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Published in: European Journal of Pediatrics 9/2012

01-09-2012 | Original Article

Associations between cardiorespiratory fitness, physical activity and clustered cardiometabolic risk in children and adolescents: the HAPPY study

Authors: Daniel P. Bailey, Lynne M. Boddy, Louise A. Savory, Sarah J. Denton, Catherine J. Kerr

Published in: European Journal of Pediatrics | Issue 9/2012

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Abstract

Clustering of cardiometabolic risk factors can occur during childhood and predisposes individuals to cardiometabolic disease. This study calculated clustered cardiometabolic risk in 100 children and adolescents aged 10–14 years (59 girls) and explored differences according to cardiorespiratory fitness (CRF) levels and time spent at different physical activity (PA) intensities. CRF was determined using a maximal cycle ergometer test, and PA was assessed using accelerometry. A cardiometabolic risk score was computed as the sum of the standardised scores for waist circumference, blood pressure, total cholesterol/high-density lipoprotein ratio, triglycerides and glucose. Differences in clustered cardiometabolic risk between fit and unfit participants, according to previously proposed health-related threshold values, and between tertiles for PA subcomponents were assessed using ANCOVA. Clustered risk was significantly lower (p < 0.001) in the fit group (mean 1.21 ± 3.42) compared to the unfit group (mean −0.74 ± 2.22), while no differences existed between tertiles for any subcomponent of PA. Conclusion These findings suggest that CRF may have an important cardioprotective role in children and adolescents and highlights the importance of promoting CRF in youth.
Literature
1.
go back to reference Abbasi F, Brown BW Jr, Lamendola C, McLaughlin T, Reaven GM (2002) Relationship between obesity, insulin resistance, and coronary heart disease risk. J Am Coll Cardiol 40(5):937–943PubMedCrossRef Abbasi F, Brown BW Jr, Lamendola C, McLaughlin T, Reaven GM (2002) Relationship between obesity, insulin resistance, and coronary heart disease risk. J Am Coll Cardiol 40(5):937–943PubMedCrossRef
2.
go back to reference Aires L, Silva P, Silva G, Santos MP, Ribeiro JC, Mota J (2010) Intensity of physical activity, cardiorespiratory fitness, and body mass index in youth. J Phys Act Health 7(1):54–59PubMed Aires L, Silva P, Silva G, Santos MP, Ribeiro JC, Mota J (2010) Intensity of physical activity, cardiorespiratory fitness, and body mass index in youth. J Phys Act Health 7(1):54–59PubMed
3.
go back to reference Anderssen SA, Cooper AR, Riddoch C, Sardinha LB, Harro M, Brage S et al (2007) Low cardiorespiratory fitness is a strong predictor for clustering of cardiovascular disease risk factors in children independent of country, age and sex. Eur Society Cardio 14(4):526–531 Anderssen SA, Cooper AR, Riddoch C, Sardinha LB, Harro M, Brage S et al (2007) Low cardiorespiratory fitness is a strong predictor for clustering of cardiovascular disease risk factors in children independent of country, age and sex. Eur Society Cardio 14(4):526–531
4.
go back to reference Baquet G, Stratton G, Van Praagh E, Berthoin S (2007) Improving physical activity assessment in prepubertal children with high-frequency accelerometry monitoring: a methodological issue. Prev Med 44(2):143–147PubMedCrossRef Baquet G, Stratton G, Van Praagh E, Berthoin S (2007) Improving physical activity assessment in prepubertal children with high-frequency accelerometry monitoring: a methodological issue. Prev Med 44(2):143–147PubMedCrossRef
5.
go back to reference Berenson GS, Srinivasan SR, Bao W, Newman WP 3rd, 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(23):1650–1656PubMedCrossRef Berenson GS, Srinivasan SR, Bao W, Newman WP 3rd, 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(23):1650–1656PubMedCrossRef
6.
go back to reference Blair SN, Cheng Y, Holder JS (2001) Is physical activity or physical fitness more important in defining health benefits? Med Sci Sports Exerc 33(Suppl 6):S379–S399PubMed Blair SN, Cheng Y, Holder JS (2001) Is physical activity or physical fitness more important in defining health benefits? Med Sci Sports Exerc 33(Suppl 6):S379–S399PubMed
7.
