Risk factors of type 2 diabetes and cardiovascular disease accumulate in children with poor aerobic fitness

Risk factors of type 2 diabetes and cardiovascular disease accumulate in children who have poor aerobic fitness, a new study from the University of Eastern Finland shows. The study also found that the traditional way of expressing aerobic fitness in proportion to total body mass overestimates the role of aerobic fitness in identifying children at an increased risk of these diseases.  

The study was conducted as part of the Physical Activity and Nutrition in Children (PANIC) Study at the University of Eastern Finland, and the findings were reported in the Scandinavian Journal of Medicine & Science in Sports.  

The study determined threshold values of aerobic fitness for girls and boys, making it possible to identify children who are at an increased risk of type 2 diabetes and cardiovascular disease. Altogether 352 Finnish children, aged between 9 and 11, were included in the current analyses. Their aerobic fitness was determined by measuring peak oxygen uptake during a maximal exercise test. In addition, their body adiposity and skeletal muscle mass were measured by bioelectrical impedance. The researchers also calculated variables indicative of the risk of type 2 diabetes and cardiovascular disease, such as waist circumference, blood levels of insulin, glucose, HDL cholesterol, and triglycerides as well as blood pressure.  

Aerobic fitness can be determined in many different ways in both children and adults. Often, aerobic fitness is determined by dividing the aerobic fitness measure obtained from an exercise test by total body mass that includes adipose tissue. This way, the calculated measure describes not only aerobic fitness but also body adiposity or fatness, which may lead to erroneous interpretations of the association of aerobic fitness with the risk of type 2 diabetes and cardiovascular disease. 

The newly published study now shows that children with poor aerobic fitness in proportion to their total body mass have a significantly higher risk of type 2 diabetes and cardiovascular disease than their peers with better aerobic fitness. When aerobic fitness was proportioned to skeletal muscle mass, the association of aerobic fitness with the risk of type 2 diabetes and cardiovascular disease remained, but was considerably weaker than when proportioned to total body mass.  

“Measures of aerobic fitness that are based on total body mass are better at predicting the risk of type 2 diabetes and cardiovascular disease than measures that are based on skeletal muscle mass; however, they exaggerate the role of aerobic fitness in children’s health. We should be cautious when interpreting aerobic fitness measures that are proportioned to total body mass in order to correctly identify children who truly need health and lifestyle intervention,” Dr Agbaje, the first author of the study, from the University of Eastern Finland concludes. 

For further information, please contact: 

Andrew Agbaje, MD, MPH, PhD Student, Institute of Biomedicine, University of Eastern Finland, andrew.agbaje@uef.fi   

Timo A. Lakka, Professor of Medical Physiology, Internal Medicine Specialist, Institute of Biomedicine, University of Eastern Finland, tel. +358 40 770 7329 

Link to the article: 

Agbaje AO, Haapala EA, Lintu N, Viitasalo A, Barker AR, Takken T, Tompuri T, Lindi V, Lakka TA. Peak oxygen uptake cut-points to identify children at increased cardiometabolic risk - The PANIC Study. Scand J Med Sci Sports. 2018;00:1–9. PubMed PMID: 30230064. https://onlinelibrary.wiley.com/doi/abs/10.1111/sms.13307 

Physical Activity and Nutrition in Children Study website:
www.panicstudy.fi 

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The University of Eastern Finland, UEF, is one of the largest universities in Finland. The activities of the UEF underscore multidisciplinarity, and the university is especially strong in research related to forests and the environment, health and well-being, and new technologies and materials. The UEF offers teaching in more than 100 major subjects. In addition to the high standard of teaching, the university offers its students a modern study environment, which is under constant development. The university comprises four faculties: the Philosophical Faculty, the Faculty of Science and Forestry, the Faculty of Health Sciences, and the Faculty of Social Sciences and Business Studies. The university’s campuses are located in the heart of beautiful eastern Finland in Joensuu, Kuopio and Savonlinna. The UEF is home to approximately 15 000 students and nearly 2 800 members of staff.

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