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Less sitting, more physical activity and higher cardiorespiratory fitness: associations with weight status among a national sample of children.

ABSTRACT: Background: Very few studies have evaluated the independent and combined associations of sedentary behavior (SB), moderate-to-vigorous physical activity (MVPA) and cardiorespiratory fitness (CRF) on obesity. Our recent work has evaluated this paradigm in the adult population,but no study has evaluated this paradigm in the child population, which was the purpose of this study. Methods: A national sample of children (N=680, 6-11 years) were evaluated via the National Youth Fitness Survey; this study was conducted in 2012, employing a nationally representative sample, occurring across 15 different geographic regions in the United States. SB and MVPA were assessed via parental recall, with CRF objectively measured via a treadmill-based aerobic test. Obesity was determined for measured body mass index. A PACS (Physical Activity Cardiorespiratory Sedentary) score was created ranging from 0-3, indicating each child's number of positive characteristics (PA, CRF, SB). Results: Meeting MVPA guidelines (OR adjusted=0.47; 95% CI: 0.29-0.77) and above-median CRF (OR adjusted=0.12; 95% CI: 0.07-0.21), but not SB (OR adjusted=0.62; 95% CI: 0.35-1.10),were associated with reduced odds of obesity. Compared to those with a PACS score of 0, the odds of obesity for PACS scores of 1-3, respectively, were: 0.31 (0.18-0.53), 0.12 (0.04-0.34), and 0.05 (0.02-0.10). Conclusion: These findings highlight the need for public health strategies to promote child MVPA and CRF, and to reduce SB.

SUBMITTER: Loprinzi PD

PROVIDER: S-EPMC5497370 | biostudies-other | 2017

REPOSITORIES: biostudies-other

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Project description:AIMS/HYPOTHESES:Our aim was to examine the independent and combined (cross-sectional) associations of sedentary time (ST), higher intensity physical activity (HPA) and cardiorespiratory fitness (CRF) with metabolic syndrome and diabetes status. METHODS:In 1933 adults (aged 40-75 years) ST and HPA (surrogate measure for moderate to vigorous physical activity) were measured with the activPAL3. CRF was assessed by submaximal cycle-ergometer testing. Metabolic syndrome was defined according to the Adult Treatment Panel (ATP) III guidelines. Diabetes status (normal, prediabetes [i.e. impaired glucose tolerance and/or impaired fasting glucose] or type 2 diabetes) was determined from OGTT. (Multinomial) logistic regression analyses were used to calculate likelihood for the metabolic syndrome, prediabetes and type 2 diabetes according to ST, HPA and CRF separately and combinations of ST-CRF and HPA-CRF. RESULTS:Higher ST, lower HPA and lower CRF were associated with greater odds for the metabolic syndrome and type 2 diabetes independently of each other. Compared with individuals with high CRF and high HPA (CRFhigh-HPAhigh), odds for the metabolic syndrome and type 2 diabetes were higher in groups with a lower CRF regardless of HPA. Individuals with low CRF and low HPA (CRFlow-HPAlow) had a particularly high odds for the metabolic syndrome (OR 5.73 [95% CI 3.84, 8.56]) and type 2 diabetes (OR 6.42 [95% CI 3.95, 10.45]). Similarly, compared with those with high CRF and low ST (CRFhigh-STlow), those with medium or low CRF had higher odds for the metabolic syndrome, prediabetes and type 2 diabetes, irrespective of ST. In those with high CRF, high ST was associated with significantly high odds for the metabolic syndrome (OR 2.93 [95% CI 1.72, 4.99]) and type 2 diabetes (OR 2.21 [95% CI 1.17, 4.17]). The highest odds for the metabolic syndrome and type 2 diabetes were observed in individuals with low CRF and high ST (CRFlow-SThigh) (OR [95% CI]: the metabolic syndrome, 9.22 [5.74, 14.80]; type 2 diabetes, 8.38 [4.83, 14.55]). CONCLUSIONS/INTERPRETATION:These data suggest that ST, HPA and CRF should all be targeted in order to optimally reduce the risk for the metabolic syndrome and type 2 diabetes.

Project description:This secondary analysis explored the association between gestational weight gain, pre-pregnancy body mass index (BMI), and prenatal diet quality in a United States national sample. The sample comprised 1322 pregnant women in the longitudinal Infant Feeding Practices Study II with Diet History Questionnaire data. Diet quality in the third trimester was assessed using the Alternative Healthy Eating Index for Pregnancy. Self-reported pre-pregnancy BMI (categorized as underweight<18.5, normal weight 18.5-24.9, overweight 25.0-29.9, and obese≥30.0) and total gestational weight gain were used to categorize adherence to the Institute of Medicine's recommendations as inadequate, adequate, or excessive weight gain. Diet quality in pre-pregnancy BMI and gestational weight gain groups were compared using Tukey-adjusted generalized linear models adjusted for sociodemographic factors, Women, Infants, and Children participation, parity, and energy intake. Due to missing gestational weight gain data, sensitivity analyses with multiply imputed data were conducted. Women were on average 28.9 years old and of higher socioeconomic status (40% college graduates) and mostly non-Hispanic White (84%), and the mean Alternative Healthy Eating Index for Pregnancy score was 61.2 (of 130). Both pre-pregnancy BMI and gestational weight gain were inversely associated with diet quality scores (p<0.01). The interaction between pre-pregnancy BMI and gestational weight gain was significant (p = 0.04), therefore gestational weight gain models were stratified by BMI group. In stratified adjusted models, gestational weight gain was differently associated with diet quality scores (p<0.05) among women with underweight, normal weight, overweight, and obesity. The relationship between gestational weight gain and prenatal diet quality depended on pre-pregnancy BMI. For example, within women with normal weight, higher diet quality was observed in the adequate gestational weight gain group. Interventions to broadly improve prenatal diet quality are needed, however, resources can be used to target women with higher pre-pregnancy BMIs and women with inadequate or excessive gestational weight gain.

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Less sitting, more physical activity and higher cardiorespiratory fitness: associations with weight status among a national sample of children.

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