Pediatrics

Physical activity attenuates metabolic risk of adolescents with overweight or obesity: the ICAD multi-country study

Abstract

Background

Although the benefits of physical activity (PA) at an early age are well established, there is no robust evidence of the role of PA as well as its intensities in attenuating the association between weight status and metabolic risk among adolescents. In this investigation, we analyzed the association between weight status, intensities of PA, and metabolic risk among adolescents.

Methods

Data from six cross-sectional studies in the International Children’s Accelerometry Database were used (N = 5216 adolescents; boys 14.6 ± 2.1 years and girls 14.7 ± 2.0 years). Weight status was assessed and classified according to body mass index. Fasting glucose, triglycerides, inverse high-density lipoprotein cholesterol, and blood pressure composed the metabolic risk indicator (z-score). PA was measured by accelerometers. The estimated age of peak height velocity was used as a covariate for somatic maturation.

Results

We observed that increase in weight status showed a strong positive relationship with metabolic risk. However, adolescents with overweight or obesity in the highest tertile of PA (moderate-to-vigorous and vigorous intensity) showed a similar metabolic risk score as the normal weight groups. Moderate intensity PA seemed related to metabolic risk even within some categories of vigorous PA.

Conclusions

We conclude that PA attenuates the metabolic risk of adolescents with overweight or obesity. Although this attenuation is largely explained by vigorous PA, moderate intensity seems also important for better metabolic profile.

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Fig. 1: Metabolic risk score according to weight status and tertiles of different intensities of physical activity in adolescents.

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Acknowledgements

The authors thank all participants and funders of the original studies that contributed data to the ICAD, all ICAD collaborators, and Prof. Chris Riddoch, Prof. Ken Judge, and Dr Pippa Griew. The ICAD collaborators include Prof. S. Anderssen, Norwegian School for Sport Science, Oslo, Norway (EYHS, Norway); Prof. G. Cardon, Department of Movement and Sports Sciences, Ghent University, Belgium (Belgium Preschool Study); Centers for Disease Control and Prevention, National Center for Health Statistics, Hyattsville, Maryland, USA (NHANES); Prof. A. Cooper, Centre for Exercise, Nutrition and Health Sciences, University of Bristol, Bristol, UK (Personal and Environmental Associations with Children’s Health [PEACH]); Dr R. Davey, Centre for Research and Action in Public Health, University of Canberra, Canberra, Australia (Children’s Health and Activity Monitoring for Schools [CHAMPS]); Prof. U. Ekelund, Norwegian School of Sport Sciences, Oslo, Norway, and MRC Epidemiology Unit, University of Cambridge, Cambridge, UK; Dr D.W. Esliger, School of Sports, Exercise, and Health Sciences, Loughborough University, Loughborough, UK; Dr K. Froberg, University of Southern Denmark, Odense, Denmark (EYHS, Denmark); Dr P. Hallal, Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil (1993 Pelotas Birth Cohort); Prof. K.F. Janz, Department of Health and Human Physiology, Department of Epidemiology, University of Iowa, Iowa City, Iowa, USA (Iowa Bone Development Study); Dr K. Kordas, School of Social and Community Medicine, University of Bristol, Bristol, UK (Avon Longitudinal Study of Parents and Children [ALSPAC]); Dr S. Kriemler, Institute of Social and Preventive Medicine, University of Z€urich, Z€urich, Switzerland (Kinder-Sportstudie [KISS]); Dr A. Page, Centre for Exercise, Nutrition and Health Sciences, University of Bristol, Bristol, UK; Prof. R. Pate, Department of Exercise Science, University of South Carolina, Columbia, South Carolina, USA (Physical Activity in Preschool Children [CHAMPS-US] and Project Trial of Activity for Adolescent Girls [Project TAAG]); Dr J.J. Puder, Service of Endocrinology, Diabetes and Metabolism, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland (Ballabeina Study); Prof. J. Reilly, Physical Activity for Health Group, School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK (Movement and Activity Glasgow Intervention in Children [MAGIC]); Prof. J. Salmon, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia (Children Living in Active Neigbourhoods [CLAN]); Dr L.B. Sherar, School of Sports, Exercise and Health Sciences, Loughborough University, Loughborough, UK; Dr A. Timperio, Centre for Physical Activity and Nutrition Research, Deakin University, Melbourne, Australia (Healthy Eating and Play Study [HEAPS]); Dr E.M.F. van Sluijs, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK (Sport, Physical activity and Eating behavior: Environmental Determinants in Young people [SPEEDY]). The UK Medical Research Council and the Wellcome Trust (Grant ref: 102215/2/13/2) and the University of Bristol provide core support for ALSPAC. Moreover, we acknowledge São Paulo Research Foundation (FAPESP) for the master’s degree scholarship of AOW (FAPESP process: 2017/27234–2).

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Correspondence to André O. Werneck.

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Werneck, A.O., Silva, D.R., Oyeyemi, A.L. et al. Physical activity attenuates metabolic risk of adolescents with overweight or obesity: the ICAD multi-country study. Int J Obes 44, 823–829 (2020). https://doi.org/10.1038/s41366-020-0521-y

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