Determining independence and associations among various cardiovascular disease risk factors in 9-12 years old school-children: a cross sectional study.

BACKGROUND: Cardiovascular disease (CVD) risk assessment of children typically includes evaluating multiple CVD risk factors some of which tend to correlate each other. However, in older children and young adolescents, there are little data on the level of independence of CVD risk factors. The purpose of this study was to examine the relationships among various CVD risk factors to determine the level of independence of each risk factor in a sample of 5th-grade public school students. METHOD: A cross-sectional analysis of 1525 children (856 girls and 669 boys; age: 9-12 years) who participated in baseline CVD risk assessment for the (S)Partners for Heart Health program from 2010 - 2018. Thirteen CVD risk factor variables were used in the analysis and included blood lipids [low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol (TC), and triglycerides], resting systolic and diastolic blood pressure (BP); anthropometrics [height, weight, body mass index (BMI), % body fat, waist circumference (WC)]. Additionally, acanthosis nigricans (a marker insulin resistance and diabetes), and cardiorespiratory fitness (VO2 ml/kg) was estimated using the PACER. Descriptive statistics, bivariate Pearson correlations, and principal component analysis were used to determine the relationships among these variables and the independence. RESULTS: Parallel analysis indicated two components should be extracted. Among the two components extracted, WC, % body fat, and BMI loaded highest on component 1, which explained 34% of the total variance. Systolic BP and diastolic BP loaded predominantly on component 2 and accounted for 17% of the variance. Cardiorespiratory fitness, acanthosis nigricans, HDL, and triglycerides loaded highest on the first component (loadings between 0.42 and 0.57) but still suggest some non-shared variance with this component. Low-density lipoprotein had low loadings on each component. Factor loadings were stable across sex. CONCLUSION: Among the various CVD risk indicators, measures of adiposity loaded highest on the component that explained the largest proportion of variability in the data reinforcing the importance of assessing adiposity in CVD risk assessment. In addition, blood pressure loaded highest on the second component, suggesting their relative independence when assessing CVD risk. The data also provide support and rationale for determining what CVD risk factors to include- based on resource needs. For example, researchers or public health programs may choose to assess WC instead of lipid profile for cardiovascular related problems if ease of assessment and cost are considerations.

Physical Activity, BMI, and Blood Pressure in US Youth: NHANES 2003-2006.

PURPOSE: The objective of this study was to examine the independent and combined association of physical activity and body mass index (BMI) with blood pressure in youth. METHODS: Youth aged 8-18 years from the 2003-2006 National Health and Nutrition Examination Survey (NHANES) with BMI, blood pressure, and physical activity (accelerometer) were included in the analyses. A total of 2585 subjects (1303 males; 47% of all 8- to 18-year-olds) met these criteria. RESULTS: Obese youth had a systolic blood pressure that was 8 mm Hg higher than normal weight youth. A significant interaction between BMI and physical activity on blood pressure was found (P < .001), and group differences among the BMI/activity groups showed that the 3 obese groups and the overweight/least active group had significantly higher systolic blood pressure than the normal weight/active group across all analyses. The overweight/least active and normal weight/least active groups had significantly higher diastolic blood pressure than the normal weight/active group as well. CONCLUSIONS: This study showed a significant independent and combined association of BMI and physical activity with blood pressure in youth. Interventions need to focus on the reduction of fatness/BMI as a way to reduce the cardiovascular risk in youth.

Project FIT: A School, Community and Social Marketing Intervention Improves Healthy Eating Among Low-Income Elementary School Children.

Project FIT was a two-year multi-component nutrition and physical activity intervention delivered in ethnically-diverse low-income elementary schools in Grand Rapids, MI. This paper reports effects on children's nutrition outcomes and process evaluation of the school component. A quasi-experimental design was utilized. 3rd, 4th and 5th-grade students (Yr 1 baseline: N = 410; Yr 2 baseline: N = 405; age range: 7.5-12.6 years) were measured in the fall and spring over the two-year intervention. Ordinal logistic, mixed effect models and generalized estimating equations were fitted, and the robust standard errors were utilized. Primary outcomes favoring the intervention students were found regarding consumption of fruits, vegetables and whole grain bread during year 2. Process evaluation revealed that implementation of most intervention components increased during year 2. Project FIT resulted in small but beneficial effects on consumption of fruits, vegetables, and whole grain bread in ethnically diverse low-income elementary school children.

