Association between eating habits, body mass index, cardiorespiratory fitness, and cardiometabolic risk factors in children
Keywords:
Cardiovascular diseases, Cardiorespiratory fitness, Children, Feeding behaviorAbstract
Objective
To verify the multivariate relationships between eating habits, cardiorespiratory fitness, body mass index, and cardiometabolic risk factors in children.
Methods
This is a cross-sectional study developed in a public elementary school with 60 first- to sixth-graders. Their eating habits were assessed using the Food Frequency Survey, weight, height, and cardiorespiratory fitness, assessed according to the Projeto Esporte Brasil protocol. Moreover, the variables, high-density lipoprotein, low-density lipoprotein, glucose, insulin, C-reactive protein, adiponectin, leptin, diastolic and systolic blood pressure were evaluated. Descriptive statistics were used for data analysis and generalized estimation equations were used for the analysis of direct and indirect relations, in a multivariate analysis model with several simultaneous outcomes.
Results
It appears that the eating habits and cardiorespiratory fitness explain 20% of the body mass index. Cardiometabolic risk factors are explained by the relationship between eating habits, cardiorespiratory fitness, and body mass index, according to the following percentages: 29% (systolic blood pressure), 18% (diastolic blood pressure), 63% (leptin), 4% (adiponectin), 14% (C-reactive protein), 17% (insulin), 10% (high-density lipoprotein), 1% (low-density lipoprotein), 4% (glucose). It is also observed that the effects of the eating habits on cardiometabolic risk factors are indirect, that is, they are dependent on changes in the body mass index and cardiorespiratory fitness levels.
Conclusion
The relationship between eating habits and cardiometabolic risk factors in children is dependent on cardiorespiratory fitness and body mass index. Thus, our findings suggest a multivariate relationship between these factors.
References
Paiva ACT, Couto CC, Lemos Masson AP, Monteiro CAS, Freitas CF. Obesidade infantil: análises antropométricas, bioquímicas, alimentares e estilo de vida. Rev Cuid. 2018;9(3):2387-99. https://doi.org/10.15649/cuidarte.v9i3.575
Jesus GMD, Assis MAAD, Kupek E, Dias LA. Avaliação da atividade física de escolares com um questionário via internet. Rev Bras Med Esporte. 2016;22(4):261-6. https://doi.org/10.1590/1517-869220162204157067
Nasreddine L, Shatila H, Itani L, Hwalla N, Jomaa L, Naja, F. A traditional dietary pattern is associated with lower odds of overweight and obesity among preschool children in Lebanon: a cross-sectional study. Eur J Nutr. 2019;58(1):91-102. https://doi.org/10.1007/s00394-017-1574-0
Bruscato, NM, Pitrez Filho MS, Vargas LTR, Hauschild JA, Baldisserotto M, Sanseverino R, et al. A prevalência de obesidade na infância e adolescência é maior em escolas públicas no sul do Brasil. Nutr Clin Diet Hosp. 2016;36(4):59-64. https://doi.org/10.12873/364bruscato
Setayeshgar S, Ekwaru JP, Maximova K, Majumdar SR, Storey KE, McGavock J, et al. Dietary intake and prospective changes in cardiometabolic risk factors in children and youth. Appl Physiol Nutr Metab. 2017;42(1):39-45. https://doi.org/10.1139/apnm-2016-0215
Pérez-Bey A, Segura-Jiménez V, Fernández-Santos, JDR, Esteban-Cornejo I, Gómez-Martínez S, Veiga OL, et al. The influence of cardiorespiratory fitness on clustered cardiovascular disease risk factors and the mediator role of body mass index in youth: The UP&DOWN Study. Pediatr Diabetes. 2018;20(1):32-40. https://doi.org/10.1111/pedi.12800
Gaya AR, Brand C, Dias AF, Gaya ACA, Lemes VB, Mota J. Obesity anthropometric indicators associated with cardiometabolic risk in Portuguese children and adolescents. Prev Med Rep. 2017;8:158-62. https://doi.org/10.1016/j.pmedr.2017.10.002
Wheelock KM, Fufaa, GD, Nelson RG, Hanson RL, Knowler WC, Sinha M. Cardiometabolic risk profile based on body mass index in American Indian children and adolescents. Pediatr Obes. 2017;12(4):295-303. https://doi.org/10.1111/ijpo.12142
