Weight-activity associations with cardiometabolic risk factors among U.S. youth

Research among adult populations suggests that underweight is associated with worse cardiometabolic health and that adequate engagement in moderate-to-vigorous physical activity (MVPA) may help to counteract the cardiometabolic consequences of overweight/obesity. Whether these findings are also true in children and adolescents (hereafter 'youth') is unknown. Therefore, the purpose of this study was to determine whether underweight and overweight/obese youth who engage in relatively more MVPA have better or similar cardiometabolic risk factors than normal weight youth who engage in relatively less MVPA. Data were extracted from the 2003-2006 National Health and Nutrition Examination Survey (N=2268). Four cardiometabolic risk factors assessed included C-reactive protein, mean arterial pressure, total cholesterol, and high-density lipoprotein (HDL) cholesterol. Weight status was assessed via dual energy X-ray absorptiometry. MVPA was assessed via accelerometry. Six weight-activity groups were created: 1) Underweight and Inactive; 2) Normal Weight and Inactive; 3) Overweight/Obese and Inactive; 4) Underweight and Active; 5) Normal Weight and Active; and, 6) Overweight/Obese and Active. An overall cardiometabolic risk score was calculated by summing the frequency with which each individual participant scored in the worst quartile for each of the 4 cardiometabolic parameters. Compared to those who were Normal Weight and Inactive, youth who were Underweight and Active (β=-0.05, p=0.78) had a similar overall cardiometabolic risk score. In contrast, Overweight/Obese and Active youth (β=1.1, p<0.001) had a higher overall cardiometabolic risk score when compared to Normal Weight and Inactive youth. These cross-sectional findings suggest that MVPA may not fully counteract the cardiometabolic consequences of overweight/obesity in youth. Rather, maintaining a normal weight may be of a more important factor related to cardiometabolic risk in youth.