go back to reference Boddy LM, Hackett AF, Stratton G (2010) Changes in fitness, body mass index and obesity in 9–10 year olds. J Hum Nutr Diet 23(3):254–259PubMedCrossRef Boddy LM, Hackett AF, Stratton G (2010) Changes in fitness, body mass index and obesity in 9–10 year olds. J Hum Nutr Diet 23(3):254–259PubMedCrossRef
8.
go back to reference Boreham C, Twisk J, Murray L, Savage M, Strain JJ, Cran G (2001) Fitness, fatness, and coronary heart disease risk in adolescents: the Northern Ireland Young Hearts Project. Med Sci Sports Exerc 33(2):270–274PubMed Boreham C, Twisk J, Murray L, Savage M, Strain JJ, Cran G (2001) Fitness, fatness, and coronary heart disease risk in adolescents: the Northern Ireland Young Hearts Project. Med Sci Sports Exerc 33(2):270–274PubMed
9.
go back to reference Bouchard C, Rankinen T (2001) Individual differences in response to regular physical activity. Med Sci Sports Exerc 33(6 Suppl):S446–S451PubMed Bouchard C, Rankinen T (2001) Individual differences in response to regular physical activity. Med Sci Sports Exerc 33(6 Suppl):S446–S451PubMed
10.
go back to reference Brage S, Wedderkopp N, Ekelund U, Franks PW, Wareham NJ, Andersen LB et al (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(9):2141–2148PubMedCrossRef Brage S, Wedderkopp N, Ekelund U, Franks PW, Wareham NJ, Andersen LB et al (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(9):2141–2148PubMedCrossRef
11.
go back to reference Camhi SM, Katzmarzyk PT (2010) Tracking of cardiometabolic risk factor clustering from childhood to adulthood. Int J Pediatr Obes 5(2):122–129PubMedCrossRef Camhi SM, Katzmarzyk PT (2010) Tracking of cardiometabolic risk factor clustering from childhood to adulthood. Int J Pediatr Obes 5(2):122–129PubMedCrossRef
12.
go back to reference Chen W, Srinivasan SR, Elkasabany A, Berenson GS (1999) Cardiovascular risk factors clustering features of insulin resistance syndrome (Syndrome X) in a biracial (Black-White) population of children, adolescents, and young adults: the Bogalusa Heart Study. Am J Epidemiol 150(7):667–674PubMedCrossRef Chen W, Srinivasan SR, Elkasabany A, Berenson GS (1999) Cardiovascular risk factors clustering features of insulin resistance syndrome (Syndrome X) in a biracial (Black-White) population of children, adolescents, and young adults: the Bogalusa Heart Study. Am J Epidemiol 150(7):667–674PubMedCrossRef
13.
go back to reference Cole TJ, Freeman JV, Preece MA (1995) Body mass index reference curves for the UK, 1990. Arch Dis Child 73(1):25–29PubMedCrossRef Cole TJ, Freeman JV, Preece MA (1995) Body mass index reference curves for the UK, 1990. Arch Dis Child 73(1):25–29PubMedCrossRef
15.
go back to reference Ekelund U, Anderssen SA, Froberg K, Sardinha LB, Andersen LB, Brage S (2007) Independent associations of physical activity and cardiorespiratory fitness with metabolic risk factors in children: the European Youth Heart Study. Diabetologia 50(9):1832–1840PubMedCrossRef Ekelund U, Anderssen SA, Froberg K, Sardinha LB, Andersen LB, Brage S (2007) Independent associations of physical activity and cardiorespiratory fitness with metabolic risk factors in children: the European Youth Heart Study. Diabetologia 50(9):1832–1840PubMedCrossRef
16.
go back to reference Ekelund U, Sardinha LB, Anderssen SA, Harro M, Franks PW, Brage S et al (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(3):584–590PubMed Ekelund U, Sardinha LB, Anderssen SA, Harro M, Franks PW, Brage S et al (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(3):584–590PubMed
17.
