Cardiorespiratory fitness, screen time and cardiometabolic risk in South Brazilian school children.

BACKGROUND: Cardiorespiratory fitness (CRF) is considered a beneficial effect of physical activity (PA). PA and excessive screen time have implications for cardiometabolic risk. OBJECTIVE: To verify the association between screen time and CRF grouped by cardiometabolic risk factors. SUBJECTS AND METHODS: Cross-sectional study evaluated 1,253 schoolchildren (54.2% girls) aged seven to 17 years from southern Brazil. The outcomes were body mass index (BMI), waist circumference (WC), systolic blood pressure (SBP), and diastolic (DBP), glucose, and lipid profile. Exposure was a combined variable of self-reported screen time (television, video game, computer) and CRF. RESULTS: The main result is that CRF had a more consistent association with anthropometric factors than with metabolic variables. Low CRF students, regardless of screen time, showed a 15% increase in the risk of elevated WC (p < 0.001) and a 24% (<2 h screen time) and 19% (≥2 h) higher risk of overweight (p < 0.001). Second, the increase in SBP was associated with a combination of the two risk factors, ≥2 h screen time/low CRF was associated with a 7% increase in elevated SBP (p = 0.025). CONCLUSION: Low CRF was a risk factor for elevated BMI and WC, regardless of screen time. High screen time and low CRF were associated with higher SBP values.

Hypertension and Different Levels of Body Mass Index and Cardiorespiratory Fitness Amongst Adolescents

Abstract Background Hypertension is an increasingly common problem in adolescents; amongst the associated factors, physical inactivity and obesity are increasing the risk of developing cardiovascular diseases. Objective To verify whether there is an association between higher blood pressure levels amongst adolescents with the relationship between different levels of body mass index (BMI) and cardiorespiratory fitness (CRF). Method Cross-sectional study consisting of 860 adolescents. Higher blood pressure (BP) was considered as borderline and hypertension as the classification. BMI was categorized as low-normal weight and overweight-obesity. The CRF was assessed by a nine-minute run/walk test and classified into low or appropriate levels (less and more favorable to health, respectively). Later, BMI and CRF were grouped into one categorical variable: (I) low/normal weight and appropriate CRF levels; (II) low/normal weight and low CRF levels; (III) overweight/obesity and appropriate CRF levels; and (IV) overweight/obesity and low CRF levels. Data were analyzed using Poisson regression, through the prevalence ratio (PR) and 95% confidence intervals (CI). The p-values of p <0.05 were considered significant. Results Adolescents with overweight/obesity and low CRF levels had a 22% higher BP prevalence. Moreover, children with overweight/obesity, but with appropriate CRF levels, have a 15% higher BP prevalence. Conclusion Adolescents with overweight/obesity had a higher prevalence of BP, regardless of CRF levels. It is suggested that maintaining normal BMI is a protective factor for less favorable BP.

Effects and Responsiveness of a Multicomponent Intervention on Body Composition, Physical Fitness, and Leptin in Overweight/Obese Adolescents.

Physical exercise reduces the biochemical markers of obesity, but the effects of multicomponent interventions on these markers should be explored. The present study aimed to elucidate how overweight/obese adolescents respond to a multicomponent program approach on body composition, physical fitness, and inflammatory markers, using a quasi-experimental study with 33 overweight/obesity adolescents (control group (CG) = 16; intervention group (IG) = 17). The intervention consisted of 24 weeks with physical exercises and nutritional and psychological guidance. Both groups were evaluated at the pre/post-intervention moments on body mass index (BMI); body fat (%Fat); waist circumference (WC); waist/hip ratio (WHR); waist-to-height ratio (WHtR), cardiorespiratory fitness (CRF); abdominal strength, flexibility; leptin; interleukin 6; interleukin 10; and tumor necrosis factor-alpha. Mixed-analysis of variance and generalized estimation equations were used for statistical analysis. There was an interaction effect between groups and time on %Fat (p = 0.002), WC (p = 0.023), WHR (p < 0.001), WHtR (p = 0.035), CRF (p = 0.050), and leptin (p = 0.026). Adolescents were classified as 82.4% responders for %Fat, 70.6% for WC, 88.2% for WHR, and 70.6% for CRF. Further, there was an association between changes in %Fat (p = 0.033), WC (p = 0.032), and WHR (p = 0.033) between responders and non-responders with CRF in the IG. There was a positive effect on body composition, physical fitness, and leptin. In addition, reductions in body composition parameters were explained by CRF improvements.

