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Published in: Journal of Public Health 2/2006

01-04-2006 | Original Article

Cardiorespiratory fitness is associated with features of metabolic risk factors in children. Should cardiorespiratory fitness be assessed in a European health monitoring system? The European Youth Heart Study

Authors: Jonatan R. Ruiz, Francisco B. Ortega, Dirk Meusel, Maarike Harro, Pekka Oja, Michael Sjöström

Published in: Journal of Public Health | Issue 2/2006

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Abstract

The question as to whether fitness should be assessed in a European health monitoring system, perhaps from the early stages of life onwards, remains to be answered. We aimed to examine the associations between cardiorespiratory fitness and metabolic risk factors in children. A total of 873 healthy children from Sweden and Estonia aged 9–10 years (444 girls and 429 boys) were randomly selected. A maximal ergometer bike test was used to estimate cardiorespiratory fitness. Additional cardiovascular risk factors were assessed. Significant differences among cardiorespiratory fitness quartiles for the sum of five skinfolds, insulin resistance, triglycerides, and total cholesterol (TC) and high-density lipoprotein cholesterol (HDLc) ratio were shown in girls whereas in boys, the sum of five skinfolds and insulin resistance were significantly different. The lowest sum of five skinfolds and insulin resistance was shown in the highest cardiorespiratory fitness quartile in girls and boys, and the lowest values of triglyceride and TC/HDLc values in the highest cardiorespiratory fitness quartile was observed only in girls. Cardiorespiratory fitness was negatively associated with a clustering of metabolic risk factors in girls and boys. The results add supportive evidence to the body of knowledge suggesting that cardiorespiratory fitness in children is an important health marker and thus should be considered to be included in a pan-European health monitoring system.
Literature
go back to reference Andersen LB, Hasselstrøm H, Grønfeldt V, Hansen SE, Froberg K (2004) The relationship between physical fitness and clustered risk, and tracking of clustered risk from adolescence to young adulthood: eight years follow-up in the Danish Youth and Sport Study. Int J Behav Nutr Phys Act 1:6CrossRefPubMed Andersen LB, Hasselstrøm H, Grønfeldt V, Hansen SE, Froberg K (2004) The relationship between physical fitness and clustered risk, and tracking of clustered risk from adolescence to young adulthood: eight years follow-up in the Danish Youth and Sport Study. Int J Behav Nutr Phys Act 1:6CrossRefPubMed
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 33:270–274PubMed 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 33:270–274PubMed
go back to reference Boreham C, Twisk J, Neville C, Savage M, Murray L, Gallagher A (2002) Associations between physical fitness and activity patterns during adolescence and cardiovascular risk factors in young adulthood: The Northern Ireland Young Hearts Project. Int J Sports Med 23:22S–26SCrossRef Boreham C, Twisk J, Neville C, Savage M, Murray L, Gallagher A (2002) Associations between physical fitness and activity patterns during adolescence and cardiovascular risk factors in young adulthood: The Northern Ireland Young Hearts Project. Int J Sports Med 23:22S–26SCrossRef
go back to reference Boreham CA, Ferrera I, Twisk JW Gallagher AM, Savage MJ, Murray LJ (2004) Cardiorespiratory fitness, physical activity, and arterial stiffness: The Northern Ireland Young Hearts Project. Hypertension 44:721–726CrossRefPubMed Boreham CA, Ferrera I, Twisk JW Gallagher AM, Savage MJ, Murray LJ (2004) Cardiorespiratory fitness, physical activity, and arterial stiffness: The Northern Ireland Young Hearts Project. Hypertension 44:721–726CrossRefPubMed