go back to reference Fairclough SJ, Boddy LM, Hackett AF, Stratton G (2009) Associations between children’s socioeconomic status, weight status, and sex, with screen-based sedentary behaviours and sport participation. Int J Pediatr Obes 4(4):299–305PubMedCrossRef Fairclough SJ, Boddy LM, Hackett AF, Stratton G (2009) Associations between children’s socioeconomic status, weight status, and sex, with screen-based sedentary behaviours and sport participation. Int J Pediatr Obes 4(4):299–305PubMedCrossRef
18.
go back to reference Freeman JV, Cole TJ, Chinn S, Jones PR, White EM, Preece MA (1995) Cross sectional stature and weight reference curves for the UK, 1990. Arch Dis Child 73(1):17–24PubMedCrossRef Freeman JV, Cole TJ, Chinn S, Jones PR, White EM, Preece MA (1995) Cross sectional stature and weight reference curves for the UK, 1990. Arch Dis Child 73(1):17–24PubMedCrossRef
19.
go back to reference Gami AS, Witt BJ, Howard DE, Erwin PJ, Gami LA, Somers VK et al (2007) Metabolic syndrome and risk of incident cardiovascular events and death: a systematic review and meta-analysis of longitudinal studies. J Am Coll Cardiol 49(4):403–414PubMedCrossRef Gami AS, Witt BJ, Howard DE, Erwin PJ, Gami LA, Somers VK et al (2007) Metabolic syndrome and risk of incident cardiovascular events and death: a systematic review and meta-analysis of longitudinal studies. J Am Coll Cardiol 49(4):403–414PubMedCrossRef
20.
go back to reference Golden SH, Folsom AR, Coresh J, Sharrett AR, Szklo M, Brancati F (2002) Risk factor groupings related to insulin resistance and their synergistic effects on subclinical atherosclerosis: the atherosclerosis risk in communities study. Diabetes 51(10):3069–3076PubMedCrossRef Golden SH, Folsom AR, Coresh J, Sharrett AR, Szklo M, Brancati F (2002) Risk factor groupings related to insulin resistance and their synergistic effects on subclinical atherosclerosis: the atherosclerosis risk in communities study. Diabetes 51(10):3069–3076PubMedCrossRef
21.
go back to reference Graham I, Atar D, Borch-Johnsen K, Boysen G, Burell G, Cifkova R et al (2007) European guidelines on cardiovascular disease prevention in clinical practice: executive summary: Fourth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice. Eur Heart J 28(19):2375–2414PubMedCrossRef Graham I, Atar D, Borch-Johnsen K, Boysen G, Burell G, Cifkova R et al (2007) European guidelines on cardiovascular disease prevention in clinical practice: executive summary: Fourth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice. Eur Heart J 28(19):2375–2414PubMedCrossRef
22.
go back to reference Gutin B, Barbeau P, Owens S, Lemmon CR, Bauman M, Allison J et al (2002) Effects of exercise intensity on cardiovascular fitness, total body composition, and visceral adiposity of obese adolescents. Am J Clin Nutr 75(5):818–826PubMed Gutin B, Barbeau P, Owens S, Lemmon CR, Bauman M, Allison J et al (2002) Effects of exercise intensity on cardiovascular fitness, total body composition, and visceral adiposity of obese adolescents. Am J Clin Nutr 75(5):818–826PubMed
23.
go back to reference 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(4):746–750PubMed 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(4):746–750PubMed
24.
go back to reference Hannon TS, Janosky J, Arslanian SA (2006) Longitudinal study of physiologic insulin resistance and metabolic changes of puberty. Pediatr Res 60(6):759–763PubMedCrossRef Hannon TS, Janosky J, Arslanian SA (2006) Longitudinal study of physiologic insulin resistance and metabolic changes of puberty. Pediatr Res 60(6):759–763PubMedCrossRef
25.
go back to reference Hawley JA (2002) Adaptations of skeletal muscle to prolonged, intense endurance training. Clin Exp Pharmacol Physiol 29(3):218–222PubMedCrossRef Hawley JA (2002) Adaptations of skeletal muscle to prolonged, intense endurance training. Clin Exp Pharmacol Physiol 29(3):218–222PubMedCrossRef
26.
