in one NOS, benches were renovated, including building raised flower beds and small tables. At baseline, 209 older adults were observed, whereas 329 were observed at follow-up. More (44%) older adults were observed at follow-up in the NOS with the renovated benches. No use of the two pavilions was observed. The interviews identified six factors important for older adults' use of NOS: weather, support for social caretakers, support for resourceful volunteers, organized activities, social interaction, and sense of ownership. Organizational resources, such as social caretakers and volunteers, are important to promote older adults' use of NOS. Social interaction is a key factor for older adults' use of NOS and should be prioritized by health promoters.
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Affiliation(s)
- Tanja Schmidt
- Research Unit for Active Living, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
| | - Charlotte Skau Pawlowski
- Research Unit for Active Living, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
| | - Jacqueline Kerr
- Department of Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Dr, La Jolla, CA, USA
| | - Jasper Schipperijn
- Research Unit for Active Living, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
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Associations Between Household Socioeconomic Status, Car Ownership, Physical Activity, and Cardiorespiratory Fitness in South African Primary Schoolchildren Living in Marginalized Communities. J Phys Act Health 2021; 18:883-894. [PMID: 34172589 DOI: 10.1123/jpah.2020-0839] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 04/06/2021] [Accepted: 04/08/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Little is known whether physical activity (PA)-promoting environments are equally accessible to children with divergent socioeconomic status (SES) in low-/middle-income countries. The authors, therefore, examined whether South African children from poorer versus wealthier families living in marginalized communities differed in moderate to vigorous PA and cardiorespiratory fitness. We also tested associations between family car ownership and PA/cardiorespiratory fitness. METHODS Parents/guardians of 908 children (49% girls, mean age = 8.3 [1.4] y) completed a survey on household SES. PA was assessed via 7-day accelerometry, parental and child self-reports, and cardiorespiratory fitness with the 20-m shuttle run test. RESULTS Based on accelerometry, most children met current moderate to vigorous PA recommendations (≥60 min/d). About 73% of the children did not engage in structured physical education lessons. Whereas children of the lowest SES quintile accumulated higher levels of device-based moderate to vigorous PA, peers from the highest SES quintile engaged in more sedentary behaviors, but self-reported higher engagement in sports, dance, and moving games after school. Families' car ownership was associated with higher parent/self-reported leisure-time PA. CONCLUSIONS A deeper understanding is needed about why wealthier children are more sedentary, but simultaneously engage in more leisure-time PA. The fact that access to structural physical education is denied to most children is critical and needs to be addressed.
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Kim E, Won Y, Shin J. Analysis of Children's Physical Characteristics Based on Clustering Analysis. CHILDREN-BASEL 2021; 8:children8060485. [PMID: 34200406 PMCID: PMC8227780 DOI: 10.3390/children8060485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 05/27/2021] [Accepted: 06/03/2021] [Indexed: 11/16/2022]
Abstract
This study assessed the physical development, physical fitness (muscular endurance, muscular strength, flexibility, agility, power, balance), and basal metabolic rate (BMR) in a total of 4410 children aged six (73–84 months) residing in Korea. Their physical fitness was visually classified according to the physical fitness factor and—considering that children showed great variations in the physical fitness criteria depending on their physique and body composition—the study aimed to assess characteristics such as physique and BMR, the precursor for fat-free mass, based on the physical health clusters selected through a multivariate approach. As a result, the physical health clusters could be subdivided into four clusters: balance (1), muscular strength (2), low agility (3), and low physical fitness (3) cluster. Cluster 1 showed a high ratio of slim and slightly slim children, while cluster 2 had a high proportion of children that were obese, tall, or heavy, and had the highest BMR. We consider such results as important primary data for constituting physical fitness management programs customized to each cluster. It seems that it is necessary to have a multidirectional approach toward physical fitness evaluation and analysis methodologies that involve various physical fitness factors of children.
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Affiliation(s)
- Eunjung Kim
- Division of Sports Science, Myongji University, Yongin-si 17058, Korea;
| | - Yumi Won
- Department of Exercise Rehabilitation, Daewon University College, Jecheon-si 27135, Korea
- Correspondence: (Y.W.); (J.S.)
| | - Jieun Shin
- Department of Biomedical Informatics, College of Medicine, Konyang University, Daejeon-si 35365, Korea
- Correspondence: (Y.W.); (J.S.)
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Mäestu E, Harro J, Veidebaum T, Kurrikoff T, Jürimäe J, Mäestu J. Changes in cardiorespiratory fitness through adolescence predict metabolic syndrome in young adults. Nutr Metab Cardiovasc Dis 2020; 30:701-708. [PMID: 32131988 DOI: 10.1016/j.numecd.2019.12.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 12/16/2019] [Accepted: 12/18/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND AND AIMS Higher cardiorespiratory fitness (CRF) has been suggested to reduce the risk of metabolic syndrome (MetS). We aimed to longitudinally examine the changes of CRF on MetS and its risk factors from adolescence to adulthood. METHODS AND RESULTS At the age of 15 years, 1076 subjects were recruited from 2 cohorts. CRF was measured on a cycle ergometer. MetS was classified as having at least 3 of the following parameters above the threshold of risk factors: waist circumference, triglycerides, high-density lipoprotein cholesterol (HDL), high blood pressure (BP) and fasting glucose. In addition, insulin, total cholesterol and low-density lipoprotein cholesterol were measured and homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. Persistently high, increasing, decreasing and persistently low CRF groups were formed according to change in CRF from adolescence to adulthood. Longitudinal increase in CRF was positively associated with change in HDL and negatively associated with change in insulin, HOMA-IR, triglycerides, BP and prevalence of MetS after adjustment for potential confounders. Subjects with persistently low CRF had 11.5- to 34.4-times higher risk of MetS at the age of 25 and 33 years compared to subjects with persistently high CRF and 14.6- to 15.9-times higher risk compared to the increasing CRF group. CONCLUSION Higher CRF is strongly related to lower values of MetS risk factors. Increasing CRF from adolescence to adulthood reduces the risk to have MetS later in adulthood. High CRF in adolescence that decreases during adulthood has similar risks to MetS compared to individuals with persistently low CRF.
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Affiliation(s)
- Evelin Mäestu
- Department of Exercise Biology, Institute of Sport Sciences and Physiotherapy, Faculty of Medicine, University of Tartu, Tartu, Estonia.
| | - Jaanus Harro
- Department of Neuropsychopharmacology, Institute of Psychology, Faculty of Social Sciences, University of Tartu, Tartu, Estonia
| | | | - Triin Kurrikoff
- Institute of Social Studies, Faculty of Social Sciences, University of Tartu, Tartu, Estonia
| | - Jaak Jürimäe
- Department of Exercise Biology, Institute of Sport Sciences and Physiotherapy, Faculty of Medicine, University of Tartu, Tartu, Estonia
| | - Jarek Mäestu
- Department of Exercise Biology, Institute of Sport Sciences and Physiotherapy, Faculty of Medicine, University of Tartu, Tartu, Estonia
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Padilla-Moledo C, Fernández-Santos JDR, Izquierdo-Gómez R, Esteban-Cornejo I, Rio-Cozar P, Carbonell-Baeza A, Castro-Piñero J. Physical Fitness and Self-Rated Health in Children and Adolescents: Cross-Sectional and Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072413. [PMID: 32252318 PMCID: PMC7177446 DOI: 10.3390/ijerph17072413] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 03/25/2020] [Accepted: 03/29/2020] [Indexed: 11/18/2022]
Abstract
Self-rated health (SRH) is an independent determinant for all-cause mortality. We aimed to examine the independent and combined associations of components of physical fitness with SRH at baseline (cross-sectional) and two years later (longitudinal) in children and adolescents. Spanish youth (N = 1378) aged 8 to 17.9 years participated at baseline. The dropout rate at 2-year follow-up was 19.5% (n = 270). Participants were categorized as either children (8 to 11.9 years age) or adolescents (12 to 17.9 years age). The ALPHA health- related fitness test battery for youth was used to assess physical fitness, and SRH was measured by a single-item question. Cumulative link, ANOVA and ANCOVA models were fitted to analyze the data. Cardiorespiratory fitness, relative upper body isometric muscular strength, muscular strength score, and global physical fitness were positively associated with SRH in children (OR, 1.048; 95% CI, 1.020–1.076; OR, 18.921; 95% CI, 3.47–104.355; OR, 1.213; 95% CI, 1.117–1.319, and OR, 1.170; 95% CI, 1.081–1.266, respectively; all p < 0.001) and adolescents (OR, 1.057; 95% CI, 1.037–1.076; OR, 5.707; 95% CI, 1.122–29.205; OR, 1.169; 95% CI, 1.070–1.278, and OR, 1.154 95% CI, 1.100–1.210, respectively; all p < 0.001); and motor fitness was positively associated with SRH only in adolescents at baseline (OR, 1.192; 95% CI, 1.066–1.309; p < 0.01). Cardiorespiratory fitness and global physical fitness were positively associated with SRH in children two years later (OR, 1.056; 95% CI, 1.023–1.091; p < 0.001; and OR, 1.082; 95% CI, 1.031–1.136; p < 0.01; respectively). Only cardiorespiratory fitness was independently associated with SRH in children and adolescents at baseline (OR, 1.059; 95% CI, 1.029–1.090; and OR, 1.073; 95% CI, 1.050–1.097, respectively; both p < 0.001) and two years later (OR, 1.075; 95% CI, 1.040–1.112; p < 0.001; and OR, 1.043; 95% CI, 1.014–1.074; p < 0.01, respectively). A high level of cardiorespiratory fitness at baseline or maintaining high levels of cardiorespiratory fitness from the baseline to 2-year follow-up were associated with a higher level of SRH at 2-year follow-up in children (p < 0.01) and adolescents (p < 0.05). These findings emphasize the importance of cardiorespiratory fitness as strong predictor of present and future SRH in youth. Intervention programs to enhance cardiorespiratory fitness level of the youth population are urgently needed for present and future youth’s health.
