Abstract
The aim of the present study was to examine the associations of cardiovascular fitness (CVF) with a clustering of metabolic risk factors in children, and to examine whether there is a CVF level associated with a low metabolic risk. CVF was estimated by a maximal ergometer bike test on 873 randomly selected children from Sweden and Estonia. Additional measured outcomes included fasting insulin, glucose, triglycerides, HDLC, blood pressure, and the sum of five skinfolds. A metabolic risk score was computed as the mean of the standardized outcomes scores. A risk score <75th percentile was considered to indicate a low metabolic risk. CVF was negatively associated with clustering of metabolic risk factors in children. Receiver operating characteristic curve analysis showed a significant discriminatory accuracy of CVF in identifying the low/high metabolic risk in girls and boys (p < 0.001). The CVF level for a low metabolic risk was 37.0 and 42.1 mL/kg/min in girls and boys, respectively. These levels are similar to the health-related threshold values of CVF suggested by worldwide recognized organizations. In conclusion, the results suggest a hypothetical CVF level for having a low metabolic risk, which should be further tested in longitudinal and/or intervention studies.
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Abbreviations
- AUC:
-
area under the curve
- CVF:
-
cardiovascular fitness
- ROC:
-
receiver operating characteristic
References
Taylor HL, Buskirk E, Henschel A 1955 Maximal oxygen uptake as an objective measure of cardiorespiratory performance. J Appl Physiol 8: 73–80
Brage S, Wedderkopp N, Ekelund U, Franks PW, Wareham NJ, Andersen LB, Froberg K, European Youth Heart Study (EYHS) 2004 Features of the metabolic syndrome are associated with objectively measured physical activity and fitness in Danish children: the European Youth Heart Study (EYHS). Diabetes Care 27: 2141–2148.
Mesa JL, Ruiz JR, Ortega FB, Warnberg J, González-Lamuño D, Moreno LA, Gutiérrez A, Castillo MJ 2006 Aerobic physical fitness in relation to blood lipids and fasting glycaemia in adolescents. Influence of weight status. Nutr Metab Cardiovasc Dis 16: 285–293
Ruiz JR, Rizzo NS, Hurtig-Wennlöf A, Ortega FB, Warnberg J, Sjöström M 2006 Relations of total physical activity and intensity to fitness and fatness in children; The European Youth Heart Study. Am J Clin Nutr 84: 299–303
Reed KE, Warburton DE, Lewanczuk RZ, Haykowsky MJ, Scott JM, Whitney CL, McGavock JM, McKay HA 2005 Arterial compliance in young children: the role of aerobic fitness. Eur J Cardiovasc Prev Rehabil 12: 492–497
Twisk JW, Kemper HC, van Mechelen W 2002 The relationship between physical fitness and physical activity during adolescence and cardiovascular disease risk factors at adult age. The Amsterdam Growth and Health Longitudinal Study. Int J Sports Med 23: S8–S14
Andersen LB, Harro M, Sardinha LB, Froberg K, Ekelund U, Brage S, Anderssen SA 2006 Physical activity and clustered cardiovascular risk in children: a cross-sectional study (The European Youth Heart Study). Lancet 368: 299–304
Carnethon MR, Gidding SS, Nehgme R, Sidney S, Jacobs DR, Liu K 2003 Cardiorespiratory fitness in young adulthood and the development of cardiovascular disease risk factors. JAMA 290: 3092–3100
LaMonte MJ, Barlow CE, Jurca R, Kampert JB, Church TS, Blair SN 2005 Cardiorespiratory fitness is inversely associated with the incidence of metabolic syndrome: a prospective study of men and women. Circulation 112: 505–512
Katzmarzyk PT, Church TS, Blair SN 2004 Cardiorespiratory fitness attenuates the effects of the metabolic syndrome on all cause and cardiovascular disease mortality in men. Arch Intern Med 164: 1092–1097
Bell RD, Macek M, Rutenfranz J, Saris WH 1986 Health indicators and risk factors of cardiovascular diseases during childhood and adolescence. In: Rutenfranz J, Mocelin R, Klimt F (eds) Children and Exercise XII. Human Kinetics, Champaign, IL, pp 19–27
The Cooper Institute for Aerobics Research 1999 FITNESSGRAM Test Administration Manual. Human Kinetics, Champaign, IL, pp 38–39
Riddoch C, Edwards D, Page A, Froberg K, Anderssen SA, Wedderkopp N, Brage S, Cooper AR, Sardinha LB, Harro M, Klasson-Heggebø L, van Mechelen W, Boreham C, Ekelund U, Bo Andersen L, the European Youth Heart Study Team 2005 Cardiovascular disease risk factors in children: rationale, aims, study, design, and validation of methods. J Phys Activ Health 2: 115–129.