Association of the Family Nutrition and Physical Activity Screening Tool with Weight Status, Percent Body Fat, and Acanthosis Nigricans in Children from a Low Socioeconomic, Urban Community.

OBJECTIVE: To examine the association of the Family Nutrition and Physical Activity (FNPA) screening tool with weight status, percent body fat, and acanthosis nigricans (AN) in 6- to 13-year-old children from a low socioeconomic, urban community. METHODS: Children (n=415) from four elementary schools located around Flint, Michigan were assessed for body mass index, percent body fat, and AN. The FNPA screening tool was completed by parents. Mann-Whitney U tests were used to assess differences in FNPA score by sex and presence of AN. Logistic regression was used to evaluate the association of the FNPA (tertiles) with weight status and AN. RESULTS: Children with AN (13.7%) had a significantly lower FNPA score (56.3 + 7.1) compared with children without AN (61.0 + 7.1; P<.05). Children with FNPA scores in the lowest tertile (high-risk) had odds ratios of 1.74 (95% CI =1.05 - 2.91) and 2.77 (95% CI =1.22 - 6.27) compared with children with FNPA scores in the highest tertile (low-risk) for being overfat and having AN, respectively. CONCLUSION: Although the FNPA screening tool did not predict risk for being overweight or obese, it was significantly associated with an increased odds of children at risk for being overfat or having AN.

Dietary Quality Evidenced by the Healthy Eating Index and Cardiovascular Disease Risk Factors in Kuwaiti Schoolchildren.

BACKGROUND: Poor dietary quality is associated with adiposity and other risks of cardiovascular disease (CVD) in children. In Kuwait, although children's food choices are a concern, no studies have evaluated dietary quality relative to the risk of CVD in Kuwaiti schoolchildren. This study hypothesized that dietary quality using the Healthy Eating Index (HEI) is associated with CVD risk factors in children and that there are associated sex differences. OBJECTIVE: Our main objective was to evaluate the dietary quality of schoolchildren and investigate whether poor HEI scores are associated with CVD risk and if there are sex differences. METHODS: This was a cross-sectional study of Kuwaiti fifth graders (n = 313; 53% girls; mean age = 10.4 ± 0.4 years) who completed an adapted Block Kids 2004 food frequency questionnaire. Anthropometric, blood pressure, and biochemical data were also measured. HEI-2010 and HEI-2015 scores were calculated. STATISTICS: A general linear model and logistic regression were applied, controlling for moderate-vigorous physical activity (MVPA) and screen time (ST). RESULTS: The total HEI-2010 and HEI-2015 scores were 58 and 52 points, respectively; a trend analysis indicated that more girls than boys had poor (≤50 points) HEI-2015 scores (p < 0.063). The maximum scores for total vegetables (p < 0.001), dairy (p < 0.034), and fatty acids (p < 0.01) were significantly higher in girls, while the maximum scores for whole grains (p < 0.046) and protein (p < 0.006), but not sodium (p < 0.009), were higher in boys. Obesity was inversely associated with poor total HEI 2010 and HEI 2015 scores (OR: 0.347, 95% CI: 0.234 - 0.516, p < 0.001 and OR: 0.561, 95% CI: 0.391-0.805, p < 0.002, respectively). However, the correlation was lost after adjustment for possible confounding factors. CONCLUSIONS: Dietary quality for children overall in this study was low, and there was only a weak association between poor scores and elevated blood pressure and none between scores and obesity. These findings have public health implications and warrant further investigation and attention.

Sex differences in the prevalence of multiple cardiovascular disease risk factors in schoolchildren: A cross-sectional study.