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Affiliation(s)
- Carmen Padilla-Moledo
- GALENO research group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, 115010 Puerto Real, Spain (R.I.-G.); (P.R.-C.); (A.C.-B.); (J.C.-P.)
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, 11008 Cádiz, Spain
- Correspondence: ; Tel.: +34-956016222
| | - Jorge DR Fernández-Santos
- GALENO research group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, 115010 Puerto Real, Spain (R.I.-G.); (P.R.-C.); (A.C.-B.); (J.C.-P.)
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, 11008 Cádiz, Spain
| | - Rocio Izquierdo-Gómez
- GALENO research group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, 115010 Puerto Real, Spain (R.I.-G.); (P.R.-C.); (A.C.-B.); (J.C.-P.)
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, 11008 Cádiz, Spain
| | - Irene Esteban-Cornejo
- PROFITH “PROmoting FITness and Health through physical activity” research group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18071 Granada, Spain;
- Center for Cognitive and Brain Health, Department of Psychology, Northeastern University, Boston, MA 02115, USA
| | - Paula Rio-Cozar
- GALENO research group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, 115010 Puerto Real, Spain (R.I.-G.); (P.R.-C.); (A.C.-B.); (J.C.-P.)
| | - Ana Carbonell-Baeza
- GALENO research group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, 115010 Puerto Real, Spain (R.I.-G.); (P.R.-C.); (A.C.-B.); (J.C.-P.)
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, 11008 Cádiz, Spain
| | - Jose Castro-Piñero
- GALENO research group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, 115010 Puerto Real, Spain (R.I.-G.); (P.R.-C.); (A.C.-B.); (J.C.-P.)
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, 11008 Cádiz, Spain
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Nikolakaros G, Vahlberg T, Sillanmäki L, Sourander A. Recurrent depression in childhood and adolescence and low childhood socioeconomic status predict low cardiorespiratory fitness in early adulthood. J Affect Disord 2020; 266:782-792. [PMID: 32217260 DOI: 10.1016/j.jad.2019.11.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 10/30/2019] [Accepted: 11/09/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Cardiorespiratory fitness (CRF) strongly influences health, but very little is known about the childhood determinants of adult CRF. Our longitudinal study investigated whether childhood psychopathology and socioeconomic status (SES) were related to adult CRF in 1647 Finnish male military conscripts. METHODS Childhood psychopathology was assessed at the age of eight using the Rutter and Children's Depression Inventory questionnaires. Parental education and family structure were used to assess childhood SES. In late adolescence, depressive symptoms were assessed with the Beck Depression Inventory and smoking with a questionnaire. CRF in early adulthood was examined with the Cooper's 12-minute run test. RESULTS General linear models showed that low parental education (p=0.001), depressive symptoms in childhood (p=0.035) and late adolescence, smoking, underweight, and overweight/obesity (all p<0.001) independently predicted lower CRF. The interaction between depressive symptoms in childhood and adolescence was significant (p=0.003). In adolescents with depressive symptoms, childhood depressive symptoms (p=0.001) and overweight/obesity (p<0.001) predicted lower CRF. In adolescents without depressive symptoms, conduct problems in childhood predicted lower CRF in the initial models, but the effect disappeared after taking into account smoking and body mass index. Mediational analysis confirmed these results. LIMITATIONS We lacked data on physical activity and only studied males at three time-points. CONCLUSIONS Recurrent depression in childhood and adolescence and low SES in childhood predict lower adult CRF. Conduct problems in childhood predict lower CRF, but the effect is mediated by overweight/obesity and smoking. Psychiatric treatment for children and adolescents should promote physical activity, particularly for children with low SES.
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Affiliation(s)
- Georgios Nikolakaros
- Department of Clinical Neurophysiology, HUS Medical Imaging Center, Helsinki University and Helsinki University Hospital, Finland; Sleep Disorders Outpatient Clinic, Psychiatry, Helsinki University and Helsinki University Hospital, Finland.
| | - Tero Vahlberg
- Department of Clinical Medicine, Biostatistics, University of Turku, Finland
| | - Lauri Sillanmäki
- Research Center for Child Psychiatry, University of Turku, Finland
| | - Andre Sourander
- Research Center for Child Psychiatry, University of Turku, Finland; INVEST Research Flagship, University of Turku, Finland (Principal Investigator)
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Chrismas BCR, Majed L, Kneffel Z. Physical fitness and physical self-concept of male and female young adults in Qatar. PLoS One 2019; 14:e0223359. [PMID: 31600266 PMCID: PMC6786589 DOI: 10.1371/journal.pone.0223359] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 09/19/2019] [Indexed: 11/18/2022] Open
Abstract
Background Physical inactivity is high within the Qatari population, particularly within females, and school-based environments, contributing to increased morbidity and mortality. School-based physical activity (PA) outcomes may be mediated by physical self-concept. Low physical self-concept may negatively impact PA engagement, compromising childhood and adolescent physical fitness, which may translate into adulthood. Normative physical fitness data for the Qatari population is unavailable. Stratifying normative physical fitness appears prudent, to not only allow comparisons to be made worldwide, but enable informed decisions for public health policy and future interventions in the Qatari population. Purpose To establish the physical fitness of young adults in Qatar, and examine differences between males and females for physical self-concept, and engagement in school-based and extra-curricular PA. Method 186 (females n = 85) healthy participants [median (minimum—maximum) age: males = 21 (18–26), females = 21 (18–24) y; height: males = 1.74 (1.57–1.99), females = 1.61 (1.46–1.76) m; body mass: males = 71.9 (49.3–145.0), females = 56.8 (35.7–96.4) kg] completed the ALPHA-FIT test battery for adults (one leg stand, figure of eight run, handgrip strength, jump and reach, modified push-up, dynamic sit-up and 2 km walk), physical self-description questionnaire (measuring physical self-concept), and were asked to answer ‘yes’ or ‘no’ to whether they participated in school-based and extra-curricular PA. Results Data is reported as effect size; ±90% confidence limit. Males compared to females most likely performed better for dynamic sit-up (2.2; ±0.76), very likely better for the figure of eight run (0.86; ±0.42) and likely better for handgrip strength (2.1; ±0.75). Males likely had higher physical self-concept for coordination (0.78; ±0.37) and endurance (0.66; ±0.27) compared to females. There were no differences for school-based PA (p ≥ 0.78) or for extra-curricular PA for males (p ≥ 0.26) or females (p ≥ 0.21). Conclusion The data suggests that the young Qatari adult population has variable, yet generally low, physical fitness traits compared to individuals worldwide, likely due to their low PA. The precise aetiology for this is not well documented, yet such data may be prudent to evidence-inform strategies to improve physical fitness through increased PA (synergistic relationship), given the strong association between physical activity/fitness and morbidity/mortality.
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Affiliation(s)
- Bryna C. R. Chrismas
- Qatar University, Sport Science Program, College of Arts and Science, Doha, Qatar
- * E-mail:
| | - Lina Majed
- Qatar University, Sport Science Program, College of Arts and Science, Doha, Qatar
| | - Zsuzsanna Kneffel
- Qatar University, Sport Science Program, College of Arts and Science, Doha, Qatar
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Associations between Neighborhood Open Space Features and Walking and Social Interaction in Older Adults-A Mixed Methods Study. Geriatrics (Basel) 2019; 4:geriatrics4030041. [PMID: 31284590 PMCID: PMC6787595 DOI: 10.3390/geriatrics4030041] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 07/01/2019] [Accepted: 07/05/2019] [Indexed: 12/01/2022] Open
Abstract
Neighborhood Open Spaces (NOS) such as public spaces around people’s homes, parks and village greens, may support activity and socializing for older adults. These spaces might be especially important for older adults as they typically are less mobile and have smaller activity spaces and social networks than other age groups. The present exploratory sequential mixed methods study investigates the association between built environment features, social interaction, and walking within NOS, among older adults living in a low socio-economic neighborhood in Copenhagen. Interviews, the Community Park Audit Tool, and the System for Observing Play and Recreation in Communities (SOPARC) were used to capture quantitative and qualitative data on 353 older adults (59–90 years old) within 11 NOS. Walking was predicted by the condition and shade along paths, seating and landscaping. Social interaction was negatively associated with walking, suggesting that older adults tend to sit down when engaging in social activities. Interviews highlighted the importance of social interaction within NOS. Future designs of NOS should acknowledge the importance of social meeting places, but at the same time provide walkable spaces for older adults to promote healthy aging.
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Socioeconomic inequalities in childhood-to-adulthood BMI tracking in three British birth cohorts. Int J Obes (Lond) 2019; 44:388-398. [PMID: 31168054 PMCID: PMC6997121 DOI: 10.1038/s41366-019-0387-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 03/27/2019] [Accepted: 04/19/2019] [Indexed: 01/10/2023]
Abstract
BACKGROUND Body mass index (BMI) tracks from childhood-to-adulthood, but the extent to which this relationship varies across the distribution and according to socio-economic position (SEP) is unknown. We aimed to address this using data from three British cohort studies. METHODS We used data from: 1946 National Survey of Health and Development (NSHD, n = 2470); 1958 National Child Development Study (NCDS, n = 7747); 1970 British Cohort Study (BCS, n = 5323). BMI tracking between 11 and 42 years was estimated using quantile regression, with estimates reflecting correlation coefficients. SEP disparities in tracking were investigated using a derived SEP variable based on parental education reported in childhood. This SEP variable was then interacted with the 11-year BMI z-score. RESULTS In each cohort and sex, tracking was stronger at the upper end of the distribution of BMI at 42 years. For example, for men in the 1946 NSHD, the tracking estimate at the 10th quantile was 0.31 (0.20, 0.41), increasing to 0.71 (0.61, 0.82) at the 90th quantile. We observed no strong evidence of SEP inequalities in tracking in men in the 1946 and 1958 cohorts. In the 1970 cohort, however, we observed tentative evidence of stronger tracking in low SEP groups, particularly in women and at the higher end of the BMI distribution. For example, women in the 1970 cohort from low SEP backgrounds had tracking coefficients at the 50th, 70th, and 90th quantiles, which were 0.05 (-0.04; 0.15), 0.19 (0.06; 0.31), and 0.22 (0.02; 0.43) units higher, respectively, than children from high SEP groups. CONCLUSION Tracking was consistently stronger at the higher quantiles of the BMI distribution. We observed suggestive evidence for a pattern of greater BMI tracking in lower (compared to higher) SEP groups in the more recently born cohort, particularly in women and at the higher end of the BMI distribution.