Wennlöf AH, Yngve A, Sjöström M 2003 Sampling procedure, participation rates and representativeness in the Swedish part of the European Youth Heart Study (EYHS). Public Health Nutr 6: 291–299
Ekelund U, Sardinha LB, Anderssen SA, Harro M, Franks PW, Brage S, Cooper AR, Andersen LB, Riddoch C, Froberg K 2004 Associations between objectively assessed physical activity and indicators of body fatness in 9- to 10-y-old European children: a population-based study from 4 distinct regions in Europe (the European Youth Heart Study). Am J Clin Nutr 80: 584–590
Allison DB, Zhu SK, Plankey M, Faith MS, Heo M 2002 Differential associations of body mass index and adiposity with all-cause mortality among men in the first and second National Health and Nutrition Examination Surveys (NHANES I and NHANES II) follow-up studies. Int J Obes Relat Metab Disord 26: 410–416
Gutin B, Litaker M, Islam S, Manos T, Smith C, Treiber F 1996 Body-composition measurement in 9–11-y-old children by dual-energy X-ray absorptiometry, skinfold thickness measurements, and bioimpedance analysis. Am J Clin Nutr 63: 287–292
Tanner J 1962 Growth at Adolescence. Blackwell, Oxford, UK
Park MK, Menard SM 1987 Accuracy of blood pressure measurement by the Dinamap monitor in infants and children. Pediatrics 79: 907–914
Wennlöf AH, Yngve A, Nilsson TK, Sjöström M 2005 Serum lipids, glucose and insulin levels in healthy schoolchildren aged 9 and 15 years from Central Sweden: reference values in relation to biological, social and lifestyle factors. Scand J Clin Lab Invest 65: 65–76
Hansen HS, Froberg K, Nielsen JR, Hyldebrandt N 1989 A new approach to assessing maximal aerobic power in children: the Odense School Child Study. Eur J Appl Physiol Occup Physiol 58: 618–624
Zweig MH, Campbell G 1993 Receiver-operating characteristic (ROC) plots: a fundamental evaluation tool in clinical medicine. Clin Chem 39: 561–577
Berenson GS, Srinivasan SR, Bao W, Newman WP, Tracy RE, Wattigney WA 1998 Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults: the Bogalusa Heart Study. N Engl J Med 338: 1650–1656
Wolfarth B, Bray MS, Hagberg JM, Perusse L, Rauramaa R, Rivera MA, Roth SM, Rankinen T, Bouchard C 2005 The human gene map for performance and health-related fitness phenotypes: the 2004 update. Med Sci Sports Exerc 37: 881–903
Mahon AD, Vaccaro P 1994 Cardiovascular adaptations in 8- to 12-year-old boys following a 14-week running program. Can J Appl Physiol 19: 139–150
Ignico AA, Mahon AD 1995 The effects of a physical fitness program on low-fit children. Res Q Exerc Sport 66: 85–90
Gutin B, Yin Z, Humphries MC, Barbeau P 2005 Relations of moderate and vigorous physical activity to fitness and fatness in adolescents. Am J Clin Nutr 81: 746–750
Cook S, Weitzman M, Auinger P, Nguyen M, Dietz WH 2003 Prevalence of a metabolic syndrome phenotype in adolescents: findings from the third National Health and Nutrition Examination Survey, 1988-1994. Arch Pediatr Adolesc Med 157: 821–827
de Ferranti SD, Gauvreau K, Ludwig DS, Neufeld EJ, Newburger JW, Rifai N 2004 Prevalence of the metabolic syndrome in American adolescents: findings from the Third National Health and Nutrition Examination Survey. Circulation 110: 2494–2497
Shaibi GQ, Cruz ML, Ball GD, Weigensberg MJ, Kobaissi HA, Salem GJ, Goran MI 2005 Cardiovascular fitness and the metabolic syndrome in overweight Latino youths. Med Sci Sports Exerc 37: 922–928
Chu NF, Wang DJ, Shieh SM, Rimm EB 2000 Plasma leptin concentrations and obesity in relation to insulin resistance syndrome components among school children in Taiwan—The Taipei Children Heart Study. Int J Obes Relat Metab Disord 24: 1265–1271
Wyszynski DF, Waterworth DM, Barter PJ, Cohen J, Kesaniemi YA, Mahley RW, McPherson R, Waeber G, Bersot TP, Sharma SS, Nolan V, Middleton LT, Sundseth SS, Farrer LA, Mooser V, Grundy SM 2005 Relation between atherogenic dyslipidemia and the Adult Treatment Program-III definition of metabolic syndrome (Genetic Epidemiology of Metabolic Syndrome Project). Am J Cardiol 95: 194–198
McArdle WD, Katch FI, Kattch VL 2006 Exercise Physiology: Energy, Nutrition and Human Performance, 6th Ed. Lippincott Williams & Wilkins, Philadelphia, pp 240–246
Acknowledgements
This work is dedicated to the late Maarike Harro, University of Tartu and the National Institutes of Health Development, Tallinn, Estonia. The authors thank Olle Carlsson for statistical assistance and Pekka Oja for highly valuable comments, both guest scientists at our unit.
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The Swedish part of the study was supported by grants from the Stockholm County Council (MS), and the Estonian part was supported by a grant from the Estonian Science Foundation No. 3277 and 5209, and by Estonian Centre of Behavioural and Health Sciences. JRR and FBO were supported by a grant from Ministerio de Educación y Ciencia de España (AP2003-2128, AP2004-2745).
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Ruiz, J., Ortega, F., Rizzo, N. et al. High Cardiovascular Fitness Is Associated with Low Metabolic Risk Score in Children: The European Youth Heart Study. Pediatr Res 61, 350–355 (2007). https://doi.org/10.1203/pdr.0b013e318030d1bd
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DOI: https://doi.org/10.1203/pdr.0b013e318030d1bd
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