A Multicomponent Intervention Program With Overweight and Obese Adolescents Improves Body Composition and Cardiorespiratory Fitness, but Not Insulin Biomarkers.

Objective: To verify the effect of a multicomponent intervention with overweight/obese adolescents on physical fitness, body composition, and insulin biomarkers. Methods: A quasi-experimental study with 37 adolescents, aged 10 to 17 years, of both sexes, overweight and obese, allocated in two groups (Intervention-IG Group, n = 17; Control-GC Group, n = 20). The IGs were submitted to a multicomponent intervention for 6 months (three weekly sessions) consisting of physical exercises (sports, functional circuit, recreational, and water activities) and nutritional and psychological guidance. Participants were assessed before and after intervention on body composition [body mass index (BMI), body fat, waist circumference, and waist-to-hip ratio (WHR)], physical fitness [cardiorespiratory fitness (CRF) and abdominal strength], and biomarkers of insulin (glucose, insulin, evaluation of the homeostasis model of insulin, and resistin resistance). The prevalence of responders in both groups was obtained according to the theoretical model applied in previous studies similar to this one to determine the cutoff points for response to intervention. Poisson regression was used to verify the difference in the prevalence ratio (PR) of the interviewees between the groups. Results: The responders' prevalence between groups CG and IG showed significant differences for body fat (CG = 30.0%; IG = 70.6%; PR = 1.396; p < 0.001), WHR (CG = 30.0%; IG = 76.5%; PR = 1.730; p < 0.001), and CRF (CG = 15.0%; IG = 52.5%; PR = 1.580; p < 0.001). Conclusions: A 6-month multicomponent intervention program improved certain body composition parameters and the CRF of overweight and obese adolescents but did not improve insulin biomarkers. Clinical Trial Registration: Clinical Trials under Protocol ID: 54985316.0.0000.5343.

Escore contínuo de risco metabólico em escolares com diferentes níveis de aptidão cardiorrespiratória / Puntuación del riesgo metabólico en escolares con diferentes niveles de aptitud cardiorrespiratoria / Continuous metabolic risk score in schoolchildren with different levels of cardiorespiratory fitness

OBJETIVO: Comparar o escore de risco metabólico em escolares com diferentes níveis de aptidão cardiorrespiratória. MÉTODO: Estudo transversal, retrospectivo, realizado com escolares, no município de Santa Cruz do Sul - RS. Foram convidados alunos de 25 escolas públicas e privadas do município, que apresentassem idade entre 7 e 17 anos com termo de autorização assinado pelos pais/responsáveis. A amostra final foi composta por 1.250 crianças e adolescentes. Foi realizada coleta de sangue para análise do perfil lipídico. Foi avaliada a pressão arterial, a circunferência da cintura (CC) e a aptidão cardiorrespiratória (APCR). O escore de risco metabólico (ERM) foi calculado por meio da soma do escore Z dos seguintes parâmetros: CC, pressão arterial sistólica, triglicerídeos, colesterol total, colesterol LDL e colesterol HDL. RESULTADOS: Observa-se, em ambos os sexos, uma diminuição do ERM com o aumento da APCR. Dessa forma, escolares no 5º quintil, os quais apresentam maiores níveis de APCR, possuem menor risco metabólico. Entre os meninos, observou-se diferença significativa entre o 1º quintil com o 2º (p = 0.037), com o 4º (p = 0.009) e 5º quintil da APCR (p < 0.001), com uma diferença média de 0.56 para este último. Entre as meninas, o ERM foi significativamente diferente na comparação do 1º quintil da APCR para o 5ª quintil (p = 0.018). CONCLUSÃO: Escolares com baixa APCR apresentam maior escore de risco metabólico, tanto entre os meninos, quanto nas meninas