BACKGROUND & AIMS: Childhood obesity is linked to adulthood cardiovascular disease (CVD) risk and mortality. Approximately 32% of Kuwaiti children are obese, particularly boys. Data on other CVD risk factors are limited. This study aimed to determine the prevalence and sex differences of CVD risks in Kuwaiti schoolchildren. METHODS: Kuwaiti fifth-grade schoolchildren (n = 367, 53% girls, age 10.4 ± 0.4 years) were evaluated. Informed parent/guardian consent and child assent were obtained for all participants. Outcome variables included (i) anthropometric: body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), percentage body fat (%BF); (ii) blood lipids: total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), non-HDL, TC:HDL ratio, triglycerides; and (iii) blood pressure (BP): systolic BP (SBP) and diastolic BP (DBP) measurements. ANOVA was conducted, while controlling for moderate-to-vigorous physical activity and screen time (ST); significance level was set at p ≤ 0.05. RESULTS: Overall prevalence of CVD risks included: overweight (21.6%), obesity (39%), WC (10.2%), WHtR (43.3%), %BF (10.1%), TC (26.4%), LDL (13.2%), HDL (36.9%), non-HDL (22.5%), TC:HDL ratio (25.9%), triglycerides (45.5%), and BP (23.3%). More girls (27.1%) than boys (15.5%) were overweight (p = 0.007). More girls than boys were at greater risk of elevated triglycerides (52.3% vs. 37.7%, p = 0.032), low HDL (20.7% vs. 12.2%, p = 0.032) and elevated SBP (21% vs. 10.7%, p = 0.008) and DBP (21% vs. 8.8%, p = 0.001), respectively. CONCLUSIONS: CVD risks are a concern overall in children, especially in girls relative to overweight, dyslipidemia, and prehypertension. Intervention programs for Kuwaiti schoolchildren are recommended to prevent CVD risks.

Project FIT: rationale, design and baseline characteristics of a school- and community-based intervention to address physical activity and healthy eating among low-income elementary school children.

BACKGROUND: This paper describes Project FIT, a collaboration between the public school system, local health systems, physicians, neighborhood associations, businesses, faith-based leaders, community agencies and university researchers to develop a multi-faceted approach to promote physical activity and healthy eating toward the general goal of preventing and reducing childhood obesity among children in Grand Rapids, MI, USA. METHODS/DESIGN: There are four overall components to Project FIT: school, community, social marketing, and school staff wellness - all that focus on: 1) increasing access to safe and affordable physical activity and nutrition education opportunities in the schools and surrounding neighborhoods; 2) improving the affordability and availability of nutritious food in the neighborhoods surrounding the schools; 3) improving the knowledge, self-efficacy, attitudes and behaviors regarding nutrition and physical activity among school staff, parents and students; 4) impacting the 'culture' of the schools and neighborhoods to incorporate healthful values; and 5) encouraging dialogue among all community partners to leverage existing programs and introduce new ones. DISCUSSION: At baseline, there was generally low physical activity (70% do not meet recommendation of 60 minutes per day), excessive screen time (75% do not meet recommendation of < 2 hours per day), and low intake of vegetables and whole grains and high intake of sugar-sweetened beverages, French fries and chips and desserts as well as a high prevalence of overweight and obesity (48.5% including 6% with severe obesity) among low income, primarily Hispanic and African American 3rd-5th grade children (n = 403). TRIAL REGISTRATION: ClinicalTrials.gov NCT01385046.

Reliability of the Block Kid's Food Frequency Questionnaire translated to Arabic and adapted for Kuwaiti children.

OBJECTIVES: Little is known about the nutrient intakes of Kuwaiti children; this is partly due to a lack of culture-specific dietary assessment instruments to estimate the usual food and nutrient intake of Arab children. The aim of this study was to describe the methodology used in translating the 2004 Block Kid's Food Frequency Questionnaire (Block FFQ) to Arabic using adapted food choices commonly consumed by Kuwaiti children, and to evaluate the reliability of the FFQ in a population of fifth-grade Kuwaiti children. METHODS: The 2004 Block FFQ was translated from English to Arabic, and food options were replaced with culturally appropriate foods. The modified FFQ was administered to 367 male and female Kuwaiti fifth graders (10.4 ± 0.4 y of age; 53% girls). The FFQ was retested 1 wk later in 26 male students, and 4 wk later in 32 female students. Intraclass correlations (ICC) assessed the reliability between the participants' first and second FFQs for food groups, macronutrients, and five key micronutrients. RESULTS: The combined analysis of boys and girls indicated a moderate reliability for food groups (ICC, 0.68; 95% confidence interval [CI]; 0.52-0.80) and micronutrients (ICC, 0.54; 95% CI, 0.29-0.72), but was poor for macronutrients (ICC, 0.43; 95% CI, 0.21-0.62). CONCLUSIONS: The modified FFQ is a modestly reliable instrument for measuring usual dietary intake in Kuwaiti children. The ICC was higher in boys than in girls, probably due to the disparity in the FFQ retest time.

