PHYSICAL ACTIVITY, CARDIORESPIRATORY FITNESS AND METABOLIC SYNDROME IN ADOLESCENTS

Oliveira, Raphael Gonçalves de; Guedes, Dartagnan Pinto

doi:10.1590/1517-869220182404174502

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Revista Brasileira de Medicina do Esporte

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Original Article, Cardiology • Rev Bras Med Esporte 24 (4) • Jul-Aug 2018 • https://doi.org/10.1590/1517-869220182404174502 copy

PHYSICAL ACTIVITY, CARDIORESPIRATORY FITNESS AND METABOLIC SYNDROME IN ADOLESCENTS

ATIVIDADE FÍSICA, APTIDÃO CARDIORRESPIRATÓRIA E SÍNDROME METABÓLICA EM ADOLESCENTES

ACTIVIDAD FÍSICA, CAPACIDAD CARDIORRESPIRATORIA Y EL SÍNDROME METABÓLICO EN ADOLESCENTES

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Introduction:

Metabolic Syndrome (MetS) has been associated with sedentary behavior, low levels of physical activity and of cardiorespiratory fitness. However, in adolescents the results are conflicting.

Objective:

To measure the association between sedentary behavior, physical activity, cardiorespiratory fitness and MetS in a representative sample of adolescents.

Methods:

The sample consisted of 1,035 adolescents (565 girls and 470 boys) between 12 and 20 years of age. Sedentary behavior was treated through recreational screen time, while information equivalent to physical activity was considered through the Physical Activity Questionnaire for Adolescents. The maximal oxygen uptake (VO_2max), estimated through PACER performance, was used as an indicator of cardiorespiratory fitness. MetS was identified using the criteria of the International Diabetes Federation.

Results:

Adolescents of both sexes identified with MetS had significantly longer recreational screen time and lower VO_2max than their unidentified MetS peers. Scores equivalent to the level of physical activity undertaken by adolescents identified and not identified with MetS were statistically similar. Probabilistically, adolescents with high recreational screen time and low VO_2max had, respectively, 79% [OR = 1.79; 95% CI 1.10 – 2.82] and 95% [OR = 1.95; 95% CI 1.20 – 3.09] greater odds of being identified with MetS.

Conclusion:

The findings indicate consistent and significant associations between longer recreational screen time, low VO_2max values and high prevalence of MetS, which suggests specific interventions designed to help minimize cardiometabolic risk exposure from a very early age. Level of Evidence III; Prognostic Studies - Investigating the Effect of a Patient's Characteristics on the Disease Outcome.

Keywords:
Sedentary Lifestyle; Motor Activity; Physical Fitness; Metabolic Diseases; Youths

		Age Groups		F Test
		12 – 15 years	16 – 20 years	Sex	Age	Interaction
Recreational Screen Time (min/day)	Girls	228.56 ± 43.17	274.62 ± 51.75	3.336	11.693	8.468
Recreational Screen Time (min/day)	Boys	249.21 ± 51.62	307.83 ± 60.47	ns	p < 0.001	p < 0.001
Physical Activity Practice (score)	Girls	2.46 ± 0.49	2.03 ± 0.53	13.278	8.782	2.117
Physical Activity Practice (score)	Boys	3.19 ± 0.64	2.87 ± 0.51	p < 0.001	p < 0.001	ns
Estimated VO_2max (ml/kg/min)	Girls	36.37 ± 7.04	31.81 ± 9.53	21.824	9.482	7.552
Estimated VO_2max (ml/kg/min)	Boys	48.82 ± 8.48	42.26 ± 7.15	p < 0.001	p < 0.001	p < 0.001