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Jordão LMR, Malta DC, Freire MDCM. Simultaneous oral health risk behaviors among adolescents: evidence from the National School-based Student Health Survey. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2018; 21:e180019. [PMID: 30517470 DOI: 10.1590/1980-549720180019.supl.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 11/16/2017] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To investigate the prevalence of simultaneous oral health risk behaviors and associated factors among Brazilian adolescents. METHODS The study comprised data of 109,104 adolescents participating in the Brazilian National School-based Student Health Survey. The simultaneous presence of less frequent toothbrushing (E), current smoking (C), no visits to the dentist (D), low fruit intake (F), and high sugar intake (A) was assessed by comparison of observed/expected prevalence (OP/EP). Logistic regression was used to assess sociodemographic and family factors associated with the clustering patterns of oral health risk behaviors. RESULTS The simultaneous occurrence of two or more oral health risk behaviors was of 60.40%. The highest prevalence values were found for the following patterns with OP/EP over 1.20: EDF, CFA, and EDFA. The odds for two or more combined oral health risk behaviors were higher for adolescents whose parents did not participate in homework, from public schools, males, and of Asian or Indigenous ethnicity (OR > 1.00; p < 0.05). Low family affluence level (FAL) acted as a risk factor for the pattern ECDFA (OR = 2.58; p = 0.009), while low and mean FAL functioned as protection factors for the pattern CFA (OR = 0.71; p < 0.001, and OR = 0.76; p = 0.011). CONCLUSION The prevalence of simultaneous oral health risk behaviors was low and negatively associated with sociodemographic and family factors. Interventions aiming at reducing these behavior patterns should prioritize the groups that have been identified as being at most risk.
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Affiliation(s)
| | - Deborah Carvalho Malta
- Escola de Enfermagem, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brasil
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Pedersen NH, Koch S, Larsen KT, Kristensen PL, Troelsen J, Møller NC, Brønd JC, Hjelmborg JVB, Brage S, Grøntved A. Protocol for evaluating the impact of a national school policy on physical activity levels in Danish children and adolescents: the PHASAR study - a natural experiment. BMC Public Health 2018; 18:1245. [PMID: 30409171 PMCID: PMC6225578 DOI: 10.1186/s12889-018-6144-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 10/23/2018] [Indexed: 12/17/2022] Open
Abstract
Background In 2014 the Danish Government introduced a wide-ranging school reform that applies to all public schools in Denmark. The reform involves changes in several aspects of the school structure and content. In a physical activity promotion perspective, a distinctive feature of the school reform is that it has become mandatory to integrate an average of 45 min of daily physical activity in the regular school day. The overarching objective of the PHASAR study is to evaluate the implementation and effect of this ambitious policy-driven physical activity promotion initiative on physical activity and overweight. This paper describes in detail the study protocol. Methods The evaluation is divided into a quantitative effect evaluation and a combined quantitative and qualitative process evaluation. A total of 31 schools are enrolled in the PHASAR study including more than 2,000 school-aged children. Objectively measured physical activity data are obtained in the PHASAR study in 2017/18 and compared to repeated cross sectional data collected in four historical school-based studies from 1998 to 2012. Body mass index data from 2012 to 2018 will be collected from The Child Database, which includes repeated cross-sectional assessments on approximately 100,000 children annually. In the absence of a control group, interrupted time-series analysis will be used to evaluate pre- and post-reform physical activity and body mass index levels and trends. A characterization of the school environment for physical activity promotion on a political, environmental, organizational and individual level and school implementation processes will be conducted to evaluate the implementation process. Data will be collected using interviews, surveys, document analyses and observations. Discussion The PHASAR study is a rare opportunity to evaluate the effectiveness of a nation-wide policy-driven school-based physical activity promotion initiative. The use of objectively measured pre- and post-reform physical activity and body mass index data combined with a characterization of the school implementation processes for physical activity promotion will provide a comprehensive source to evaluate the school reform. The study findings have the potential to influence national and international policy makers, health professionals and school staff.
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Affiliation(s)
- Natascha Holbæk Pedersen
- Centre of Research in Childhood Health, Research Unit for Exercise Epidemiology, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.
| | - Sofie Koch
- Research unit for Active Living, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - Kristian Traberg Larsen
- Centre of Research in Childhood Health, Research Unit for Exercise Epidemiology, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - Peter Lund Kristensen
- Centre of Research in Childhood Health, Research Unit for Exercise Epidemiology, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - Jens Troelsen
- Research unit for Active Living, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - Niels Christian Møller
- Centre of Research in Childhood Health, Research Unit for Exercise Epidemiology, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - Jan Christian Brønd
- Centre of Research in Childhood Health, Research Unit for Exercise Epidemiology, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - Jacob von Bornemann Hjelmborg
- The Danish Twin Registry, Epidemiology, Biostatistics and Biodemography, SDU eScience Centre, J. B. Winsløws Vej 9, 5000, Odense C, Denmark
| | - Søren Brage
- Centre of Research in Childhood Health, Research Unit for Exercise Epidemiology, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.,MRC Epidemiology Unit, Cambridge School of Clinical Medicine, Institute of Metabolic Science, University of Cambridge, Box 285, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Anders Grøntved
- Centre of Research in Childhood Health, Research Unit for Exercise Epidemiology, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
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Castro-Piñero J, Perez-Bey A, Segura-Jiménez V, Aparicio VA, Gómez-Martínez S, Izquierdo-Gomez R, Marcos A, Ruiz JR. Cardiorespiratory Fitness Cutoff Points for Early Detection of Present and Future Cardiovascular Risk in Children: A 2-Year Follow-up Study. Mayo Clin Proc 2017; 92:1753-1762. [PMID: 29157533 DOI: 10.1016/j.mayocp.2017.09.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 09/11/2017] [Accepted: 09/13/2017] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To examine the association between cardiorespiratory fitness (CRF) at baseline and cardiovascular disease (CVD) risk in 6- to 10-year-olds (cross-sectional) and 2 years later (8- to 12-year-olds [longitudinal]) and whether changes with age in CRF are associated with CVD risk in children aged 8 to 12 years. PATIENTS AND METHODS Spanish primary schoolchildren (n=236) aged 6 to 10 years participated at baseline. Of the 23 participating primary schools, 22% (n=5) were private schools and 78% (n=18) were public schools. The dropout rate at 2-year follow-up was 9.7% (n=23). The 20-m shuttle run test was used to estimate CRF. The CVD risk score was computed as the mean of 5 CVD risk factor standardized scores: sum of 2 skinfolds, systolic blood pressure, insulin/glucose, triglycerides, and total cholesterol/high-density lipoprotein cholesterol. RESULTS At baseline, CRF was inversely associated with single CVD risk factors (all P<.05) and CVD risk score at baseline and follow-up (P<.001). Cardiorespiratory fitness cutoff points of 39.0 mL/kg per minute or greater in boys and 37.5 mL/kg per minute or greater in girls are discriminative to identify CVD risk in childhood (area under the curve, >0.85; P<.001) and to predict CVD risk 2 years later (P=.004). Persistent low CRF or the decline of CRF from 6-10 to 8-12 years of age is associated with increased CVD risk at age 8 to 12 years (P<.001). CONCLUSION During childhood, CRF is a strong predictor of CVD risk and should be monitored to identify children with potential CVD risk.
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Affiliation(s)
- José Castro-Piñero
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Puerto Real, Spain.
| | - Alejandro Perez-Bey
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Puerto Real, Spain
| | - Víctor Segura-Jiménez
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Puerto Real, Spain
| | - Virginia A Aparicio
- Department of Physiology, Faculty of Pharmacy, Faculty of Sport Sciences, and Institute of Nutrition and Food Technology, University of Granada, Granada, Spain; Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
| | - Sonia Gómez-Martínez
- Immunonutrition Group, Institute of Food Science, Technology and Nutrition, Spanish National Research Council, Madrid, Spain
| | - Rocio Izquierdo-Gomez
- Research Center, Faculty of Education, Universidad Central de Chile, Santiago, Chile
| | - Ascensión Marcos
- Immunonutrition Group, Institute of Food Science, Technology and Nutrition, Spanish National Research Council, Madrid, Spain
| | - Jonatan R Ruiz
- PROmoting FITness and Health through physical activity research group (PROFIT), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
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Alzahrani SG, Sheiham A, Tsakos G, Watt RG. Psychosocial determinants of clustering health-compromising behaviors among Saudi male adolescents. Int J Pediatr Adolesc Med 2017; 4:26-32. [PMID: 30805496 PMCID: PMC6372447 DOI: 10.1016/j.ijpam.2016.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 11/05/2016] [Accepted: 11/22/2016] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND OBJECTIVES To assess whether the clustering of six specific health-compromising behaviors, namely, low fruit consumption, high sweet consumption, infrequent tooth brushing, physical inactivity, fighting and smoking, varied by different psychosocial determinants such as life satisfaction, peer relationships, self-confidence, and future orientation among male adolescents in Saudi Arabia. PATIENTS AND METHODS A representative stratified cluster random sample of 1335 Saudi Arabian male adolescents living in the city of Riyadh answered a questionnaire on health-related behaviors. Poisson regression models were constructed separately for younger (13-14-years-old) and older (17-19-years-old) adolescents to assess variations between explanatory psychosocial variables and the clustering of six health-compromising behaviors, adjusting for father's education. RESULTS Older adolescents who perceived high levels of life satisfaction had a lower rate of clustering of multiple health-compromising behaviors compared to those reporting lower levels (RR: 1.22; 95%CI: 1.09-1.37), and the respective difference between those with high and those with middle levels of satisfaction was marginally non-significant (RR: 1.08; 95%CI: 0.98-1.19). Younger adolescents who reported that they felt "less than always" self-confident were more likely to have high clustering of health compromising behaviors compared to those who were always confident (RR: 1.08; 95%CI: 1.01-1.21). The clustering of multiple health-compromising behaviors was marginally associated with the frequency of evening meetings among older adolescents (RR: 1.03; 95%CI: 1.01-1.04 for each extra meeting), while the respective association among younger adolescents was marginally non-significant (RR: 1.02; 95%CI: 0.99-1.05). The association between clustering of health-compromising behaviors and future orientation was non-significant among both younger and older adolescents. CONCLUSIONS Clustering of health-compromising behaviors was found to be associated with perceived life satisfaction and peer relationships among older male Saudi adolescents and with self-confidence among younger male Saudi adolescents in Riyadh.
