Association of physical activity and sedentary behavior at school with cardiovascular risk factors in adolescents

Santos, Priscila Cristina dos; Lima, Luiz Rodrigo Augustemak de; Costa, Bruno Gonçalves Galdino da; Martins, Cilene Rebolho; Minatto, Giseli; Berria, Juliane; Nunes, Everson Araújo; Petroski, Edio Luiz; Silva, Kelly Samara da

doi:10.1590/1980-0037.2020v22e72397

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Brasil

Revista Brasileira de Cineantropometria & Desempenho Humano

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original article • Rev. bras. cineantropom. desempenho hum 22 • 2020 • https://doi.org/10.1590/1980-0037.2020v22e72397 copy

Association of physical activity and sedentary behavior at school with cardiovascular risk factors in adolescents

Associação da atividade física e comportamento sedentário realizados na escola com fatores de risco cardiovascular em adolescentes

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

The association of moderate to vigorous physical activity and sedentary behavior performed in the school context with cardiovascular risk factors is unclear. Thus, the purpose of this study was to evaluate whether MVPA and SB during school time are associated with single and clustered cardiovascular risk factors in 10- to 16-year-old school students. This study used the baseline data from a non-randomized controlled clinical trial (“MEXA-SE”) conducted on 6th to 9th-grade students from schools in Florianopolis, Brazil. Skinfolds, resting blood pressure, 20-m shuttle-run test, fasting glucose, triglycerides, total cholesterol, high-density lipoprotein cholesterol, and white blood cell counts were obtained. MVPA and SB were objectively measured with accelerometers. A minimum of 180 minutes was considered valid school-time for analysis. Multiple linear regression adjusted for age, sex and habitual physical activity was used. School-time MVPA was positively associated with the peak VO₂ (β = 0.17 ml.kg.min^-1), and inversely associated with sum of four skinfolds (β = -0.96 mm), diastolic blood pressure (β = -0.36 mmHg), systolic blood pressure (β = -0.301 mmHg); triglycerides (β = -1.49 mg.dL^-1), and clustered cardiovascular risk factors (β = -0.123). School-time SB was positively associated with clustered cardiovascular risk factors (β = 0.033). In conclusion, independently of habitual physical activity level, school-time MVPA and a lower time in SB were associated to single and clustered cardiovascular risk factors. Thus, the promotion of strategies aimed increase MVPA and reduce SB at school may prevent the onset and early accumulation of cardiovascular risk factors in adolescence.

Key words
Adolescent; Cardiovascular abnormalities; Exercise; Sedentary lifestyle

Variables	Total		Boys		Girls		p-value
Variables	n	(Mean ± SD)	n	(Mean ± SD)	n	(Mean ± SD)
Peak VO₂(ml.kg.min^-1)	324	40.89 ± 4.69	148	42.82 ± 4.91	176	39.27 ± 3.81	<0.001^* * Significant difference between sex (t-test and Mann-Whitney test). TC/HDL ratio had the most missing data: 40.6%.
Sum of four skinfold (mm)	336	46.84 ± 23.86	153	41.00 ± 23.45	183	51.72 ± 23.15	<0.001^* * Significant difference between sex (t-test and Mann-Whitney test). TC/HDL ratio had the most missing data: 40.6%.
Diastolic blood pressure (mmHg)	339	64.30 ± 8.82	154	62.73 ± 8.54	185	65.6 ± 8.87	0.027^* * Significant difference between sex (t-test and Mann-Whitney test). TC/HDL ratio had the most missing data: 40.6%.
Systolic blood pressure (mmHg)	339	109.97 ± 11.75	154	109.27 ± 12.53	185	110.56 ± 11.07	0.722
Glucose (mg.dL^-1)	157	78.04 ± 16.99	70	78.38 ± 17.26	87	77.81 ± 16.87	0.442
Triglycerides (mg.dL^-1)	157	76.54 ± 35.54	70	69.52 ± 29.33	87	82.19 ± 39.10	0.004^* * Significant difference between sex (t-test and Mann-Whitney test). TC/HDL ratio had the most missing data: 40.6%.
TC/HDL ratio	155	3.50 ± 1.35	70	3.64 ± 1.45	87	3.39 ± 1.25	0.969
White Blood Cell (cells.mm^-3)	158	5.80 ± 2.08	71	5.44 ± 1.42	87	6.10 ± 2.46	0.004^* * Significant difference between sex (t-test and Mann-Whitney test). TC/HDL ratio had the most missing data: 40.6%.
Self-reported physical activity (min.day)	341	86.95 ± 126.73	156	102.87 ± 143.34	185	77.53 ± 109.42	0.010^* * Significant difference between sex (t-test and Mann-Whitney test). TC/HDL ratio had the most missing data: 40.6%.
School-time MVPA (min.day^-1)	344	10.49 ± 6.43	156	14.33 ± 6.74	188	7.31 ± 3.97	<0.001^* * Significant difference between sex (t-test and Mann-Whitney test). TC/HDL ratio had the most missing data: 40.6%.
School-time SB (min.day^-1)	344	139.28 ± 22.25	156	129.33 ± 20.24	188	147.54 ± 20.42	<0.001^* * Significant difference between sex (t-test and Mann-Whitney test). TC/HDL ratio had the most missing data: 40.6%.

