Joint Association of Screen Time and Physical Activity with Cardiometabolic Risk Factors in a National Sample of Iranian Adolescents: The CASPIANIII Study

Abstract

Metabolic syndrome (MetS) and its contributing factors are considered important health problems in the pediatric age group. This study was designed to assess the joint association of ST and PA with cardiometabolic risk factors among Iranian adolescents. A representative sample of 5625 (50.2% boys) school students with a mean age of 14.73 (SD: 2.41) were selected through multistage random cluster sampling method from urban and rural areas of 27 provinces in Iran. ST and PA were assessed by self-administered validated questionnaires. Anthropometric measures (height, weight and waist circumference (WC)) and MetS components (abdominal obesity, elevated blood pressure (BP), low high-density lipoprotein cholesterol (HDL-C), elevated triglycerides (TG) and high fasting blood sugar (FBG)) were measured according to standardized protocols. MetS was defined according to the Adult Treatment Panel III criteria modified for the pediatric age group. Moreover, elevated total cholesterol (TC), elevated low-density lipoprotein cholesterol (LDL-C), and generalized obesity were considered as other cardiometabolic risk factors. Students with high ST levels had significantly higher body mass index z-score (BMI z-score), WC, TG, LDL-C, and BP as well as lower HDL-C level; whereas those with high PA levels had significantly higher HDL-C levels as well as lower BMI z-score, TC, and BP. Adolescents with low PA/ high ST levels had significantly higher BMI, WC, LDL-C levels, as well as higher SBP and DBP compared to their other counterparts. In Multivariate model, joint effect of low PA/ high ST (compared to the high PA/low ST group) increased the odds of overweight, abdominal obesity and low HDL-C and decreased the odds of elevated TC. The findings of this study showed that joint association of high ST and low PA have direct association with abdominal obesity, overweight and low HDL-C and indirect association with elevated TC.

Determine the BMI levels, self-concept and healthy life behaviours of children during a school based obesity training programme

“…In primary school students, inadequate nutrition and malnutrition problems, such as not having the habit of eating breakfast every day [5] , consuming fast food at least once a day and skipping meals are frequently observed [1] , [3] , [6] . The ratio of physical activity and healthy nutrition [7] for children who spend most of their time in front of a television and/or computer is also low [8] . It is found that as the daily time children spend in front of a computer increases, their BMI (Body Mass Index) also increases; however, as the daily time they spend on physical activity increases, the value of BMI decreases [8] , [9] .…”

“…The ratio of physical activity and healthy nutrition [7] for children who spend most of their time in front of a television and/or computer is also low [8] . It is found that as the daily time children spend in front of a computer increases, their BMI (Body Mass Index) also increases; however, as the daily time they spend on physical activity increases, the value of BMI decreases [8] , [9] .…”

“…Being overweight can cause various physical and psychological problems in children [12] , such as Type-2 diabetes, cardiovascular system problems, hypertension and respiratory system problems (such as sleep apnea), as well as some cancer and osteoarthritis. Low self-esteem and body image, eating disorders and a decrease in the quality of life are wide-spread psychological problems [8] . There is also a negative impact from higher BMI levels on the perception of self-concept in children [13] , [14] .…”

Screening for Cardio-Metabolic Risk Factors Among Student Nurses: A Cross-Sectional Study

“…Cardiometabolic risk factors are clusters of various factors such as tobacco use, (hypertension, dyslipidaemia, low physical activity, high fasting plasma glucose and high body mass index (BMI) (Cardiometabolic Risk Working Group, 2011). Behavioural risk factors such as tobacco use, insufficient physical activity, unhealthy diet and excessive alcohol consumption typically cluster together (Cardiometabolic Risk Working Group, 2011;Zimmet et al, 2007) to contribute to the development of various CVDs and CMDs such as hypertension, diabetes, dyslipidemia and overweight and obesity (Forket et al, 2016;Hazree et al, 2014;Heshmat et al, 2016;Nkeh-Chungag, Sekokotla, Rusike, Namugowa, & Iputo, 2015;Odunaiya, Grimmer, & Louw, 2015). Consequently, these diseases confers a higher cost to manage and treat CMDs in the future (Institute of Public Health, 2011;Mathers, & Loncar, 2006).…”

Non-Formal Physical Education of Children: Increase Factor of Physical Activity and Physical Fitness

“…P hysical activity is important to the overall health and well-being of everyone, including all school-age children. The benefits of physical activity are well-documented and involve the mitigation of many health risks, including those for developing Type 2 diabetes (Costanian, Bennett, Hwalla, Assaad, & Sibai, 2014;Rottensteiner et al, 2014), high blood pressure and high blood cholesterol (Carpio-Rivera, Moncada-Jiménez, Salazar-Rojas, & Solera-Herrera, 2016;Heshmat et al, 2016). Physical activity also contributes to the building and maintenance of healthy bones and muscles (Sioen et al, 2015), to improve positive mental health (Hilmn, Erikon, & Kramer, 2008;Nguyen -Michel, Unger, Hamilton, & Spruijt-Metz, 2006;Wang et al, 2010), and health-related physical fitness (HRPF) (De Baere, Philippaert, De Martelaer, & Lefevre, 2016;Malacko & Pejčić, 2009).…”