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Improving cardiorespiratory fitness protects against inflammation in children: the IDEFICS study

Pediatric Research volume 91, pages 681–689 (2022)Cite this article

Abstract

Background

Muscular and cardiorespiratory fitness (MF and CRF) have been related to inflammation. Thus, the aim of this study was to assess the relationship between fitness and high-sensitivity C-reactive protein (hs-CRP) in European children both in the cross-sectional and longitudinal analysis.

Methods

Three hundred and fifty-seven children (46.2% males) aged 2–9 years with hs-CRP measured, data from MF and CRF, diet quality, objectively measured physical activity (PA) and screen time at baseline and follow-up after 2 years were included. Body mass index z-score (zBMI), waist circumference (WC) and fat mass index (FMI) were assessed. MF and CRF were also dichotomized as follows: low-medium quartiles (Q1–Q3) and highest quartile (Q4).

Results

At follow-up, children with the highest CRF (Q4) showed a lower probability of having high hs-CRP. In the longitudinal analysis, children who improved their CRF over time showed a significantly lower probability (p < 0.05) of being in the highest hs-CRP category at follow-up, independently of the body composition index considered: odds ratio (OR) = 0.22 for zBMI, OR = 0.17 for WC, and OR = 0.21 for FMI.

Conclusions

Improving CRF during childhood reduces the odds of an inflammatory profile, independently of body composition and lifestyle behaviours. These highlight the importance of enhancing fitness, especially CRF, to avoid an inflammatory state in children.

Impact

  • Improvements in the cardiorespiratory profile during childhood could reverse an unfavourable inflammatory status.

  • There is a longitudinal and inverse association between CRF and inflammation in children.

  • This is the first longitudinal study assessing the relationship between fitness and inflammation during childhood that takes also into account the lifestyle behaviours.

  • Results from the present study suggest a protective role of fitness already in childhood.

  • Efforts to improve fitness in children should be aimed at as inflammation could trigger future cardiovascular disease.

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Fig. 1: Flow chart of the population involved in the current study from the IDEFICS study.
Fig. 2: Muscular fitness and cardiovascular fitness grouping design between baseline and follow-up.
Fig. 3: Proportion of the study population included in each category of the muscular or cardiorespiratory fitness over time.

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Acknowledgements

This work was done as part of the IDEFICS study (www.idefics.eu). We gratefully acknowledge the financial support of the European Community within the Sixth RTD Framework Programme Contract No. 016181 (FOOD). E.M.G.-G. was supported by the Ministerio de Ciencia and innovación (Juan de la Cierva Formación grant, FJCI-2017-34967G).

Author information

Author notes

  1. These authors contributed equally: Esther M. González-Gil, Alba M. Santaliestra-Pasías

Authors and Affiliations

  1. Department of Biochemistry and Molecular Biology II, Instituto de Nutrición y Tecnología de los Alimentos, Center of Biomedical Research (CIBM), Universidad de Granada, Granada, Spain

    Esther M. González-Gil

  2. GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain

    Esther M. González-Gil, Alba M. Santaliestra-Pasías, Luis Gracia-Marco & Luis A. Moreno

  3. Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain

    Esther M. González-Gil, Alba M. Santaliestra-Pasías & Luis A. Moreno

  4. Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain

    Alba M. Santaliestra-Pasías & Luis A. Moreno

  5. Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain

    Alba M. Santaliestra-Pasías & Luis A. Moreno

  6. Leibniz Institute for Prevention Research and Epidemiology—BIPS, Bremen, Germany

    Christoph Buck, Heike Schwarz & Wolfgang Ahrens

  7. PROFITH (PROmoting FITness and Health through physical activity) Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain

    Luis Gracia-Marco

  8. Institute of Food Sciences, National Research Council, Avellino, Italy

    Fabio Lauria

  9. Epidemiology and Prevention Unit, Fondazione IRCCS—Istituto Nazionale dei Tumori, Milan, Italy

    Valeria Pala

  10. Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary

    Denes Molnar

  11. National Institute for Health Development, Center of Health and Behavioral Science, Tallinn, Estonia

    Toomas Veidebaum

  12. Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli, Italy

    Licia Iacoviello

  13. Department of Medicine and Surgery, Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, Varese, Italy

    Licia Iacoviello

  14. Research and Education Institute of Child Health, Strovolos, Cyprus

    Michael Tornaritis

  15. Department of Public Health, School of Health Sciences, University of Skövde, Skövde, Sweden

    Gabriele Eiben

  16. Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden

    Lauren Lissner

  17. Institute of Statistics, Bremen University, Bremen, Germany

    Wolfgang Ahrens

  18. Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium

    Stefaan De Henauw

  19. Laboratoriumsmedizin Dortmund, Eberhard & Partner, Dortmund, Germany

    Arno Fraterman

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  1. Esther M. González-Gil
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Contributions

E.M.G.-G., A.S.-P., C.B., W.A. and L.A.M. conceptualized and designed the study, collected data, carried out the initial analyses, drafted the initial manuscript, and revised the manuscript. V.P., D.M., W.A., T.V., M.T., G.E., S.D.H., and A.F. designed the data collection instruments, coordinated and supervised data collection, and reviewed the manuscript. F.L., L.I., L.L., and H.S. designed the study and critically reviewed the manuscript for important intellectual content. All authors have read and approved the final version of the manuscript, and agree with the order of presentation of the authors.

Corresponding author

Correspondence to Esther M. González-Gil.

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González-Gil, E.M., Santaliestra-Pasías, A.M., Buck, C. et al. Improving cardiorespiratory fitness protects against inflammation in children: the IDEFICS study. Pediatr Res 91, 681–689 (2022). https://doi.org/10.1038/s41390-021-01471-0

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