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Affiliation(s)
- Saeed G. Alzahrani
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK
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Morgen CS, Andersen PK, Mortensen LH, Howe LD, Rasmussen M, Due P, Sørensen TIA, Andersen AMN. Socioeconomic disparities in birth weight and body mass index during infancy through age 7 years: a study within the Danish National Birth Cohort. BMJ Open 2017; 7:e011781. [PMID: 28110282 PMCID: PMC5253532 DOI: 10.1136/bmjopen-2016-011781] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 11/07/2016] [Accepted: 12/15/2016] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Socioeconomic inequalities in birth weight and in body mass index (BMI) later in childhood are in opposite directions, which raises questions about when during childhood the change in direction happens. We examined how maternal and paternal education and household income were associated with birthweight z-scores and with BMI z-scores at age 5 and 12 months and 7 years, and we examined the socioeconomic differences in the tracking of these z-scores across infancy and childhood. METHODS The associations were studied in a cohort of children in the Danish National Birth Cohort, single born between 1997 and 2003, for whom information on body size from at least 1 of 4 time points (n=85 062) was recorded. We examined the associations using linear mixed-effects modelling. RESULTS Children from families with a low maternal and paternal educational level changed their body size z-scores upwards between birth and age 7 years. At age 5 and 12 months, there were no educational gradient. A low maternal educational level was associated with lower birth weight for gestational age z-scores at birth for boys (-0.199; 95% CI -0.230 to -0.169) and girls (-0.198; 95% CI -0.229 to -0.167) and higher BMI z-scores at age 7 for boys (0.198; 95% CI 0.154 to 0.242) and girls (0.218; 95% CI 0.173 to 0.264). There was not a similarly clear pattern in the tracking between different household income groups. However, a low household income level was associated with higher z-scores of both birth weight and BMI at age 7 years, but with a much weaker gradient at 5 and 12 months. CONCLUSIONS The educational gradient shifts from positive with birth weight, to none during infancy to inverse with BMI at age 7 years. In contrast, the income gradient was positive at birth and at 7 years and much weaker during infancy.
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Affiliation(s)
- Camilla Schmidt Morgen
- Department of Clinical Epidemiology (formerly Institute of Preventive Medicine), Copenhagen, Denmark
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Per Kragh Andersen
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Laust Hvas Mortensen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Laura D Howe
- MRC Integrative Epidemiology Unit, The University of Bristol, and School of Social and Community Medicine, University of Bristol, Bristol, UK
| | | | - Pernille Due
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Thorkild I A Sørensen
- Department of Clinical Epidemiology (formerly Institute of Preventive Medicine), Copenhagen, Denmark
- MRC Integrative Epidemiology Unit, The University of Bristol, and School of Social and Community Medicine, University of Bristol, Bristol, UK
- Faculty of Health and Medical Sciences, Novo Nordisk Foundation Center for Basic Metabolic Research and Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Anne-Marie Nybo Andersen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Gidding SS. Special Article: Physical Activity, Physical Fitness, and Cardiovascular Risk Factors in Childhood. Am J Lifestyle Med 2016. [DOI: 10.1177/1559827607306432] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
In adults, physical activity and exercise training are associated with reduced cardiovascular morbidity and mortality, a reduced likelihood of developing adverse cardiovascular risk factors, and improved insulin sensitivity. In childhood, participation in appropriate physical activity may prevent the development of cardiovascular risk factors in the future and complement treatment of existing cardiovascular risk factors, including hypertension, dyslipidemia, and overweight. Exercise in children can also significantly improve insulin sensitivity independent of weight loss. These e fects are mediated in overweight children by increases in lean body mass relative to fat mass and associated improvements in inflammatory mediators, endothelial function, and the associated adverse hormonal milieu.
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Affiliation(s)
- Samuel S. Gidding
- Jefferson Medical College and Nemours Cardiac Center, A. I. duPont Hospital for Children, Wilmington, Delaware,
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Cardiorespiratory fitness cut points to avoid cardiovascular disease risk in children and adolescents; what level of fitness should raise a red flag? A systematic review and meta-analysis. Br J Sports Med 2016; 50:1451-1458. [DOI: 10.1136/bjsports-2015-095903] [Citation(s) in RCA: 185] [Impact Index Per Article: 23.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2016] [Indexed: 02/06/2023]
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The 2013 cholesterol guideline controversy: Would better evidence prevent pharmaceuticalization? Health Policy 2016; 120:797-808. [PMID: 27256859 DOI: 10.1016/j.healthpol.2016.05.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2015] [Revised: 05/10/2016] [Accepted: 05/12/2016] [Indexed: 01/08/2023]
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Sherar LB, Griffin TP, Ekelund U, Cooper AR, Esliger DW, van Sluijs EMF, Bo Andersen L, Cardon G, Davey R, Froberg K, Hallal PC, Janz KF, Kordas K, Kriemler S, Pate RR, Puder JJ, Sardinha LB, Timperio AF, Page AS. Association between maternal education and objectively measured physical activity and sedentary time in adolescents. J Epidemiol Community Health 2016; 70:541-8. [PMID: 26802168 PMCID: PMC4893139 DOI: 10.1136/jech-2015-205763] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 12/14/2015] [Indexed: 11/24/2022]
Abstract
Background Investigating socioeconomic variation in physical activity (PA) and sedentary time is important as it may represent a pathway by which socioeconomic position (SEP) leads to ill health. Findings on the association between children's SEP and objectively assessed PA and/or sedentary time are mixed, and few studies have included international samples. Objective Examine the associations between maternal education and adolescent's objectively assessed PA and sedentary time. Methods This is an observational study of 12 770 adolescents (10–18 years) pooled from 10 studies from Europe, Australia, Brazil and the USA. Original PA data were collected between 1997 and 2009. The associations between maternal education and accelerometer variables were examined using robust multivariable regression, adjusted for a priori confounders (ie, body mass index, monitor wear time, season, age and sex) and regression coefficients combined across studies using random effects meta-analyses. Analyses were conducted in March 2014. Results Adolescents of university educated mothers spent more time sedentary (9.5 min/day, p=0.005) and less time in light activity (10 min/day, p<0.001) compared with adolescents of high school educated mothers. Pooled analysis across two studies from Brazil and Portugal (analysed separately because of the different coding of maternal education) showed that children of higher educated mothers (tertiary vs primary/secondary) spent less time in moderate to vigorous PA (MVPA) (6.6 min/day, p=0.001) and in light PA (39.2 min/day: p<0.001), and more time sedentary (45.9 min/day, p<0.001). Conclusions Across a number of international samples, adolescents of mothers with lower education may not be at a disadvantage in terms of overall objectively measured PA.
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Affiliation(s)
- Lauren B Sherar
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK NIHR Leicester - Loughborough Diet, Lifestyle, and Physical Activity Biomedical Research Unit, Leicester, UK
| | - Tom P Griffin
- Centre for Exercise, Nutrition and Health Sciences/School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Ulf Ekelund
- Norwegian School for Sport Science, Oslo, Norway MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Ashley R Cooper
- Centre for Exercise, Nutrition and Health Sciences/School for Policy Studies, University of Bristol, Bristol, UK
| | - Dale W Esliger
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK NIHR Leicester - Loughborough Diet, Lifestyle, and Physical Activity Biomedical Research Unit, Leicester, UK
| | - Esther M F van Sluijs
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK Centre of Diet and Activity Research, Unicersity of Cambridge, Cambridge, UK
| | - Lars Bo Andersen
- Norwegian School for Sport Science, Oslo, Norway Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Greet Cardon
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - Rachel Davey
- Centre for Research & Action in Public Health, University of Canberra, Canberra, Australia
| | - Karsten Froberg
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | | | - Kathleen F Janz
- Department of Health and Human Physiology, Department of Epidemiology, University of Iowa, Iowa City, Iowa, USA
| | - Katarzyna Kordas
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Susi Kriemler
- Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Zürich, Switzerland
| | - Russell R Pate
- Department of Exercise Science at the University of South Carolina, South Carolina, USA
| | - Jardena J Puder
- Service of Endocrinology, Diabetes and Metabolism, University Hospital, CHUV, Lausanne, Switzerland
| | - Luis B Sardinha
- Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
| | - Anna F Timperio
- School of Exercise and Nutrition Sciences/Centre for Physical Activity and Nutrition Research, Deakin University, Melbourne, Victoria, Australia
| | - Angie S Page
- Centre for Exercise, Nutrition and Health Sciences/School for Policy Studies, University of Bristol, Bristol, UK
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Hartman E, Smith J, Westendorp M, Visscher C. Development of physical fitness in children with intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2015; 59:439-449. [PMID: 24953003 DOI: 10.1111/jir.12142] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/30/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND Few studies examined the development of physical fitness in children and youth with intellectual disabilities (ID), but the developmental patterns of physical fitness are largely unknown. The first aim was to examine physical fitness of primary school children with ID, aged 8-12, and compare the results with typically developing children in order to determine the performance level of children with ID. The second aim was to investigate the developmental trajectory of physical fitness in children with ID and the possible influence of gender and severity of cognitive impairment in a 4-year during longitudinal study. METHOD Seventy-three children with borderline or mild ID (51 boys, 22 girls; age range 8-11 in the year of enrolment) were measured annually on running speed, aerobic endurance (cardiovascular endurance), explosive strength, handgrip strength and trunk strength. Physical fitness scores of 515 typically developing children (266 boys, 249 girls; age range 8-12) were collected for reference values. RESULTS The results indicated statistically significant differences (with moderate to large Effect Sizes) between children with ID and typically developing children in all ages, favouring the typically developing children, and showed that the gap remained stable across the ages or decreased with increasing age. Multilevel models showed that the children with ID developed statistically significant on all items of physical fitness between age 8 and age 12. There was no statistically significant effect of gender on physical fitness, and the developmental trajectories were similar for boys and girls. For children with borderline and mild ID the developmental trajectories were parallel, but children with mild ID scored statistically significant worse on running speed, explosive strength and handgrip strength. CONCLUSIONS Despite statistically significant development of physical fitness in children with ID, their physical fitness levels should be stimulated. This should start already in young children (<8 years) and the children with the most severe cognitive impairments need special attention.
