Sports participation plays a relevant role in the relationship between birth weight and bone mineral content in adolescents.

The Developmental Origins of Health and Disease hypothesis (DOHaD) proposes that growth during the prenatal period might play a critical role in health, affecting the development of diseases, such as osteoporosis. Bone health is particularly affected by human behaviors when sports participation constitutes the main manifestation of physical exercise. The aim of this study is to analyze the relationship between birth weight (BW) and bone mineral content (BMC) among adolescents, as well as to identify if sports participation and maturity can affect this relationship. The sample was composed of adolescents with ages ranging from 11 to 18 years, stratified according to normal birth weight (n = 331), low birth weight (n = 36), and macrosomia (n = 47), extracted from a wider cross-sectional study (ABCD Growth Study). BW was self-reported by the adolescent's parent. Sports participation was assessed by face-to-face interview. BMC was assessed using dual-energy X-ray absorptiometry. In the multivariate models, the relationships between BW and BMC remained non-significant, while sports participation was significantly related to BMC on lower limbs among boys (r = 0.154; p value = .001) and BMC of upper limbs among girls (r = 0.124; p value = .044). APHV was related to BMC of upper limbs among boys (r = 0.137; p value = .001). In conclusion, BMC was not affected by BW, while this phenomenon seems to be significantly affected by the positive impact of sports participation and maturation on it.

The impact of early sports participation on body fatness in adulthood is not mediated by current physical activity.

OBJECTIVE: The aim was to analyze the relationship between early sports participation (ESP) and body fatness (BF) in adults, as well as to identify whether this possible relationship is directly influenced by the current physical activity (PA) level. METHODS: This cross-sectional study combined baseline data of two cohort. The BF estimated by DXA. The ESP, the subjects reported the engagement in sports during childhood (7-10 years) and adolescence (11-17 years) through two yes/no questions and current PA (described as steps) was device-measured using pedometers. Were identified as potential covariates and therefore adjusted the multivariate models: age, ethnicity, alcohol consumption, smoking, and sleep quality. Statistical analysis consisted of the chi-square test, analysis of variance/covariance, and structural equation modeling (software BioEstat version 5.0; p-value < .05). RESULTS: Adults engaged in ESP had lower BF; among women, the variance in BF explained by ESP was 25.5%; among men, it was 9.2%. Sports participation in early life (r = -.436 [95% CI: -0.527 to -0.346]) and current PA (r = -.431 [95% CI: -0.522 to -0.340]) were inversely related to BF, as well as positively related to each other (r = .328 [95% CI: 0.226 to 0.430]). In the mediation model, current PA partially mediated (18.5%) the impact of ESP on BF, while current PA and ESP remained relevant determinants of BF. CONCLUSION: Early sports participation and current PA have a significant impact on BF in adulthood, which is of similar magnitude and independent of each other.

Resistance training presents beneficial effects on bone development of adolescents engaged in swimming but not in impact sports: ABCD Growth Study.

