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Kwon S, Wehrmeister FC, Gonçalves H, da Silva BGC, Menezes AMB. The Joint Associations of Physical Activity and Sedentary Behaviors on Adiposity during Adolescence: The 1993 Pelotas (Brazil) Cohort Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:265. [PMID: 36832397 PMCID: PMC9954888 DOI: 10.3390/children10020265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/17/2023] [Accepted: 01/28/2023] [Indexed: 02/04/2023]
Abstract
A prior study conducted in high-income countries demonstrated that specific sedentary behavior, such as TV viewing, is prospectively associated with adiposity in both active and inactive adolescents. The aim of this study was to examine the joint associations of sedentary behaviors and moderate- and vigorous-intensity physical activity (MVPA) with adiposity among Brazilian adolescents. This prospective cohort study included 377 participants of the 1993 Pelotas (Brazil) Study who completed an accelerometry assessment at age 13 years and a dual-energy X-ray absorptiometry (DXA) assessment at age 18 years. Accelerometer-measured MVPA was dichotomized into high (≥60 min/day) and low (<60 min/day). Accelerometer-measured sedentary time (SED) was dichotomized into low (<49 min/h) and high (≥49 min/h) based on the median. Self-reported TV viewing time was also dichotomized into low (<3 h/day) and high (≥3 h/day) based on the median. We combined the two MVPA groups (high and low) and two SED groups (low and high) to form the four MVPA&SED groups: high&low, high&high, low&low, and low&high. We also created four MVPA&TV groups in the same manner. Fat mass index (FMI; kg/m2) was calculated using DXA-derived fat mass. Multivariable linear regression analyses compared FMI at 18 years among the four MVPA&SED groups and among the four MVPA&TV groups, adjusting for socioeconomic status, energy intake, and baseline adiposity. The analysis results showed that SED or TV viewing time was not prospectively associated with adiposity in both active and inactive Brazilian adolescents. This study suggests that the association between specific sedentary behaviors, such as TV viewing, and adiposity may differ across societal settings-in this case, high-income vs. middle-income countries.
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Affiliation(s)
- Soyang Kwon
- Department of Pediatrics, Northwestern University, Chicago, IL 60611, USA
| | - Fernando C. Wehrmeister
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Peloas CEP96020-220, RS, Brazil
| | - Helen Gonçalves
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Peloas CEP96020-220, RS, Brazil
| | | | - Ana M. B. Menezes
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Peloas CEP96020-220, RS, Brazil
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Kwon S, Menezes AMB, Ekelund U, Wehrmeister FC, Gonçalves H, da Silva BGC, Janz KF. Longitudinal change in physical activity and adiposity in the transition from adolescence to early adulthood: the 1993 Pelotas cohort study. Int J Behav Nutr Phys Act 2022; 19:83. [PMID: 35836186 PMCID: PMC9284823 DOI: 10.1186/s12966-022-01321-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 06/20/2022] [Indexed: 11/18/2022] Open
Abstract
Background In the current Physical Activity Guidelines (PAG) for moderate- and vigorous-intensity physical activity (MVPA), abrupt transition from ≥ 60 min/day [youth PAG] to ≥ 150 min/week (≥ 22 min/day on average) [adult PAG] during emerging adulthood is poorly justified. The aim of this study was to examine body fat mass changes according to whether meeting the youth and adult PAGs in late adolescence (age 18 years) to early adulthood (age 22 years). Methods The study sample included 2,099 participants (1,113 females) from the 1993 Pelotas (Brazil) Study. At ages 18 and 22 years, MVPA was measured using wrist-worn accelerometry and fat mass was measured using dual-energy X-ray absorptiometry. MVPA at age 18 was categorized into two groups: 0–59 or ≥ 60 min/day (no [N] or yes [Y] for meeting the youth recommendation, respectively). MVPA at age 22 was categorized into three groups: 0–21, 22–59, or ≥ 60 min/day (N, Y22, or Y60 for not meeting the adult recommendation, meeting the adult recommendation, or meeting the youth recommendation, respectively). The combination of these groups created six MVPA groups (N&N, N&Y22, N&Y60, Y&N, Y&Y22, and Y&Y60). Sex-specific multivariable linear regression analyses were conducted to estimate change in fat mass index (FMI) from age 18 to 22 years in the six MVPA groups. Results Among males, compared to Y&Y60 (FMI increase = 1.2 kg/m2 [95% CI = 1.0, 1.4]), Y&Y22 and Y&N had larger FMI increases (1.9 [1.6, 2.1] and 1.9 [1.2, 2.5], respectively). Among females, Y&Y60 and Y&Y22 had an equal FMI increase (1.6 [1.4, 1.9] for both groups), while Y&N had a larger FMI increase (2.4 [1.8, 3.0]). Conclusions These findings suggest that among those who were active in late adolescence, engaging in ≥ 22 min/day of MVPA in adulthood is associated with lower body fat gain for females, but not for males. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-022-01321-0.