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Affiliation(s)
- E Hartman
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands
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Boylan SM, Gill TP, Hare-Bruun H, Andersen LB, Heitmann BL. Associations between adolescent and adult socioeconomic status and risk of obesity and overweight in Danish adults. Obes Res Clin Pract 2015; 8:e163-71. [PMID: 24743012 DOI: 10.1016/j.orcp.2013.03.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Revised: 03/21/2013] [Accepted: 03/24/2013] [Indexed: 11/18/2022]
Abstract
BACKGROUND It has been suggested that socioeconomic status (SES) may influence the risk of obesity; however it is important to consider individual changes in SES over the life-course in addition to SES at specific time-points to better understand the complex associations with obesity. We explored the relationship between lifetime-specific and life-course SES and risk of obesity and overweight in Danish adults. METHODS Data were used from the Danish Youth and Sports Study (DYSS) – a 20–22 year follow-up study of Danish teenagers born between 1964 and 1969. Baseline data gathered in 1983 and 1985 included self-reported BMI, SES and physical activity. The follow-up survey (2005) repeated these assessments in addition to an assessment of diet. Complete data on adolescent and adult SES and BMI were available for 623 participants. RESULTS Following adjustments, adolescent SES had no significant association with overweight/obesity in this sample, however females of low or medium adult SES were significantly more likely to be overweight/obese compared to those of high SES (low SES: OR: 2.7; 95% CI: (1.3–5.8); p = 0.008; medium SES: OR: 4.0, 95% CI (1.6–10.2); p = 0.003). Females who decreased in SES during adulthood were significantly more likely to be overweight/obese compared to those who remained of high SES (OR: 3.1; 95% CI (1.1–9.2); p = 0.04). CONCLUSION Effects of early life-factors may be conditional upon the environment in adulthood, particularly for the women. Further research should consider the timing of SES exposure and the mechanisms which may be responsible for the socioeconomic gradients in prevalence of obesity and overweight.
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Affiliation(s)
- Sinead M Boylan
- Institute of Sports Science and Clinical Biomechanics, and National Institute of Public Health, University of Southern Denmark, DK-5230 Odense M, Denmark
| | - Timothy P Gill
- Institute of Sports Science and Clinical Biomechanics, and National Institute of Public Health, University of Southern Denmark, DK-5230 Odense M, Denmark
| | - Helle Hare-Bruun
- Institute of Sports Science and Clinical Biomechanics, and National Institute of Public Health, University of Southern Denmark, DK-5230 Odense M, Denmark
| | - Lars B Andersen
- Institute of Sports Science and Clinical Biomechanics, and National Institute of Public Health, University of Southern Denmark, DK-5230 Odense M, Denmark
| | - Berit L Heitmann
- Institute of Sports Science and Clinical Biomechanics, and National Institute of Public Health, University of Southern Denmark, DK-5230 Odense M, Denmark
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Howe LD, Firestone R, Tilling K, Lawlor DA. Trajectories and Transitions in Childhood and Adolescent Obesity. A LIFE COURSE PERSPECTIVE ON HEALTH TRAJECTORIES AND TRANSITIONS 2015. [DOI: 10.1007/978-3-319-20484-0_2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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A 6 year longitudinal study of accelerometer-measured physical activity and sedentary time in Swedish adults. J Sci Med Sport 2014; 18:553-7. [PMID: 25277849 DOI: 10.1016/j.jsams.2014.07.012] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2014] [Revised: 07/04/2014] [Accepted: 07/17/2014] [Indexed: 11/22/2022]
Abstract
OBJECTIVES The aim of this study was to investigate changes over six years in physical activity and sedentary behavior assessed with accelerometry in a representative sample of Swedish adults. DESIGN A longitudinal study over six years. METHODS The cohort consisted of 1172 participants (46% males) in 2002 and 511 participants (46% males) in 2008, of which 478 (45% males) had valid data on both occasions. Mean (SD) age at baseline was 45 (15) years. To analyze changes over time, a mixed linear model for average intensity physical activity (counts/min) and time in sedentary behavior and light- and moderate- or higher-intensity physical activity was conducted, stratified for sex and age, and adjusted for BMI, education, self-rated health and Δ wear time. RESULTS Over a six year period no significant changes were seen in the total cohort for average intensity and time in moderate- or higher intensity physical activity. A significant decrease in average intensity physical activity was found for men (p=0.006) and those aged 60+ years at baseline (p<0.001). A significant increase (26 min/day) for sedentary time in the total cohort (p<0.001) and for time in moderate or higher intensity physical activity among women (p<0.001) and those aged 40-59 years at baseline (p=0.014) was found over the follow-up period. CONCLUSIONS The overall increase in sedentary time and decrease in average physical activity among men and the elderly are of concern, since they might result in an elevated risk of developing chronic diseases.
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Ortega FB, Ruiz JR, Labayen I, Hurtig-Wennlöf A, Harro J, Kwak L, Oja L, Merenäkk L, Veidebaum T, Sjöström M. Role of socio-cultural factors on changes in fitness and adiposity in youth: a 6-year follow-up study. Nutr Metab Cardiovasc Dis 2013; 23:883-890. [PMID: 22795868 DOI: 10.1016/j.numecd.2012.05.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2011] [Revised: 05/08/2012] [Accepted: 05/12/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND AND AIMS Optimal cardio-respiratory fitness and adiposity levels are tightly related to health in youth. We analysed changes in fitness and adiposity in young individuals from two countries, and examined the role of maternal education in these changes. METHODS AND RESULTS A 6-year follow-up study was conducted on 483 Estonian children (9 years) and 466 Swedish children (9-10 years) and adolescents (15 years). Fitness was assessed by a maximal bike test, and total and central adiposity were indirectly estimated by skinfolds (Slaughter's equation for fat mass) and waist circumference. At follow-up, fitness and adiposity had increased in the children cohort (P ≤ 0.001), while small or no change occurred in the adolescent cohort. In the children cohort, Estonian participants had a lower increase in fitness and a higher increase in adiposity (total and central) than Swedish participants. Higher maternal education increased the odds of remaining fit (top quartile) by half and reduced the risk of remaining fat (top quartile) by half; odds ratios = 1.56 (1.00-2.43), 0.50 (0.32-0.77) and 0.61 (0.39-0.94) for fitness, total and central adiposity, respectively. CONCLUSIONS Our data suggest that the socioeconomic situation of a country might influence key cardiovascular risk factors (fitness and adiposity), being at higher risk for a low-middle income country (Estonia) than a higher income country (Sweden). The findings stress the role of socioeconomic status, particularly maternal education, in the maintenance of healthy fitness and adiposity levels from childhood into later life. Preventive efforts have to be taken from early age.
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Affiliation(s)
- F B Ortega
- Department of Biosciences and Nutrition at NOVUM, Karolinska Institutet, Huddinge, Sweden; Department of Medical Physiology, School of Medicine, University of Granada, Granada, Spain; Department of Physical Education and Sport, School of Sport Sciences, University of Granada, Granada, Spain.
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Yaghoubi A, Safaie N, Azarfarin R, Alizadehasl A, Golzari SEJ. Evaluation of cardiovascular diseases and their risk factors in hospitalized patients in East azerbaijan province, northwest iran: a review of 18323 cases. J Tehran Heart Cent 2013; 8:101-5. [PMID: 23967032 PMCID: PMC3740106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2011] [Accepted: 10/10/2012] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Coronary artery disease (CAD) is accountable for more than 30% of deaths worldwide and is, thus, deemed the most important factor in terms of disease burden around the globe. This study aimed to evaluate CAD and its risk factors in hospitalized patients in the East Azerbaijan Province, northwest Iran, from 2006 to 2007. METHODS Data on 18.323 patients hospitalized due to cardiovascular diseases were collected to evaluate the diseases and their risk factors in 15 hospitals in the East Azerbaijan Province, northwest Iran. We assessed the main diagnosis of cardiovascular disease on admission in each hospital. Also, types of interventional and surgical procedures were assessed and all these variables were compared between men and women. RESULTS The study population consisted of 56.6% male and 43.4% female patients. The median and range between quartile 1 and 3 (Q1-Q3) ages of the males and females were 59 (49-70) and 62 (51-71) years, respectively. Ischemic heart diseases were diagnosed in 68.4%, electrophysiological disorders in 6.5%, and valvular heart diseases in 4.5% of the patients. The frequencies of the studied risk factors were as follows: cigarette smoking (47.5%); hypertension (66.95%); diabetes mellitus (35.9%); and history of cerebrovascular accident (16.4%) and renal disease (13.4%). Medical therapy was performed in 79.23%, surgery in 6.28%, and cardiovascular interventional therapy in 13.99% of the patients. The in-hospital mortality rate was 1.57% (1.42% in the males and 1.76% in the females; p value = 0.009). CONCLUSION The most frequent known risk factors in the hospitalized patients were smoking, alcohol consumption, and diabetes. In the northwest of Iran, age at hospitalization due to cardiovascular diseases is slightly lower than that in the Western populations; however, sex distribution, diagnoses, and treatment modalities are not significantly different from those reported in Western countries.