go back to reference Brage S, Wedderkopp N, Ekelund U, Franks PW, Wareham NJ, Andersen LB, Froberg K (2004) European Youth Heart Study (EYHS): 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 27:2141–2148PubMedCrossRef Brage S, Wedderkopp N, Ekelund U, Franks PW, Wareham NJ, Andersen LB, Froberg K (2004) European Youth Heart Study (EYHS): 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 27:2141–2148PubMedCrossRef
go back to reference 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 290:3092–3100CrossRefPubMed 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 290:3092–3100CrossRefPubMed
go back to reference Church TS, LaMonte MJ, Barlow CE, Blair SN (2005) Cardiorespiratory fitness and body mass index as predictors of cardiovascular disease mortality among men with diabetes. Arch Intern Med 10:2114–21220CrossRef Church TS, LaMonte MJ, Barlow CE, Blair SN (2005) Cardiorespiratory fitness and body mass index as predictors of cardiovascular disease mortality among men with diabetes. Arch Intern Med 10:2114–21220CrossRef
go back to reference Eisenmann JC, Katzmarzyk PT, Perusse L, Tremblay A, Despres JP, Bouchard C (2005a) Aerobic fitness, body mass index, and CVD risk factors among adolescents: the Quebec family study. Int J Obes Relat Metab Disord 29:1077–1083CrossRef Eisenmann JC, Katzmarzyk PT, Perusse L, Tremblay A, Despres JP, Bouchard C (2005a) Aerobic fitness, body mass index, and CVD risk factors among adolescents: the Quebec family study. Int J Obes Relat Metab Disord 29:1077–1083CrossRef
go back to reference Eisenmann JC, Wickel EE, Welk GJ, Blair SN (2005b) Relationship between adolescent fitness and fatness and cardiovascular disease risk factors in adulthood: the Aerobics Center Longitudinal Study (ACLS). Am Heart J 149:46–53CrossRefPubMed Eisenmann JC, Wickel EE, Welk GJ, Blair SN (2005b) Relationship between adolescent fitness and fatness and cardiovascular disease risk factors in adulthood: the Aerobics Center Longitudinal Study (ACLS). Am Heart J 149:46–53CrossRefPubMed
go back to reference Ferreira I, Twisk JW, Stehouwer CD, van Mechelen W, Kemper HC. (2003) Longitudinal changes in VO2max: associations with carotid IMT and arterial stiffness. Med Sci Sports Exerc 35:1670–1678CrossRefPubMed Ferreira I, Twisk JW, Stehouwer CD, van Mechelen W, Kemper HC. (2003) Longitudinal changes in VO2max: associations with carotid IMT and arterial stiffness. Med Sci Sports Exerc 35:1670–1678CrossRefPubMed
go back to reference Ferreira I, Twisk JW, Stehouver CD, van Mechelen W, Kemper HC (2005) The metabolic syndrome, cardiopulmonary fitness, and subcutaneous trunk fat as independent determinants of arterial stiffness: the Amsterdam growth and health longitudinal study. Arch Intern Med 25:875–882CrossRef Ferreira I, Twisk JW, Stehouver CD, van Mechelen W, Kemper HC (2005) The metabolic syndrome, cardiopulmonary fitness, and subcutaneous trunk fat as independent determinants of arterial stiffness: the Amsterdam growth and health longitudinal study. Arch Intern Med 25:875–882CrossRef
go back to reference Gulati M, Pandey DK, Arnsdorf MF, Lauderdale DS, Thisted RA, Wicklund RH, Al-Hani AJ, Black HR (2003) Exercise capacity and the risk of death in women: the St. James women take heart project. Circulation 108:1554–1559CrossRefPubMed Gulati M, Pandey DK, Arnsdorf MF, Lauderdale DS, Thisted RA, Wicklund RH, Al-Hani AJ, Black HR (2003) Exercise capacity and the risk of death in women: the St. James women take heart project. Circulation 108:1554–1559CrossRefPubMed
go back to reference 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 63:287–292PubMed 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 63:287–292PubMed
go back to reference Gutin B, Yin Z, Humphries MC, Bassali R, Le NA, Daniels S, Barbeau P (2004) Relations of fatness and fitness to fasting insulin in black and white adolescents. J Pediatr 145:737–743CrossRefPubMed Gutin B, Yin Z, Humphries MC, Bassali R, Le NA, Daniels S, Barbeau P (2004) Relations of fatness and fitness to fasting insulin in black and white adolescents. J Pediatr 145:737–743CrossRefPubMed
