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Forseth B, Noel-MacDonnell JR, Hampl S, Carlson JA, Halpin K, Davis A, Phillips T, Shook RP. Relationship between youth cardiometabolic health and physical activity in medical records. PLoS One 2024; 19:e0303583. [PMID: 38843219 PMCID: PMC11156312 DOI: 10.1371/journal.pone.0303583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 04/28/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Thers is limited research examining modifiable cardiometabolic risk factors with a single-item health behavior question obtained during a clinic visit. Such information could support clinicians in identifying patients at risk for adverse cardiometabolic health. We investigated if children meeting physical activity or screen time recommendations, collected during clinic visits, have better cardiometabolic health than children not meeting recommendations. We hypothesized that children meeting either recommendation would have fewer cardiometabolic risk factors. METHODS AND FINDINGS This cross-sectional study used data from electronic medical records (EMRs) between January 1, 2013 through December 30, 2017 from children (2-18 years) with a well child visits and data for ≥1 cardiometabolic risk factor (i.e., systolic and diastolic blood pressure, glycated hemoglobin, alanine transaminase, high-density and low-density lipoprotein, total cholesterol, and/or triglycerides). Physical activity and screen time were patient/caregiver-reported. Analyses included EMRs from 63,676 well child visits by 30,698 unique patients (49.3% female; 41.7% Black, 31.5% Hispanic). Models that included data from all visits indicated children meeting physical activity recommendations had reduced risk for abnormal blood pressure (odds ratio [OR] = 0.91, 95%CI 0.86, 0.97; p = 0.002), glycated hemoglobin (OR = 0.83, 95%CI 0.75, 0.91; p = 0.00006), alanine transaminase (OR = 0.85, 95%CI 0.79, 0.92; p = 0.00001), high-density lipoprotein (OR = 0.88, 95%CI 0.82, 0.95; p = 0.0009), and triglyceride values (OR = 0.89, 95%CI 0.83, 0.96; p = 0.002). Meeting screen time recommendations was not associated with abnormal cardiometabolic risk factors. CONCLUSION Collecting information on reported adherence to meeting physical activity recommendations can provide clinicians with additional information to identify patients with a higher risk of adverse cardiometabolic health.
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Affiliation(s)
- Bethany Forseth
- Department of Physical Therapy, Rehabilitation Science, & Athletic Training, University of Kansas Medical Center, Kansas City, KS, United States of America
- Center for Children’s Healthy Lifestyles & Nutrition, Kansas City, MO, United States of America
| | - Janelle R. Noel-MacDonnell
- Department of Health Services and Outcomes Research, Children’s Mercy Kansas City, Kansas City, MO, United States of America
- Department of Pediatrics, Children’s Mercy Kansas City, Kansas City, MO, United States of America
- University of Missouri—Kansas City School of Medicine, Kansas City, MO, United States of America
| | - Sarah Hampl
- Center for Children’s Healthy Lifestyles & Nutrition, Kansas City, MO, United States of America
- Department of Pediatrics, Children’s Mercy Kansas City, Kansas City, MO, United States of America
| | - Jordan A. Carlson
- Center for Children’s Healthy Lifestyles & Nutrition, Kansas City, MO, United States of America
- Department of Pediatrics, Children’s Mercy Kansas City, Kansas City, MO, United States of America
| | - Kelsee Halpin
- University of Missouri—Kansas City School of Medicine, Kansas City, MO, United States of America
- Division of Pediatric Endocrinology and Diabetes, Children’s Mercy Kansas City, Kansas City, MO, United States of America
| | - Ann Davis
- Center for Children’s Healthy Lifestyles & Nutrition, Kansas City, MO, United States of America
- Department of Pediatrics, University of Kansas Medical Center, Kansas City, KS, United States of America
| | - Tarin Phillips
- Kirksville College of Osteopathic Medicine, A.T. Still University, Kirksville, MO, United States of America
| | - Robin P. Shook
- Center for Children’s Healthy Lifestyles & Nutrition, Kansas City, MO, United States of America
- Department of Pediatrics, Children’s Mercy Kansas City, Kansas City, MO, United States of America
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Psychosocial aspects of sports medicine in pediatric athletes: Current concepts in the 21 st century. Dis Mon 2022:101482. [PMID: 36100481 DOI: 10.1016/j.disamonth.2022.101482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Behavioral aspects of organized sports activity for pediatric athletes are considered in a world consumed with winning at all costs. In the first part of this treatise, we deal with a number of themes faced by our children in their sports play. These concepts include the lure of sports, sports attrition, the mental health of pediatric athletes (i.e., effects of stress, anxiety, depression, suicide in athletes, ADHD and stimulants, coping with injuries, drug use, and eating disorders), violence in sports (i.e., concepts of the abused athlete including sexual abuse), dealing with supervisors (i.e., coaches, parents), peers, the talented athlete, early sports specialization and sports clubs. In the second part of this discussion, we cover ergolytic agents consumed by young athletes in attempts to win at all costs. Sports doping agents covered include anabolic steroids (anabolic-androgenic steroids or AAS), androstenedione, dehydroepiandrostenedione (DHEA), human growth hormone (hGH; also its human recombinant homologue: rhGH), clenbuterol, creatine, gamma hydroxybutyrate (GHB), amphetamines, caffeine and ephedrine. Also considered are blood doping that includes erythropoietin (EPO) and concepts of gene doping. In the last section of this discussion, we look at disabled pediatric athletes that include such concepts as athletes with spinal cord injuries (SCIs), myelomeningocele, cerebral palsy, wheelchair athletes, and amputee athletes; also covered are pediatric athletes with visual impairment, deafness, and those with intellectual disability including Down syndrome. In addition, concepts of autonomic dysreflexia, boosting and atlantoaxial instability are emphasized. We conclude that clinicians and society should protect our precious pediatric athletes who face many challenges in their involvement with organized sports in a world obsessed with winning. There is much we can do to help our young athletes find benefit from sports play while avoiding or blunting negative consequences of organized sport activities.
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