The postprandial increase in blood triglycerides has no direct effect on the brain BOLD response.

A previous study showed that ingestion of a liquid meal high in polyunsaturated lipids decreased the blood-oxygenation-level-dependent (BOLD) response measured by functional magnetic resonance imaging (fMRI) during a finger-tapping motor task, and suggested that this effect was due to a direct effect of blood lipids on the cerebral vasculature. This study compared the time course and magnitude of the BOLD response in fixed anatomic locations before and 3 h after ingestion of high versus low lipid content liquid meals (235 ml Ensure Plus [Abbot Labs] with or without 50 ml added canola oil). Blood triglyceride content peaked 3 h after the high lipid meal and was elevated by 33% compared with the low lipid meal. There was no significant effect of meal composition on the time course or magnitude of the BOLD response in fixed-location clusters of voxels which were activated during either a motor (finger-tapping), a visual (flashing checkerboard), or an integrative/cognitive (number addition) block-design task paradigm. The results indicate that increased blood total triglyceride content after a meal with relatively high polyunsaturated fat does not directly alter the hemodynamic BOLD response to neural activity. However, the postprandial effect on BOLD response of other meals with varying fat types and amounts, as well as other nutrients and phytochemicals, remains to be determined.

(S)Partners for Heart Health: a school-based program for enhancing physical activity and nutrition to promote cardiovascular health in 5th grade students.

BACKGROUND: The American Heart Association Position Statement on Cardiovascular Health Promotion in Public Schools encourages school-based interventions for the primary prevention of cardiovascular disease (CVD) through risk factor prevention or reduction in children with an emphasis on creating an environment that promotes healthy food choices and physical activity (PA). In an effort to address issues related to CVD risk factors including obesity in Michigan children, a multi-disciplinary team of Michigan State University (MSU) faculty, clinicians, and health profession students was formed to "(S)partner" with elementary school physical education (PE) teachers and MSU Extension staff to develop and implement a cost-effective, sustainable program aimed at CVD risk factor prevention and management for 5th grade students. This (S)partnership is intended to augment and improve the existing 5th grade PE, health and nutrition curriculum by achieving the following aims: 1) improve the students' knowledge, attitudes and confidence about nutrition, PA and heart health; 2) increase the number of students achieving national recommendations for PA and nutrition; and 3) increase the number of students with a desirable CVD risk factor status based on national pediatric guidelines. Secondary aims include promoting school staff and parental support for heart health to help children achieve their goals and to provide experiential learning and service for MSU health profession students for academic credit. METHODS/DESIGN: This pilot effectiveness study was approved by the MSU IRB. At the beginning and the end of the school year students undergo a CVD risk factor assessment conducted by MSU medical students and graduate students. Key intervention components include eight lesson plans (conducted bi-monthly) designed to promote heart healthy nutrition and PA behaviors conducted by PE teachers with assistance from MSU undergraduate dietetic and kinesiology students (Spartners). The final 10 minutes of each lesson, MSU Spartners conduct small breakout/discussion groups with the 5th grade students. Additionally, each Spartner case manages/mentors two to three 5th grade students using a web-based goal setting and tracking protocol throughout the school year. DISCUSSION: This paper describes the rationale, development, and methods of the Spartners for Heart Health program. This is a multi-level intervention designed to promote heart healthy behaviors and prevent or manage CVD risk factors in children. We believe this will be a viable sustainable intervention that can be disseminated and adopted by other institutions with minimal cost by engaging college students as an integral part of the measurement and intervention teams.

Safety and efficacy of a ginkgo biloba-containing dietary supplement on cognitive function, quality of life, and platelet function in healthy, cognitively intact older adults.

