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Steps, moderate-to-vigorous physical activity, and cardiometabolic profiles.

ABSTRACT: The relative benefits of meeting the current moderate-to-vigorous intensity physical activity (MVPA) and active step count recommendations are unknown. Using robust linear regressions, we compared cardiometabolic marker differences (blood pressure, lipid levels, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), hemoglobin A1C, C-reactive protein (CRP), and body mass index (BMI)) across MVPA (150min/week) and step (10,000 steps/day) thresholds and between step categories (low active: 5000 to 7499, somewhat active: 7500 to 9999, and active: ?10,000 steps/day vs. inactive: <5000 steps/day) in approximately 6000 Canadian adults (41.5years, SD 14.9). Differences across MVPA and step thresholds were similar but additional benefits were observed for BMI and A1C for the MVPA target (i.e., above vs. below 150min/week MVPA: -1.02kg/m2 (95% Confidence Interval [CI] -1.25 to -0.80) and -0.04% (95% CI -0.06 to -0.02); above vs. below ?10,000 steps/day: -0.40kg/m2 (95% CI -0.63 to -0.16) and 0.01% (95% CI -0.01 to 0.03)). In terms of steps categories, the greatest incremental improvement was achieved at the somewhat active threshold (e.g., somewhat active vs. inactive: -0.90kg/m2, 95% CI -1.28 to -0.53; low active vs. inactive: -0.36kg/m2, 95% CI -0.73 to 0.02). Additional benefits beyond the 10,000 step/day threshold were limited (e.g., -0.93kg/m2, 95% CI -1.30 to -0.57). Given that most benefits to markers of cardiometabolic health were at the ?7500 step/day threshold and that there was some additional benefit across the 150min/week MVPA threshold compared to a 10,000 steps/day threshold, we suggest aiming for ?7500 steps/day and then advancing to a 150min/MVPA goal.

SUBMITTER: Hajna S

PROVIDER: S-EPMC6625960 | biostudies-literature | 2018 Feb

REPOSITORIES: biostudies-literature

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Steps, moderate-to-vigorous physical activity, and cardiometabolic profiles.

Hajna Samantha S Ross Nancy A NA Dasgupta Kaberi K

Preventive medicine 20171107

The relative benefits of meeting the current moderate-to-vigorous intensity physical activity (MVPA) and active step count recommendations are unknown. Using robust linear regressions, we compared cardiometabolic marker differences (blood pressure, lipid levels, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), hemoglobin A1C, C-reactive protein (CRP), and body mass index (BMI)) across MVPA (150min/week) and step (10,000 steps/day) thresholds and between step categories (low active: ...[more]

PMID: 29126915

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Project description:An evidence-based steps/day translation of U.S. federal guidelines for youth to engage in ?60?minutes/day of moderate-to-vigorous physical activity (MVPA) would help health researchers, practitioners, and lay professionals charged with increasing youth's physical activity (PA). The purpose of this study was to determine the number of free-living steps/day (both raw and adjusted to a pedometer scale) that correctly classified children (6-11?years) and adolescents (12-17?years) as meeting the 60-minute MVPA guideline using the 2005-2006 National Health and Nutrition Examination Survey (NHANES) accelerometer data, and to evaluate the 12,000 steps/day recommendation recently adopted by the President's Challenge Physical Activity and Fitness Awards Program.Analyses were conducted among children (n?=?915) and adolescents (n?=?1,302) in 2011 and 2012. Receiver Operating Characteristic (ROC) curve plots and classification statistics revealed candidate steps/day cut points that discriminated meeting/not meeting the MVPA threshold by age group, gender and different accelerometer activity cut points. The Evenson and two Freedson age-specific (3 and 4 METs) cut points were used to define minimum MVPA, and optimal steps/day were examined for raw steps and adjusted to a pedometer-scale to facilitate translation to lay populations.For boys and girls (6-11?years) with???60?minutes/day of MVPA, a range of 11,500-13,500 uncensored steps/day for children was the optimal range that balanced classification errors. For adolescent boys and girls (12-17) with ?60?minutes/day of MVPA, 11,500-14,000 uncensored steps/day was optimal. Translation to a pedometer-scaling reduced these minimum values by 2,500 step/day to 9,000 steps/day. Area under the curve was ?84% in all analyses.No single study has definitively identified a precise and unyielding steps/day value for youth. Considering the other evidence to date, we propose a reasonable 'rule of thumb' value of???11,500 accelerometer-determined steps/day for both children and adolescents (and both genders), accepting that more is better. For practical applications, 9,000 steps/day appears to be a more pedometer-friendly value.