OBJETIVO: Comparar la puntuación de riesgo metabólico en escolares con diferentes niveles de aptitud cardiorrespiratoria. MÉTODO: Estudio transversal, retrospectivo, realizado con escolares, en el municipio de Santa Cruz do Sul - RS. Se invitaron alumnos de 25 escuelas públicas y privadas del municipio, que presentaran edad entre 7 y 17 años con término de autorización firmado por los padres/responsables. La muestra final fue compuesta por 1.250 niños y adolescentes. Se realizó la recolección de sangre para el análisis del perfil lipídico. Se evaluó la presión arterial, la circunferencia de la cintura (CC) y la aptitud cardiorrespiratoria (APCR). La puntuación de riesgo metabólico (PRM) se calculó mediante la suma de la puntuación Z de los siguientes parámetros: CC, presión arterial sistólica, triglicéridos, colesterol total, colesterol LDL y colesterol HDL. RESULTADOS: Se observa, en ambos sexos, una disminución del PRM con el aumento de la APCR. De esta forma, escolares en el 5º quintil, los cuales presentan mayores niveles de APCR, poseen menor riesgo metabólico. En los niños, se observó una diferencia significativa entre el primer quintil con el 2º (p = 0.037), el 4º (p = 0.009) y 5º quintil de la APCR (p <0.001), con una diferencia media de 0.56 para este último. Entre las niñas, el PRM fue significativamente diferente en la comparación del primer quintil de APCR para el quinto quintil (p = 0.018). CONCLUSIÓN: Los escolares con baja APCR presentan mayor puntuación de riesgo metabólico, tanto entre los niños, como en las niñas

OBJECTIVE: To compare the metabolic risk score in schoolchildren with different levels of cardiorespiratory fitness (CRF). METHOD: A retrospective cross-sectional study carried out with schoolchildren in the municipality of Santa Cruz do Sul - RS. Students from 25 public and private schools were invited, who were aged between 7 and 17 years with an authorization signed by parents/guardians. The final sample consisted of 1,250 children and adolescents. Blood sampling was performed to analyze the lipid profile. Blood pressure, waist circumference (WC) and CRF were evaluated. The continuous metabolic risk score (cMetS) was calculated by summing the Z score of the following parameters: WC, systolic blood pressure, triglycerides, total cholesterol, LDL cholesterol and HDL cholesterol. RESULTS: In both sexes, a decrease of cMetS was observed with the increase of CRF levels. Thus, schoolchildren in the 5th quintile, who have higher levels of CRF, have lower metabolic risk. Among boys, there was a significant difference between the 1st quintile to 2nd quintile (p = 0.037), to 4th (p = 0.009) and 5th quintile of CRF (p < 0.001). Among girls, cMetS was significantly different in the comparison of the 1st quintile to the 5th quintile (p = 0.018) of CRF. CONCLUSION: Schoolchildren with low levels of CRF have higher metabolic risk scores, both among boys and girls

Youth overweight/obesity and its relationship with cardiovascular disease and parental risk factors.

OBJECTIVE: The prevalence of overweight and obesity is gradually increasing in both developed and developing countries. Obesity, for instance, can present multifactorial causes that interact with each other. Among the important factors, parental obesity plays a prominent role in the onset of obesity during childhood and teenage years through genetics and ambient aspects. This study aims to verify the possible existence of an association between overweight/obesity of schoolchildren and cardiovascular risk (CVR) factors for their parents. SUBJETCS AND METHODS: For this purpose, a cross-sectional study was conducted with a sample of 1,243 children and adolescents, aged between 7 and 17. Out of the total number of participants, 563 (45.3%) were boys who were selected across 19 schools in the urban and rural areas of Santa Cruz do Sul, Rio Grande do Sul (Brazil). The overweight/obesity status of the schoolchildren was evaluated through their body mass index (BMI). Additionally, a self-reference questionnaire was employed to measure their parents' CVR. RESULTS: The results of this study revealed that students with overweight/obesity have a higher probability of having a father with hypertension (OR = 1.49; p = 0.038) and obesity (OR = 2.36; p = 0.002) and a mother with obesity (OR = 1.72; p = 0.016). CONCLUSION: To conclude, this study confirms a relationship between overweight/obesity of schoolchildren with CVR for their parents.

