by Bianca Garilli, ND
Obesity is not age-discriminate, affecting both adults and children quite dramatically over the past few decades. In the United States, nearly one in five children ages 6-19 years old are currently obese, resulting in both long-term health consequences and a financial burden to the individual, family and nation.1 One of the most detrimental effects of the rise in obesity prevalence is the corresponding elevation in cardiometabolic risk factors in the growing child. Commonly, the recommendations for children with obesity include reducing daily screen and sedentary time while increasing physical activity levels in an attempt to lower these chronic disease risk factors.
A study published in the American Journal of Clinical Nutrition aimed to elucidate the components of the sedentary-physical activity balance to ascertain which component was most predictive of reducing cardiometabolic risk factors in a subset of children. The Active Smarter Kids (ASK) study, a school-based cluster randomized controlled trial in Norway, examined 700 ten-year-old children (51% female), measuring their sedentary and active time through accelerometry with wearable devices to measure movement during various activities.2
At baseline and again prospectively at 7 months, blood pressure, waist circumference (WC) and fasting blood tests including total cholesterol, HDL-cholesterol, triglycerides, glucose, and insulin were measured.2 Homeostatic model assessment for insulin resistance (HOMA-IR) was used as a surrogate measure of insulin resistance.2 Outcome variables were considered individually and collectively in a clustered cardiometabolic risk score.2
Results from the study indicate children who were already engaging in regular, moderate physical activity at baseline had lower concentrations of triglycerides and HOMA-IR at the 7-month follow-up. Participating in moderate-to-vigorous physical activity and vigorous physical activity predicted lower, clustered cardiometabolic risk at follow-up. Sedentary time, on the other hand, was not associated with any of the individual nor clustered cardiometabolic risk factors.2
Why is this Clinically Relevant?
- Moderate intensity physical activity in children reduces obesity and cardiometabolic risk
- Sedentary time, although important to limit, is not as influential as time spent engaging in physical activity, particularly moderate-to-vigorous intensity activities, when targeting a reduction in cardiometabolic risk factors in children
- Clinicians and care-givers should encourage regular physical activity which requires at least moderate intensity movement
- School- and community-based physical activity initiatives should include those which allow for moderate-to-vigorous exercise
- CDC. Childhood Obesity Facts. https://www.cdc.gov/healthyschools/obesity/facts.htm Accessed April 26, 2018.
- Skrede T, Stavnsbo M, Aadland E, et al. Moderate-to-vigorous activity, but not sedentary time, predicts changes in cardiometabolic risk factors in 10-y-old children: the Active Smarter Kids Study. Am J Clin Nutr. 2017 Jun;105(6):1391-1398.