With respect to data presented, we established that longitudinal changes in Ad are mainly accompanied by changes in PA and, to a lesser extent, AF levels.

Background: State school physical education (PE) programmes are common throughout Greece. However, it is not known if the main objectives of the Greek PE curriculum are achieved. Objective: To assess the current national PE curriculum in relation to selected motor and cardiovascular health related fitness parameters. Methods: A sample of 84 Greek schoolboys (mean (SD) age 13.6 (0.3) years, height 160.7 (8.6) cm, weight 50 (10.8) kg) volunteered. Forty three indicated participation only in school PE classes and habitual free play (PE group). The remaining 41 were involved in extracurricular organised physical activities in addition to school PE and habitual free play (PE+ group). The subjects underwent anthropometric, motor (flexibility, balance, standing broad jump, hand grip, sit ups, and plate tapping), and cardiovascular health related (percentage body fat, aerobic fitness, and physical activity) fitness assessments. Results: Children in the PE group had inferior motor and cardiovascular health related fitness profiles compared with those in the PE+ group. Body fat (20.3 (8.8) v 13.9 (3.5); p<0.001), aerobic fitness (34.7 (3.7) v 43.9 (4.2); p<0.001), and time spent in intensive physical activity (0.2 (0.2) v 0.7 (0.3); p<0.001) showed the greatest differences between the two groups. In the pupils in the PE group, these were lower than the levels proposed to be necessary to combat future health risks. Adjustments for confounding variables showed a decrease in the significance of motor fitness, but not in cardiovascular health related parameters. Conclusions: The national PE curriculum for Greek secondary schools does not achieve the required levels of motor and cardiovascular health related fitness and should be reconsidered.

Objective: To detect metabolic risk factor cutoff points in adolescence for the diagnosis of metabolic syndrome that develops at the age of 17 years (MS 17 ). Design: This study adopted a 6-year design incorporating four data collection time points (TPs). Volunteers were assessed prospectively at the ages of 12, 13, 14 and 17. Participants: A total of 210, 204, 198 and 187 schoolchildren volunteered at the first (TP 1 ¼ 12 years old), second (TP 2 ¼ 13 years old), third (TP 3 ¼ 14 years old) and fourth (TP 4 ¼ 17 years old) data collection TP, respectively. Measurements: At each data collection TP, anthropometrical, biological and lifestyle data were obtained. Identical protocols were used for each assessment conducted by the same trained investigators. Results: A total of 12% of the participants were diagnosed with MS 17 , the majority of them being boys (Po0.05). The prevalence of the syndrome increased directly with the degree of obesity. Using body mass index (BMI), adiposity and/or aerobic fitness levels in both genders, MS 17 could be correctly diagnosed as early as TP 1 . No such cutoff points were found for high-density lipoprotein cholesterol, triglycerides, blood pressure and fasting plasma glucose levels. Conclusion: With respect to the data presented, it has been established that the calculated longitudinal preventive-screening cutoffs allow successful diagnosis of metabolic syndrome in adolescents using BMI, adiposity or aerobic fitness levels in both sexes. Adoption of such pediatric guidelines may help mitigate future increase in the prevalence of metabolic syndrome.

The prevalence of 14 selected modifiable coronary heart disease (CHD) risk factors was determined in randomly selected adolescent boys (n = 117) and girls (n = 93) from provisional Greece. Based on published criteria thresholds for CHD, 45% of boys and 50% of girls exhibited three or more risk factors with time spent on "vigorous" activities, low cardiorespiratory fitness and fatness being among the most frequent in both sexes. Stronger associations were found between cardiorespiratory fitness and time spent on "vigorous" rather than "moderate-to-vigorous" activities in both boys and girls. Regression analysis indicated that energy expenditure (P < .01) in boys and energy expenditure (P < .05) and energy intake (P < .01) in girls could alone explain about 60% of the body-fat related findings in either group. In conclusion, broadly based primary prevention strategies-aimed at children-should concentrate on reducing the overall energy intake and increasing the time spent on "vigorous" activities if future Greek adult CHD mortality is to be reduced.

We examined the prevalence of 14 modifiable CHD risk factors in a sample of 210 provincial Greek children as they progressed from age 12 to 14. It was found that 46.2% of boys and 49.5% of girls (p > 0.05) exhibited three or more risk factors at their 12th year, with values of 42% for boys and 51.1% (p > 0.05) for girls for their 13th year, and 29.4% for boys and 55% (p < 0.001) for girls in their 14th year. Risk factors with the highest prevalence in both sexes included low vigorous physical activity, low aerobic fitness, and elevated body fatness. The fact that boys exhibited progressively fewer risk factors with age was mainly attributed to increased time spent on vigorous physical activity (P < 0.001) and higher predicted oxygen intake (P < 0.001) with a concomitant decrease in body fat (P < 0.001). The opposite pattern demonstrated by girls was primarily due to elevated predicted % body fat (P < 0.05), % saturated fat intake (P < 0.05), total cholesterol (TC; P < 0.001), low-density lipoprotein cholesterol (LDL-C; P < 0.001), and decreased high-density lipoprotein cholesterol (HDL-C)/TC; P < 0.001). In conclusion, a high percentage of young adolescent Greek boys and girls exhibit three or more modifiable CHD risk factors. However, as the children progress from age 12 to 14, gender differences emerge regarding the development of their CHD risk profiles. The present data support the notion that preventive strategies for combating CHD should begin early in life.