Accelerometer-measured physical activity, fitness and indicators of cardiometabolic risk among rural adolescents: a cross-sectional study at 15-year follow-up of the MINIMat cohort

• Background: Little is known about the relationship of physical activity (PA) and fitness with cardiometabolic risk among adolescents in resource-limited settings of low- and middle-income countries. We sought to examine the associations of accelerometer-measured PA and objective measures of physical fitness with conventional indicators of cardiometabolic risk along with difference in associations by gender in a birth cohort of rural adolescents. Methods: This cross-sectional study availed data from the 15-year follow-up of the Maternal and Infant Nutrition Interventions in Matlab (MINIMat) cohort in southeast Bangladesh (n = 2253). Wrist-mounted ActiGraph wGT3x-BT devices were used to estimate sedentary time (ST), total PA and time spent in intensity-specific PA. Fitness was assessed through: handgrip strength, standing long jump and maximal oxygen consumption (VO2max) estimated from Chester Step Test. Anthropometric parameters and systolic blood pressure (SBP) were recorded. Fasting plasma triglyceride (TG), total cholesterol (TC), low- and high-density lipoproteins (LDL and HDL), insulin and glucose levels were measured. We calculated insulin resistance (IR) using the Homeostasis Model Assessment equation (HOMA-IR). Three right-skewed outcome variables were natural log (Ln) transformed: WC, TG and HOMA-IR. Omnibus and gender-specific multiple linear regression models were fitted.Results: Total PA displayed weak, negative associations; whereas ST showed weak, positive associations with WC and IR. A 10-minute-per-day higher vigorous PA (VPA) was associated with: 4.9% (95% CI: 2.9%–6.8%; P < 0.001) lower WC, 3.2 mm of Hg (95% CI: 1.5–4.8; P < 0.001) lower SBP, 10.4% (95% CI: 2.9%–17.3%; P = 0.008) lower TG, 24.4% (95% CI: 11.3%–34.9%; P < 0.001) lower IR. Time engaged in moderate-to-vigorous PA showed similar associations of notably smaller magnitude with the indicators. Except for WC, the associations were more pronounced among the boys. Weight-normalized grip strength was favorably associated with all seven indicators and the unstandardized effect sizes were considerably large. Higher VO2max was only associated with a small reduction in HOMA-IR.   Conclusion: Our findings highlight the beneficial role of VPA, moderate-to-vigorous PA and muscular fitness in shaping cardiometabolic risk profile at mid-adolescence. VPA and handgrip strength represent potential targets for preventive strategies targeting adolescents in a rural context.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)

Keyword

Accelerometer-measured physical activity

sedentary behavior

rural adolescents

low- and middle-income countries

cardiometabolic risk markers

blood pressure

lipid profile

waist circumference

Bangladesh

Publication and Content Type

vet (subject category)

ovr (subject category)