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      Association of Physical Activity and the Metabolic Syndrome in Children and Adolescents: CASPIAN Study

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          Abstract

          Background/Aim: To determine the association of physical activity and the metabolic syndrome in a large national-representative sample of children. Methods: This study was performed in 2003–2004 on 4,811 school students aged 6–18 years, selected by multi-stage random cluster sampling from six provinces in Iran. We assessed the level of physical activity using a standardized questionnaire, and categorized it to the tertiles. The metabolic syndrome was defined based on criteria analogous to those of the Adult Treatment Panel III. Results: The participants comprised 2,248 boys and 2,563 girls with a mean age of 12.07 ± 3.2 years. In all age groups, boys were more physically active than girls. The metabolic syndrome was detected in 14.1% of participants, and its prevalence was higher in those subjects in the 1st, 2nd and 3rd tertiles of physical activity, respectively (15.1 vs.14.2 and 13.1%, respectively, p <0.05). This difference was seen in boys, while no difference was found between girls in the 2nd and 3rd tertiles of physical activity. Physical activity was linked to a cluster of factors consisting of high-density lipoprotein-cholesterol and waist circumference, followed by triglycerides in boys, and of triglycerides, waist circumference and blood pressure in girls. In both genders, before and after adjustment for age and body mass index, low levels of physical activity significantly increased the risk of having the metabolic syndrome [in boys: OR: 1.8, 95% CI: 1.1, 2.1; and in girls, OR: 1.6 (1.1, 1.9)]. Conclusion: We found an association between physical activity and the metabolic syndrome, which was independent of body mass index and age. Children should be encouraged to have greater physical activity.

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          Most cited references 14

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          Prevalence of the metabolic syndrome in American adolescents: findings from the Third National Health and Nutrition Examination Survey.

          Metabolic syndrome (MetS) is defined by the Third Report of the Adult Treatment Panel (ATP III) using criteria easily applied by clinicians and researchers. There is no standard pediatric definition. We defined pediatric MetS using criteria analogous to ATP III as > or =3 of the following: (1) fasting triglycerides > or =1.1 mmol/L (100 mg/dL); (2) HDL or =6.1 mmol/L (110 mg/dL); (4) waist circumference >75th percentile for age and gender; and (5) systolic blood pressure >90th percentile for gender, age, and height. MetS prevalence in US adolescents was estimated with the Third National Health and Nutritional Survey 1988 to 1994. Among 1960 children aged > or =12 years who fasted > or =8 hours, two thirds had at least 1 metabolic abnormality, and nearly 1 in 10 had MetS. The racial/ethnic distribution was similar to adults: Mexican-Americans, followed by non-Hispanic whites, had a greater prevalence of MetS compared with non-Hispanic blacks (12.9%, [95% CI 10.4% to 15.4%]; 10.9%, [95% CI 8.4% to 13.4%]; and 2.5%, [95% CI 1.3% to 3.7%], respectively). Nearly one third (31.2% [95% CI 28.3% to 34.1%]) of overweight/obese adolescents had MetS. Our definition of pediatric MetS, designed to be closely analogous to ATP III, found MetS is common in adolescents and has a similar racial/ethnic distribution to adults in this representative national sample. Because childhood MetS likely tracks into adulthood, early identification may help target interventions to improve future cardiovascular health.
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            Validation of a new self-report instrument for measuring physical activity.

            Development and validation of a physical activity scale for measuring physical activity in 24 h of sports, work, and leisure time on an average weekday. For development of the physical activity scale, 2500 randomly selected Danish men and women between the age of 20 and 60 were contacted by mail and asked to select frequent and relevant physical activities from a number of activities of known MET intensity. The activities were included in the physical activity scale, organized in nine different MET levels ranging from sleep/rest (0.9 METs) to high-intensity physical activities (>6 METs). Face validity of the physical activity scale was explored through interviews with 10 volunteer men and women. Concurrent validity was assessed against 4 d of accelerometry (CSA 7164) and physical activity diary in 40 volunteer men and women between 20 and 60 yr of age. The correlation between the activity scale and the diary was high (r = 0.74, P = 0.000), whereas correlation between the activity scale and accelerometer measurements was poor (r = 0.20, NS). The physical activity scale MET-time was systematically higher than average MET-time estimated from the diary, and the difference increased with increasing total MET-time. The physical activity scale appears to be a simple and valid alternative to measuring physical activity by diary in adult sedentary to moderately active Danes. The scale encompasses work, leisure time, and sports activity in one measure; it is easy to administer, and it provides detailed information on different activity levels as well as a single measure of the total amount of physical activity on an average weekday.
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              Body mass index, waist circumference, and clustering of cardiovascular disease risk factors in a biracial sample of children and adolescents.

              To derive optimal body mass index (BMI) and waist circumference thresholds for children and adolescents, to predict risk factor clustering. Cross-sectional receiver operating characteristic curve analysis. The Bogalusa Heart Study, a community-based study of cardiovascular disease risk factors in early life. A total of 2597 black and white children and adolescents, 5 to 18 years of age, who were examined between 1992 and 1994. The presence or absence of > or =3 age-adjusted risk factors (low high-density lipoprotein cholesterol level, high low-density lipoprotein cholesterol level, high triglyceride level, high glucose level, high insulin level, and high blood pressure) was predicted from age-adjusted BMI and waist circumference values. The areas under the receiver operating characteristic curves were significantly different from 0.5 for both BMI and waist circumference for all gender/race groups, ranging from 0.73 to 0.82. The optimal BMI thresholds were at the 53rd and 50th percentiles for white and black male subjects, respectively, and at the 57th and 51st percentiles for white and black female subjects, respectively. Similarly, the optimal waist circumference thresholds were at the 56th and 50th percentiles for white and black male subjects, respectively, and at the 57th and 52nd percentiles for white and black female subjects, respectively. The sensitivity and specificity at the thresholds were similar for all gender/race groups, ranging from 67% to 75%. The use of BMI and waist circumference for the prediction of risk factor clustering among children and adolescents has significant clinical utility. In this sample, race and gender differences in the optimal thresholds were minimal.
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                Author and article information

                Journal
                HRE
                Horm Res Paediatr
                10.1159/issn.1663-2818
                Hormone Research in Paediatrics
                S. Karger AG
                1663-2818
                1663-2826
                2007
                February 2007
                11 October 2006
                : 67
                : 1
                : 46-52
                Affiliations
                Department of Preventive Pediatric Cardiology, Isfahan Cardiovascular Research Centre, Isfahan University of Medical Sciences, Isfahan, Iran
                Article
                96121 Horm Res 2007;67:46–52
                10.1159/000096121
                17035710
                © 2007 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                Page count
                Figures: 1, Tables: 3, References: 30, Pages: 7
                Categories
                Original Paper

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