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Affiliation(s)
- Soyang Kwon
- Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E Chicago Ave. Box 157, Chicago, IL, 60611, USA.
| | - Ana M B Menezes
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, R Marechal Deodoro, 1160 - 3rd floor,, Pelotas, RS, CEP 96020-220, Brazil
| | - Ulf Ekelund
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway.,Department of Chronic Diseases, Norwegian Institute of Public Health, Postboks 4014 Ulleål Stadion, 0806, Oslo, Norway.,Norwegian Institute of Public Health, Oslo, Norway
| | - Fernando C Wehrmeister
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, R Marechal Deodoro, 1160 - 3rd floor,, Pelotas, RS, CEP 96020-220, Brazil
| | - Helen Gonçalves
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, R Marechal Deodoro, 1160 - 3rd floor,, Pelotas, RS, CEP 96020-220, Brazil
| | - Bruna Gonçalves C da Silva
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, R Marechal Deodoro, 1160 - 3rd floor,, Pelotas, RS, CEP 96020-220, Brazil
| | - Kathleen F Janz
- Department of Health and Human Physiology, University of Iowa, 102 E FH, Iowa City, 52242, USA
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Perumal N, Roth DE, Cole DC, Zlotkin SH, Perdrizet J, Barros AJD, Santos IS, Matijasevich A, Bassani DG. Effect of Correcting the Postnatal Age of Preterm-Born Children on Measures of Associations Between Infant Length-for-Age z Scores and Mid-Childhood Outcomes. Am J Epidemiol 2021; 190:477-486. [PMID: 32809017 PMCID: PMC7936033 DOI: 10.1093/aje/kwaa169] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Revised: 08/03/2020] [Accepted: 08/11/2020] [Indexed: 12/27/2022] Open
Abstract
Child growth standards are commonly used to derive age- and sex-standardized anthropometric indices but are often inappropriately applied to preterm-born children (<37 weeks of gestational age (GA)) in epidemiology studies. Using the 2004 Pelotas Birth Cohort, we examined the impact of correcting for GA in the application of child growth standards on the magnitude and direction of associations in 2 a priori–selected exposure-outcome scenarios: infant length-for-age z score (LAZ) and mid-childhood body mass index (scenario A), and infant LAZ and mid-childhood intelligence quotient (scenario B). GA was a confounder that had a strong (scenario A) or weak (scenario B) association with the outcome. Compared with uncorrected postnatal age, using GA-corrected postnatal age attenuated the magnitude of associations, particularly in early infancy, and changed inferences for associations at birth. Although differences in the magnitude of associations were small when GA was weakly associated with the outcome, model fit was meaningfully improved using corrected postnatal age. When estimating population-averaged associations with early childhood growth in studies where preterm- and term-born children are included, incorporating heterogeneity in GA at birth in the age scale used to standardize anthropometric indices postnatally provides a useful strategy to reduce standardization errors.