Variables	School-time MVPA (min.day^-1) Unadjusted				School-time MVPA (min.day^-1) Adjusted
Variables	n	β	CI 95%	p-value	β	CI 95%	p-value
Peak VO₂	324	0.306	0.23;0.38	≤0.001^* * represent significant associations (p ≤ 0.05), statistical analysis was adjusted for sex, age and habitual physical activity.	0.166	0.08;0.25	≤0.001^* * represent significant associations (p ≤ 0.05), statistical analysis was adjusted for sex, age and habitual physical activity.
Sum of four skinfolds	336	-1.109	-1.49; -0.73	≤0.001^* * represent significant associations (p ≤ 0.05), statistical analysis was adjusted for sex, age and habitual physical activity.	-0.96	-1.42; -0.49	≤0.001^* * represent significant associations (p ≤ 0.05), statistical analysis was adjusted for sex, age and habitual physical activity.
Diastolic blood pressure	339	-0.387	-0.53; -0.24	≤0.001^* * represent significant associations (p ≤ 0.05), statistical analysis was adjusted for sex, age and habitual physical activity.	-0.362	-0.54; -0.19	≤0.001^* * represent significant associations (p ≤ 0.05), statistical analysis was adjusted for sex, age and habitual physical activity.
Systolic blood pressure	339	-0.367	-0.56; -0.17	≤0.001^* * represent significant associations (p ≤ 0.05), statistical analysis was adjusted for sex, age and habitual physical activity.	-0.301	-0.53; -0.07	0.010^* * represent significant associations (p ≤ 0.05), statistical analysis was adjusted for sex, age and habitual physical activity.
Glucose	157	-0.370;	-0.83;0.09	0.113	-0.320	-0.88;0.24	0.259
Triglycerides	157	-1.510	-2.45; -0.57	0.002^* * represent significant associations (p ≤ 0.05), statistical analysis was adjusted for sex, age and habitual physical activity.	-1.490	-2.66; -0.32	0.013^* * represent significant associations (p ≤ 0.05), statistical analysis was adjusted for sex, age and habitual physical activity.
TC/HDL-c ratio	155	-0.004	-0.04;0.33	0.827	-0.035	-0.08;0.01	0.126
White blood cells	158	-0.053	-0.11; 0.003	0.063	-0.24	-0.09;0.04	0.487
Clustered cardiovascular risk factor	148	-0.126	-0.20; -0.05	≤0.001^* * represent significant associations (p ≤ 0.05), statistical analysis was adjusted for sex, age and habitual physical activity.	-0.123	-0.20; -0.05	0.002^* * represent significant associations (p ≤ 0.05), statistical analysis was adjusted for sex, age and habitual physical activity.

Variables	School-time SB (min.day^-1) Unadjusted				School-time SB (min.day^-1) Adjusted
	n	β	CI 95%	p-value	β	CI 95%	p-value
Peak VO₂	324	-0.073	- 0.095; -0.050	≤0.001^* * represent significant associations (p ≤ 0.05), statistical analysis was adjusted for sex, age and habitual physical activity	-0.024	-0.05; -0.00^-4	0.050
Sum of four skinfolds	336	0.189	0.075;0.303	≤0.001^* * represent significant associations (p ≤ 0.05), statistical analysis was adjusted for sex, age and habitual physical activity	0.115	-0.02;0.25	0.086
Diastolic blood pressure	339	0.083	0.042;0.125	≤0.001^* * represent significant associations (p ≤ 0.05), statistical analysis was adjusted for sex, age and habitual physical activity	-0.646	-0.02;0.11	0.090
Systolic blood pressure	339	0.951	0.040; 0.151	≤0.001^* * represent significant associations (p ≤ 0.05), statistical analysis was adjusted for sex, age and habitual physical activity	-0.464	-0.02;0.11	0.148
Glucose	157	0.082	-0.038;0.202	0.181	0.015	-0.14;0.17	0.846
Triglycerides	157	0.280	0.029;0.527	0.029	0.258	-0.62;0.58	0.113
TC/HDL-c ratio	155	-0.005	-0.014;0.005	0.320	0.001	-0.01;0.01	0.859
White blood cells	158	0.153	0.001;0.030	0.041^* * represent significant associations (p ≤ 0.05), statistical analysis was adjusted for sex, age and habitual physical activity	0.010	-0.01;0.03	0.304
Clustered cardiovascular risk factor	148	0.349	0.14;0.56	≤0.001^* * represent significant associations (p ≤ 0.05), statistical analysis was adjusted for sex, age and habitual physical activity	0.033	0.011;0.05	0.003^* * represent significant associations (p ≤ 0.05), statistical analysis was adjusted for sex, age and habitual physical activity

Universidade Federal de Santa Catarina Universidade Federal de Santa Catarina, Campus Universitário Trindade, Centro de Desportos - RBCDH, Zip postal: 88040-900 - Florianópolis, SC. Brasil, Fone/fax : (55 48) 3721-8562/(55 48) 3721-6348 - Florianópolis - SC - Brazil
E-mail: rbcdh@contato.ufsc.br

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[1] Corresponding author Priscila Cristina dos Santos Federal University of Santa Catarina. Physical Education Department. Address: Campus Universitario – Trindade. 88040-900, Florianopolis, SC, Brazil. E-mail address: prisantos.personal@gmail.com