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Changes in physical activity behavior and development of cardiovascular risk in children
Giulia Lona1, Christoph Hauser1, Sabrina Köchli1
1Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland.
Insights
Higher cardiorespiratory fitness (CRF) in children improved body mass index (BMI) and retinal microvascular health. Reducing screen time also benefited retinal health in children with high blood pressure (BP).
Area of Science:
- Pediatrics
- Cardiovascular Health
- Ophthalmology
Background:
- Childhood obesity and cardiovascular disease risk factors are increasing.
- Early identification of health markers is crucial for long-term well-being.
- Retinal microvascular changes can indicate systemic vascular health.
Purpose of the Study:
- To examine the association between changes in physical activity, screen time, and cardiorespiratory fitness (CRF) with body mass index (BMI), blood pressure (BP), and retinal microvascular health in children over four years.
- To identify potential primary prevention strategies for cardiovascular disease in children.
Main Methods:
- Longitudinal study of 262 children aged 6-8 years at baseline, re-examined after four years.
- Objective assessment of cardiorespiratory fitness (CRF) using a 20m shuttle run.
- Measurement of retinal arteriolar and venular diameters using a retinal vessel analyzer; BMI and BP assessed via standardized protocols.
Main Results:
- Higher CRF levels were associated with reduced BMI and wider retinal arteriolar diameters (CRAE) at follow-up.
- Children with elevated baseline systolic blood pressure (BP) and lower screen time showed wider CRAE.
- Increased CRF over four years correlated with reduced BMI and wider retinal arterioles.
Conclusions:
- Improvements in cardiorespiratory fitness (CRF) are linked to better body mass index (BMI) and retinal microvascular health in children.
- Reducing screen time may be a beneficial intervention for children with elevated blood pressure (BP) to improve retinal microvascular health.
- These findings support lifestyle interventions for primary prevention of cardiovascular disease in childhood.
Abstract:
The study aimed to investigate the association of changes in physical activity, screen time, and cardiorespiratory fitness (CRF) with development of body mass index (BMI), blood pressure (BP), and retinal microvascular health in children over four years. In 2014, 391 children aged 6-8 years were screened, and thereof 262 children were reexamined after four years following standardized protocols. Retinal arteriolar (CRAE) and venular diameters were measured by a retinal vessel analyzer. CRF was objectively assessed by a 20 m shuttle run, physical activity, and screen time by use of a questionnaire. Children who achieved higher CRF levels reduced their BMI (β [95% CI] -0.35 [-0.46 to -0.25] kg/m2 per stage, P ≤ .001) and thereby developed wider CRAE (β [95% CI] 0.25 [0.24 to 0.48] µm per stage, P = .03) at follow-up. Moreover, children with elevated or high systolic BP at baseline, but lower levels of screen time during the observation period, had wider CRAE at follow-up (β [95% CI] -0.37 [-0.66 to -0.08] µm per 10 min/d, P = .013). Change in CRF was not directly associated with better microvascular health at follow-up. However, an increase of CRF over four years was associated with a reduced BMI and consequently wider retinal arterioles at follow-up. In children with elevated or high systolic BP, a reduction of screen time significantly improved retinal microvascular health as a primary prevention strategy to promote childhood health and combat development of manifest CV disease later in life.
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