Physical activity intensity, bout-duration, and cardiometabolic risk markers in children and adolescents.

Objectives: To determine the role of physical activity intensity and bout-duration in modulating associations between physical activity and cardiometabolic risk markers. Methods: A cross-sectional study using the International Children ’ s Accelerometry Database (ICAD) including 38,306 observations (in 29,734 individuals aged 4 – 18 years). Accelerometry data was summarized as time accumulated in 16 combinations of intensity thresholds ( ≥ 500 to ≥ 3000 counts/min) and bout-durations ( ≥ 1 to ≥ 10 min). Outcomes were body mass index (BMI, kg/m 2 ), waist circumference, biochemical markers, blood pressure, and a composite score of these metabolic markers. A second composite score excluded the adiposity component. Linear mixed models were applied to elucidate the associations and expressed per 10 min difference in daily activity above the intensity/bout-duration combination. Estimates (and variance) from each of the 16 combinations of intensity and bout-duration examined in the linear mixed models were analyzed in meta-regression to investigate trends in the association. Results: Each 10 min positive difference in physical activity was signi fi cantly and inversely associated with the risk factors irrespective of the combination of intensity and bout-duration. In meta-regression, each 1000 counts/min increase in intensity threshold was associated with a − 0.027 (95% CI: − 0.039 to − 0.014) standard deviations lower composite risk score, and a − 0.064 (95% CI: − 0.09 to − 0.038) kg/m 2 lower BMI. Conversely, meta-regression suggested bout-duration was not signi fi cantly associated with effect-sizes (per 1 min increase in bout-duration: − 0.002 (95% CI: − 0.005 to 0.0005) standard deviations for the composite risk score, and − 0.005 (95% CI: − 0.012 to 0.002) kg/m 2 for BMI). Conclusions: Time spent at higher intensity physical activity was the main determinant of variation in cardiometabolic risk factors, not bout-duration. Greater magnitude of associations was consistently observed with higher intensities. These results suggest that, in children and adolescents, physical activity, preferably at higher intensities, of any bout-duration should be promoted.

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