Physical Activity, Obesity Status, and Blood Pressure in Preschool Children

Abstract

Objective To examine the combined effects of physical activity and weight status on blood pressure (BP) in preschool-aged children. Study designThe sample included 733 preschool-aged children (49% female). Physical activity was objectively assessed on 7 consecutive days by accelerometry. Children were categorized as sufficiently active if they met the recommendation of at least 60 minutes daily of moderate-to-vigorous physical activity (MVPA). Body mass index was used to categorize children as nonoverweight or overweight/obese, according to the International Obesity Task Force benchmarks. BP was measured using an automated BP monitor and categorized as elevated or normal using BP percentile-based cut-points for age, sex, and height.Results The prevalence of elevated systolic BP (SBP) and diastolic BP was 7.7% and 3.0%, respectively. The prevalence of overweight/obese was 32%, and about 15% of children did not accomplish the recommended 60 minutes of daily MVPA. After controlling for age and sex, overweight/obese children who did not meet the daily MVPA recommendation were 3 times more likely (OR 3.8; CI 1.6-8.6) to have elevated SBP than nonoverweight children who met the daily MVPA recommendation.Conclusions Overweight or obese preschool-aged children with insufficient levels of MVPA are at significantly greater risk for elevated SBP than their nonoverweight and sufficiently active counterparts. (J Pediatr 2015;167:98-102).A n important risk factor for cardiovascular disease (CVD) is elevated blood pressure (BP). Even though elevated BP is unusual during childhood, 1 prospective cohort studies have shown that BP tracks from early childhood into adulthood, 2,3 In the Bogalusa Heart Study, children in the top quintile of systolic BP (SBP) were 3-4 times more likely to develop clinical hypertension by age 30 than their normotensive peers, and 50% of hypertensive adults had elevated SBP during childhood. 4 Overweight and obesity are thought to be important contributing factors to the development of elevated BP in children and youth. A number of studies have demonstrated that there is a positive relationship between body mass index (BMI) and SBP in school-aged children, 5-8 as well as preschool-aged children. 9 Among youth, the relationship between physical activity and BP is not well understood; however, it has been shown that moderate intensity physical activity is associated with lower SBP [10][11][12] and that exercise training can reduce BP in adolescents with hypertension. [13][14][15][16] The purpose of the study was to examine the combined effects of physical activity and weight status on BP in preschool-aged children. We hypothesized that overweight or obese and insufficiently active children would be more likely to have elevated BP than healthy-weight children meeting guidelines for daily physical activity. MethodsParticipants in this study were children enrolled in the Preschool Physical Activity, Body Composition and Lifestyle Study. A random sample of 1566 children, aged 2-6 years, was recruited from k...

Secular Changes of Adiposity in Czech Children Aged from 3 to 6 Years: Latent Obesity in Preschool Age

“…The composition of food intake due to the changes of overall lifestyle has not been desirable, as shown by other studies not only in Czech children [19–23, 35]. However, higher energy intake, even along with, for example, higher fats or simple carbohydrates, has been shown not to be increase BMI and adiposity, for example, in very active adolescents, participating in some organized sport training.…”

“…They demonstrate therefore also increasing health risks, for example, with regard to tracking of increased weight and BMI up to primary school age [33, 34]; however, data on later longitudinal development have not been up to the present available. Moreover, children who are overweight or obese along with low level of moderate and/or vigorous physical activity in preschool age were also shown to be at greater risk of an increased systolic blood pressure, or metabolic syndrome [15, 16, 35]. Therefore, secular trend of increasing adiposity along with reduced motor development and physical fitness during early growth can be present and increase in later years [5, 8, 36].…”

Objectively measured physical activity level and sedentary behavior in Norwegian children during a week in preschool

“…However, most evidence indicates that a substantial proportion of preschool aged children do not meet the widely accepted World Health Organization (WHO) guidelines (WHO, 2010) of at least 60 min of moderate- to vigorous-intensity physical activity (MVPA) per day (Hnatiuk et al, 2014), but rather spend most of their waking hours engaged in sedentary behavior (Kelly et al, 2007, Reilly et al, 2004). Insufficient MVPA levels and high amounts of sedentary time are associated with high systolic blood pressure (Vale et al, 2015), poor motor skills (Iivonen et al, 2013) and low cardiorespiratory fitness (Burgi et al, 2011) in preschool children. Moreover, both lack of MVPA and high sedentary time are implicated in the etiology of childhood obesity (Troiano and Flegal, 1998, Reilly et al, 1999) and children tend to carry this excessive adiposity into adulthood (Jimenez-Pavon et al, 2010, Rey-Lopez et al, 2008).…”

Assessment of vascular function in low socioeconomic status preschool children: a pilot study

“…Although BP elevation in this age group has not been extensively studied, the proportion of preschoolers with elevated BP has ranged from 7.7% to over 30% in prior reports. 9,22,23 It is possible that elevated BP in our study may not indicate HTN since our measurements were performed on only one occasion and the current definition of HTN in children requires BP elevation in three distinct encounters. 6 However, there is mounting evidence that BP elevation in children, even on a single encounter, predicts the development of HTN and CVD in adulthood.…”