go back to reference Gutin B, Yin Z, Humphries MC, Bassali R, Le NA, Daniels S, Barbeau P (2005) Relations of body fatness and cardiovascular fitness to lipid profile in black and white adolescents. Pediatr Res 58:78–82CrossRefPubMed Gutin B, Yin Z, Humphries MC, Bassali R, Le NA, Daniels S, Barbeau P (2005) Relations of body fatness and cardiovascular fitness to lipid profile in black and white adolescents. Pediatr Res 58:78–82CrossRefPubMed
go back to reference 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 58:618–624CrossRefPubMed 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 58:618–624CrossRefPubMed
go back to reference Hasselstrøm H, Hansen SE, Froberg K, Andersen LB (2002) Physical fitness and physical activity during adolescence as predictors of cardiovascular disease risk in young adulthood. Danish youth and sports study. An eight-year follow-up study. Int J Sports Med 23:27S–31SCrossRef Hasselstrøm H, Hansen SE, Froberg K, Andersen LB (2002) Physical fitness and physical activity during adolescence as predictors of cardiovascular disease risk in young adulthood. Danish youth and sports study. An eight-year follow-up study. Int J Sports Med 23:27S–31SCrossRef
go back to reference Janz KF, Dawson JD, Mahoney LT (2002) Increases in physical fitness during childhood improve cardiovascular health during adolescence: The muscatine study. Int J Sports Med 23:15S–21SCrossRef Janz KF, Dawson JD, Mahoney LT (2002) Increases in physical fitness during childhood improve cardiovascular health during adolescence: The muscatine study. Int J Sports Med 23:15S–21SCrossRef
go back to reference 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 164:1092–1097CrossRefPubMed 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 164:1092–1097CrossRefPubMed
go back to reference Katzmarzyk PT, Church TS, Janssen I, Ross R, Blair SN (2005) Metabolic syndrome, obesity, and mortality: impact of cardiorespiratory fitness. Diabetes Care 28:391–397PubMedCrossRef Katzmarzyk PT, Church TS, Janssen I, Ross R, Blair SN (2005) Metabolic syndrome, obesity, and mortality: impact of cardiorespiratory fitness. Diabetes Care 28:391–397PubMedCrossRef
go back to reference Kurl S, Laukkanen JA, Rauramaa R, Lakka TA, Sivenius J, Salonen JT (2003) Cardiorespiratory fitness and the risk for stroke in men. Arch Intern Med 163:1682–1688CrossRefPubMed Kurl S, Laukkanen JA, Rauramaa R, Lakka TA, Sivenius J, Salonen JT (2003) Cardiorespiratory fitness and the risk for stroke in men. Arch Intern Med 163:1682–1688CrossRefPubMed
go back to reference 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 26:505–512CrossRef 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 26:505–512CrossRef
go back to reference Lee CD, Blair SN, Jackson AS (1999) Cardiorespiratory fitness, body composition, and all-cause and cardiovascular disease mortality in men. Am J Clin Nutr 69:373–380PubMed Lee CD, Blair SN, Jackson AS (1999) Cardiorespiratory fitness, body composition, and all-cause and cardiovascular disease mortality in men. Am J Clin Nutr 69:373–380PubMed
go back to reference Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC (1985) Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 28:412–419CrossRefPubMed Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC (1985) Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 28:412–419CrossRefPubMed
go back to reference Mora S, Redberg RF, Cui Y, Whiteman MK, Flaws JA, Sharrett AR, Blumenthal R (2003) Ability of exercise testing to predict cardiovascular and all-cause death in asymptomatic women: a 20-year follow-up of the lipid research clinics prevalence study. JAMA 290:1600–1607CrossRefPubMed Mora S, Redberg RF, Cui Y, Whiteman MK, Flaws JA, Sharrett AR, Blumenthal R (2003) Ability of exercise testing to predict cardiovascular and all-cause death in asymptomatic women: a 20-year follow-up of the lipid research clinics prevalence study. JAMA 290:1600–1607CrossRefPubMed
