Low Muscle Strength Is Associated with Metabolic Risk Factors in Colombian Children: The ACFIES Study

Abstract

PurposeIn youth, poor cardiorespiratory and muscular strength are associated with elevated metabolic risk factors. However, studies examining associations between strength and risk factors have been done exclusively in high income countries, and largely in Caucasian cohorts. The aim of this study was to assess these interactions in schoolchildren in Colombia, a middle income Latin American country.MethodsWe measured body mass index, body composition, handgrip strength (HG), cardiorespiratory fitness (CRF) and metabolic risk factors in 669 low-middle socioeconomic status Colombian schoolchildren (mean age 11.52±1.13, 47% female). Associations between HG, CRF and metabolic risk factors were evaluated.ResultsHG and CRF were inversely associated with blood pressure, HOMA index and a composite metabolic risk score (p<0.001 for all) and HG was also inversely associated with triglycerides and C-reactive protein (CRP) (both p<0.05). Associations between HG and risk factors were marginally weakened after adjusting for CRF, while associations between CRF and these factors were substantially weakened after adjusting for HG. Linear regression analyses showed inverse associations between HG and systolic BP (β = −0.101; p = 0.047), diastolic BP (β = −0.241; p> = 0.001), HOMA (β = −0.164; p = 0.005), triglycerides (β = −0.583; p = 0.026) and CRP (β = −0.183; p = 0.037) but not glucose (p = 0.698) or HDL cholesterol (p = 0.132). The odds ratios for having clustered risk in the weakest quartile compared with the strongest quartile were 3.0 (95% confidence interval: 1.81–4.95).ConclusionsIn Colombian schoolchildren both poorer handgrip strength/kg body mass and cardiorespiratory fitness were associated with a worse metabolic risk profile. Associations were stronger and more consistent between handgrip and risk factors than between cardiorespiratory fitness and these risk factors. Our findings indicate the addition of handgrip dynamometry to non-invasive youth health surveillance programs would improve the accuracy of the assessment of cardio-metabolic health.

Prediabetes in Colombia: Expert Consensus

“…81 . We have also observed in Colombian children with low birth weight for gestational age evaluated at 10 years old, that those in the highest quartile of BMI were those with the highest CRP concentrations, had higher HOMA index of insulin resistance and a larger amount of fat mass but lower handgrip strength, and a higher metabolic risk index 82 . Low handgrip strength is a known risk factor for cardiovascular and all-cause mortality in adults in the PURE study 83 , and in patients with Prediabetes and DM2 of the ORIGIN study 84 .…”

Results From Colombia’s 2016 Report Card on Physical Activity for Children and Youth

“…Local evidence from the cities of Bogotá showed that 55% of the children and adolescents from Bogotá were under the healthy fitness zone. 47 Similarly, studies from Cali and Bucaramanga showed that 60% 50 and 73% 49 of girls and 52% 50 and 72% 49 of boys did not achieve the healthy fitness zone, respectively.…”

“…46 A grade of INC was assigned to the fitness indicator considering the limited data available for the country. However, the RWG highlighted the surveillance efforts from cities, such as Bogotá, 47,48 Bucaramanga, 49 and Cali, 50 to measure the cardiorespiratory fitness of children and youth. A recommended "healthy fitness zone" for cardiorespiratory fitness, below which the risk of chronic diseases is elevated, 51 Colombia.…”

Results from Colombia’s 2014 Report Card on Physical Activity for Children and Youth

“…Data from Bogota also included the International Study of Childhood Obesity, Lifestyle and Environment (ISCOLE) in 2012, 18 and the Biennial Survey of Culture for 2013. 19 Data from Bucaramanga and its metropolitan area also included the Study of Active and Sedentary Behaviors in Children from preschool to 4th grade (Caracterización de los Comportamientos Activos y Sedentarios en Niños desde Preescolar hasta 4° de la Ciudad de Bucaramanga y su Área Metropolitana), 20,21 and a study of the relationships of cardiorespiratory fitness, strength and body composition with metabolic risk factors in school children (Asociación entre la Capacidad Cardiorrespiratoria, la Fuerza Muscular y la Composición Corporal con Factores de Riesgo Metabólicos en Niños Escolares de Bucaramanga, Colombia [ACFIES] 22 ). Data for Cali also included a survey of risk factors for adult NCDs in the school-age population ( 23 ).…”