OBJECTIVE: To determine if a ginkgo biloba-containing supplement improves cognitive function and quality of life, alters primary hemostasis, and is safe in healthy, cognitively intact older adults. DESIGN: Four-month, randomized, double-blind, placebo-controlled parallel design. SUBJECTS/SETTING: Ninety men and women (age range 65 to 84 years) were recruited to a university clinic. Eligibility included those without dementia or depression, not taking psychoactive medications or medications or supplements that alter hemostasis. INTERVENTION: Ninety subjects were randomly assigned to placebo or a ginkgo biloba-based supplement containing 160 mg ginkgo biloba, 68 mg gotu kola, and 180 mg decosahexaenoic acid per day for 4 months. MAIN OUTCOME MEASURES: Assessments included: six standardized cognitive function tests, the SF-36 Quality of Life questionnaire, the Platelet Function Analyzer-100 (Dade Behring, Eschbom, Germany), and the monitoring of adverse events. STATISTICAL ANALYSES: Baseline characteristics and study hypotheses were tested using analysis of covariance. Tests were two-tailed with a 0.05 significance level. RESULTS: Seventy-eight subjects (87%) completed both baseline and 4-month testing (n=36 in placebo group, n=42 in ginkgo biloba group). At baseline, the participants' cognitive function was above average. One of six cognitive tests indicated significant protocol differences at 4 months (P=0.03), favoring the placebo. There were no significant differences in quality of life, platelet function, or adverse events. CONCLUSIONS: These finding do not support the use of a ginkgo biloba-containing supplement for improving cognitive function or quality of life in cognitively intact, older, healthy adults. However, high baseline scores may have contributed to the null findings. The ginkgo biloba product seems safe and did not alter platelet function, though additional studies are needed to evaluate the interaction of varying doses of ginkgo biloba and ginkgo biloba-containing supplements with medications and supplements that alter hemostasis.

Relationship of ghrelin and leptin hormones with body mass index and waist circumference in a random sample of adults.

OBJECTIVE: To evaluate the relationship of ghrelin and leptin hormones with body mass index (BMI) and waist circumference in a population-based random sample of adult men and women subsequently categorized from normal weight to severely obese based on BMI criteria. The relationship between total ghrelin and leptin was also evaluated. DESIGN: A cross-sectional study was conducted on adults. METHODS: Two-hundred thirty-three men (n=107) and women (n=126) between the ages of 23 and 75 years were randomly selected from a database of over 600,000 adults who had previously participated in a population-based study conducted by the University of Utah Cardiovascular Genetics Program. Items collected included height, weight, waist circumference, and fasting blood samples. Blood samples were later thawed, and plasma leptin and total ghrelin levels were analyzed with radioimmunoassay kits. RESULTS: Leptin levels were directly associated with BMI (r=0.72, P=0.001) and waist circumference (r=0.71, P=0.0001), whereas total ghrelin was inversely associated with BMI (r=-0.39, P=0.001) and waist circumference (r=-0.37, P=0.001). There were also statistically significant linear changes in means across the BMI categories for both hormones. After controlling for BMI and waist circumference, the highly significant correlation of leptin with ghrelin (r=-0.39) was reduced but still significant (r=-0.17, P=0.01). CONCLUSION: Leptin increases and ghrelin decreases were linear over the five BMI categories, suggesting there is no threshold of BMI where the hormone levels change abruptly. There remain other factors beyond current BMI and waist circumference that induce a correlation of these two hormones. Further understanding of the role that each of these hormones has in influencing appetite and body weight may provide insight into mechanisms involved with obesity.

Physical activity does not attenuate the relationship between daily cortisol and metabolic syndrome in obese youth.

OBJECTIVE: We examined the associations among daily cortisol, physical activity (MVPA) and continuous metabolic syndrome score (cMetS) in obese youth. METHODS: Fifty adolescents (mean age 14.8 ± 1.9 years) were recruited from medical clinics. Daily MVPA (min/day) was assessed by accelerometry. Saliva was sampled at prescribed times: immediately upon waking; 30 min after waking; and 3, 6 and 9 h after waking. Fasting lipids, glucose, waist circumference and blood pressure were used to calculate a continuous metabolic syndrome score (cMetS). Multiple linear regression analysis was used to examine associations among variables. RESULTS: The mean cMetS score was 4.16 ± 4.30 and did not differ by clinic or sex. No significant relationship was found between cortisol area under the curve (cAUC) and cMetS, nor did the interaction of MVPA with cAUC significantly predict cMetS. CONCLUSIONS: Physical activity, cortisol, and metabolic risk were not associated in this sample of obese adolescents. Future research should examine the role of insulin sensitivity in these relationships.