Project description:ContextSparse data exist on the combined associations between physical activity and sedentary time with cardiometabolic risk factors in healthy children.ObjectiveTo examine the independent and combined associations between objectively measured time in moderate- to vigorous-intensity physical activity (MVPA) and sedentary time with cardiometabolic risk factors.Design, setting, and participantsPooled data from 14 studies between 1998 and 2009 comprising 20 871 children (aged 4-18 years) from the International Children's Accelerometry Database. Time spent in MVPA and sedentary time were measured using accelerometry after reanalyzing raw data. The independent associations between time in MVPA and sedentary time, with outcomes, were examined using meta-analysis. Participants were stratified by tertiles of MVPA and sedentary time.Main outcome measuresWaist circumference, systolic blood pressure, fasting triglycerides, high-density lipoprotein cholesterol, and insulin.ResultsTimes (mean [SD] min/d) accumulated by children in MVPA and being sedentary were 30 (21) and 354 (96), respectively. Time in MVPA was significantly associated with all cardiometabolic outcomes independent of sex, age, monitor wear time, time spent sedentary, and waist circumference (when not the outcome). Sedentary time was not associated with any outcome independent of time in MVPA. In the combined analyses, higher levels of MVPA were associated with better cardiometabolic risk factors across tertiles of sedentary time. The differences in outcomes between higher and lower MVPA were greater with lower sedentary time. Mean differences in waist circumference between the bottom and top tertiles of MVPA were 5.6 cm (95% CI, 4.8-6.4 cm) for high sedentary time and 3.6 cm (95% CI, 2.8-4.3 cm) for low sedentary time. Mean differences in systolic blood pressure for high and low sedentary time were 0.7 mm Hg (95% CI, -0.07 to 1.6) and 2.5 mm Hg (95% CI, 1.7-3.3), and for high-density lipoprotein cholesterol, differences were -2.6 mg/dL (95% CI, -1.4 to -3.9) and -4.5 mg/dL (95% CI, -3.3 to -5.6), respectively. Geometric mean differences for insulin and triglycerides showed similar variation. Those in the top tertile of MVPA accumulated more than 35 minutes per day in this intensity level compared with fewer than 18 minutes per day for those in the bottom tertile. In prospective analyses (N = 6413 at 2.1 years' follow-up), MVPA and sedentary time were not associated with waist circumference at follow-up, but a higher waist circumference at baseline was associated with higher amounts of sedentary time at follow-up.ConclusionHigher MVPA time by children and adolescents was associated with better cardiometabolic risk factors regardless of the amount of sedentary time.

