Physical Activity, Cardiorespiratory Fitness, and Clustered Cardiometabolic Risk in 10- to 12-year-old School Children: The REACH Y6 Study

Lynne M Boddy, Marie H Murphy, Conor Cunningham, Gavin Breslin, Lawrence Foweather, Rebecca Gobbi, Lee E F Graves, Nicola D Hopkins, Marcus K H Auth, Gareth Stratton

Research output: Contribution to journalArticlepeer-review

46 Citations (Scopus)


Objectives(1) Investigate whether clustered cardiometabolic risk score, cardiorespiratory fitness (CRF), sedentary time (ST), and body mass index Z-scores (BMI Z-scores), differed between participants that met and did not achieve ≥60 min of daily moderate to vigorous intensity physical activity (MVPA). (2) Compare clustered cardiometabolic risk score, BMI Z-score, ST, and MVPA by CRF status. MethodsOne hundred and one (n = 45 boys) 10- to 12-year-old participants took part in this cross-sectional study, conducted in Liverpool (Summer 2010) and Ulster (Spring 2011) UK. Assessments of blood markers, stature, sitting stature, body mass, waist circumference, flow mediated dilation (FMD), and resting blood pressure (BP) were completed. CRF (VO2 peak) was estimated using an individually calibrated treadmill protocol. Habitual MVPA and ST were assessed using an individually calibrated accelerometer protocol. Clustered cardiometabolic risk scores were calculated using blood markers, FMD (%), BP and anthropometric measures. Participants were classified as active (≥60 min MVPA) or inactive and as fit or unfit. Multivariate analysis of covariance (MANCOVA) was used to investigate differences in cardiometabolic risk, BMI Z-score, CRF, and ST by activity status. MANCOVA was also completed to assess differences in cardiometabolic risk, MVPA, ST, and BMI Z-score by fitness status. ResultsInactive children exhibited significantly higher clustered cardiometabolic risk scores and ST, and lower CRF than active children. Unfit participants exhibited significantly higher clustered cardiometabolic risk scores, BMI Z-scores and ST and lower MVPA in comparison to fit participants. ConclusionsThis study highlights the importance of children achieving 60 min MVPA daily and provides further evidence surrounding the importance of CRF for health. Am. J. Hum. Biol., 2014. © 2014 Wiley Periodicals, Inc.
Original languageEnglish
JournalAmerican Journal of Human Biology
Early online date6 Mar 2014
Publication statusE-pub ahead of print - 6 Mar 2014