go back to reference Holten MK, Zacho M, Gaster M, Juel C, Wojtaszewski JF, Dela F (2004) Strength training increases insulin-mediated glucose uptake, GLUT4 content, and insulin signaling in skeletal muscle in patients with type 2 diabetes. Diabetes 53(2):294–305PubMedCrossRef Holten MK, Zacho M, Gaster M, Juel C, Wojtaszewski JF, Dela F (2004) Strength training increases insulin-mediated glucose uptake, GLUT4 content, and insulin signaling in skeletal muscle in patients with type 2 diabetes. Diabetes 53(2):294–305PubMedCrossRef
27.
go back to reference Kelly AS, Wetzsteon RJ, Kaiser DR, Steinberger J, Bank AJ, Dengel DR (2004) Inflammation, insulin, and endothelial function in overweight children and adolescents: the role of exercise. J Pediatr 145(6):731–736PubMedCrossRef Kelly AS, Wetzsteon RJ, Kaiser DR, Steinberger J, Bank AJ, Dengel DR (2004) Inflammation, insulin, and endothelial function in overweight children and adolescents: the role of exercise. J Pediatr 145(6):731–736PubMedCrossRef
28.
go back to reference Lee IM, Paffenbarger RS Jr (2000) Associations of light, moderate, and vigorous intensity physical activity with longevity. The Harvard Alumni Health Study. Am J Epidemiol 151(3):293–299PubMedCrossRef Lee IM, Paffenbarger RS Jr (2000) Associations of light, moderate, and vigorous intensity physical activity with longevity. The Harvard Alumni Health Study. Am J Epidemiol 151(3):293–299PubMedCrossRef
29.
go back to reference Martinez-Gomez D, Eisenmann JC, Warnberg J, Gomez-Martinez S, Veses A, Veiga OL et al (2010) Associations of physical activity, cardiorespiratory fitness and fatness with low-grade inflammation in adolescents: the AFINOS Study. Int J Obes (Lond) 34(10):1501–1507CrossRef Martinez-Gomez D, Eisenmann JC, Warnberg J, Gomez-Martinez S, Veses A, Veiga OL et al (2010) Associations of physical activity, cardiorespiratory fitness and fatness with low-grade inflammation in adolescents: the AFINOS Study. Int J Obes (Lond) 34(10):1501–1507CrossRef
30.
go back to reference Mattocks C, Ness A, Leary S, Tilling K, Blair SN, Shield J et al (2008) Use of accelerometers in a large field-based study of children: protocols, design issues, and effects on precision. J Phys Act Health 5(Suppl 1):S98–S111PubMed Mattocks C, Ness A, Leary S, Tilling K, Blair SN, Shield J et al (2008) Use of accelerometers in a large field-based study of children: protocols, design issues, and effects on precision. J Phys Act Health 5(Suppl 1):S98–S111PubMed
31.
go back to reference McCarthy HD, Cole TJ, Fry T, Jebb SA, Prentice AM (2006) Body fat reference curves for children. Int J Obes (Lond) 30(4):598–602CrossRef McCarthy HD, Cole TJ, Fry T, Jebb SA, Prentice AM (2006) Body fat reference curves for children. Int J Obes (Lond) 30(4):598–602CrossRef
32.
go back to reference McGill HC Jr, McMahan CA, Zieske AW, Tracy RE, Malcom GT, Herderick EE et al (2000) Association of coronary heart disease risk factors with microscopic qualities of coronary atherosclerosis in youth. Circulation 102(4):374–379PubMedCrossRef McGill HC Jr, McMahan CA, Zieske AW, Tracy RE, Malcom GT, Herderick EE et al (2000) Association of coronary heart disease risk factors with microscopic qualities of coronary atherosclerosis in youth. Circulation 102(4):374–379PubMedCrossRef
33.