Liberali R, Kupek E, Assis MAAD. Dietary patterns and childhood obesity risk: a systematic review. Child Obes. 2020;16(2):70-85. https://doi.org/10.1089/chi.2019.0059
Calderón García A, Marrodan Serrano D, Villarino Marín A, Martínez Álvarez JR. Valoración del estado nutricional y de hábitos y preferencias alimentarias en una población infanto-juvenil (7 a 16 años) de la Comunidad de Madrid. Nutr Hosp. 2019;36(2):394-404. https://doi.org/10.20960/nh.2244
Rocha NP, Milagres LC, Longo GZ, Ribeiro AQ, Novaes JF. Association between dietary pattern and cardiometabolic risk in children and adolescents: a systematic review. J Pediatr. 2016;93(3):214-22. https://doi.org/10.1016/j.jped.2017.01.002
Agostinis-Sobrinho C, Brand C, Moreira C, Lopes L, Oliveira-Santos J, Silva P, et al. Muscular fitness, Southern European Atlantic diet and inflammation in adolescents. Azorean Physical Activity and Health Study II. Eur J Sport Sci. 2018;18(1):104-11. https://doi.org/10.1080/17461391.2017.1394368
Ortega FB, Cadenas-Sanchez C, Migueles JH, Labayen I, Ruiz JR, Sui X, et al. Role of physical activity and fitness in the characterization and prognosis of the metabolically healthy obesity phenotype: a systematic review and metaanalysis. Prog Cardiovasc Dis. 2018;61(2):190-205. https://doi.org/10.1016/j.pcad.2018.07.008
Cabanas-Sánchez V, Martínez-Gómez D, Izquierdo-Gómez R, Segura-Jiménez V, Castro-Piñero J, Veiga OL. Association between clustering of lifestyle behaviors and health-related physical fitness in youth: The UP&DOWN Study. J Pediatr. 2018;199:41-8. https://doi.org10.1016/j.jpeds.2018.03.075
Andersen LB, Lauersen JB, Brond, JC, Anderssen SA, Sardinha LB, Steene-Johannessen J, et al. A new approach to define and diagnose cardiometabolic disorder in children. J Diabetes Res. 2015;2015. https://doi.org/10.1155/2015/539835
Á Latorre Roman P, Mora López D, García FP. Prácticas de alimentación, actividad física y condición física de niños preescolares españoles: Influencia de variables sociodemográficas. Arch Argent Pediatr. 2016;114(5):441-7.
Coledam DHC, Ferraiol PF, Santos JW, Oliveira AR. Fatores associados à aptidão cardiorrespiratória de escolares. Rev Bras Med Esporte. 2016;22(1):21-6. https://doi.org/10.1590/1517-869220162201123568
Straatmann VS, Santos LAVD, Palma A, Veiga GVD. Cardiorespiratory fitness and physical activity level in adolescents. Rev Bras Cineantropom Desempenho. 2015;17(1):21-30. https://doi.org/10.5007/1980-0037.2015v17n1p21
Goñi IL, Arenaza L, Medrano M, García N, Cadenas-Sanchez C, Ortega FB. Associations between the adherence to the Mediterranean diet and cardiorespiratory fitness with total and central obesity in preschool children: the PREFIT project. Eur J Nutr. 2018;57(8):2975-83. https://doi.org/10.1007/s00394-017-1571-3
Todendi PF, Valim ARM, Reuter CP, Mello ED, Gaya AR, Burgos MS. Metabolic risk in schoolchildren is associated with low levels of cardiorespiratory fitness, obesity, and parents’ nutritional profile. J Pediatr. 2016;92(4):388-93. https://doi.org/10.1016/j.jpedp.2016.05.007
Eisenmann JC, Welk GJ, Ihmels M, Dollman, J. Fatness, fitness, and cardiovascular disease risk factors in children and adolescents. Med Sci Sports Exerc. 2007;39(8):1251-6. https://doi.org/10.1249/MSS.0b013e318064c8b0
Stoner L, Pontzer H, Gibbs BB, Moore JB, Castro N, Skidmore P, et al. Fitness and fatness are both associated with cardiometabolic risk in preadolescents. J Pediatr. 2018;217:39-45.
Leal DB, Assis MAA, Conde WL, Lobo AS, Bellisle F, Andrade DF. Individual characteristics and public or private schools predict the body mass index of Brazilian children: a multilevel analysis. Cad Saúde Pública. 2018;34(5):117. https://doi.org/10.1590/0102-311X00053117
Vilchis-Gil J, Galván-Portillo M, Klünder-Klünder M, Cruz M, Flores-Huerta S. Food habits, physical activities and sedentary lifestyles of eutrophic and obese school children: a case-control study. Bmc Public Health. 2015;15(1):124.https://doi.org/10.1186/s12889-015-1491-1
Faul F, Erdfelder E, Buchner A, Lang, AG. G* Power Version 3.1. 7 [software]. Germany: Uiversität Kiel; 2013.