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Affiliation(s)
- Alireza Yaghoubi
- Cardiovascular Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Naser Safaie
- Cardiovascular Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran.,Corresponding Author: Naser Safaie, Cardiovascular Research Center, Tabriz University of Medical Sciences, Daneshghah Street, Tabriz, Iran. 5166615573. Tel: +98 411 3373950. Fax: +98 411 3373950. E-mail:
| | - Rasoul Azarfarin
- Cardiovascular Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Azin Alizadehasl
- Cardiovascular Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Samad EJ Golzari
- Physical Medicine and Rehabilitation Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran.,Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
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Ried-Larsen M, Grøntved A, Froberg K, Ekelund U, Andersen LB. Physical activity intensity and subclinical atherosclerosis in Danish adolescents: The European Youth Heart Study. Scand J Med Sci Sports 2013; 23:e168-77. [PMID: 23336399 DOI: 10.1111/sms.12046] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2012] [Indexed: 11/28/2022]
Affiliation(s)
- M. Ried-Larsen
- Institute of Sport Science and Clinical Biomechanics; Research unit for Exercise Epidemiology; Centre of Research in Childhood Health; University of Southern Denmark; Odense; Denmark
| | - A. Grøntved
- Institute of Sport Science and Clinical Biomechanics; Research unit for Exercise Epidemiology; Centre of Research in Childhood Health; University of Southern Denmark; Odense; Denmark
| | - K. Froberg
- Institute of Sport Science and Clinical Biomechanics; Research unit for Exercise Epidemiology; Centre of Research in Childhood Health; University of Southern Denmark; Odense; Denmark
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Abstract
The amino acid arginine is a well-known growth hormone (GH) stimulator and GH is an important modulator of linear growth. The aim of the present study was to investigate the effect of dietary arginine on growth velocity in children between 7 and 13 years of age. Data from the Copenhagen School Child Intervention Study during 2001–2 (baseline), and at 3-year and 7-year follow-up, were used. Arginine intake was estimated via a 7 d precoded food diary at baseline and 3-year follow-up. Data were analysed in a multilevel structure in which children were embedded within schools. Random intercept and slopes were defined to estimate the association between arginine intake and growth velocity, including the following covariates: sex; age; baseline height; energy intake; puberty stage at 7-year follow-up and intervention/control group. The association between arginine intake and growth velocity was significant for the third and fourth quintile of arginine intake (2·5–2·8 and 2·8–3·2 g/d, respectively) compared with the first quintile ( < 2·2 g/d) (P for trend = 0·04). Protein intake (excluding arginine) was significantly associated with growth velocity; however, the association was weaker than the association between arginine intake and growth velocity (P for trend = 0·14). The results of the present study suggest a dose-dependent physiological role of habitual protein intake, and specifically arginine intake, on linear growth in normally growing children. However, since the study was designed in healthy children, we cannot firmly conclude whether arginine supplementation represents a relevant clinical strategy. Further research is needed to investigate whether dietary arginine may represent a nutritional strategy potentially advantageous for the prevention and treatment of short stature.
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Buchan DS, Ollis S, Thomas NE, Simpson A, Young JD, Cooper SM, Malina RM, Cockcroft JR, Baker JS. Prevalence of traditional and novel markers of cardiovascular disease risk in Scottish adolescents: socioeconomic effects. Appl Physiol Nutr Metab 2012; 37:829-39. [PMID: 22686348 DOI: 10.1139/h2012-052] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Information on the health status and physical activity of Scottish adolescents is limited. This study examines the prevalence of cardiovascular disease (CVD) risk in Scottish adolescents by socioeconomic status (SES). Participants were recruited from two high schools that differed in the SES of the students in attendance. The sample included 73 boys and 34 girls (16.4 ± 0.6 years). Variables included anthropometry, physical activity, physical fitness, blood pressure, diet, and 11 metabolic markers of CVD risk. Significant sex differences (P ≤ 0.01) were noted for stature, waist circumference, waist-hip ratio, physical activity, cardiorespiratory fitness, muscular power, sprint speed, and several CVD risk factors: high-density lipoprotein (HDL), low-density lipoprotein (LDL), interleukin-6 (IL-6), and C-reactive protein (CRP) levels. Boys from a lower SES had significantly higher levels of glucose and plasminogen activator inhibitor-1 (PAI-1) but lower levels of adiponectin compared with boys from a higher SES. Girls from a lower SES had significantly (P ≤ 0.01) higher glucose and PAI-1 levels but lower levels of insulin and adiponectin than girls from a higher SES. High fat diets, low physical activity levels, and elevated CRP and total cholesterol levels were the CVD risk factors most commonly identified as being at-risk levels in this cohort, regardless of sex or SES. SES differences were not consistently apparent, but several CVD risk factors were identified as elevated in this sample of adolescents, regardless of sex or SES.
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Affiliation(s)
- Duncan S Buchan
- School of Science and Technology, University of the West of Scotland, Hamilton, Scotland, UK.
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Rasmussen M, Holstein BE, Due P. Tracking of overweight from mid-adolescence into adulthood: consistent patterns across socio-economic groups. Eur J Public Health 2012; 22:885-7. [PMID: 22542540 DOI: 10.1093/eurpub/cks024] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Socially differentiated tracking of health and health behaviours may contribute to health inequalities in adulthood. The modifying effect of socio-economic position on the tracking of overweight from mid-adolescence (age 15 years) into adulthood (age 27 years) was assessed in a randomly sampled Danish cohort (n = 561). The tracking was studied by prediction analyses conducted by logistic regression analyses. Strong tracking patterns were found to be independent of socio-economic background.
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Affiliation(s)
- Mette Rasmussen
- University of Southern Denmark, National Institute of Public Health, Copenhagen, Denmark
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Tomkinson GR, Macfarlane D, Noi S, Kim DY, Wang Z, Hong R. Temporal Changes in Long-Distance Running Performance of Asian Children between 1964 and 2009. Sports Med 2012; 42:267-79. [DOI: 10.2165/11599160-000000000-00000] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Sandercock G, Voss C, Cohen D, Taylor M, Stasinopoulos DM. Centile curves and normative values for the twenty metre shuttle-run test in English schoolchildren. J Sports Sci 2012; 30:679-87. [PMID: 22339646 DOI: 10.1080/02640414.2012.660185] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The aim of this study was to provide normative data for performance on the 20 m shuttle-run test of cardiorespiratory fitness in English schoolchildren. A total of 7366 10-16 year olds completed the 20 m shuttle-run test. We expressed performance as the number of shuttles completed, test score (shuttles and levels) and estimated peak oxygen consumption (VO2peak). We calculated descriptive statistics for each age-sex group to construct percentile curves and tables. To assess the cardiorespiratory fitness of our sample, we calculated the number of participants who fell below proposed cut-offs for low cardiorespiratory fitness based on either completed shuttles or VdotO2peak. These cut-offs did not agree in terms of frequency of classification. The classification based on estimated VO2peak suggested low fitness was more prevalent in males and that the incidence of low fitness increased with age in both sexes. These are the first normative data for shuttle-run performance in English youth and can now be used to interpret data from this cardiorespiratory fitness test. The two cut-offs used for low fitness did not agree and future research should establish a cut-off for test performance which can predict present or future ill-health.
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Affiliation(s)
- Gavin Sandercock
- University of Essex, Centre for Sports and Exercise Science, School of Biological Sciences, Wivenhoe Park, Colchester, UK.
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Spiroski I, Dimitrovska Z, Gjorgjev D, Mikik V, Efremova-Stefanoska V, Naunova-Spiroska D, Kendrovski V. Nutritional status and growth parameters of school-age Roma children in the Republic of Macedonia. Cent Eur J Public Health 2011; 19:102-7. [PMID: 21739902 DOI: 10.21101/cejph.a3642] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Main objective of the study was to assess the nutritional status of school age Roma children in Macedonia in order to detect precursors of possible health risks at an early age. The study was designed as a comparative case control study. Study group consisted of 229 Roma school children from the 1st and 272 from the 5th grade residing in different towns in Macedonia. The control group was recruited from other than Roma ethnic background and consisted of 283 children attending 1st and 356 children attending 5th grade. Every participant was measured for his/hers body height and weight. The t-test and Chi square (Chi2) were applied to test statistical significance of variables. The WHO's AnthroPlus software was applied to assess growth parameters and population at risk. There were significant differences in values of the body weight (p = 0.001) and height (p = 0.001) between Roma and non-Roma children attending the 1st grade of primary school. Weight-for-age, height-for-age and BMI-for-age indexes of the 1st grade children significantly differred in in the same intervals of SD (> or = -2SD and < -1SD; > or = -1SD and median; > +1SD and < or = +2SD; between Roma and non-Roma 5th graders. Anthropometric parameters of nutritional status of Roma children in Macedonia are significantly different than those of their non-Roma peers. Their health risks are predominantly related to underweight. The parameters related to health risks of overweight or obesity are lower in Roma than in non-Roma children.
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Affiliation(s)
- Igor Spiroski
- Institute of Public Health of the Republic of Macedonia, Skopje, Republic of Macedonia.
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Tamayo T, Christian H, Rathmann W. Impact of early psychosocial factors (childhood socioeconomic factors and adversities) on future risk of type 2 diabetes, metabolic disturbances and obesity: a systematic review. BMC Public Health 2010; 10:525. [PMID: 20809937 PMCID: PMC2940917 DOI: 10.1186/1471-2458-10-525] [Citation(s) in RCA: 149] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2009] [Accepted: 09/01/2010] [Indexed: 12/10/2023] Open
Abstract
Background Psychological factors and socioeconomic status (SES) have a notable impact on health disparities, including type 2 diabetes risk. However, the link between childhood psychosocial factors, such as childhood adversities or parental SES, and metabolic disturbances is less well established. In addition, the lifetime perspective including adult socioeconomic factors remains of further interest. We carried out a systematic review with the main question if there is evidence in population- or community-based studies that childhood adversities (like neglect, traumata and deprivation) have considerable impact on type 2 diabetes incidence and other metabolic disturbances. Also, parental SES was included in the search as risk factor for both, diabetes and adverse childhood experiences. Finally, we assumed that obesity might be a mediator for the association of childhood adversities with diabetes incidence. Therefore, we carried out a second review on obesity, applying a similar search strategy. Methods Two systematic reviews were carried out. Longitudinal, population- or community-based studies were included if they contained data on psychosocial factors in childhood and either diabetes incidence or obesity risk. Results We included ten studies comprising a total of 200,381 individuals. Eight out of ten studies indicated that low parental status was associated with type 2 diabetes incidence or the development of metabolic abnormalities. Adjustment for adult SES and obesity tended to attenuate the childhood SES-attributable risk but the association remained. For obesity, eleven studies were included with a total sample size of 70,420 participants. Four out of eleven studies observed an independent association of low childhood SES on the risk for overweight and obesity later in life. Conclusions Taken together, there is evidence that childhood SES is associated with type 2 diabetes and obesity in later life. The database on the role of psychological factors such as traumata and childhood adversities for the future risk of type 2 diabetes or obesity is too small to draw conclusions. Thus, more population-based longitudinal studies and international standards to assess psychosocial factors are needed to clarify the mechanisms leading to the observed health disparities.