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Affiliation(s)
- Nandita Perumal
- Correspondence to Dr. Nandita Perumal, Department of Global Health and Population, Harvard T. H. Chan School of Public Health, 90 Smith Street, 3rd Floor, Boston MA 02215 (e-mail: )
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Cheng L, Pohlabeln H, Ahrens W, Russo P, Veidebaum T, Chadjigeorgiou C, Molnár D, Eiben G, De Henauw S, Moreno L, Page A, Hebestreit A. Sex differences in the longitudinal associations between body composition and bone stiffness index in European children and adolescents. Bone 2020; 131:115162. [PMID: 31760215 DOI: 10.1016/j.bone.2019.115162] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 10/20/2019] [Accepted: 11/20/2019] [Indexed: 10/25/2022]
Abstract
Fat mass (FM) and fat free mass (FFM) may influence bone health differentially. However, existing evidences on associations between FM, FFM and bone health are inconsistent and vary according to sex and maturity. The present study aims to evaluate longitudinal associations between FM, FFM and bone stiffness index (SI) among European children and adolescents with 6 years follow-up. A sample of 2468 children from the IDEFICS/I.Family was included, with repeated measurements of SI using calcaneal quantitative ultrasound, body composition using skinfold thickness, sedentary behaviors and physical activity using self-administrated questionnaires. Regression coefficients (β) and 99%-confidence intervals (99% CI) were calculated by sex-specified generalized linear mixed effects models to analyze the longitudinal associations between FM and FFM z-scores (zFM and zFFM) and SI percentiles, and to explore the possible interactions between zFM, zFFM and maturity. Baseline zFFM was observed to predict the change in SI percentiles in both boys (β = 4.57, 99% CI: 1.36, 7.78) and girls (β = 3.42, 99% CI: 0.05, 6.79) after 2 years. Moreover, baseline zFFM (β = 8.72, 99% CI: 3.18, 14.27 in boys and β = 5.89, 99% CI: 0.34, 11.44 in girls) and the change in zFFM (β = 6.58, 99% CI: 0.83, 12.34 in boys and β = 4.81, 99% CI: -0.41, 10.02 in girls) were positively associated with the change in SI percentiles after 6 years. In contrast, a negative association was observed between the change in zFM and SI percentiles in boys after 6 years (β = -3.70, 99% CI: -6.99, -0.42). Besides, an interaction was observed between the change in zFM and menarche on the change in SI percentiles in girls at 6 years follow-up (p = .009), suggesting a negative association before menarche while a positive association after menarche. Our findings support the existing evidences for a positive relationship between FFM and SI during growth. Furthermore, long-term FM gain was inversely associated with SI in boys, whereas opposing associations were observed across menarche in girls.
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Affiliation(s)
- Lan Cheng
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany; Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - Hermann Pohlabeln
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany; Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - Paola Russo
- Institute of Food Sciences, National Research Council, Avellino, Italy
| | - Toomas Veidebaum
- Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia
| | | | - Dénes Molnár
- Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary
| | - Gabriele Eiben
- Department of Biomedicine and Public Health, School of Health and Education, University of Skövde, Skövde, Sweden
| | | | - Luis Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), University of Zaragoza, 50009 Zaragoza, Spain
| | - Angie Page
- Centre for Exercise, Nutrition & Health Sciences, University of Bristol, Bristol, UK
| | - Antje Hebestreit
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
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Dong H, Liu J, Yan Y, Hou D, Zhao X, Cheng H, Li S, Chen W, Mi J. Long-term childhood body mass index and adult bone mass are linked through concurrent body mass index and body composition. Bone 2019; 121:259-266. [PMID: 30710728 DOI: 10.1016/j.bone.2019.01.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 01/25/2019] [Accepted: 01/29/2019] [Indexed: 11/19/2022]
Abstract