Weight status, physical activity, and vascular health in 9- to 12-year-old children.

BACKGROUND: The purpose of this study was to determine the independent and joint association of weight status and physical activity on resting blood pressure and C-reactive protein in children. METHODS: Participants were 174 (71 males, 103 females) children (mean age = 10.5 ± 0.4 yrs). Physical activity was self-reported, body mass index was calculated from measured height and body mass, and blood pressure was measured according to standard procedures. A subset of 91 children had C-reactive protein measured by fingerstick blood sample. Four weight/physical activity groups were created by cross tabulation of weight status classification and physical activity level. RESULTS: The prevalence of low physical activity (< 5 days/wk moderate-vigorous activity) did not differ between overweight and normal weight children (50%). Physical activity was not correlated with C-reactive protein (r = 0.01; P = 0.91) and C-reactive protein was not significantly different between physical activity groups (P = 0.87). Physical activity did not modify the difference in blood pressure or C-reactive protein within weight categories. CONCLUSIONS: Fatness (specifically overweight and obesity), but not physical activity, was shown to be associated with blood pressure and C-reactive protein levels in children. Physical activity did not attenuate blood pressure or C-reactive protein in overweight and obese children.

Differences in energy expenditure between high- and low-volume training.

Several studies have examined energy expenditure in various sports but there is a lack of research on the contribution of exercise and habitual activity during different training periods. This study examined changes in total daily energy expenditure (TDEE) and its components during high- and low-volume training periods. Further, changes in time spent in sedentary, light, moderate and vigorous activity in response to different training volumes were explored. Energy expenditure was measured in 15 male endurance athletes during 2 non-consecutive weeks - 1 week of high volume (>13 hours) training and another week of low volume (<7 hours) training. The SenseWear Pro 3 Armband, individual heart-rate-oxygen consumption regression and indirect calorimetry was used to measure non-exercise activity thermogensis (NEAT), exercise energy expenditure (EEE) and resting metabolic rate, respectively. Time spent at different intensities was assessed using previously established MET cutpoints. TDEE as well as EEE increased significantly with higher training volume, while no difference in NEAT occurred. Further, significantly less time was spent in sedentary activities during the high-volume week. These results suggest that highly trained athletes do not compensate for increased training volume and reduce sedentary activities to allow for more training time.

Junk food consumption and screen time: association with childhood adiposity.

OBJECTIVES: To determine the joint association of junk food consumption (JFC) and screen time (ST) with adiposity in children. METHODS: Two hundred fourteen (121 girls, 93 boys) third-to-fifth-grade students (54% Hispanic, 35% African American, 8% white) completed a lifestyle behavior survey, which included self-reported JFC and ST, as part of a school-based lifestyle intervention program. RESULTS: Neither JFC nor ST, independently or jointly, was associated with adiposity measures. JFC and ST were significantly correlated (r = .375). CONCLUSIONS: The low achievement of physical activity and screen time recommendations and high prevalence of overweight/obesity in this mostly minority, low socioeconomic status population indicates a potential focus for intervention.

Physical activity and self-efficacy in normal and over-fat children.

OBJECTIVE: To examine the independent and combined association of self-efficacy and fatness with physical activity in 5(th) grade children. METHODS: Participants were 281 students (10.4 ± 0.7 years). Physical activity was assessed using a self-report question. Self-efficacy to be physically active was assessed using a 5-point scale. Body fatness was assessed by bioelectrical impedance. Descriptive statistics, ANOVA, and t-tests were used. RESULTS: There were no differences in reported days of physical activity between boys and girls, and normal-fat and over-fat children. However, children with high self-efficacy participated in significantly more physical activity compared to their low self-efficacy counterparts (3.4 ± 2.0 days vs. 5.4 ± 1.8 days, respectively, p < .001). CONCLUSIONS: Only physical activity self-efficacy was related to physical activity, fatness was not.

Energy expenditure and dietary intake during high-volume and low-volume training periods among male endurance athletes.