BACKGROUND: Sports practice during adolescence is important to enhance bone development, although it may provide different effects depending on the mechanical impact present in the sport. Besides, resistance training (RT) may also induce bone changes directly (via muscle contractions) and indirectly (via myokines). However, there have been no studies analyzing the longitudinal influence of engaging in sport with and without added mechanical load. Thus, this study aims to analyze the combined effects of sports participation and resistance training on areal bone mineral density (aBMD) accrual in adolescent athletes participating in swimming and impact sports for 12-months. METHODS: This was a 12-month longitudinal study. The sample comprised 91 adolescents (21 females) aged 10 to 18 years, engaged in impact sports (basketball, tennis, track & field, baseball and gymnastics, n = 66) and non-impact sport (swimming, n = 25). The sample was divided according to resistance training participation: impact sports only (n = 45), impact sports + resistance training (n = 21), swimming-only (n = 17) and swimming + resistance training (n = 8). aBMD and soft tissues were measured using dual-energy X-ray absorptiometry. Generalized linear models analysis was used for the resistance training (RT) x type of sport interaction in predicting aBMD changes overtime, adjusting for maturation, sex and baseline aBMD. RESULTS: After 12-months, all groups showed a significant increase in aBMD, except for the swimming groups (regardless of resistant training), which showed a significant loss in spine aBMD (-0.045 [-0.085 to -0.004] g/cm2 in swimming-only and - 0.047 [-0.073 to -0.021] g/cm2 in swimming + RT). In comparisons between groups, only swimming + RT group, compared with swimming-only group presented higher upper limbs aBMD (0.096 g/cm2 [0.074 to 0.118] in swimming + RT vs. 0.046 [0.032 to 0.060] g/cm2 in swimming only; p < 0.05) and whole body less head (WBLH) aBMD (0.039 [0.024 to 0.054] g/cm2 in swimming + RT vs. 0.017 [0.007 to 0.027] g/cm2 swimming-only; p < 0.05). CONCLUSION: Despite the significant gain in aBMD in all groups and body sites after 12-months, except for the spine site of swimmers, the results indicate that participation in RT seems to improve aBMD accrual in swimmers at the upper limbs and WBLH.

Interrelationship between muscle fitness in childhood and bone mineral density in adulthood: mediation analysis of muscle fitness in adulthood.

BACKGROUND: This study was aimed to examine the relationship between muscular fitness indicators in childhood and areal bone mineral density (aBMD) in adulthood and to verify whether the relationship is mediated by performance on muscular fitness indicators in adulthood. METHODS: A sample of 138 healthy adults (69 males; 22.3 years) were followed after a previous assessment at the age of 7-10 years. Stature, body mass and muscular fitness indicators (handgrip strength, standing long jump and sit-ups tests) were assessed in childhood and adulthood. Additionally, total body, upper limbs, lower limbs, right femoral neck and lumbar spine aBMD was assessed in adulthood using dual X-ray absorptiometry. Analysis included descriptive statistics; t-test or Mann-Whitney U-test for comparison between males and females, multiple linear regression for the prediction aBMD from muscular fitness indicators in childhood, mediation analysis of the respective muscular fitness indicators in adulthood and the relationship between muscular fitness indicators in childhood and aBMD. RESULTS: Males were stronger compared to females regarding muscular fitness indicators in childhood and adulthood, and presented higher mean values for aBMD in adulthood, except for lumbar spine (p < 0.05). Regression analysis revealed that some muscular fitness indicators in childhood showed significant positive relationship with bone health indicators in adulthood, such as: handgrip strength and total body aBMD (ß = 0.005; R2 = 0.35; p = 0.040) and upper limbs aBMD (ß = 0.005; R2 = 0.55; p = 0.019); and sit-ups test was a significant predictors of lumbar spine BMD (ß = 0.003; R2 = 0.06; p = 0.039). Mediation analysis pointed out the following: adulthood handgrip strength mediated relationships between childhood handgrip strength and total aBMD (indirect effect (IE) = 0.0025; 95%CI = 0.0005-0.0048), and upper limbs aBMD (IE = 0.0040; 95%CI = 0.0017-0.0069). CONCLUSIONS: Muscular fitness indicators in childhood showed significant relationship with bone health indicators in adulthood and the sit-ups test in childhood had direct effect on lumbar spine aBMD in adulthood. Adulthood handgrip strength mediated the relationship between childhood handgrip strength and total body and upper limb aBMD, pointing out that muscular fitness in childhood may be a aBMD determinant in adulthood, especially when higher muscle fitness performance is maintained in adulthood.

The Combined Relationship of Vitamin D and Weight-Bearing Sports Participation on Areal Bone Density and Geometry Among Adolescents: ABCD - Growth Study.