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Affiliation(s)
- Teresa Tamayo
- Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University, Düsseldorf, Germany.
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Welk GJ, Meredith MD, Ihmels M, Seeger C. Distribution of health-related physical fitness in Texas youth: a demographic and geographic analysis. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2010; 81:S6-S15. [PMID: 21049833 DOI: 10.1080/02701367.2010.10599689] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
This study examined demographic and geographic variability in aggregated school-level data on the percentage of students achieving the FITNESSGRAM Healthy Fitness Zones (HFZ). Three-way analyses of variance were used to examine differences in fitness achievement rates among schools that had distinct diversity and socioeconomic status profiles. The results revealed age-related declines in the percentage of youth who achieved the HFZ standard for cardiovascular fitness (elementary school: 70%; middle school: 46%; high school: 34%). Interestingly, there was little evidence of age-related declines in other fitness dimensions. School-level attainment of fitness was consistently higher in schools categorized as low diversity and high socioeconomic status. Clear spatial patterns in fitness achievement were also evident when data were analyzed at the region and county level using geodemographic information system software.
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Affiliation(s)
- Gregory J Welk
- Department of Kinesiology, Iowa State University, Ames, IA 50011, USA.
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Sandercock GRH, Voss C, Dye L. Associations between habitual school-day breakfast consumption, body mass index, physical activity and cardiorespiratory fitness in English schoolchildren. Eur J Clin Nutr 2010; 64:1086-92. [DOI: 10.1038/ejcn.2010.145] [Citation(s) in RCA: 94] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Associations between school-day breakfast consumption, BMI, physical activity and cardiorespiratory fitness in English schoolchildren. Proc Nutr Soc 2010. [DOI: 10.1017/s0029665109992436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Jones A, Hillsdon M, Coombes E. Greenspace access, use, and physical activity: understanding the effects of area deprivation. Prev Med 2009; 49:500-5. [PMID: 19857513 PMCID: PMC3748371 DOI: 10.1016/j.ypmed.2009.10.012] [Citation(s) in RCA: 107] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2009] [Revised: 10/12/2009] [Accepted: 10/16/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To understand the patterning of greenspace provision and use by area deprivation, and determine how deprivation moderates relationships with physical activity. METHODS The responses obtained from 6821 respondents to the 2005 'The Quality of Life in your Neighbourhood Survey' undertaken in Bristol, England, were combined with objective measures of access to greenspaces. Area deprivation was determined using the Index of Multiple Deprivation. Descriptive analyses examined how mean distance, perceived greenspace access and safety, visit frequency, and physical activity varied by deprivation quartile. Logistic regression models examined how relationships were moderated by deprivation. RESULTS Respondents in more deprived areas lived closer to greenspaces, but reported poorer perceived accessibility, poorer safety, and less frequent use. Frequency of use declined with distance but only in the most affluent areas. Relationships between physical activity and perceived accessibility, safety, and visit frequency were moderated by deprivation. CONCLUSIONS The accessibility of greenspaces was better in more deprived areas but those residents had more negative perceptions and were less likely to use the greenspaces. Interventions may be most effective if they target the perceptions and needs of residents of deprived neighbourhoods.
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Affiliation(s)
- Andy Jones
- Centre for Diet and Activity Research (CEDAR), School of Environmental Sciences, University of East Anglia, Norwich, Norfolk, NR4 7TJ, UK.
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Cleland VJ, Ball K, Magnussen C, Dwyer T, Venn A. Socioeconomic position and the tracking of physical activity and cardiorespiratory fitness from childhood to adulthood. Am J Epidemiol 2009; 170:1069-77. [PMID: 19767351 DOI: 10.1093/aje/kwp271] [Citation(s) in RCA: 91] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
This study examined the influence of childhood socioeconomic position (SEP) and social mobility on activity and fitness tracking from childhood into adulthood. In a prospective cohort of 2,185 Australian adults (aged 26-36 years), first examined in 1985 (at ages 7-15 years), self-reported physical activity and cardiorespiratory fitness (subsample only) were measured. SEP measures included retrospectively reported parental education (baseline) and own education (follow-up). There was little evidence of a relation between childhood SEP and activity tracking, but high childhood SEP (maternal education) was associated with a 59% increased likelihood of persistent fitness, and medium childhood SEP (paternal and parental education) was associated with a 33%-36% decreased likelihood of persistent fitness. Upward social mobility was associated with a greater likelihood of increasing activity (38%-49%) and fitness (90%), and persistently high SEP was associated with a greater likelihood of increasing activity (males: 58%) and fitness (males and females combined: 89%). In conclusion, persistently high SEP and upward social mobility were associated with increases in activity and fitness from childhood to adulthood. Findings highlight socioeconomic differentials in activity and fitness patterns and suggest that improvements in education may represent a pathway through which physical activity levels can be increased and health benefits achieved.
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Affiliation(s)
- Verity J Cleland
- Centre for Physical Activity and Nutrition Research, Deakin University, Burwood, Victoria 3125, Australia.
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Association between intake of dietary protein and 3-year-change in body growth among normal and overweight 6-year-old boys and girls (CoSCIS). Public Health Nutr 2009; 13:647-53. [PMID: 19758483 DOI: 10.1017/s1368980009991510] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Growth hormone (GH) affects linear growth and body composition, by increasing the secretion of insulin-like growth factor-I (IGF-I), muscle protein synthesis and lipolysis. The intake of protein (PROT) as well as the specific amino acids arginine (ARG) and lysine (LYS) stimulates GH/IGF-I secretion. The present paper aimed to investigate associations between PROT intake as well as intake of the specific amino acids ARG and LYS, and subsequent 3-year-change in linear growth and body composition among 6-year-old children. DESIGN Children's data were collected from Copenhagen (Denmark), during 2001-2002, and again 3 years later. Boys and girls were separated into normal weight and overweight, based on BMI quintiles. Fat-free mass index (FFMI) and fat mass index (FMI) were calculated. Associations between change (Delta) in height, FMI and FFMI, respectively, and habitual PROT intake as well as ARG and LYS were analysed by multiple linear regressions, adjusted for baseline height, FMI or FFMI and energy intake, age, physical activity and socio-economic status. SETTING Eighteen schools in two suburban communities in the Copenhagen (Denmark) area participated in the study. SUBJECTS In all, 223 children's data were collected for the present study. RESULTS High ARG intake was associated with linear growth (beta = 1.09 (se 0.54), P = 0.05) among girls. Furthermore, in girls, DeltaFMI had a stronger inverse association with high ARG intake, if it was combined with high LYS intake, instead of low LYS intake (P = 0.03). No associations were found in boys.ConclusionIn prepubertal girls, linear growth may be influenced by habitual ARG intake and body fat gain may be relatively prevented over time by the intake of the amino acids ARG and LYS.
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McNeil DA, Wilson BN, Siever JE, Ronca M, Mah JK. Connecting Children to Recreational Activities: Results of a Cluster Randomized Trial. Am J Health Promot 2009; 23:376-87. [DOI: 10.4278/ajhp.071010107] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose. Identify if outreach support increases school-aged children's participation in recreational activities. Design. Cluster randomized trial. Setting. Sixteen schools in economically vulnerable neighborhoods were randomized to either an intervention or control group. Subjects. Children in grades 3 to 5 and their families were invited to participate. Intervention. Children in intervention schools were assigned a “connector” (outreach worker) to facilitate participation in recreation activities. Measures. The Children's Assessment of Participation and Enjoyment (CAPE) was the primary measure at baseline, middle, and end of 1 year. Demographics, body mass index, child physical and psychosocial health, coordination, and self-esteem were measured. Analysis. A generalized linear model was used to test differences between intervention and control groups. Results. Three hundred and sixty children enrolled, and 306 (85 %) completed the study. A greater proportion of children in the intervention group compared with the control group increased participation in physical activity (21 % vs. 10%, p = .02). Children who increased their activity were more likely to have higher levels of contact with the connectors (31 % vs. 8%, p = .001). Study limitations included (I) 29% of eligible families participated, (2) first use of the CAPE instrument as a longitudinal measure, and (3) connectors were not blinded to group assignment. Conclusion. Children living in vulnerable neighborhoods benefit from outreach workers to connect them with physical activity programs.
