Dataset Information

BMI as a mediator of the relationship between muscular fitness and cardiometabolic risk in children: a mediation analysis.

ABSTRACT:

Objective

Muscular fitness levels have been associated with cardiometabolic risk in children, although whether body weight acts as a confounder or as an intermediate variable in this relationship remains controversial. The aim of this study was to examine whether the association between muscular fitness and cardiometabolic risk factors is mediated by body mass index (BMI).

Design and methods

Cross-sectional study using a sample of 1158 schoolchildren aged 8-11 years from the province of Cuenca, Spain. We measured anthropometrics and biochemical variables and we calculated a muscular fitness index as the sum of z-scores of handgrip dynamometry/weight and standing long jump, and we estimated a previously validated cardiometabolic risk index (CMRI). Linear regression models were fitted for mediation analysis to assess whether the association between muscular fitness and cardiometabolic risk was mediated by BMI.

Results

Children with normal weight (NW) had a better cardiometabolic risk profile than their overweight (OW) or obese (OB) peers after controlling for muscular fitness. Marginal estimated mean ± SE values for NW, OW and OB categories of CMRI were -0.75 ± 0.06 < 0.84 ± 0.10 < 2.18 ± 0.16 in boys and -0.73 ± 0.06 < 0.96 ± 0.10 < 2.71 ± 0.17 in girls, both p < 0.001. Children with higher levels of muscular fitness had a better cardiometabolic risk profile (CMRI marginal estimated mean ± SE 1.04 ± 0.13 > 0.05 ± 0.09 >-1.16 ± 0.13 for lower, middle and upper quartiles of muscular fitness in boys and 1.01 ± 0.16 > 0.10 ± 0.09 > -1.02 ± 0.15 in girls, both p < 0.001), but differences disappeared when controlling for BMI. BMI acted as a full mediator between muscular fitness and most cardiometabolic risk factors (Sobel test z = -11.44 for boys; z = -11.83 for girls; p < 0.001 in CMRI mediation model) and as a partial mediator in the case of waist circumference (Sobel test z=-14.86 for boys; z=-14.51 for girls; p<0.001).

Conclusions

BMI mediates the association between muscular fitness and cardiometabolic risk in schoolchildren. Overall, good muscular fitness is associated with lower cardiometabolic risk, but particularly when accompanied by normal weight.

SUBMITTER: Diez-Fernandez A

PROVIDER: S-EPMC4295865 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

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Publications

BMI as a mediator of the relationship between muscular fitness and cardiometabolic risk in children: a mediation analysis.

Díez-Fernández Ana A Sánchez-López Mairena M Gulías-González Roberto R Notario-Pacheco Blanca B Cañete García-Prieto Jorge J Arias-Palencia Natalia N Martínez-Vizcaíno Vicente V

PloS one 20150115 1

<h4>Objective</h4>Muscular fitness levels have been associated with cardiometabolic risk in children, although whether body weight acts as a confounder or as an intermediate variable in this relationship remains controversial. The aim of this study was to examine whether the association between muscular fitness and cardiometabolic risk factors is mediated by body mass index (BMI).<h4>Design and methods</h4>Cross-sectional study using a sample of 1158 schoolchildren aged 8-11 years from the provi ...[more]

PMID: 25590619

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Project description:Background:Good nutrition and physical activity of school-aged children are important for ensuring optimum growth and reducing obesity. This present study assessed associations between breakfast consumption, BMI-for-Age (BMI) and physical fitness in a cross-section of school-aged children attending government-owned primary schools in Kumasi, Ghana. Method:The sample consisted of 438 pupils (boys?=?213; girls?=?225; mean age 11.1?±?1.1), attending 10 randomly selected schools. Weight (kg), height (cm) and Mid Upper Arm Circumference (MUAC) were measured for each participant, and BMI-for-age z-scores determined using the World Health Organisation (WHO) anthroplus software. Participants were stratified into thinness, normal weight, overweight/obese using WHO cut offs. Physical fitness was assessed using forward jump, left and right handgrips, flexibility, sit-ups and 50?metre run following standard procedures and converted to scores of 1 to 10 following Japanese standards, based on which percentiles were derived. Total fitness score for each pupil was computed by adding all scores. A questionnaire was used to assess meal intake patterns. Results:The mean BMI-for-age z-score for participants was -?0.24?±?0.99. Thinness, normal weight and overweight/obesity were 2.7, 86.5, and 10.5% respectively among the pupils. Overweight was higher in girls (14.2%) compared to boys (4.2%), p?=?0.003. Similarly, mean MUAC was significantly (p?=?0.021) higher in the girls (22.0 ± 3.2?cm) than the boys (20.7 ± 7.3?cm). For physical fitness, the girls scored higher in forward jump (p?<?0.0001), 50-m run (p?=?0.002) and overall fitness score than the boys (21.0?±?6.2 versus 19.2?±?8.3, p?=?0.012). However, a larger proportion of boys performed excellently and poorly than girls (p?=?0.019). A positive correlation was observed between BMI z-score and hand grip (r =?0.21, p?<?0.001), while sit up (r =?-?0.11, p?=?0.018) showed a negative correlation with BMI z-score. No other fitness test varied by BMI. Overweight children performed best in handgrip. Majority of children said they engaged in exercise (89.9%) and consumed breakfast (78.9%). Breakfast consumption was not associated with BMI z-score (x2 0.0359, p?=?0.549) but non-breakfast consumers performed better in 50?m run compared to consumers (7.0 seconds?±?2.3 vrs 6.3 seconds?±?2.5, p?=?0.022). Children who reported to exercise were physically fitter than those who did not. Conclusion:Underweight levels were low while overweight was over 10% in these children. Girls were more than 3 times affected by overweight than boys, and were also physically fitter than boys. Breakfast consumption was not related to weight or fitness.

Dataset Information

BMI as a mediator of the relationship between muscular fitness and cardiometabolic risk in children: a mediation analysis.

Objective

Design and methods

Results

Conclusions

Publications

BMI as a mediator of the relationship between muscular fitness and cardiometabolic risk in children: a mediation analysis.

Similar Datasets

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