Osteoporosis is a public health problem, which negatively impacts society and national health services worldwide. Altered mineralization of the skeleton can be caused by persistent vitamin D deficiency. However, the combined impact of both on bone health is still under investigation. In fact, although there is compelling evidence in the literature about the positive effect of weight-bearing sports participation on bone mineral density, its impact on bone geometry gains more attention in pediatric population. The sports modalities that we evaluated were artistic gymnastics and track and field. Nonsports group was composed of 43 adolescents. Bone density was assessed using dual-energy X-ray absorptiometry. Vitamin D concentration was assessed by blood analysis. In the crude comparison of bone outcomes, the sport group presented higher aBMD only in the trochanter (p-value = 0.040). Considering the combination of the engagement in sports and vitamin D, adolescents in the sports group presented significantly higher values of aBMD in lower limbs, whole body, trochanter, shaft, and femur whole body (p-value = 0.024, 0.035, 0.001, 0.019 and 0.003 respectly). In contrast, only the sport group with high vitamin D presented a higher CSA (p-value = 0.015) and femur neck aBMD compared to the non-sport/low vitamin D group. Only adolescents with a combination of sports participation and higher serum concentrations of vitamin D presented better bone geometry, denoting the relevance of the combination of both factors to bone health.

Relationship Between Muscle Strength, Body Composition and Bone Mineral Density in Adolescents.

Adolescence is an important period for the acquisition of bone mass, which can be enhanced by several factors. This study aimed examine the relationships of handgrip strength, free-fat mass, and fat mass with bone mineral density in adolescents. 118 adolescents (60 girls), aged 10 to 14 years, participated in the study. Information on sex, age, handgrip strength, free-fat mass, fat mass and bone mineral density were collected. Multiple linear regression analyses were conducted to examine possible relationships between bone mineral density and handgrip strength, free-fat mass and fat mass. There was a relation between handgrip strength and free-fat mass with bone mineral density in both sexes. Fat mass was correlated with bone mineral density only in girls (r= 0.314, p< 0.014). The final models, adjusted for sexual maturation, included free-fat mass (girls - ß= 0.419, p< 0.001; boys - ß= 0.455; p< 0.001) and handgrip strength (girls - ß= 0.358, p< 0.05; boys - ß= 0.325; p< 0.05) and these variables together explained 51.8% and 62.9% of the variation of bone mineral density, in girls and boys, respectively. Handgrip strength and free-fat mass were positively associated with bone mineral density. A sex-specific difference indicated that higher levels of free-fat mass are of paramount importance for both sexes.

Relationship between vigorous physical activity and health care costs among adolescents: ABCD Growth Study.

BACKGROUND: The relationship between physical activity and health care costs among adolescents is not yet clear in the literature. OBJECTIVE: To analyze the relationship between physical activity and annual health care costs among adolescents. METHODS: The present sample was composed of 85 adolescents of both sexes with ages ranging from 11 to 18 years (mean age 15.6 ± 2.1). Health care costs were self-reported every month for 12 months, and information on health care values was verified with local pharmacies, private health care plans, and the National Health Service. The time spent in different physical activity intensities was objectively measured by accelerometers. Confounding variables were: sex, age, somatic maturation, body fatness, blood pressure, and components of dyslipidemia and insulin resistance. Multivariate models were generated using generalized linear models with gamma distribution and a log-link function. RESULTS: The overall annual health care cost was US$ 733.60/ R$ 2,342.38 (medication: US$ 400.46 / R$ 1,278.66; primary and secondary care: US$ 333.14 / R$ 1,063.70). The time spent in vigorous physical activity (minutes/day) was negatively related to health care costs (r = -0.342 [95% CI: -0.537,-0.139]; ß = -0.06 cents (95% CI: -0.089, -0.031). CONCLUSION: Vigorous physical activity seems to be associated with lower health care costs among adolescents.

Characterization of subclinical diastolic dysfunction by cardiac magnetic resonance feature-tracking in adult survivors of non-Hodgkin lymphoma treated with anthracyclines.

