High-intensity activity is more strongly associated with metabolic health in children compared to sedentary time: a cross-sectional study of the I.Family cohort

Abstract

Background Physical activity (PA) during childhood is important for preventing future metabolic syndrome (MetS). To examine the relationship between PA and MetS in more detail, accurate measures of PA are needed. Previous studies have only utilized a small part of the information available from accelerometer measured PA. This study investigated the association between measured PA and MetS in children with a new method for data processing and analyses that enable more detailed interpretation of PA intensity level. Methods The association between PA pattern and risk factors related to MetS was investigated in a cross- sectional sample of children (n = 2592, mean age 10.9 years, 49.4% male) participating in the European multicenter I. Family study. The risk factors examined include body mass index, blood pressure, high-density lipoprotein cholesterol, insulin resistance and a combined risk factor score (MetS score). PA was measured by triaxial accelerometers and raw data was processed using the 10 Hz frequency extended method (FEM). The PA output was divided into an intensity spectrum and the association with MetS risk factors was analyzed by partial least squares regression. Results PA patterns differed between the European countries investigated, with Swedish children being most active and Italian children least active. Moderate intensity physical activity was associated with lower insulin resistance (R2 = 2.8%), while vigorous intensity physical activity was associated with lower body mass index (R2 = 3.6%), MetS score (R2 = 3.1%) and higher high-density lipoprotein cholesterol (R2 = 2.3%). PA of all intensities was associated with lower systolic- and diastolic blood pressure, although the associations were weaker than for the other risk factors (R2 = 1.5% and R2 = 1.4%). However, the multivariate analysis implies that the entire PA pattern must be considered. The main difference in PA was observed between normal weight and overweight children. Conclusions The present study suggests a greater importance of more PA corresponding to an intensity of at least brisk walking with inclusion of high-intense exercise, rather than a limited time spent sedentary, in the association to metabolic health in children. The methods of data processing and statistical analysis enabled accurate analysis and interpretation of the health benefits of high intensity PA that have not been shown previously.

Association between Metabolic Syndrome Diagnosis and the Physical Activity—Sedentary Profile of Adolescents with Obesity: A Complementary Analysis of the Beta-JUDO Study

“…The results of the presented mutually adjusted model of correlations between movement-related behaviors and the dichotomous diagnosis of the MetS are also in line with a recent meta-analysis showing that PA of at least moderate intensity, but not SED time, was independently associated with the presence of the MetS defined with dichotomous criteria in children and adolescents [ 18 ]. For Fridolfsson et al, the association between SED time and cardiometabolic health is generally weaker in contrast to high-intensity PA in youths [ 46 ]. However, the independence of the associations between movement-related behaviors and obesity-related health parameters remains debatable [ 18 , 23 , 46 , 47 , 48 ], as some recent longitudinal studies have reported significant positive associations between SED behaviors, BMI and fat mass index during childhood and adolescence, even after adjustment for MVPA [ 47 , 48 ].…”

“…For Fridolfsson et al, the association between SED time and cardiometabolic health is generally weaker in contrast to high-intensity PA in youths [ 46 ]. However, the independence of the associations between movement-related behaviors and obesity-related health parameters remains debatable [ 18 , 23 , 46 , 47 , 48 ], as some recent longitudinal studies have reported significant positive associations between SED behaviors, BMI and fat mass index during childhood and adolescence, even after adjustment for MVPA [ 47 , 48 ]. In the present study, the independence of the association between SED time and the continuous z-score of cardiometabolic risks is in line with these last results [ 47 , 48 ] and highlights the importance of reducing SED time in order to improve cardiometabolic health in adolescents with obesity, whatever the level of MVPA.…”

“…Nevertheless, wrist worn accelerometers can provide higher values of MVPA than hip-worn accelerometers [ 56 , 57 , 58 ]. However, it is worth noting the major geographical differences in PA patterns, with Swedish children (representing more than two third of the present sample) having a meaningful higher MVPA than other European countries [ 46 ].…”

Effects of Extreme Weight Loss on Cardiometabolic Health in Children With Metabolic Syndrome: A Metabolomic Study

“…Weight loss is an effective strategy for reducing cardiometabolic risk in children with metabolic syndrome. Physical activity, which has attracted increasing amount of attention, can not only effectively reduce weight but also improve cardiometabolic health and increase cardiovascular fitness (Dias et al, 2018;Hansen et al, 2018;Labayen et al, 2020;Fridolfsson et al, 2021). A randomized controlled trial by Davis et al also showed that moderate-intensity aerobic exercise (heart rate approximately 150 beats/min) reduced body composition and the risk of diabetes effectively and improved glucose metabolism in overweight and obese children (Davis et al, 2012).…”

Current Approaches to Arterial Hypertension Management in Children and Adolescents: Clinical Guidelines Review

“…Недавние исследования подтвердили, что любые упражнения, будь то аэробные, силовые или смешанные, в равной степени полезны, но нагрузки большей интенсивности не только позволяют снизить АД, но и способствуют уменьшению частоты регистрации метаболических факторов риска [31].…”