Childrens physical activity and clustered cardiovascular risk: implications for guidelines. The European Youth Heart Study.
Involverte ansatte ProsjektstatusSubmitted to the Lancet 2006.
BeskrivelsePhysical activity recommendations in children are mainly based on studies using quite crude measures of exposure and outcome. The aim of the present study was to assess the associations of objectively measured PA with clustering of cardiovascular disease (CVD) risk factors in children and derive guidelines based on the analysis.
Methods Cross sectional study of 1732 9- and 15-year-old randomly selected school children. Risk factors included in the composite risk factor score (mean of z-scores) were systolic blood pressure, triglyceride, ratio total cholesterol:HDL, insulin resistance (HOMA), sum of four skinfolds, and aerobic fitness. Subjects having a risk score above 1SD of the composite variable were defined to be “at risk”. PA was assessed by accelerometry.
Findings Odds ratios for having clustered risk for ascending quintiles of counts per minute (cpm) were 3.29 (95% CI: 1.96-5.52), 3.13 (95% CI: 1.87-5.25), 2.51 (95% CI: 1.47-4.26), and 2.03 (95% CI: 1.18-3.50), respectively, compared to the most active quintile. The first to the third quintile of PA had elevated risk in all analyses. The mean time spent above 2000 cpm in the fourth quintile was 116 min in 9-year olds and 88 min in 15-year olds.
Interpretation Current guidelines of at least 1 hour per day of physical activity of at least moderate intensity may be an underestimation of the activity necessary to prevent clustering of CVD risk factors in children.