Youth overweight/obesity and its relationship with cardiovascular disease and parental risk factors

ABSTRACT Objective The prevalence of overweight and obesity is gradually increasing in both developed and developing countries. Obesity, for instance, can present multifactorial causes that interact with each other. Among the important factors, parental obesity plays a prominent role in the onset of obesity during childhood and teenage years through genetics and ambient aspects. This study aims to verify the possible existence of an association between overweight/obesity of schoolchildren and cardiovascular risk (CVR) factors for their parents. Subjetcs and methods For this purpose, a cross-sectional study was conducted with a sample of 1,243 children and adolescents, aged between 7 and 17. Out of the total number of participants, 563 (45.3%) were boys who were selected across 19 schools in the urban and rural areas of Santa Cruz do Sul, Rio Grande do Sul (Brazil). The overweight/obesity status of the schoolchildren was evaluated through their body mass index (BMI). Additionally, a self-reference questionnaire was employed to measure their parents' CVR. Results The results of this study revealed that students with overweight/obesity have a higher probability of having a father with hypertension (OR = 1.49; p = 0.038) and obesity (OR = 2.36; p = 0.002) and a mother with obesity (OR = 1.72; p = 0.016). Conclusion To conclude, this study confirms a relationship between overweight/obesity of schoolchildren with CVR for their parents.

Relationship between Dyslipidemia, Cultural Factors, and Cardiorespiratory Fitness in Schoolchildren / Relação entre Dislipidemia, Fatores Culturais e Aptidão Cardiorrespiratória em Escolares

Abstract Background: The presence of dyslipidemia and behavioral aspects are determinants of cardiovascular risk, especially in childhood and adolescence. Objective: To verify possible relationships between dyslipidemia, cultural factors, and cardiorespiratory fitness (CRF) in schoolchildren. Methods: This cross-sectional study evaluated a sample of 1,254 children and adolescents between the ages of 7 and 17 from the South of Brazil, 686 of whom were female. Dyslipidemia was defined as increased levels of at least one of the following lipid profile parameters: triglycerides (TG), total cholesterol (TC) and fractions of high (HDL-c) and low-density lipoprotein (LDL-c). Cultural aspects were evaluated by a self-reported questionnaire. Data were analyzed by logistic regression, considering the odds ratios (OR) and confidence intervals (CI) at 95%. Results: The results revealed a high prevalence of dyslipidemia (41.9%), which was associated with female sex (OR: 1.56; IC: 1.24-1.96) and overweight/obese status (OR: 1.55; IC: 1.20-2.00). When lipid profile parameters were evaluated separately, high levels of LDL-c were observed to be associated with sedentary school transport (OR: 1.59; IC: 1.20-2.09). Schoolchildren who were overweight/obese had higher chances of elevated levels of TC (OR: 1.40; IC: 1.07-1.84) and TG (OR: 3.21; IC: 1.96-5.26). HDL-c was shown to be related to high television time (OR: 1.59; IC: 1.00-2.54). Conclusion: Alterations in lipid parameters are associated with cultural factors, especially those related to sedentary lifestyle and low levels of CRF.