Faul F, Erdfelder E, Lang AG, Buchner A. G* Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39(2):175-91. https://doi.org/10.3758/BF03193146
Ministério da Saúde (Brasil). Orientações para avaliação de marcadores de consumo alimentar na atenção básica. Brasília: Ministério; 2015 [citado 20 set 2019]. Disponível em: https://bvsms.saude.gov.br/bvs/publicacoes/marcadores_consumo_alimentar_atencao_basica.pdf
Ministério da Saúde (Brasil). Guia Alimentar para a população brasileira. 2a ed. Brasília: Ministério; 2014 [citado 20 set 2019]. Disponível em: https://bvsms.saude.gov.br/bvs/publicacoes/guia_alimentar_populacao_brasileira_2ed.pdf
Instituto Brasileiro de Geografia e Estatística. Pesquisa Nacional de Saúde do Escolar (PeNSE): 2015. Rio de Janeiro: Instituto; 2016 [citado 29 dez 2019]. Disponível em: https://biblioteca.ibge.gov.br/visualizacao/livros/liv97870.pdf
Gaya A, AR Gaya. Projeto Esporte Brasil: manual de testes e avaliação: 2016. 5a ed. Porto Alegre: Edições Perfil; 2016 [citado 28 set 2019]. Disponível em: https://www.ufrgs.br/proesp/arquivos/manual-proesp-br-2016.pdf
Onis MD, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J. Development of a WHO growth reference for school-aged children and adolescents. Bulletin World Health Organization. 2007;(85):660-7.
Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972;18(6):499-502. https://doi.org/10.1093/clinchem/18.6.499
Kellar, SP, Kelvin EA. Munro’s statistical methods for health care research. 6a ed. Philadelphia: Wolters Kluwer Health; 2012.
International Business Machines Corporation. Statistical Package for Social Sciences. version 22.0 [software]. Chicago: IBM; 2013.
Costa MC, Sousa AF, Lima JTN, Sousa SDF, Ferreira FV, Marques ARA. Estado nutricional, práticas alimentares e conhecimentos em nutrição de escolares. Rev Aten Saúde. 2018;16(56):12-7. https://doi.org/10.13037/ras.vol16n56.481
Skrede T, Aadland E, Andersen LB, Stavnsbo M, Anderssen SA, Resaland GK. Does cardiorespiratory fitness moderate the prospective association between physical activity and cardiometabolic risk factors in children? Int J Obes. 2018;42(5):1029-38. https://doi.org/10.1038/s41366-018-0108-z
Racette SB, Uhrich ML, White ML, Yu L, Clark, BR. Sex differences in FITNESSGRAM® health risk based on aerobic capacity and body composition among urban public elementary school children. Prev Med. 2017;103:56-9. https://doi.org/10.1016/j.ypmed.2017.07.032
Nyström CD, Henriksson P, Martínez-Vizcaíno V, Medrano M, Cadenas-Sanchez C, Arias-Palencia, et al. Does cardiorespiratory fitness attenuate the adverse effects of severe/morbid obesity on cardiometabolic risk and insulin resistance in children? A pooled analysis. Diabetes Care. 2017;40(11):1580-7. https://doi.org/10.2337/dc17-1334
Sociedade Brasileira de Pediatria. Manual de orientação para a alimentação do lactente, do pré-escolar, do escolar, do adolescente e na escola. 3a. ed. Rio de Janeiro: Sociedade; 2012 [citado 29 dez 2019]. Disponível em: https://www.sbp.com.br/fileadmin/user_upload/pdfs/14617a-PDManualNutrologia-Alimentacao.pdf
Cunha DB, Costa THM, Veiga GV, Pereira RA, Sichieri R. Ultra-processed food consumption and adiposity trajectories in a Brazilian cohort of adolescents: ELANA study. Nutr Diabetes. 2018;8(1):28. https://doi.org/10.1038/s41387-018-0043-z
Skrede T, Stavnsbo M, Aadland E, Aadland KN, Anderssen SA, Resaland, GK, et al. Moderate-to-vigorous physical activity, but not sedentary time, predicts changes in cardiometabolic risk factors in 10-y-old children: the active smarter Kids Study. Am J Clin Nutr. 2017;105(6):1391-8. https://doi.org/10.3945/ajcn.116.150540
Seabra A, Katzmarzyk P, Carvalho MJ, Seabra A, Coelho-e-Silva M, Abreu S, et al. Effects of 6-month soccer and traditional physical activity programmes on body composition, cardiometabolic risk factors, inflammatory, oxidative stress markers and cardiorespiratory fitness in obese boys. J Sports Sci. 2016;34(19):1822-9. https://doi.org/10.1080/02640414.2016.1140219
Granacher U, Borde R. Effects of sport-specific training during the early stages of long-term athlete development on physical fitness, body composition, cognitive, and academic performances. Front Physiol. 2017;8:810. https://doi.org/10.3389/fphys.2017.00810
Oliveira L, Braga F, Lemes V, Dias A, Brand C, Mello J, et al. Effect of an intervention in physical education classes on health related levels of physical fitness in youth. Rev Bras Ativ Fís Saúde. 2017;22(1):46-53. https://doi.org/10.12820/rbafs.v.22n1p46-53
World Health Organization. World health statistics 2010. Geneva: Organization; 2010. [cited 2020 Jan 9]. Available from: https://www.who.int/whosis/whostat/2010/en/
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Copyright (c) 2022 Miguel Angelo dos Santos Duarte Junior, Adroaldo Cezar r Araujo Gaya, Vanilson Batista Lemes, Camila Felin Fochesatto, Caroline Brand, Anelise Reis Gaya
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