BACKGROUND: The use of anthracycline-based chemotherapy is associated with the development of heart failure, even years after the end of treatment. Early detection of cardiac dysfunction could identify a high-risk subset of survivors who would eventually benefit from early intervention. Cardiac magnetic resonance feature-tracking (CMR-FT) analysis offers a practical and rapid method to calculate systolic and diastolic strains from routinely acquired cine images. While early changes in systolic function have been described, less data are available about late effects of chemotherapy in diastolic parameters by CMR-FT. The main goal of this study was to determine whether left ventricular (LV) early diastolic strain rates (GDSR-E) by CMR-FT are impaired in long-term adult survivors of non-Hodgkin lymphoma (NHL). Our secondary objective was to analyze associations between GDSR-E with cumulative anthracycline dose, systolic function parameters and myocardial tissue characteristics. METHODS: This is a single center cross-sectional observational study of asymptomatic patients in remission of NHL who previously received anthracycline therapy. All participants underwent their CMR examination on a 3.0-T scanner, including cines, T2 mapping, T1 mapping and late gadolinium enhancement imaging. Derived myocardial extracellular volume fraction was obtained from pre- and post-contrast T1 maps. CMR-FT analysis was performed using Trufi Strain software. The data obtained were compared between anthracycline group and volunteers without cardiovascular disease or neoplasia. RESULTS: A total of 18 adult survivors of NHL, 14 (77.8%) males, at mean age of 57.6 (± 14.7) years-old, were studied 88.2 (± 52.1) months after exposure to anthracycline therapy (median 400 mg/m2). Compared with controls, anthracycline group showed impaired LV global early diastolic circumferential strain rate (GCSR-E) [53.5%/s ± 19.3 vs 72.2%/s ± 26.7, p = 0.022], early diastolic longitudinal strain rate (GLSR-E) [40.4%/s ± 13.0 vs 55.9%/s ± 17.8, p = 0.006] and early diastolic radial strain rate (GRSR-E) [- 114.4%/s ± 37.1 vs - 170.5%/s ± 48.0, p < 0.001]. Impaired LV GCSR-E, GLSR-E and GRSR-E correlated with increased anthracycline dose and decreased systolic function. There were no correlations between GDSR-E and myocardial tissue characteristics. CONCLUSIONS: Left ventricular early diastolic strain rates by CMR-FT are impaired late after anthracycline chemotherapy in adult survivors of non-Hodgkin lymphoma.

Sports participation improves metabolic profile in adolescents: ABCD growth study.

To analyze the impact of participation in sports with different cardiorespiratory fitness (CRF) demands on changes in metabolic and cardiovascular markers in adolescents. Longitudinal study with 12 months of follow-up (Analysis of Behaviors of Children During Growth [ABCD Growth Study]). Overall, 184 adolescents (age 15.6 ± 2.1) were classified according to sports participation: non-sport (control), low CRF sports, and high CRF sports. Metabolic outcomes were total cholesterol (TC) and its fractions, triacylglycerol (TG), glucose, insulin levels, and the insulin resistance index. Cardiovascular outcomes were arterial thickness (carotid and femoral [ultrasound]), blood pressure, and resting heart rate. Adolescents engaged in sports classified as high CRF demand presented a significant increase in HDL-c (1.2 mg/dL [95%CI: -0.5 to 3.0]) when compared to the non-sport group (-2.4 mg/dL [95%CI: -4.4 to -0.5]). Regular engagement in high CRF sports was significantly related to changes in TC (ß = -0.027 [95%CI: -0.048 to -0.005]), HDL-c (ß = 0.009 [95%CI: 0.001 to 0.019]), LDL-c (ß = -0.032 [95%CI: -0.049 to -0.016]), and glucose (ß = -0.017 [95%CI: -0.025 to -0.008]), while engagement in low CRF sports was related to changes in TG (ß = -0.065 [95%CI: -0.112 to -0.019]). No significant relationships for cardiovascular parameters were observed in the low CRF group, but one significant relationship was found between high CRF sports and changes in SBP (ß = -0.063 [95%CI: -0.117 to -0.009]). In conclusion, engagement in sports seems to be beneficial for improvements in metabolic and cardiovascular parameters in adolescents, mainly sports with higher CRF demand.