Resumo Fundamento: A presença de dislipidemia e os aspectos comportamentais são fatores determinantes do risco cardiovascular, sobretudo na infância e adolescência. Objetivos: Verificar possíveis relações entre dislipidemia, fatores culturais e aptidão cardiorrespiratória (APCR) em escolares. Métodos: São sujeitos deste estudo transversal 1.254 crianças e adolescentes do Sul do Brasil, sendo 686 do sexo feminino, com idade entre 7 e 17 anos. Foi considerada dislipidemia a presença de níveis aumentados em pelo menos um dos parâmetros do perfil lipídico: triglicerídeos (TG), colesterol total (CT) e frações de alta (HDL-c) e baixa densidade (LDL-c). Os aspectos culturais foram avaliados por meio de questionário autorreferido pelo escolar. Os dados foram analisados pela regressão logística, considerando os valores de razão de chances (odds ratio; OR) e intervalos de confiança (IC) para 95%. Resultados: Foi encontrada elevada prevalência de dislipidemia (41,9%), a qual esteve associada com o sexo feminino (OR: 1,56; IC: 1,24-1,96) e com a presença de sobrepeso/obesidade (OR: 1,55; IC: 1,20-2,00). Quando os componentes do perfil lipídico foram avaliados de forma separada, observou-se que altos níveis de LDL-c se associaram ao deslocamento sedentário para a escola (OR: 1,59; IC: 1,20-2,09). Escolares com sobrepeso/obesidade apresentam maiores chances de elevação nos níveis de CT (OR: 1,40; IC: 1,07-1,84) e TG (OR: 3,21; IC: 1,96-5,26). O HDL-c apresentou associação com o elevado tempo em frente à televisão (OR: 1,59; IC: 1,00-2,54). Conclusão: A presença de alteração nos parâmetros lipídicos associa-se com fatores culturais, especialmente voltados ao sedentarismo e baixos níveis de APCR.

Relationship between Dyslipidemia, Cultural Factors, and Cardiorespiratory Fitness in Schoolchildren.

BACKGROUND: The presence of dyslipidemia and behavioral aspects are determinants of cardiovascular risk, especially in childhood and adolescence. OBJECTIVE: To verify possible relationships between dyslipidemia, cultural factors, and cardiorespiratory fitness (CRF) in schoolchildren. METHODS: This cross-sectional study evaluated a sample of 1,254 children and adolescents between the ages of 7 and 17 from the South of Brazil, 686 of whom were female. Dyslipidemia was defined as increased levels of at least one of the following lipid profile parameters: triglycerides (TG), total cholesterol (TC) and fractions of high (HDL-c) and low-density lipoprotein (LDL-c). Cultural aspects were evaluated by a self-reported questionnaire. Data were analyzed by logistic regression, considering the odds ratios (OR) and confidence intervals (CI) at 95%. RESULTS: The results revealed a high prevalence of dyslipidemia (41.9%), which was associated with female sex (OR: 1.56; IC: 1.24-1.96) and overweight/obese status (OR: 1.55; IC: 1.20-2.00). When lipid profile parameters were evaluated separately, high levels of LDL-c were observed to be associated with sedentary school transport (OR: 1.59; IC: 1.20-2.09). Schoolchildren who were overweight/obese had higher chances of elevated levels of TC (OR: 1.40; IC: 1.07-1.84) and TG (OR: 3.21; IC: 1.96-5.26). HDL-c was shown to be related to high television time (OR: 1.59; IC: 1.00-2.54). CONCLUSION: Alterations in lipid parameters are associated with cultural factors, especially those related to sedentary lifestyle and low levels of CRF.

High blood pressure in schoolchildren: Associated sociodemographic and biochemical factors. / Pressão arterial elevada em escolares: fatores sociodemográficos e bioquímicos associados.