go back to reference Mitchell MS, Gaul CA, Naylor PJ, Panagiotopoulos C (2010) Habitual moderate-to-vigorous physical activity is inversely associated with insulin resistance in Canadian first nations youth. Pediatr Exerc Sci 22(2):254–265PubMed Mitchell MS, Gaul CA, Naylor PJ, Panagiotopoulos C (2010) Habitual moderate-to-vigorous physical activity is inversely associated with insulin resistance in Canadian first nations youth. Pediatr Exerc Sci 22(2):254–265PubMed
34.
go back to reference Moran A, Jacobs DR Jr, Steinberger J, Steffen LM, Pankow JS, Hong CP et al (2008) Changes in insulin resistance and cardiovascular risk during adolescence: establishment of differential risk in males and females. Circulation 117(18):2361–2368PubMedCrossRef Moran A, Jacobs DR Jr, Steinberger J, Steffen LM, Pankow JS, Hong CP et al (2008) Changes in insulin resistance and cardiovascular risk during adolescence: establishment of differential risk in males and females. Circulation 117(18):2361–2368PubMedCrossRef
35.
go back to reference Parikh P, Mochari H, Mosca L (2009) Clinical utility of a fingerstick technology to identify individuals with abnormal blood lipids and high-sensitivity C-reactive protein levels. Am J Health Promot 23(4):279–282PubMedCrossRef Parikh P, Mochari H, Mosca L (2009) Clinical utility of a fingerstick technology to identify individuals with abnormal blood lipids and high-sensitivity C-reactive protein levels. Am J Health Promot 23(4):279–282PubMedCrossRef
36.
go back to reference Patrick K, Norman GJ, Calfas KJ, Sallis JF, Zabinski MF, Rupp J et al (2004) Diet, physical activity, and sedentary behaviors as risk factors for overweight in adolescence. Arch Pediatr Adolesc Med 158(4):385–390PubMedCrossRef Patrick K, Norman GJ, Calfas KJ, Sallis JF, Zabinski MF, Rupp J et al (2004) Diet, physical activity, and sedentary behaviors as risk factors for overweight in adolescence. Arch Pediatr Adolesc Med 158(4):385–390PubMedCrossRef
37.
go back to reference Riddoch C, Edwards D, Page A, Froberg K, Anderssen SA, Wedderkopp N et al (2005) The European Youth Heart Study—cardiovascular disease risk factors in children: rationale, aims, study design, and validation of methods. J Phys Act Health 2(1):115–129 Riddoch C, Edwards D, Page A, Froberg K, Anderssen SA, Wedderkopp N et al (2005) The European Youth Heart Study—cardiovascular disease risk factors in children: rationale, aims, study design, and validation of methods. J Phys Act Health 2(1):115–129
38.
go back to reference Ridgers ND, Fairclough SJ (2011) Assessing free-living physical activity using accelerometry: practical issues for researchers and practitioners. Eur J Sport Sci 11(3):205–213CrossRef Ridgers ND, Fairclough SJ (2011) Assessing free-living physical activity using accelerometry: practical issues for researchers and practitioners. Eur J Sport Sci 11(3):205–213CrossRef
39.
go back to reference Rowlands AV, Pilgrim EL, Eston RG (2008) Patterns of habitual activity across weekdays and weekend days in 9–11-year-old children. Prev Med 46(4):317–324PubMedCrossRef Rowlands AV, Pilgrim EL, Eston RG (2008) Patterns of habitual activity across weekdays and weekend days in 9–11-year-old children. Prev Med 46(4):317–324PubMedCrossRef
40.
go back to reference Rowlands AV, Thomas PW, Eston RG, Topping R (2004) Validation of the RT3 triaxial accelerometer for the assessment of physical activity. Med Sci Sports Exerc 36(3):518–524PubMedCrossRef Rowlands AV, Thomas PW, Eston RG, Topping R (2004) Validation of the RT3 triaxial accelerometer for the assessment of physical activity. Med Sci Sports Exerc 36(3):518–524PubMedCrossRef
41.
go back to reference Ruiz JR, Ortega FB, Rizzo NS, Villa I, Hurtig-Wennlof A, Oja L et al (2007) High cardiovascular fitness is associated with low metabolic risk score in children: the European Youth Heart Study. Pediatr Res 61(3):350–355PubMedCrossRef Ruiz JR, Ortega FB, Rizzo NS, Villa I, Hurtig-Wennlof A, Oja L et al (2007) High cardiovascular fitness is associated with low metabolic risk score in children: the European Youth Heart Study. Pediatr Res 61(3):350–355PubMedCrossRef
42.