Influential role of lean soft tissue in the association between training volume and bone mineral density among male adolescent practitioners of impact-loading sports: ABCD Growth study.

BACKGROUND: Training volume is associated with direct and indirect pathways of bone adaptations. In addition, training volume is a training variable associated with lean soft tissue (LST), which has been shown to be an important predictor of areal bone mineral density (aBMD). Thus, the aim of this study is to investigate the influential role of lean soft tissue (LST) in the association between training volume and aBMD in male adolescent athletes. METHODS: This cross-sectional study was composed of 299 male adolescent athletes, mean age 14.1 (1.8) years, from 9 different weight-bearing modalities. The Ethical Board approved the investigation. The adolescents reported the number of days per week they trained and the time spent training and, from this, the training volume (h/wk) was estimated. The LST and aBMD were assessed by dual-energy x-ray absorptiometry. Somatic maturation was estimated by the peak of height velocity. Mediation analysis was performed to investigate the role of LST in the association between training volume and aBMD. Level of significance was set at p < 0.05. RESULTS: LST partially explained the association between training volume and aBMD in all body segments: upper limbs (58.37%; ß = 0.00142), lower limbs (28.35%; ß = 0.00156), spine (33.80%; ß = 0.00124), and whole body (41.82%, ß = 0.00131). There was no direct effect of training volume on aBMD in upper limbs (CI -0.00085 to 0.00287). CONCLUSION: The association between training volume and aBMD is influenced by LST in different body segments, mainly upper limbs, demonstrating that interventions aiming to enhance aBMD should also consider LST as an important variable to be managed.

Participation in Non-professional Sports and Cardiovascular Outcomes Among Adolescents: ABCD Growth Study.

OBJECTIVES: Sports are an important way to improve health during adolescence. However, it is still unclear whether the association between sports, blood pressure, and metabolic profile could be affected by sex, biological maturation, and trunk fatness. The aim of this study was to analyze the association between sports participation and the cluster of cardiovascular markers among adolescents of both sexes. METHODS: A cross-sectional study involving 285 adolescents aged from 11 to 17 years of age (202 boys and 83 girls). Cardiovascular variables were composed of systolic blood pressure (SBP), diastolic blood pressure (DBP), resting heart rate (RHR), and carotid (CIMT) and femoral (FIMT) intima-media thickness, which were used to calculate the CardiovascularZ score. Sports participation was assessed through a face-to-face interview. Age of peak height velocity (APHV) was used as a covariate. RESULTS: Among girls, the group engaged in sports presented lower values of RHR (sport: - 0.344 [95% CI - 0.650 to - 0.037] versus non-sport: 0.540 [95% CI 0.125 to 0.954]) and CardiovascularZ score (sport: - 0.585 [95% CI - 1.329 to 0.159] versus non-sport: 0.879 [95% CI - 0.127 to 1.884]), explaining 12.2% and 6.1% of all variance, respectively. Among boys, the group engaged in sports presented lower values of DBP (sport: - 0.158 [95% CI - 0.335 to 0.018] versus non-sport: 0.160 [95% CI - 0.091 to 0.412]) and FIMT (sport: - 0.128 [95% CI - 0.300 to - 0.044] versus non-sport: 0.211 [95% CI - 0.032 to 0.454]), explaining 2.2% and 2.6% of all variance, respectively. CONCLUSIONS FOR PRACTICE: Adolescents engaged in sports presented healthier cardiovascular parameters, and sports participation seems to affect cardiovascular health differently in boys and girls.

Sports participation is inversely associated with C-reactive protein levels in adolescents: ABCD Growth Study.