Bibliographical note

Reference text: Al Suwaidi J, Hamasaki S, Higano ST, Nishimura RA, Holmes DR, Lerman A. 2000. Long-term follow-up of patients with mild coronary artery disease and endothelial dysfunction. Circulation 101:948–954.
Andersen LB, Harro M, Sardinha LB, Froberg K, Ekelund U, Brage S, Anderssen SA. 2006. Physical activity and clustered cardiovascular risk in children: a cross-sectional study (The European Youth Heart Study). Lancet 368:299–304.
Andersen LB, Riddoch C, Kriemler S, Hills AP. 2011. Physical activity and cardiovascular risk factors in children. Br J Sports Med 45:871–876.
Anderssen SA, Cooper AR, Riddoch C, Sardinha LB, Harro M, Brage S, Andersen LB. 2007. Low cardiorespiratory fitness is a strong predictor for clustering of cardiovascular disease risk factors in children independent of country, age and sex. Eur J Cardiovasc Prevention Rehabil 14:526–531.
Bailey DP, Boddy LM, Savory LA, Denton SJ, Kerr CJ. 2012. Associations between cardiorespiratory fitness, physical activity and clustered cardiometabolic risk in children and adolescents: the HAPPY study. Eur J Pediatr 171:1317–1323.
Bailey DP, Boddy LM, Savory LA, Denton SJ, Kerr CJ. 2013. Choice of activity-intensity classification thresholds impacts upon accelerometer-assessed physical activity-health relationships in children. PLoS One 8:e57101.
Bell LM, Byrne S, Thompson A, Ratnam N, Blair E, Bulsara M, Jones TW, Davis EA. 2007. Increasing body mass index z-score is continuously associated with complications of overweight in children, even in the healthy weight range. J Clin Endocrinol Metab 92:517–522.
Berenson GS, Srnivasan SR, Bogalusa Heart Study G. 2005. Cardiovascular risk factors in youth with implications for aging: the Bogalusa Heart Study. Neurobiol Aging 26:303–307.
Biddle S, Gorley T, Stensel D. 2004. Health-enhancing physical activity and sedentary behaviour in children and adolescents. J Sports Sci 22:679–707.
Boddy LM, Fairclough SJ, Atkinson G, Stratton G. 2012a. Changes in cardiorespiratory fitness in 9- to 10.9-year-old children: SportsLinx 1998–2010. Med Sci Sports Exerc 44:481–486.
Boddy LM, Thomas NE, Fairclough SJ, Tolfrey K, Brophy S, Rees A, Knox G, Baker JS, Stratton G. 2012b. ROC generated thresholds for field-assessed aerobic fitness related to body size and cardiometabolic risk in schoolchildren. PLoS One 7:e45755.
Bouchard C, An P, Rice T, Skinner JS, Wilmore JH, Gagnon J, Perusse L, Leon AS, Rao DC. 1999. Familial aggregation of VO(2max) response to exercise training: results from the HERITAGE Family Study. J Appl Physiol 87:1003–1008.
Catellier DJ, Hannan PJ, Murray DM, Addy CL, Conway TL, Yang S, Rice JC. 2005. Inputation of missing data when measuring activity by accelerometry. Med Sci Sports Exerc 37:S555–S562.
Celemajer DS, Ayer JGJ. 2006. Childhood risk factors for adult cardiovascular disease and primary prevention in childhood. Heart 92:1701–1706.
Dencker M, Thorsson O, Karlsson MK, Linden C, Wollmer P, Andersen LB. 2007. Daily physical activity related to aerobic fitness and body fat in an urban sample of children. Scand J Med Sci Sports 18:728–735.
Department of Health. 2011. Start Active, Stay Active: A report on physical activity for health from the four home countries' Chief Medical Officers, Crown copyright, London UK.
Ekelund U, Luan J, Sherar LB, Esliger DW, Griew P, Cooper A, International Children's Accelerometry Database C. 2012. Moderate to vigorous physical activity and sedentary time and cardiometabolic risk factors in children and adolescents. J Am Med Assoc 307:704–712.
Ekelund U, Sjöström M, Yngve A, Poortvliet E, Nilsson A, Froberg K, Wedderkopp N, Westerterp K. 2001. Physical activity assessed by activity monitor and doubly labelled water in children. Med Sci Sports Exerc 33:275–281.
Ekelund U, Tomkinson G, Armstrong N. 2011. What proportion of youth are physically active? Measurement issues, levels and recent time trends. Br J Sports Med 45:859–865.
Hopkins N, Stratton G, Maia J, Tinken TM, Graves LE, Cable NT, Green DJ. 2010. Heritability of arterial function, fitness, and physical activity in youth: a study of monozygotic and dizygotic twins. J Pediatr 157:943–948.