go back to reference Ruiz JR, Rizzo NS, Hurtig-Wennlof A, Ortega FB, Warnberg J, Sjostrom 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(2):299–303PubMed Ruiz JR, Rizzo NS, Hurtig-Wennlof A, Ortega FB, Warnberg J, Sjostrom 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(2):299–303PubMed
43.
go back to reference Shaibi GQ, Cruz ML, Ball GD, Weigensberg MJ, Kobaissi HA, Salem GJ et al (2005) Cardiovascular fitness and the metabolic syndrome in overweight Latino youths. Med Sci Sports Exerc 37(6):922–928PubMed Shaibi GQ, Cruz ML, Ball GD, Weigensberg MJ, Kobaissi HA, Salem GJ et al (2005) Cardiovascular fitness and the metabolic syndrome in overweight Latino youths. Med Sci Sports Exerc 37(6):922–928PubMed
44.
go back to reference Shemesh T, Rowley KG, Shephard M, Piers LS, O’Dea K (2006) Agreement between laboratory results and on-site pathology testing using Bayer DCA2000+ and Cholestech LDX point-of-care methods in remote Australian Aboriginal communities. Clin Chim Acta 367(1–2):69–76PubMedCrossRef Shemesh T, Rowley KG, Shephard M, Piers LS, O’Dea K (2006) Agreement between laboratory results and on-site pathology testing using Bayer DCA2000+ and Cholestech LDX point-of-care methods in remote Australian Aboriginal communities. Clin Chim Acta 367(1–2):69–76PubMedCrossRef
45.
go back to reference Stratton G, Canoy D, Boddy LM, Taylor SR, Hackett AF, Buchan IE (2007) Cardiorespiratory fitness and body mass index of 9-11-year-old English children: a serial cross-sectional study from 1998 to 2004. Int J Obes (Lond) 31(7):1172–1178CrossRef Stratton G, Canoy D, Boddy LM, Taylor SR, Hackett AF, Buchan IE (2007) Cardiorespiratory fitness and body mass index of 9-11-year-old English children: a serial cross-sectional study from 1998 to 2004. Int J Obes (Lond) 31(7):1172–1178CrossRef
46.
go back to reference Twisk JW, Kemper HC, van Mechelen W (2000) Tracking of activity and fitness and the relationship with cardiovascular disease risk factors. Med Sci Sports Exerc 32(8):1455–1461PubMedCrossRef Twisk JW, Kemper HC, van Mechelen W (2000) Tracking of activity and fitness and the relationship with cardiovascular disease risk factors. Med Sci Sports Exerc 32(8):1455–1461PubMedCrossRef
47.
go back to reference 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(Suppl 1):S8–S14PubMedCrossRef 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(Suppl 1):S8–S14PubMedCrossRef
48.
go back to reference Zimmet P, Alberti KG, Kaufman F, Tajima N, Silink M, Arslanian S et al (2007) The metabolic syndrome in children and adolescents—an IDF consensus report. Pediatr Diabetes 8(5):299–306PubMedCrossRef Zimmet P, Alberti KG, Kaufman F, Tajima N, Silink M, Arslanian S et al (2007) The metabolic syndrome in children and adolescents—an IDF consensus report. Pediatr Diabetes 8(5):299–306PubMedCrossRef
Metadata
Title
Associations between cardiorespiratory fitness, physical activity and clustered cardiometabolic risk in children and adolescents: the HAPPY study
Authors
Daniel P. Bailey
Lynne M. Boddy
Louise A. Savory
Sarah J. Denton
Catherine J. Kerr
Publication date
01-09-2012
Publisher
Springer-Verlag
Published in
European Journal of Pediatrics / Issue 9/2012
Print ISSN: 0340-6199
Electronic ISSN: 1432-1076
DOI
https://doi.org/10.1007/s00431-012-1719-3

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