		Recreational Screen Time (min/day)		Physical Activity Practice (score)		Estimated VO_2max (ml/kg/min)
		Girls	Boys	Girls	Boys	Girls	Boys
Waist Circumference^* * Cut-off points for adolescents ≥ 16 years: boys ≥ 90 cm and girls ≥ 80 cm.	≥ percentile 90	264.74 ± 54.16	305.32 ± 64.74	2.31 ± 0.56	3.13 ± 0.61	26.84 ± 7.12	39.07 ± 7.17
	< percentile 90	238.35 ± 46.84	250.76 ± 56.48	2.18 ± 0.48	2.88 ± 0.52	39.21 ± 8.95	52.95 ± 8.65
		p = 0.027	p < 0.001	ns	ns	p < 0.001	p < 0.001
Triglycerides	≥ 150 mg/dL	259.21 ± 51.93	291.77 ± 59.12	2.24 ± 0.47	3.06 ± 0.58	30.27 ± 7.74	43.74 ± 7.89
	< 150 mg/dL	244.52 ± 48.42	266.45 ± 53.85	2.27 ± 0.52	2.95 ± 0.53	35.98 ± 8.12	48.12 ± 8.25
		ns	ns	ns	ns	ns	ns
HDL-cholesterol^ Cut-off points for adolescents ≥ 16 years: boys < 40 mg/dL and girls < 50 mg/dL.	< 40 mg/dL	267.68 ± 55.32	299.73 ± 60.83	2.36 ± 0.58	2.90 ± 0.50	29.15 ± 7.69	41.84 ± 7.68
	≥ 40 mg/dL	235.73 ± 40.97	257.19 ± 55.62	2.15 ± 0.44	3.11 ± 0.59	36.83 ± 8.37	48.36 ± 8.21
		p = 0.001	p = 0.021	ns	ns	p = 0.034	p = 0.041
Fasting glycemia	≥ 100 mg/dL	260.37 ± 50.06	293.41 ± 57.74	2.28 ± 0.53	3.04 ± 0.57	31.38 ± 7.88	42.75 ± 6.93
	< 100 mg/dL	243.94 ± 47.64	264.73 ± 52.34	2.22 ± 0.49	2.98 ± 0.53	35.01 ± 8.14	48.67 ± 8.15
		ns	ns	ns	ns	ns	ns
Blood Pressure	≥ 85 mmHg / ≥ 130 mmHg	263.65 ± 51.47	311.52 ± 65.92	2.09 ± 0.41	2.80 ± 0.49	27.84 ± 7.63	40.74 ± 7.58
	< 85 mmHg / < 130 mmHg	239.38 ± 43.52	246.78 ± 50.67	2.42 ± 0.61	3.21 ± 0.62	38.21 ± 8.22	49.81 ± 8.34
		p = 0.032	p < 0.001	p = 0.019	p = 0.008	p < 0.001	p = 0.011
Metabolic Syndrome	Yes	270.84 ± 52.74	303.59 ± 62.32	2.34 ± 0.53	3.05 ± 0.56	30.03 ± 7.46	41.03 ± 7.37
	No	232.53 ± 42.96	252.84 ± 55.37	2.16 ± 0.48	2.94 ± 0.54	37.94 ± 8.53	50.53 ± 8.40
		p < 0.001	p < 0.001	ns	ns	p = 0.021	p = 0.008

	Metabolic Syndrome Components
		≤ 1 Component¹ 1 Including obligatorily high waist circumference, as proposed by the International Diabetes Federation.	2 Components¹ 1 Including obligatorily high waist circumference, as proposed by the International Diabetes Federation.	≥ 3 Components¹ 1 Including obligatorily high waist circumference, as proposed by the International Diabetes Federation.
Recreational Screen Time	Low	Reference	Reference	Reference
	Moderate	1.40 (0.80 – 2.23)	1.51 (0.90 – 2.40)	1.62 (0.98 – 2.54)
	High	1.49 (0.88 – 2.37)	1.60 (0.97 – 2.53)	1.79 (1.10 – 2.82)
Physical Activity Practice	High	Reference	Reference	Reference
	Moderate	1.34 (0.83 – 2.11)	1.41 (0.88 – 2.22)	1.52 (0.93 – 2.42)
	Low	1.43 (0.90 – 2.18)	1.50 (0.94 – 2.31)	1.61 (0.98 – 2.49)
Estimated VO_2max	High	Reference	Reference	Reference
	Moderate	1.51 (0.89 – 2.44)	1.64 (0.97 – 2.63)	1.80 (1.06 – 2.82)
	Low	1.59 (0.91 – 2.60)	1.81 (1.12 – 2.86)	1.95 (1.20 – 3.09)

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[1] Correspondence: Universidade Estadual do Norte do Paraná (UENP), Centro de Ciências da Saúde. Alameda Padre Magno 841, Nova Alcântara, Jacarezinho, PR, Brazil. 86400-000. rgoliveira@uenp.edu.br