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Affiliation(s)
- Deborah A. McNeil
- Deborah A. McNeil, RN, MN, PhD; Brenda N. Wilson, OT, MSc; and Jodi E. Siever, MSc, are with the Decision Support Research Team, Calgary Health Region, Alberta Children's Hospital, Calgary, Alberta, Canada. Deborah A. McNeil, RN, MN, PhD, is also with the Faculty of Nursing and Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada. Margie Ronca, BEd, MA, is with the Calgary Children's Initiative, Calgary, Alberta, Canada. Jean K. Mah, MD, MSc, FRCPC
| | - Brenda N. Wilson
- Deborah A. McNeil, RN, MN, PhD; Brenda N. Wilson, OT, MSc; and Jodi E. Siever, MSc, are with the Decision Support Research Team, Calgary Health Region, Alberta Children's Hospital, Calgary, Alberta, Canada. Deborah A. McNeil, RN, MN, PhD, is also with the Faculty of Nursing and Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada. Margie Ronca, BEd, MA, is with the Calgary Children's Initiative, Calgary, Alberta, Canada. Jean K. Mah, MD, MSc, FRCPC
| | - Jodi E. Siever
- Deborah A. McNeil, RN, MN, PhD; Brenda N. Wilson, OT, MSc; and Jodi E. Siever, MSc, are with the Decision Support Research Team, Calgary Health Region, Alberta Children's Hospital, Calgary, Alberta, Canada. Deborah A. McNeil, RN, MN, PhD, is also with the Faculty of Nursing and Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada. Margie Ronca, BEd, MA, is with the Calgary Children's Initiative, Calgary, Alberta, Canada. Jean K. Mah, MD, MSc, FRCPC
| | - Margie Ronca
- Deborah A. McNeil, RN, MN, PhD; Brenda N. Wilson, OT, MSc; and Jodi E. Siever, MSc, are with the Decision Support Research Team, Calgary Health Region, Alberta Children's Hospital, Calgary, Alberta, Canada. Deborah A. McNeil, RN, MN, PhD, is also with the Faculty of Nursing and Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada. Margie Ronca, BEd, MA, is with the Calgary Children's Initiative, Calgary, Alberta, Canada. Jean K. Mah, MD, MSc, FRCPC
| | - Jean K. Mah
- Deborah A. McNeil, RN, MN, PhD; Brenda N. Wilson, OT, MSc; and Jodi E. Siever, MSc, are with the Decision Support Research Team, Calgary Health Region, Alberta Children's Hospital, Calgary, Alberta, Canada. Deborah A. McNeil, RN, MN, PhD, is also with the Faculty of Nursing and Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada. Margie Ronca, BEd, MA, is with the Calgary Children's Initiative, Calgary, Alberta, Canada. Jean K. Mah, MD, MSc, FRCPC
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Jago R, Wedderkopp N, Kristensen PL, Møller NC, Andersen LB, Cooper AR, Froberg K. Six-year change in youth physical activity and effect on fasting insulin and HOMA-IR. Am J Prev Med 2008; 35:554-60. [PMID: 18848414 DOI: 10.1016/j.amepre.2008.07.007] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2008] [Revised: 05/20/2008] [Accepted: 07/31/2008] [Indexed: 10/21/2022]
Abstract
BACKGROUND There is a shortage of longitudinal data analyzing associations between physical activity and indicators of insulin resistance among children and adolescents after accounting for adiposity change. To guide future prevention efforts, data were used from the Danish arm of the European Youth Heart Study to examine these issues. METHODS Participants were 384 students in Grade 9 (aged 15 years) from the municipality of Odense, Denmark, who participated in surveys in 1997 and 2003. Physical activity was monitored for at least 3 days by accelerometer, and mean counts per minute (CPM) and minutes >3000 CPM per day were obtained. Blood samples were collected, and levels of fasting insulin, fasting glucose, and homeostasis model of assessment of insulin resistance (HOMA-IR) were obtained. Data were analyzed in 2008. RESULTS Physical activity declined from 45 minutes >3000 CPM in 1997 to 35 minutes >3000 CPM in 2003. Longitudinal regression analyses showed that a change in minutes >3000 CPM was negatively associated with fasting insulin levels (z=-2.47, p=0.014) and HOMA-IR (z=-2.31, p=0.021) in 2003. Similar findings were found when CPM was used as the physical activity variable. Results demonstrated that a 6-year decline in physical activity was associated with higher insulin and HOMA-IR levels. CONCLUSIONS The 6-year change in the volume of physical activity engaged in by adolescents aged 15 years was negatively associated with fasting insulin and HOMA-IR. Preventing an age-related decline in physical activity may be an effective means of preventing youth insulin resistance.
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Affiliation(s)
- Russell Jago
- Department of Exercise, Nutrition and Health Sciences, University of Bristol, Bristol, England.
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Barnett TA, Gauvin L, Craig CL, Katzmarzyk PT. Distinct trajectories of leisure time physical activity and predictors of trajectory class membership: a 22 year cohort study. Int J Behav Nutr Phys Act 2008; 5:57. [PMID: 18990250 PMCID: PMC2613394 DOI: 10.1186/1479-5868-5-57] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2008] [Accepted: 11/07/2008] [Indexed: 12/02/2022] Open
Abstract
UNLABELLED or BACKGROUND Prospective studies linking social factors to long term patterns of physical activity are lacking. In this 22 year longitudinal study, we seek to identify long term patterns of involvement in leisure time physical activity (LTPA), and explore socioeconomic and demographic predictors of distinct LTPA trajectories. METHODS Among 2102 individuals aged 18-60 years in 1981 who participated in the 1981 Canada Fitness Survey/1988 Campbell's Survey of Well-Being, 1186 (56.4%) completed questionnaires for the 2002/04 follow-up. Complete data on LTPA at all 3 surveys were available for 884 participants. Latent class growth analysis was used to identify major classes of LTPA trajectories; predictors of class membership were identified using polytomous logistic regression. RESULTS Four latent classes were identified: inactive, increasers, active, and decreasers (53%, 26%, 12%, and 9% of participants, respectively). Women, older participants, those with lower household income, and with lower educational attainment, were significantly less likely to follow active (Vs. inactive) trajectories of LTPA. Disadvantaged groups with respect to education and income were also significantly more likely to follow decreasing (Vs. active) trajectories. CONCLUSION There is a need for continued efforts to increase overall population levels of LTPA, particularly among socially disadvantaged groups with respect to income and education, who are most likely to experience unfavorable trajectories of LTPA.
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Affiliation(s)
- Tracie A Barnett
- Centre de recherche du Centre Hospitalier Universitaire Sainte-Justine, 3175, Côte-Sainte-Catherine Montréal (Québec), H3T 1C5, Canada
- Département de médecine sociale et préventive, Université de Montréal, Canada
| | - Lise Gauvin
- Département de médecine sociale et préventive, Université de Montréal, Canada
- CRCHUM-Centre de recherche du Centre Hospitalier de l'Université de Montréal, Centre de Recherche Léa-Roback sur les Inégalités Sociales de Santé de Montréal, Canada
| | - Cora L Craig
- Canadian Fitness and Lifestyle Research Institute, School of Public Health, University of Sydney, Australia
| | - Peter T Katzmarzyk
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
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Stea TH, Wandel M, Mansoor MA, Uglem S, Frolich W. BMI, lipid profile, physical fitness and smoking habits of young male adults and the association with parental education. Eur J Public Health 2008; 19:46-51. [DOI: 10.1093/eurpub/ckn122] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
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Hestbaek L, Korsholm L, Leboeuf-Yde C, Kyvik KO. Does socioeconomic status in adolescence predict low back pain in adulthood? A repeated cross-sectional study of 4,771 Danish adolescents. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2008; 17:1727-34. [PMID: 18830719 DOI: 10.1007/s00586-008-0796-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 08/30/2007] [Revised: 06/09/2008] [Accepted: 09/14/2008] [Indexed: 10/21/2022]
Abstract
Social and economic disadvantage is associated with general poor physical health. This relationship has been recognised for centuries, but it is unknown whether socioeconomic factors have a specific influence on low back pain (LBP). Furthermore, it is unknown how social and economic disadvantages in youth affect adult health. Therefore, the specific objectives of this study are to explore (1) the cross-sectional association between socioeconomic status (SES) and LBP in adolescence and (2) the longitudinal association between SES in adolescence and LBP in early adulthood. A database containing LBP data from 4,771 twins was merged with their parents' social and economic data, available from Statistics Denmark. Low back pain data ['any low back pain' and 'persistent low back pain (more than 30 days)'] were collected in 1994, when the subjects were 12-18 years of age, and collected again eight years later. Socioeconomic data of the parents (education, income, social class and long-term illness, all for both mother and father) were collected in 1994. Logistic regression analyses were used to estimate the associations between each parameter of parental SES in adolescence and LBP at baseline as well as at follow-up. Finally, the influence of a variable combining the different socioeconomic parameters was established. All estimates were controlled for smoking, alcohol consumption and body mass index at baseline. In the logistic regression models, only three of the 32 estimates were statistically significant. When merging the socioeconomic variables into a combined score, the results indicated that a good social background had a protective effect against the persistent LBP, while there was no association with any LBP. However, the statistical significance of this effect was unclear. We found no or very weak indications of possible relationships between social factors in adolescence and LBP at baseline and at follow-up.
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Affiliation(s)
- Lise Hestbaek
- Clinical Locomotion Science, The Back Research Center, Hospital of Funen, University of Southern Denmark, Lindevej 5, 5950, Ringe, Denmark.
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Steele RM, Brage S, Corder K, Wareham NJ, Ekelund U. Physical activity, cardiorespiratory fitness, and the metabolic syndrome in youth. J Appl Physiol (1985) 2008; 105:342-51. [PMID: 18369096 PMCID: PMC2494842 DOI: 10.1152/japplphysiol.00072.2008] [Citation(s) in RCA: 165] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The metabolic syndrome is defined as the coexistence of multiple cardiovascular and diabetes risk factors, the prevalence of which has increased dramatically in adult populations in the last decades. More recently, the same cluster of metabolic risk factors has also been recognized in children and adolescents. Epidemiological evidence suggests that high levels of cardiorespiratory fitness (CRF) and physical activity are associated with a favorable metabolic risk profile in adults. However, in youth the role of these factors is less clear. Therefore, the purpose of this mini-review is to examine the recent evidence between objectively measured habitual physical activity and CRF with clustered metabolic risk in youth. In general, it appears that both physical activity and CRF are separately and independently associated with metabolic risk factors in youth, possibly through different causal pathways. Further research is necessary to quantify how much physical activity is needed to prevent the metabolic syndrome and the diseases with which it is associated. Public health approaches that encourage increased physical activity and reduce sedentary behaviors may prove useful in reducing the population burden associated with metabolic risk.
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Affiliation(s)
- Rebekah M Steele
- Medical Research Council Epidemiology Unit, Institute of Metabolic Science, Box 285, Addenbrooke's Hospital, Hills Rd., Cambridge CB2 0QQ, UK
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