Hopkins ND, Stratton G, Tinken TM, McWhannell N, Ridgers ND, Graves LEF, George KP, Cable NT, Green DJ. 2009. Relationships between measures of fitness, physical activity, body composition and vascular function in children. Atherosclerosis 204:244–249.
Houston EL, Baker JS, Buchan DS, Stratton G, Fairclough SJ, Foweather L, Gobbi R, Graves LEF, Hopkins N, Boddy LM. 2013. Cardiorespiratory fitness predicts clustered cardiometabolic risk in 10-11.9 year olds. Eur J Pediatr 172:913–918.
Hussey J, Bell C, Bennett K, O'Dwyer J, Gormley J. 2007. Relationship between the intensity of physical activity, inactivity, cardiorespiratory fitness and body composition in 7-10-year-old Dublin children. Br J Sports Med 41:311–316.
Janssen I, Leblanc AG. 2010. Systematic review of the health benefits of physical activity and fitness in school-aged children and youth. Int J Behav Nutr Phys Act 7:40.
Jimenez-Pavon D, Kelly J, Reilly JJ. 2010. Associations between objectively measured habitual physical activity and adiposity in children and adolescents: systematic review. Int J Pediatr Obes 5:3–18.
Kaptoge S, Thompson SG, Danesh J, Emerging Risk Factors C. 2013. C-reactive protein, fibrinogen, and cardiovascular risk. N Engl J Med 368:85–86.
Kristensen PL, Moeller NC, Korsholm L, Kolle E, Wedderkopp N, Froberg K, Andersen LB. 2010. The association between aerobic fitness and physical activity in children and adolescents: the European youth heart study. Eur J Appl Physiol 110:267–275.
Lohman T, Roche AF, Martorell R. 1988. Anthropometric standardization reference manual. Champaign, Illinois: Human Kinetics.
Mackintosh KA, Fairclough SJ, Eccles K, Stratton G, Ridgers ND. 2011. Field-based protocol for the calibration of population-specific accelerometer cut points in children. Pediatric Work Physiology Conference, Mawgan Porth, 19–23 September 2011.
Mattocks C, Ness A, Leary S, Tilling K, Blair S, Shield J, Deere K, Saunders J, Kirkby J, Smith G, et al. 2008. Use of accelerometers in a large field-based study of children: protocols, design issues, and effects on precision. J Phys Activ Health 5:S98–S111.
Mirwald R, Baxter-Jones A, Bailey D, Beunen G. 2002. An assessment of maturity from anthropometric measurements. Med Sci Sports Exerc 34:689–694.
Ortega FB, Ruiz JR, Castillo MJ, Sjostrom M. 2008. Physical fitness in childhood and adolescence: a powerful marker of health. Int J Obes (London) 32:1–11.
Ridgers ND, Fairclough SJ. 2011. Assessing free-living physical activity using accelerometry: practical issues for researchers and practitioners. Eur J Sport Sci 11:205–213.
Rizzo NS, Ruiz JR, Hurtig-Wennlof A, Ortega FB, Sjostrom M. 2007. Relationship of physical activity, fitness, and fatness with clustered metabolic risk in children and adolescents: the European youth heart study. J Pediatr 150:388–394.
Rowlands AV, Pilgrim EL, Eston RG. 2008. Patterns of habitual activity across weekdays and weekend days in 9-11-year-old children. Prev Med 46:317–324.
Rowlands RV. 2007. Accelerometer assessment of physical activity in children: an update. Pediatr Exerc Sci 19:252–266.
Taskase B, Hamabe A, Satomura KTA, Uehata A, Ohsuzu F, Ishihara M, Kurita A. 2005. Close relationship between the vasodilator response to acetylcholine in the brachial and coronary artery in suspected coronary artery disease. Int J Cardiol 105:58–66.
The Health and Social Care Information Centre. 2013. Statistics on obesity, physical activity and diet. England: The Health and Social Care Information Centre.
Treuth MS, Schmitz K, Catellier DJ, McMurray RG, Murray DM, Almeida MJ, Going S, Norma JE, Pate R. 2004. Defining accelerometer thresholds for activity intensities in adolescent girls. Med Sci Sports Exerc 36:1259–1266.
Watts K, Beye P, Siafarikas A, Davis EA, Jones TW, O'Driscoll G, Green DJ. 2004. Exercise training normalizes vascular dysfunction and improves central adiposity in obese adolescents. J Am Coll Cardiol 43:1823–1827.
Woo KS, Chook P, Yu CW, Sung RY, Qiao M, Leung SS, Lam CW, Metreweli C, Celermajer DS. 2004. Effects of diet and exercise on obesity-related vascular dysfunction in children. Circulation 109:1981–1986.


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