OBJECTIVE: To analyze the relationship between sports participation and C-reactive protein (CRP) levels in adolescents and to identify the possible role of mediation developed by trunk fatness (TF). METHODS: Cross-sectional design, part of the longitudinal study entitled "Analysis of Behaviors of Children During Growth" (ABCD Growth Study), Presidente Prudente, SP, Brazil. The sample comprised 259 adolescents (14.7 ± 2.1 [182 boys and 77 girls]) stratified according to sex and engagement in sports in agreement with the inclusion criteria: absence of any known diseases; previous engagement in sports for at least 12 months (≥300 minutes weekly); no regular engagement in sports in the previous 12 months (non-regular sports participation or <300 min/wk); written parental consent and adolescents' assent both signed. Engagement in sports was self-reported. CRP levels were used to assess the inflammatory status. TF was estimated by a densitometer scanner. Age, biological maturation, HOMA-IR, and blood pressure were treated as covariates. RESULTS: There was no mediation effect of TF in the association of any indicators of sports practice and CRP. However, a direct effect of sports was observed on CRP levels when considering previous months of engagement, frequency, and volume of sports for boys and also previous months of engagement in sports for girls. CONCLUSION: Previous sports participation and the amount of engagement in sports per week (≥300 min/wk) presented an inverse relationship with CRP levels; however, trunk fatness did not mediate this process.

Sedentary behaviour is associated with diabetes mellitus in adults: findings of a cross-sectional analysis from the Brazilian National Health System.

BACKGROUND: Sedentary behaviour (SB) may contribute to the development of several chronic diseases, such as hypertension, diabetes mellitus (DM) and all-cause mortality. The aim of this study is to investigate the association between different domains of SB with diabetes among adult users of the Brazilian National Health System (NHS). METHODS: Cross-sectional study from the primary care system of the Brazilian NHS in the city of Bauru, Brazil. SB, physical activity (PA), DM and other chronic diseases were assessed by face-to-face interviews and medical records. As potential confounders in the adjusted model, we used gender, age, economic status, smoking status, hypertension, hypercholesterolaemia and PA. RESULTS: The study was composed of 147 men and 410 women. The fully adjusted model showed that Brazilian adults spending ≥3 h per day in television viewing (OR = 1.61 [95% CI: 1.11-2.33]) and overall SB (OR = 1.60 [95% CI: 1.09-2.36]) had increased prevalence of DM compared to those spending <3 h per day. CONCLUSIONS: TV viewing and overall SB was associated with higher prevalence of DM in Brazilian adults from the NHS, even after controlling for potential confounders including PA.

Impact of sports participation on mortality rates among Brazilian adults.

Objective: To analyze the possible dose-response association between components of sports participation (intensity, volume and previous engagement) and 4-year mortality rates among Brazilian adults. Methods: 679 males and females (mean age among men = 66.7 ± 9.3 years old and mean age among women = 64.8 ± 8.9 years old) composed the study sample. Sports participation was assessed using Baecke's questionnaire, which considers intensity, duration and previous engagement. Medical records were used to identify the cause of the death. Cox regression analysis was performed to determine the independent associations of exercise components and mortality. Results: Participants that reported exercising at moderate-vigorous intensity (Moderate/vigorous: 4.1% versus None/light: 10.3% [p-value = 0.012]; HR = 0.42 [0.1 to 0.94)] and for more than four months (≥4 months: 5.3% versus <4 months: 10.2% [p-value = 0.038]; HR = 0.47 [0.24 to 0.94]) had lower mortality risk. The percentage of survival according to all-cause mortality was significantly higher for participants engaged in sports at moderate-vigorous intensity (p-value = 0.014), as well as for those engaged in sports for periods superior than four months (p-value = 0.036). Conclusion: We found higher percentage of survival among adults engaged in sports at moderate-vigorous intensity and with at least four months of previous engagement.

Association of TV Viewing and All-Cause Mortality in Older Adults With Hypertension: A 6-Year Longitudinal Study.

