TOPLINE

Higher levels of moderate-to-vigorous physical activity were associated with lower levels of insulin, low-density lipoprotein (LDL) cholesterol, and triglycerides among children and adolescents, although associations were weak and varied by age and BMI. Sedentary time was inversely associated with systolic blood pressure.

METHODOLOGY

• Researchers conducted a meta-analysis using harmonized individual-level data from 14 cohort studies spanning 16 countries to determine how physical activity and sedentary time relate to cardiometabolic health markers among children and adolescents.
• A total of 12,874 participants (mean age, 10.4 years) who had accelerometer-measured physical activity and sedentary time were included, with a mean duration of follow-up of 3.1 years.
• Intensities of physical activity were defined as sedentary time (a maximum of 100 counts per minute), moderate physical activity (2296-4011 counts per minute), and vigorous physical activity (at least 4012 counts per minute), with moderate-to-vigorous physical activity representing combined moderate and vigorous physical activity.
• Six cardiometabolic risk markers were assessed: systolic blood pressure at rest; levels of glucose, insulin, LDL cholesterol, and triglycerides; and BMI, along with two clustered risk scores combining these markers.
• Three models with progressive adjustments were considered: model 1 controlled for sex, age and sexual maturity at baseline, wear time of the accelerometer, socioeconomic status, birth weight, ethnicity, intervention status, and length of follow-up; model 2 (primary) additionally controlled for BMI at baseline; and model 3 additionally controlled for values of the outcome at baseline.

TAKEAWAY

• In the primary model, each SD increase in moderate-to-vigorous physical activity (26 min/d) was associated with reduced levels of insulin (-0.24 µIU/mL; P < .001), LDL cholesterol (-1.54 mg/dL; P < .001), and triglycerides (-1.77 mg/dL; P < .001) but with elevated systolic blood pressure (0.25 mm Hg; P = .02). Following model 3 adjustment, most associations diminished.
• Each SD increase in vigorous physical activity (12 min/d) demonstrated comparable associations; however, no association was observed with blood pressure. Moderate-to-vigorous and vigorous physical activity showed no association with subsequent BMI.
• Higher sedentary time per SD (106 min/d) was associated with reduced systolic blood pressure (-0.90 mm Hg; P < .001).
• Associations between moderate-to-vigorous physical activity and the clustered risk were observed among participants with higher BMI at baseline (P < .001), those younger than 13 years (P < .001), and those with follow-up under 2 years (P = .002).

IN PRACTICE

"[The study] findings do not confirm the strong inverse dose-response associations between MVPA [moderate-to-vigorous physical activity] and cardiometabolic risk factors observed in cross-sectional studies," the researchers wrote.

"Our findings suggest that (1) MVPA above the current 60 minutes per day recommendation may be needed to improve later cardiometabolic risk profile, (2) MVPA may not prevent excess weight gain in youth, (3) the magnitude of the association between MVPA and later cardiometabolic risk profile was stronger in younger children and those with higher BMI, and (4) sedentary time was not associated with the cardiometabolic risk profile," they added.

SOURCE

The study was led by Anders Husøy, PhD, of the Oslo Research Centre for Physical Activity and Population Health at the Norwegian School of Sport Sciences in Oslo, Norway. It was published online on October 6 in JAMA Pediatrics.

LIMITATIONS

Controlling for BMI at baseline in the primary model might have addressed unmeasured confounding; however, earlier physical activity may have reduced BMI and adjusting for BMI may be inappropriate. Some variables including quality of diet, sleep, and additional factors may likely introduce residual confounding. Metabolic parameters were assessed through standardized yet distinct methods among cohorts, possibly limiting comparability.

DISCLOSURES

Some authors reported receiving research grants from organizations including the Medical Research Council, Novo Nordisk Foundation, European Union, Canadian Institutes of Health Research, National Health and Medical Research Council of Australia, and Spain’s Ministry of Science and Innovation and other organizations during the conduct of the study; two of them also reported salary awards, and one reported advisory roles with health agencies. The individual cohorts were supported by their own specific funding sources. 

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.