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      Physical activity, cardiorespiratory fitness, and metabolic syndrome in adolescents: A cross-sectional study

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          Abstract

          Background

          In adults, there is a substantial body of evidence that physical inactivity or low cardiorespiratory fitness levels are strongly associated with the development of metabolic syndrome. Although this association has been studied extensively in adults, little is known regarding this association in adolescents. The aim of this study was to analyze the association between physical activity and cardiorespiratory fitness levels with metabolic syndrome in Brazilian adolescents.

          Methods

          A random sample of 223 girls (mean age, 14.4 ± 1.6 years) and 233 boys (mean age, 14.6 ± 1.6 years) was selected for the study. The level of physical activity was determined by the Bouchard three-day physical activity record. Cardiorespiratory fitness was estimated by the Leger 20-meter shuttle run test. The metabolic syndrome components assessed included waist circumference, blood pressure, HDL-cholesterol, triglycerides, and fasting plasma glucose levels. Independent Student t-tests were used to assess gender differences. The associations between physical activity and cardiorespiratory fitness with the presence of metabolic syndrome were calculated using logistic regression models adjusted for age and gender.

          Results

          A high prevalence of metabolic syndrome was observed in inactive adolescents (males, 11.4%; females, 7.2%) and adolescents with low cardiorespiratory fitness levels (males, 13.9%; females, 8.6%). A significant relationship existed between metabolic syndrome and low cardiorespiratory fitness (OR, 3.0 [1.13-7.94]).

          Conclusion

          The prevalence of metabolic syndrome is high among adolescents who are inactive and those with low cardiorespiratory fitness. Prevention strategies for metabolic syndrome should concentrate on enhancing fitness levels early in life.

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          Most cited references38

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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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            Status of implementation of Framework Convention on Tobacco Control (FCTC) in Ghana: a qualitative study

            Background The Framework Convention on Tobacco Control (FCTC), a World Health Organization treaty, has now been ratified by over 165 countries. However there are concerns that implementing the Articles of the treaty may prove difficult, particularly in the developing world. In this study we have used qualitative methods to explore the extent to which the FCTC has been implemented in Ghana, a developing country that was 39th to ratify the FCTC, and identify barriers to effective FCTC implementation in low income countries. Methods Semi-structured interviews with 20 members of the national steering committee for tobacco control in Ghana, the official multi-disciplinary team with responsibility for tobacco control advocacy and policy formulation, were conducted. The Framework method for analysis and NVivo software were used to identify key issues relating to the awareness of the FCTC and the key challenges and achievements in Ghana to date. Results Interviewees had good knowledge of the content of the FCTC, and reported that although Ghana had no explicitly written policy on tobacco control, the Ministry of Health had issued several tobacco control directives before and since ratification. A national tobacco control bill has been drafted but has not been implemented. Challenges identified included the absence of a legal framework for implementing the FCTC, and a lack of adequate resources and prioritisation of tobacco control efforts, leading to slow implementation of the treaty. Conclusion Whilst Ghana has ratified the FCTC, there is an urgent need for action to pass a national tobacco control bill into law to enable it to implement the treaty, sustain tobacco control efforts and prevent Ghana's further involvement in the global tobacco epidemic.
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              A method to assess energy expenditure in children and adults.

              A variety of studies has a need to estimate the amount and pattern of daily energy expenditure. To this end, a 3-day activity record was developed and is described. Every 15-min period over 3 days, including a weekend day, was qualified in terms of energy cost on a 1 to 9 scale corresponding to a range of 1.0 MET to 7.8 METs and higher. A reliability study of 61 subjects indicated a highly reproducible procedure as shown by an intraclass correlation of 0.96 for mean kcal of energy expenditure over 3 days. Repeatability was unchanged whether or not the hours of sleep were included in the record. Samples of 150 children and 150 adults were also drawn to investigate the relationship between energy expenditure, physical working capacity, and body fatness. Results support the hypothesis that mean energy expenditure per kg of body weight is significantly correlated with physical working capacity expressed per kg of body weight (r = 0.31; p less than 0.01). Mean energy expenditure per kg of body weight is negatively related to body fat (-0.08 less than or equal to r less than or equal to -0.13). It is concluded that the 3-day activity record is a procedure suitable to estimate energy expenditure in population studies.
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                Author and article information

                Journal
                BMC Public Health
                BMC Public Health
                BioMed Central
                1471-2458
                2011
                30 August 2011
                : 11
                : 674
                Affiliations
                [1 ]Center for Health Sciences, Universidade Estadual do Norte do Paraná, Jacarezinho, Brazil
                [2 ]Deparment of Kinesiology, University of Massachusetts, Amherst, USA
                [3 ]Departament of Pediatrics, Universidade Federal do Paraná, Curitiba, Brazil
                [4 ]Departament of Physical Education, Universidade Federal do Paraná, Curitiba, Brazil
                Article
                1471-2458-11-674
                10.1186/1471-2458-11-674
                3223865
                21878095
                5a34fd3e-e4c9-41e6-a45f-4ccbb37ae9a7
                Copyright ©2011 Stabelini Neto et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 27 January 2011
                : 30 August 2011
                Categories
                Research Article

                Public health
                Public health

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