Muscle Strength Indexes and Its Association With Cardiometabolic Risk Factors in Adolescents: An Allometric Approach.

Background and aims: Muscle strength (MS) has been associated with better cardiometabolic health prognosis. However, the result for the beneficial relationship seems to be dependent on the influence of body size in determining MS levels. We investigate the association between allometric MS indexes and its association with cardiometabolic risk factors in adolescents. Methods: It was a cross-sectional study comprising 351 adolescents (male: 44.4%; age range 14-19 years) from Southern Brazil. MS was assessed by handgrip strength and three different allometric approaches were adopted: 1) MS index based on theoretical allometric exponent; 2) MS index including body mass and height; 3) MS index including fat-free mass and height. Obesity, high blood pressure, dyslipidemia, glucose imbalance and high-sensitivity C-reactive protein were investigated as individual factors or as combinations (either as combinations of components - presence of two adverse conditions, or number of components present in an individual - 0, 1, 2, 3+ cardiometabolic risk factors). Logistic and multinomial logistic regression analyses adjusted for confounding factors were used. The statistical significance adopted was 5%. Results: MS index based on theoretical allometric exponent was associated with lower likelihood (OR: 0.54; 95% CI: 0.28 - 0.89) for the presence of three or more cardiometabolic risk factors in the same individual. Conclusion: This study suggests that MS index based on the theoretical allometric exponent can be superior to allometric MS indexes that included body mass and height, or fat-free mass and height in representing the presence of high number of cardiometabolic risk factors in adolescents.

Clusters of lifestyle behaviors associated with atherosclerosis risk factors in children and adolescents with congenital heart disease: Floripa CHild Study.

Secondary cardiovascular disease is the main cause of mortality in congenital heart disease (CHD) patients. The cardiovascular risk could be widely prevented with adherence to a healthy lifestyle; however, clusters of lifestyle behaviors related to atherosclerosis risk factors in children and adolescents with CHD remain unclear. We aimed to describe the clusters of lifestyle behaviors of children and adolescents with CHD and to evaluate their association with atherosclerosis risk factors. We conducted a cross-sectional study on 227 children and adolescents with CHD (median age:10.02 [IQR:7.08-13.02] years). Dietary intake, physical activity (PA), and sedentary behavior (SB) were evaluated. Clusters of lifestyle behaviors were determined using a two-step cluster analysis. Atherosclerosis risk factors evaluated include body fat mass, central obesity, blood pressure, lipid parameters, glucose, C-reactive protein, and carotid intima-media thickness (cIMT). Multiple logistic regressions were used. The "unhealthy: high SB + low PA" cluster was associated with elevated body fat mass, central obesity, and elevated cIMT. Furthermore, the "unhealthy: low PA + unhealthy eating habits" cluster was associated with elevated body fat mass, central obesity, and elevated glucose. The unhealthier lifestyle behavior clusters were associated with atherosclerosis risk factors in children and adolescents with CHD. Multidisciplinary strategies to promote healthy behaviors are needed to prevent cardiovascular disease in later life.

Muscle Strength Assessed by Handgrip Strength Moderates the Relationship Between Overweight and Obesity With Cardiometabolic Risk Markers Among Adults and Older Adults.

Background and aims: Few population-based studies have studied whether muscle strength (MS) levels influence the relationship between cardiometabolic markers with excess body weight. We investigate the possible moderator role of MS in the relationship between overweight and obesity with cardiometabolic markers. Methods: Cross-sectional analysis using data from two studies in Florianópolis, Brazil (EpiFloripa Adult Cohort Study, n = 862, 39.3 ± 11.4 years; EpiFloripa Aging Cohort Study, n = 1,197, 69.7 ± 7.1 years). MS was assessed by handgrip strength. Body mass index (BMI) was classified as overweight or obesity (BMI 25.0-29.9 or ≥30.0 kg/m2, respectively). Cardiometabolic markers included systolic (SBP) and diastolic blood pressure (DBP), C-reactive protein (CRP), lipids, glucose markers, and carotid intima-media thickness (CIMT). Linear regression models stratified by age groups (adults: <60 years; older adults: ≥60 years) and adjusted for confounders were used. Results: Compared to those with a normal BMI, overweight and obesity were related to higher SBP, DBP, lnCRP, ln triglycerides, fasting glucose (FG), and glicated hemoglobin (HbA1c), and inversely associated with HDL-C among adults and older adults (p value < .05 for all). Additionally, BMI was positively associated with LDL-C and CIMT only among adults (p value < .05). Among adults and older adults, elevated MS attenuated the adverse relationship between excess body weight with FG and HbA1c. Conclusion: Higher MS might help adults and older adults with overweight or obesity reduce their cardiovascular risk by keeping their FG and HbA1c at the same levels of those with a normal BMI.

Individual and Combined Association Between Healthy Lifestyle Habits With Muscle Strength According to Cardiovascular Health Status in Adults and Older Adults.

BACKGROUND: The authors aimed to identify the effect of adherence to healthy lifestyle habits on muscle strength (MS) according to a distinct health status. METHODS: Longitudinal analysis using data from 2 population-based cohorts in Brazil (EpiFloripa adult, n = 862, 38.8 [11.4] y-6 y of follow-up length; EpiFloripa Aging, n = 1197, 69.7 [7.1] y-5 y of follow-up length). MS was assessed by handgrip strength (kgf). Information assessed by questionnaire regarding adequate physical activity levels, regular consumption of fruit and vegetables, low alcohol consumption, and nonsmoking habits were analyzed in the relationship with MS according to the health status. The participants were grouped into 3 health status categories: (1) with cardiovascular disease (CVD); (2) at risk of CVD (abdominal obesity or overweight/obesity, high blood pressure, hyperglycemia, and dyslipidemia); and (3) healthy individuals (without CVD and risk of CVD). RESULTS: Simultaneous adherence of 4 healthy lifestyle habits was directly associated with MS among healthy individuals (ß = 10.0, 95% CI, 2.0-18.0, SE = 4.0), at risk of CVD (ß = 5.5, 95% CI, 0.3-12.6, SE = 3.6), and those with CVD (ß = 11.4, 95% CI, 5.8-16.7, SE = 2.8). CONCLUSIONS: Adopting a healthy lifestyle can contribute to increased MS in adults and older adults, regardless of health status.

Association between muscle strength and risk factors for metabolic syndrome in children and adolescents: a systematic review.

The aim of this systematic review was to identify and summarize evidence for the association between muscle strength (MS) and metabolic syndrome (MetS), and MS and combinations of risk factors for MetS in children and adolescents. Five databases (Medline/PubMed, EBSCO, Scielo, Scopus, and Web of Knowledge) were searched up to November 2019 with complementary reference list searches. Inclusion criteria were studies that investigated the relationship between MS and MetS or MS and combinations of risk factors for MetS in children and adolescents (≤19 years of age). Risk of bias was assessed using standard procedures. From the total of 15,599 articles initially identified, 13 articles were included, representing 11,641 children and adolescents. Higher MS values were associated with lower risk for MetS or combinations of risk factors for MetS (n=11/13 studies). Of the total of included studies, about 23.1% (03/13) were longitudinal and all included studies were classified as having a moderate risk of bias. This review provides preliminary evidence for a beneficial relationship between MS and MetS among children and adolescents. Additionally, although the body of evidence points to the beneficial relationship between higher MS and lower risk for combination of factors for MetS in children and adolescents, this relationship is inconclusive.