The purpose of this study was to examine the longitudinal association between television (TV) viewing and all-cause mortality in older adults with hypertension. Sedentary behavior, physical activity, hypertension, and other chronic diseases were assessed by face-to-face interviews and confirmed by medical history. Mortality was reported by relatives and confirmed in medical records of the National Health System. The fully adjusted model showed a direct association between high TV viewing time and all-cause mortality; hazard ratio: 1.65 (95% confidence interval [1.02-2.68]). Women with high TV viewing were more likely to die than men. Higher TV viewing time was associated with all-cause mortality among those with diabetes and hypertension; hazard ratio: 3.54 (95% confidence interval [1.64-7.66]). The findings from this longitudinal study show that higher TV viewing time is associated with higher risk for all-cause mortality among older adults with hypertension, independently of physical activity, and other potential confounders.

Sport-based physical activity recommendations and modifications in C-reactive protein and arterial thickness.

We analyzed the effects of 1 year of engagement in ≥ 300 min/week of organized sports on inflammatory levels and vascular structure in adolescents. The sample was composed of 89 adolescents (11.6 ± 0.7 years old [43 boys and 46 girls]), stratified according to engagement in ≥ 300 min/week of sport practice during at least 12 months of follow-up (n = 15, sport practice; n = 74, non-sport practice). Arterial thickness (carotid and femoral) was assessed by ultrasound scan, while high sensitive C-reactive protein levels were used to assess inflammatory status. Trunk fatness (densitometry scanner), biological maturation (age at peak height velocity), blood pressure, and skipping breakfast were treated as covariates. Independently of body fatness and biological maturation, the group engaged in sports presented a higher reduction in C-reactive protein (mean difference -1.559 mg/L [95%CI -2.539 to -0.579]) than the non-sport group (mean difference -0.414 mg/L [95%CI -0.846 to 0.017]) (p = 0.040). There was a significant relationship between changes in C-reactive protein and changes in femoral intima-media thickness in the non-sport group (r = 0.311 [95%CI 0.026 to 0.549]). CONCLUSION: Inflammation decreased in adolescents engaged in organized sports, independently of trunk fatness and biological maturation. Moreover, inflammation was related to arterial thickening only in adolescents not engaged in sports. What is Known: • Intima media thickness is a relevant marker of cardiovascular disease in pediatric groups, being affected by obesity and inflammation. • The importance of monitoring inflammatory markers from childhood is enhanced by the fact that alterations in these inflammatory markers in early life predict inflammation and alterations in carotid IMT in adulthood. What is New: • Anti-inflammatory properties related to physical exercise performed at moderate intensity, on inflammation and alterations in IMT are not clear in pediatric groups. • Due to the importance that sport participation has assumed as a promoter of improvements in health and quality of life, it is necessary to understand its potential benefits for cardiovascular health during human growth.

Sport Participation and Metabolic Risk During Adolescent Years: A Structured Equation Model.

Sports practice during childhood can influence health indicators in later ages through direct and indirect pathways. Thus, this study aimed to test direct and indirect pathways to the association between sports practice in childhood and metabolic risk in adolescence, adopting physical activity, adiposity, and cardiorespiratory fitness at adolescence as potential mediators. This cross-sectional study with retrospective information was conducted with 991 adolescents (579 girls, 412 boys) aged 10 to 16 y. Sports activity was self-reported in childhood (retrospective data) and physical activity evaluated in adolescence through questionnaires. Somatic maturation (Mirwald method), cardiorespiratory fitness (20-m shuttle-run test), body fat (skinfolds), waist circumference, blood pressure (automatic instrument) and blood variables (fasting glucose, HDL cholesterol, and triglycerides) were measured at adolescence. Waist circumference, blood pressure and blood variables composed the metabolic risk score. Structured equation modeling was adopted. In both sexes, the relationship between sports practice at childhood and metabolic risk was fully mediated by habitual physical activity, which is related to the obesity construct and cardiorespiratory fitness. Obesity was associated with metabolic risk in boys (ß=0.062; p<0.001) and girls (ß=0.047; p<0.001). The relationship between sports practice in childhood and metabolic risk in adolescence was mediated by physical activity, obesity, and cardiorespiratory fitness.

