Reduced cardiorespiratory fitness, low physical activity and an urban environment are independently associated with increased cardiovascular risk in children

Abstract

Aims/hypothesis To assist in the development of preventive strategies, we studied whether the neighbourhood environment or modifiable behavioural parameters, including cardiorespiratory fitness (CRF) and physical activity (PA), are independently associated with obesity and metabolic risk markers in children. Methods We carried out a cross-sectional analysis of 502 randomly selected first and fifth grade urban and rural Swiss schoolchildren with regard to CRF, PA and the neighbourhood (rural vs urban) environment. Outcome measures included BMI, sum of four skinfold thicknesses, homeostasis model assessment of insulin resistance (HOMA-IR) and a standardised clustered metabolic risk score. Results CRF and PA (especially total PA, but also the time spent engaged in light and in moderate and vigorous intensity PA) were inversely associated with measures of obesity, HOMA-IR and the metabolic risk score, independently of each other, and of sociodemographic and nutritional parameters, media use, sleep duration, BMI and the neighbourhood environment (all p<0.05). Children living in a rural environment were more physically active and had higher CRF values and reduced HOMA-IR and metabolic risk scores compared with children living in an urban environment (all p<0.05). These differences in cardiovascular risk factors persisted after adjustment for CRF, total PA and BMI. Conclusions/interpretation Reduced CRF, low PA and an urban environment are independently associated with an increase in metabolic risk markers in children.

Associação de índice de massa corporal e aptidão física aeróbica com fatores de risco cardiovascular em crianças

“…These results are similar to several other studies in the pediatric population 1011 , 23 , 24 Kriemler et al 9 found an inverse association between aerobic fitness and the sum of four skinfolds, insulin resistance, and metabolic risk; furthermore, they observed a 6% reduction in insulin resistance for each increase of one stage in an aerobic fitness test.…”

Excessive sedentary time and low cardiorespiratory fitness in European adolescents: the HELENA study

“…Ekelund et al 22 showed an inverse correlation (partial r=–0.11) in 1709 European children and adolescents aged 9 and 15 years old from the European Youth Heart Study. In a Swiss sample, accelerometer-measured sedentary activity was not related to CRF 23. It must be noted that the main purposes of these two studies were not to examine the associations between sedentary time and CRF and, in addition, associations were not controlled for body fat and physical activity measures.…”

“…Minimising the decline in CRF during adolescence may have a positive impact on adulthood health 9. It is not known if engagement in physical activity counteracts the effect of sedentary time on CRF during adolescence 22 23…”

Body mass index, fitness and physical activity from childhood through adolescence

“…Among the detrimental consequences of childhood overweight on current and future health, children and adolescents with overweight are less fit than their leaner peers 1–3. Also, overweight may lead to inactivity and not be the result of it 4.…”