Project description:PurposeThis study aimed to examine the validity of wrist acceleration cut points for classifying moderate (MPA), vigorous (VPA), and moderate-to-vigorous (MVPA) physical activity.MethodsFifty-seven children (5-12 yr) completed 15 semistructured activities. Three sets of wrist cut points (>192 mg, >250 mg, and >314 mg), previously developed using Euclidian norm minus one (ENMO192+), GENEActiv software (GENEA250+), and band-pass filter followed by Euclidian norm (BFEN314+), were evaluated against indirect calorimetry. Analyses included classification accuracy, equivalence testing, and Bland-Altman procedures.ResultsAll cut points classified MPA, VPA, and MVPA with substantial accuracy (ENMO192+: κ = 0.72 [95% confidence interval = 0.72-0.73], MVPA: area under the receiver operating characteristic curve (ROC-AUC) = 0.85 [0.85-0.86]; GENEA250+: κ = 0.75 [0.74-0.76], MVPA: ROC-AUC = 0.85 [0.85-0.86]; BFEN314+: κ = 0.73 [0.72-0.74], MVPA: ROC-AUC = 0.86 [0.86-0.87]). BFEN314+ misclassified 19.7% non-MVPA epochs as MPA, whereas ENMO192+ and GENEA250+ misclassified 32.6% and 26.5% of MPA epochs as non-MVPA, respectively. Group estimates of MPA time were equivalent (P < 0.01) to indirect calorimetry for the BFEN314+ MPA cut point (mean bias = -1.5%, limits of agreement [LoA] = -57.5% to 60.6%), whereas estimates of MVPA time were equivalent (P < 0.01) to indirect calorimetry for the ENMO192+ (mean bias = -1.1%, LoA = -53.7% to 55.9%) and GENEA250+ (mean bias = 2.2%, LoA = -56.5% to 52.2%) cut points. Individual variability (LoA) was large for MPA (min: BFEN314+, -60.6% to 57.5%; max: GENEA250+, -42.0% to 104.1%), VPA (min: BFEN314+, -238.9% to 54.6%; max: ENMO192+, -244.5% to 127.4%), and MVPA (min: ENMO192+, -53.7% to 55.0%; max: BFEN314+, -83.9% to 25.3%).ConclusionWrist acceleration cut points misclassified a considerable proportion of non-MVPA and MVPA. Group-level estimates of MVPA were acceptable; however, error for individual-level prediction was larger.

Project description:Increasing prevalence of sedentary behavior (SB) combined with low levels of physical activity (PA) in children and adolescents has become a growing public health concern. Therefore, this study aimed to identify the daily behavioral pattern of adolescents and examine the isotemporal substitution effects of SB with light-intensity PA (LIPA) or moderate-to-vigorous PA (MVPA) on cardiometabolic markers. In this cross-sectional study, the daily behavioral pattern of Brazilian male adolescents was objectively measured for 7 days. Vector magnitude activity counts were used to estimate SB, LIPA, and MVPA with cut-points specifically validated for youth. The isotemporal substitution model was used to assess the effects of replacing different SB bouts (5, 10, 30, and 60 min) with LIPA or MVPA on cardiometabolic markers [body mass index, waist circumference, body fat percentage (BF%), total cholesterol, high-density lipoprotein cholesterol (HDL-C), non-HDL-C, low-density lipoprotein cholesterol, triglyceride (TG), glucose, insulin, homeostatic model assessment of insulin resistance (HOMA2-IR), insulin sensitivity (HOMA2-S), beta cell function (HOMA2-β), systolic-blood pressure (SBP), diastolic-blood pressure, and cardiometabolic risk score]. Male adolescents (n = 84; age, 16.7 ± 0.9 years) wore the GT3X+ for 6.7 ± 0.6 days, during 15.2 ± 2.3 h, and spent 72.9% of the time in SB, 17.3% in LIPA, and 9.8% in MVPA. SB replacement with LIPA was associated with increased HDL-C, TG, HOMA2-IR, and HOMA2-S and decreased SBP. In contrast, SB replacement with MVPA was associated with decreased BF%. Therefore, our findings suggest that replacing SB with LIPA showed positive results on HDL-C, HOMA2-S and SBP, while replacing SB with MVPA was associated with only one obesity indicator (BF%). Moreover, participants met the daily MVPA recommendations, but they still had a daily behavioral pattern with high SB. In this context, LIPAs can be considered an effective alternative to reduce SB and improve the health indicators of this population.

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Steps, moderate-to-vigorous physical activity, and cardiometabolic profiles.

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Steps, moderate-to-vigorous physical activity, and cardiometabolic profiles.

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