go back to reference Myers J, Prakash M, Froelicher V, Do D, Partington S, Atwood JE (2002) Exercise capacity and mortality among men referred for exercise testing. N Engl J Med 346:793–801CrossRefPubMed Myers J, Prakash M, Froelicher V, Do D, Partington S, Atwood JE (2002) Exercise capacity and mortality among men referred for exercise testing. N Engl J Med 346:793–801CrossRefPubMed
go back to reference Nielsen GA, Andersen LB (2003) The association between high blood pressure, physical fitness, and body mass index in adolescents. Prev Med 36:229–234CrossRefPubMed Nielsen GA, Andersen LB (2003) The association between high blood pressure, physical fitness, and body mass index in adolescents. Prev Med 36:229–234CrossRefPubMed
go back to reference Park MK, Menard SM (1987) Accuracy of blood pressure measurement by the Dinamap monitor in infants and children. Pediatrics 79:907–914PubMed Park MK, Menard SM (1987) Accuracy of blood pressure measurement by the Dinamap monitor in infants and children. Pediatrics 79:907–914PubMed
go back to reference Poortvliet E, Yngve A, Ekelund U, Hurtig-Wennlöf A, Nilsson A, Hagströmer M, Sjöström M (2003) The European Youth Heart Survey (EYHS). An international study that addresses the multi-dimensional issues of CVD risk factors. Forum Nutr 56:254–256PubMed Poortvliet E, Yngve A, Ekelund U, Hurtig-Wennlöf A, Nilsson A, Hagströmer M, Sjöström M (2003) The European Youth Heart Survey (EYHS). An international study that addresses the multi-dimensional issues of CVD risk factors. Forum Nutr 56:254–256PubMed
go back to reference Reed KA, Warburton DE, Lewanczuk RZ, Haykowski 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 12:492–497CrossRefPubMed Reed KA, Warburton DE, Lewanczuk RZ, Haykowski 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 12:492–497CrossRefPubMed
go back to reference 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, and the European Youth Heart Study team (2005) Cardiovascular disease risk factors in children: Rationale, aims, study, design, and validation of methods. J Phys Act Health 2:115–129 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, and the European Youth Heart Study team (2005) Cardiovascular disease risk factors in children: Rationale, aims, study, design, and validation of methods. J Phys Act Health 2:115–129
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:S8–S14CrossRefPubMed 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–S14CrossRefPubMed
go back to reference Sjöström M, Poortvliet E, Nelson M (2005) Monitoring public health nutrition in Europe: nutritional indicators and determinants of health status. J Public Health1 3:74–83CrossRef Sjöström M, Poortvliet E, Nelson M (2005) Monitoring public health nutrition in Europe: nutritional indicators and determinants of health status. J Public Health1 3:74–83CrossRef
go back to reference 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 6:291–299CrossRefPubMed 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 6:291–299CrossRefPubMed
go back to reference 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 65:65–76CrossRefPubMed 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 65:65–76CrossRefPubMed
Metadata
Title
Cardiorespiratory fitness is associated with features of metabolic risk factors in children. Should cardiorespiratory fitness be assessed in a European health monitoring system? The European Youth Heart Study
Authors
Jonatan R. Ruiz
Francisco B. Ortega
Dirk Meusel
Maarike Harro
Pekka Oja
Michael Sjöström
Publication date
01-04-2006
Publisher
Springer-Verlag
Published in
Journal of Public Health / Issue 2/2006
Print ISSN: 2198-1833
Electronic ISSN: 1613-2238
DOI
https://doi.org/10.1007/s10389-006-0026-8

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