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Prevention of Non Communicable Diseases

Intensity matters: impact of physical activity energy expenditure at moderate and vigorous intensity on total and abdominal obesity in children



Physical activity (PA) guidelines advocate that children should accumulate at least 60 min of moderate-to-vigorous PA daily. Still, it is not clear how body fat may differ if the same dose of PA is accumulated at different intensities. We aimed to determine the independent associations of energy expenditure (EE) at moderate (MPA) and vigorous (VPA) PA intensity on total and abdominal fat in children and if these associations were moderated by cardiorespiratory fitness (CRF).


A total of 326 children (girls = 171, boys = 151) aged 10–12 years had PA assessed with accelerometers. Total fat mass index (FMI) and abdominal FMI were assessed with DXA. CRF was assessed by a cycle ergometer test. Linear regression models were used to model the outcomes with the inclusion of an interaction term to test for moderation effects.


An inverse association was found between VPA EE and FMI (β = −0.013, p < 0.001) and abdominal FMI (β = −0.0014, p < 0.001) independent of MPA EE. In contrast, MPA EE was not related to adiposity independent of VPA EE (p > 0.05). The relationships between the PA intensities and FMI and abdominal FMI were moderated by CRF. MPA EE was positively associated with adiposity in children with high levels of CRF, whereas VPA EE remained inversely associated with adiposity regardless of CRF level, although the strength of the association was lower in those with higher CRF levels.


PA programs should provide opportunities for children to perform VPA in order to achieve healthier body fat profiles and avoid excess adiposity.

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Fig. 1: Relationship between FMI and abdominal FMI with energy expenditure.

Data availability

Data are available from the corresponding author upon reasonable request.


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We would like to express our gratitude to the participants for their contribution to the present investigation.


This investigation was conducted at Interdisciplinary Center of the Study of Human Performance (CIPER), Faculty of Human Kinetics of University of Lisbon, and supported by fellowships from the Portuguese Foundation for Science and Technology (Grant number: PTDC/DES/108372/2008).

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Authors and Affiliations



LBS conceived and planned the experiments. DAS carried out the experiments and data collection. JPM, DAS, and MH-R did the data analysis. LBS, JPM, DAS, and MH-R contributed to the interpretation of the results. LBS and MH-R took the lead in writing the manuscript. All authors provided critical feedback and helped shape the research, analysis, and manuscript.

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Correspondence to Luís B. Sardinha.

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The authors declare no competing interests.

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The research protocol was approved by the Portuguese Ministry of Education and all participants, and their parents or legal guardians provided written informed consent prior to their participation and in accordance with the World Medical Association’s Declaration of Helsinki on human studies.

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Sardinha, L.B., Magalhães, J.P., Santos, D.A. et al. Intensity matters: impact of physical activity energy expenditure at moderate and vigorous intensity on total and abdominal obesity in children. Eur J Clin Nutr (2022).

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