Association of moderate to vigorous physical activity and sedentary time with cardiometabolic risk factors in children and adolescents

By Ulf Ekelund, J. Luan, L. Sherar, D. Esliger, P. Griew, A. Cooper. Journal of the American Medical Association (JAMA), 2012

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CONTEXT Data on the combined associations between physical activity and sedentary time with cardio-metabolic risk factors in healthy children is sparse. OBJECTIVE To examine the independent and combined associations between objectively measured time in moderate and vigorous intensity physical activity and sedentary time with cardio-metabolic risk factors. DESIGN, SETTING AND PARTICIPANTS Pooled data from 14 studies collected between 1998 and 2009 comprising 20,871 children (4-18 years) from the International Children’s Accelerometry Database was used. Time spent in moderate and vigorous physical activity and sedentary time was measured using accelerometry after reanalysing raw data files. The independent associations between time in moderate and vigorous physical activity and sedentary time with outcomes were examined using meta-analysis. In combined analyses, participants were stratified by tertiles of time spent in moderate and vigorous physical activity and tertiles of sedentary time. MAIN OUTCOME MEASURES Waist circumference, systolic blood pressure, fasting triglycerides, HDL-Cholesterol and insulin. RESULTS Children accumulated 354±96 min/d and 30±21 min/d sedentary and in MVPA, respectively. Time in moderate and vigorous physical activity was significantly associated with all cardio-metabolic outcomes independent of sex, age, monitor wear time, time spent sedentary and waist circumference (when waist circumference was not the outcome). Sedentary time was not associated with any outcome independent of time in moderate and vigorous physical activity. In the combined analyses, higher levels of moderate and vigorous physical activity were associated with better cardiometabolic risk factors across tertiles of sedentary time. The differences in outcomes between higher and lower moderate and vigorous physical activity were greater the lower the sedentary time. The mean differences in waist circumference between the bottom and top tertiles of moderate and vigorous physical activity varied between 3.6 cm (95% CI, 2.8-4.3) for high sedentary time to 5.6 (95% CI, 4.8-6.4) for low sedentary time. For systolic blood pressure, the mean differences were 0.7 mm Hg (95% CI, −0.07-1.6) for high sedentary time and 2.5 mm Hg (95% CI, 1.7-3.3) for low sedentary time, and for HDL-cholesterol, −2.6 mg/dL (95% CI, −1.4- −3.9) for high sedentary time and −4.5 mg/dL (95% CI, −3.3- −5.6) for low. Geometric mean differences for insulin and triglycerides showed similar variation. Children in the top tertile of MVPA accumulated >35 minutes/day in this intensity level compared with <18 minutes/day for those in the bottom tertile. In prospective analyses (N=6413, 2.1 yrs follow-up time), neither MVPA nor SED were associated with WC at follow-up, whereas a higher WC at baseline was associated with higher amounts of SED at follow-up. CONCLUSION Higher levels of time spent in MVPA by children and adolescents were associated with better cardio-metabolic risk factors regardless of the amount of time spent sedentary.

Subfields: Developmental and Educational Psychology, Physiology, Public Health, Environmental and Occupational Health

View Paper: https://www.semanticscholar.org/paper/b6b5991f5e30ed1c9b5917b8296fcba5c77d99f6

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In Developmental and Educational Psychology

  1. Ulf Ekelund
  2. R. Pate

In Physiology

  1. Ulf Ekelund
  2. A. Timperio
  3. P. Hallal
  4. R. Pate

In Public Health, Environmental and Occupational Health

  1. Ulf Ekelund
  2. A. Timperio
  3. R. Pate

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