INTRODUCTION AND OBJECTIVE: Pediatric hypertension has increased in the last decade, and it is thus crucial to identify the factors associated with the development of high blood pressure (BP) and other cardiovascular disorders. The aim of this study was to determine whether there is an association between high BP and sociodemographic and biochemical factors in schoolchildren. METHODS: This cross-sectional study included 1201 children and adolescents, between seven and 17 years old, of both sexes. The sociodemographic data analyzed were gender, age, school system and socioeconomic status. Among biochemical indicators, blood glucose, triglycerides, total cholesterol, HDL-cholesterol (HDL-C) and LDL-cholesterol (LDL-C) were assessed. In the analysis of BP, schoolchildren were classified as normal, borderline or hypertensive. Associations were tested using Poisson regression through prevalence ratios (PR). RESULTS: High BP was identified in 16.2% of the students. In females, the prevalence of high BP was 7% lower than in males (p=0.001), but was higher among adolescents (PR: 1.11, p<0.001) and schoolchildren in the state school system (PR: 1.05; p=0.013). Concerning biochemical indicators, BP change was associated with pre-diabetes (PR: 1.09; p=0.001) and borderline HDL-C (PR: 1.09; p=0.007). CONCLUSION: Among the sociodemographic factors associated with high BP are male gender, adolescence and attending the state education system. This condition was also associated with pre-diabetes and borderline HDL-C.

Obesidade e aptidão física relacionada à saúde: um estudo com escolares de 10 a 13 anos de Santa Cruz do Sul - Brasil / Obesity and health related physical fitness: a study with schoolchildren aged 10 to 13 years from Santa Cruz do Sul ­ Brazil

Introdução: O sobrepeso e a obesidade são considerados problemas de saúde pública e têm sido ligados a baixos níveis de atividade física, tornando-se fatores de risco à saúde e contribuindo para o aparecimento de doenças crônicas.Bons níveis de aptidão física também são fatores que reduzemdoenças crônicas. Objetivo: Avaliar a associação entre obesidade e aptidão física relacionada àsaúde em escolares de 10 a 13 anos de idade. Casuística e métodos: Estudo transversal compostopor 785 escolares, de ambos os sexos, entre 10 e 13 anos de idade, pertencentes a escolas municipais e estaduais de Santa Cruz do Sul, RS ­ Brasil. Foram avaliados o Índice de Massa Corporal (IMC) de acordo com os parâmetros da Organização Mundial da Saúde, e as características de aptidão físicade flexibilidade, resistência muscular e aptidão cardiorrespiratória (APCR) segundo os protocolosdo Projeto Esporte Brasil. Resultados: Em ambos os sexos, os valores médios de Índice de MassaCorporal são superiores entre os adolescentes classificados na faixa de risco à saúde para resistênciaabdominal e aptidão cardiorrespiratória, em relação aos adolescentes na faixa saudável (p<0,05).Além disso, adolescentes com sobrepeso/obesidade apresentam maior prevalência de baixos níveisde resistência abdominal (10% para meninos e 20% para meninas) e de aptidão cardiorrespiratória(21% para meninos e 22% para meninas). Conclusão: A presença de sobrepeso e obesidade estáassociada com baixos níveis de resistência abdominal e de aptidão cardiorrespiratória, em escolarescom 10 a 13 anos de idade.

Introduction: Overweight and obesity are considered public health problems and have been linked to low levels of physical activity. Both diseases became risk factors for health and contribute to the development of chronic diseases. Good levels of physical fitness are risk-reducing factors for chronic diseases. Objective: Evaluate the association between obesity and health-related physical fitness in schoolchildren aged 10 to 13 years. Patients and Methods: We carried out a cross-sectional study with 785 schoolchildren of both sexes age ranging from 10 to 13 years-old, who attend public schools in Santa Cruz do Sul, RS ­ Brazil. We evaluated the Body Mass Index (BMI), according to parameters of World Health Organization, and health-related physical fitness characteristics of flexibility, muscular endurance and cardiorespiratory fitness (CRF) according to the protocols of the Projeto Esporte Brasil. Results: In both sexes, the mean values ofBody MassIndex were higher among adolescents classified in the health-risk zone for abdominal resistance and cardiorespiratory fitness, in relation to adolescents in the healthy zone (p<0.05). In addition, overweight/obese adolescents showeda higher prevalence of low levels of abdominal resistance (10% for boys and 20% for girls) and cardiorespiratory fitness (21% for boys and 22% for girls). Conclusion: The presence of overweight and obesity is associated with low levels of abdominal resistance and cardiorespiratory fitness in schoolchildren aged 10 to 13 years-old.