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Physical Activity Intensity and Cardiometabolic Risk in Youth

Jacqueline Hay, BSc; Katerina Maximova, PhD; Anita Durksen, MSc; Valerie Carson, MSc; Randi Lynn Rinaldi, MSc; Brian Torrance, MSc; Geoff D. C. Ball, PhD; Sumit R. Majumdar, MD; Ronald C. Plotnikoff, PhD; Paul Veugelers, PhD; Normand G. Boulé, PhD; Paul Wozny, MEd; Linda McCargar, PhD; Shauna Downs, MSc; Richard Lewanczuk, MD, PhD; Jonathan McGavock, PhD
Arch Pediatr Adolesc Med. 2012;166(11):1022-1029. doi:10.1001/archpediatrics.2012.1028.
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Objective  To determine the association between physical activity (PA) intensities and cardiometabolic risk factors in youth.

Design  Cross-sectional study using data from the 2008 Healthy Hearts Prospective Cohort Study of Physical Activity and Cardiometabolic Health in Youth.

Setting  Rural and urban communities in Alberta, Canada.

Participants  A convenience sample of 605 youth aged 9 to 17 years. Youth were on average aged 12.1 years, 248 were boys (41%), and 157 were overweight or obese (26%).

Main Exposure  Actical accelerometer–measured PA intensity.

Main Outcomes Measures  The primary outcome was body mass index (calculated as weight in kilograms divided by height in meters squared) z score. Secondary outcome measures included waist circumference, systolic blood pressure, and cardiorespiratory fitness (maximal oxygen consumption [[Vdot]O2max]).

Results  Body mass index z score, waist circumference, and systolic blood pressure decreased and [Vdot]O2max increased in a dose-response manner across tertiles of vigorous PA (adjusted P < .001). No significant differences in cardiometabolic risk factors were seen across tertiles of moderate or light PA in multivariable analyses. Achieving more than 7 minutes of vigorous PA daily was associated with a reduced adjusted odds ratio of overweight status (0.56; 95% CI, 0.33-0.95) and elevated systolic blood pressure (0.36; 95% CI, 0.16-0.79). The odds of overweight status and elevated blood pressure decreased with increasing time and intensity of PA.

Conclusions  Only vigorous PA was consistently associated with lower levels of waist circumference, body mass index z score, systolic blood pressure, and increased cardiorespiratory fitness in youth. These findings underscore the importance of vigorous PA in guidelines for children and adolescents.

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Figure 1. Cardiometabolic risk factors are associated with vigorous but not moderate or light physical activity (PA). Waist circumference (A), body mass index (BMI) z score (B), systolic blood pressure (C), and [Vdot]O2max (D) according to tertiles of light, moderate, and vigorous PA. Physical activity tertiles: short, medium, and long. Means are adjusted for age, sex, sedentary time, and BMI z score, where applicable. Error bars are standard error of the mean. * P < .05. Numbers on the x-axis denote the mean number of minutes spent in that form of PA within the particular tertile.

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Figure 2. The association between the odds of overweight status and high normal systolic blood pressure across various intensities of physical activity. This graphic representation of the results of a series of logistic regression analyses depicts the slope of the association between the time spent being physically active at various accelerometer cutpoints (ie, physical activity intensities) and the odds of overweight status (A) and high normal systolic blood pressure (B). cpm indicates counts per minute.

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Figure 3. Vigorous physical activity attenuates cardiometabolic risk factor clustering in overweight youth. Values for waist circumference (A), systolic blood pressure (B), body mass index (BMI) z score (C), and [Vdot]O2max(D) according to tertiles of vigorous physical activity in overweight students compared with normal-weight students. Physical activity tertiles: short, medium, and long. Means are adjusted for age and sex. Error bars are standard error of the mean. Numbers on the x-axis denote the mean number of minutes spent in that form of physical activity within the particular tertile.

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