Body mass plays a crucial role in the bone growth and development, but few studies have examined the association of long-term cumulative impact and trajectory patterns of childhood body mass index (BMI) with adult bone mass, and the mediation effect of adult BMI and body composition on these associations. A total of 397 Chinese adults (54.4%) who had been examined for BMI 4-8 times during childhood (6-19 years) and bone mass in adulthood (29-37 years), were included for analysis. Adult bone mineral content (BMC), areal bone mineral density (aBMD) and body composition were assessed via dual-energy x-ray absorptiometry. Childhood BMI growth curves were constructed using a random-effects mixed model. The area under the curve (AUC) was calculated to represent the long-term impact of childhood BMI. At baseline, 24.4%, 66.2%, 7.6% and 1.8% of the participants were underweight, normal weight, overweight and obese, respectively. Quadratic curve parameters of childhood BMI differed significantly between groups of adult whole body (WB) BMC, lumbar spine (LS) aBMD and femoral neck (FN) aBMD, with low BMC/aBMD groups having lower childhood BMI than the normal groups. AUC of childhood BMI was significantly and positively related to adult WB BMC and aBMD at each site, irrespective of sex. Significant mediation effects of adult BMI were shown on the association of childhood BMI AUC with adult WB BMC in males (52.0%) and FN aBMD in both sexes (males: 65.4%; females: 64.3%). Additionally, mediation effect of fat mass index was only noted on the association of childhood BMI AUC with adult WB BMC (41.3%), with a positive total indirect effect estimated at 0.118. The adult lean mass index, by contrast, mediated the childhood BMI-adult BMC/aBMD association positively at all sites in males (71.5%~89.2%) and at WB BMC in females (45.0%). These findings suggest that the impact of body weight on adult bones originates from childhood, which is mediated by concurrent BMI and body composition.
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Affiliation(s)
- Hongbo Dong
- Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China; Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Junting Liu
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Yinkun Yan
- Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China; Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Dongqing Hou
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Xiaoyuan Zhao
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Hong Cheng
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Shengxu Li
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Wei Chen
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Jie Mi
- Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
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Khwanchuea R, Punsawad C. Association between Anthropometric Indices, Body Composition and Bone Parameters in Thai Female Adolescents. Indian J Pediatr 2017; 84:908-914. [PMID: 28799060 DOI: 10.1007/s12098-017-2422-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Accepted: 07/05/2017] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To investigate correlations between anthropometrics and body composition with bone parameters of the whole-body and lumbar spine in non-obese and obese Thai female adolescents. METHODS This study was performed in 135 female adolescents aged 15 to 18 y enrolled in secondary schools in southern Thailand. Subjects were grouped into non-obesity (underweight and normal-to-overweight) (BMI < 25) and obesity (BMI ≥ 25) groups. Anthropometric indices for obesity [body weight (BW), waist circumference (WC), and body mass index (BMI)] were recorded. Bone parameters (BMC, BMD, and Z-scores) of the whole-body and lumbar spine (L1-L4) and body composition (LBM, BFM, %fat, %lean, and %bone) were assessed by dual-energy X-ray absorptiometry (DXA). Correlations between anthropometrics, body composition, and bone parameters were evaluated and compared between subject groups. RESULTS The obesity group had significantly higher means of whole-body BMD, BMC and Z-score than non-obese group (p < 0.05). BMI and BW were positively associated with BFM and %fat (p < 0.05) for non-obese subjects. Obese subjects had greater lumbar spine BMC compared to non-obese subjects. BFM was correlated with whole-body BMC in obese group. BW was a positive determinant of BMC at both sites in all subject groups, particularly for obese subjects; BW had positive associations with all bone parameters at the lumbar spine. CONCLUSIONS BW can be used as a determinant of all bone parameters at lumbar spine, and BFM had a positive effect on whole-body BMC in Thai obese female adolescent subjects.
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Affiliation(s)
- Rapheeporn Khwanchuea
- School of Medicine, Walailak University, 222 Thasala District, Nakhon Si Thammarat, 80161, Thailand.
| | - Chuchard Punsawad
- School of Medicine, Walailak University, 222 Thasala District, Nakhon Si Thammarat, 80161, Thailand
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