Association between Cluster of Lifestyle Behaviors and HOMA-IR among Adolescents: ABCD Growth Study.

Objective: To analyze the association of potential risk factors to health with body fatness and insulin resistance. Baseline measures of the ongoing longitudinal Analysis of Behaviors of Children During (ABCD) Growth Study. Materials and Methods: The sample was composed of 280 adolescents of both sexes (198 boys and 82 girls) aged from 10 to 18 years. Four risk factors were considered, as follows: no sports practice, skipping breakfast, poor sleep quality, and TV viewing. The outcomes considered were insulin resistance (HOMA-IR) and body fatness (densitometer scanner). Age, sex, maturity offset, and ethnicity were treated as covariates. Results: No sports practice and skipping breakfast were associated with higher body fatness (Sports practice: Wald: 8.786; p = 0.003. Breakfast: Wald: 9.364; p = 0.002). Poor sleep quality was related to a greater HOMA-IR index (Wald: 6.013; p = 0.014). Adolescents with ≥3 risk factors presented a higher risk of high HOMA-IR (OR = 4.89 (95%CI: 1.61 to 14.84)) than their counterparts with no risk factors. Conclusion: Lifestyle risk factors seem relevant to affect obesity and insulin resistance, while the aggregation of these risk factors affects insulin resistance, independent of adiposity.

Objectively Measured Physical Activity and Healthcare Expenditures Related to Arterial Hypertension and Diabetes Mellitus in Older Adults: SABE Study.

Research using questionnaires has shown that physical activity level (PAL) is associated with healthcare costs. The purpose of this study was to examine the association between objectively measured PAL and healthcare costs among hypertensive and diabetic noninstitutionalized Brazilian older people. The method consisted of a cross-sectional study forming part of the SABE Study, composed of 377 older people interviewed in 2010. Expenditures were estimated taking into account self-reported medicine prescription, outpatient service, and hospitalizations, with the highest quartile of expenditures considered as a risk category. PAL was estimated using an Actigraph accelerometer. Associations were expressed as odds ratios and 95% confidence intervals, adjusted for covariates. Overall expenditures were higher in the sedentary group. The insufficiently active group presented greater odds for higher total, outpatient, and hospitalization expenditure. It was concluded that healthcare expenditures were lower in more active hypertensive and diabetic older people. The promotion of physical activity could be relevant in the attenuation of the burden of chronic diseases in economic losses.

The mediating role of physical inactivity on the relationship between inflammation and artery thickness in prepubertal adolescents.

OBJECTIVE: To analyze the relationship between inflammatory markers and the lipid profile, blood flow, and artery structure in prepubertal adolescents stratified according to sports practice. STUDY DESIGN: The sample was composed of 120 adolescents (57 boys and 63 girls) with a mean age of 11.7 ± 0.7 years (ranging from 11 to 13 years). Intima-media thickness (IMT) and blood flow were measured with ultrasonography. The lipid profile and high-sensitivity C-reactive protein were measured after the subjects had fasted for 12 hours overnight. Trunk fatness was measured by dual-energy x-ray absorptiometry. Organized sports participation was analyzed as a categorical variable. Biological maturation was determined via the age at peak height velocity. RESULTS: In the adjusted model, high-sensitivity C-reactive protein was significantly related to high-density lipoprotein-cholesterol (ß = -5.797 [-11.500 to -0.093]), femoral IMT (ß = 0.062 [0.008-0.116]), and the sum of femoral and carotid IMT (ß = 1.107 [0.223-1.919]), but only in the group without sports participation. Slopes of the crude linear regression were greater in the group without sports participation for femoral IMT (t = 2.621; P = .009) and the sum of femoral and carotid IMT (t = 2.876; P = .004) when compared with the group with sports participation. CONCLUSION: Independent of body fatness and biological maturation, inflammatory status was related to artery IMT and dyslipidemia in prepubertal adolescents, modulated by sport participation.