The primary purpose of this study was to examine dietary intake in endurance-trained athletes during a week of high-volume and a week of low-volume training while measuring exercise energy expenditure (EEE), resting metabolic rate (RMR), and nonexercise activity thermogenesis (NEAT). In addition, compliance with current American College of Sports Medicine/American Dietetic Association nutrition and performance recommendations for macronutrients was evaluated. Energy expenditure and dietary intake were measured in 15 male endurance athletes during 2 nonconsecutive weeks resembling a high-volume and a low-volume training period. Anthropometric measurements were taken and percentage body fat was determined at the beginning and end of each week of training. Total daily energy expenditure (TDEE) was calculated by summing RMR, NEAT, and EEE. Dietary intake was assessed with an online food-frequency questionnaire completed at the end of each week of data collection. Despite significant differences between TDEE and energy intake, no difference in body composition between the beginning and end of either week of training was observed, suggesting underreporting of caloric intake. Further, no changes in total caloric intake or macronutrient intake occurred even though TDEE increased significantly during the high-volume training. Reported carbohydrate intake (4.5 g·kg(-1)) and fiber intake (25 g·day(-1)) were below recommendations, whereas fat intake (1.3 g·kg(-1)) was slightly above recommendations. In summary, no short-term dietary adjustments occurred in response to differences in training regimen. Because these athletes were generally consuming a Western diet, they may have required some support to achieve desirable intakes for health and performance.

Joint association of physical activity/screen time and diet on CVD risk factors in 10-year-old children.

The increasing prevalence of childhood overweight and obesity has been associated with an increased risk for cardiovascular disease (CVD). While several studies examined the effect of single behaviors such as physical activity (PA), sedentary behavior or diet on CVD risk, there is a lack of research on combined associations, specifically in children. Therefore, the purpose of this study was to examine the joint association of PA or screen time (ST) and diet on CVD risk factors in children. PA, STand diet were assessed via questionnaire in 210 fifth grade students (age: 10.6 ± 0.4 years). The healthy eating index (HEI) was subsequently calculated as indicator for diet quality. Height, weight, % body fat, and resting blood pressure were measured according to standard procedures and blood samples obtained via fingerprick were assayed for blood lipids. Total cholesterol HDL ratio (TC:HDL), mean arterial pressure (MAP), and % body fat were used as indicators of CVD risk. 55% of children did not meet current PA recommendations on at least 5 days/week and 70% exceeded current recommendations for ST. Further, only 2.5% possessed a "good" diet (HEI> 80). There was no significant association of PA or STand diet on CVD risk score. Neither TC:HDL, MAP, and % body fat nor the total CVD risk score was significantly correlated with diet, PA, or ST. Children in the high PA group, however, had significantly better diet scores. Despite the fact that self-reported PA, ST, or dietary intake were not directly related to CVD risk in this sample, higher activity levels were associated with a healthier diet and lower ST indicating an overall healthier lifestyle of this subgroup.

Association between The Family Nutrition and Physical Activity Screening Tool and cardiovascular disease risk factors in 10-year old children.

OBJECTIVE: To examine the association of the Family Nutrition and Physical Activity (FNPA) screening tool with cardiovascular disease (CVD) risk factors in 10-year old children. METHODS: A total of 119 children were assessed for body mass index (BMI), percent body fat, waist circumference, total cholesterol, high-density lipoprotein-cholesterol (HDL), and resting blood pressure. A continuous CVD risk score was created using total cholesterol to HDL-cholesterol ratio (TC:HDL), mean arterial pressure (MAP), and waist circumference. The FNPA survey was completed by parents. RESULTS: The FNPA score was significantly correlated with adiposity measures (r = ?0.35 to ?0.43) and the continuous CVD risk score (r = ?0.22) (p < 0.05) but not with TC:HDL or MAP. The prevalence of overweight and obese (43.1% vs. 14.9%) and the mean values for BMI (20.3 ? 4.3 vs. 18.0 ? 2.7 kg/m(2)) and percent body fat (24.8 ? 8.3% vs. 20.1 ? 5.7%) were significantly higher in children with a FNPA score ? 25 when compared to those with a FNPA score > 25 (median split) (p < 0.05). The continuous CVD risk score was not significantly different between these two groups. Overweight and obese children had a significantly lower mean FNPA score when compared to normal weight children. CONCLUSION: Children from a high-risk, obesogenic family environment (determined using the FNPA) have a higher level of adiposity and CVD risk factor profile than children from a low-risk family environment. The FNPA screening tool can help identify children that may be at risk for overweight and adverse CVD risk factor development.