A Cross-Sectional Investigation of Preadolescent Cardiometabolic Health: Associations with Fitness, Physical Activity, Sedentary Behavior, Nutrition, and Sleep

Background: Cardiometabolic disease (CMD) risk often begins early in life. Healthy lifestyle behaviors can mitigate risk, but the optimal combination of behaviors has not been determined. This cross-sectional study simultaneously examined the associations between lifestyle factors (fitness, activity behaviors, and dietary patterns) and CMD risk in preadolescent children. Methods: 1480 New Zealand children aged 8-10 years were recruited. Participants included 316 preadolescents (50% female, age: 9.5 +/- 1.1 years, BMI: 17.9 +/- 3.3 kg/m(2)). Fitness (cardiorespiratory fitness [CRF], muscular fitness), activity behaviors (physical activity, sedentary, sleep), and dietary patterns were measured. Factor analysis was used to derive a CMD risk score from 13 variables (adiposity, peripheral and central hemodynamics, glycemic control, and blood lipids). Results: Only CRF (beta = -0.45, p < 0.001) and sedentary time (beta = 0.12, p = 0.019) were associated with the CMD risk score in the adjusted multivariable analysis. CRF was found to be nonlinear (VO2 max <= approximate to 42 mL/kg/min associated with higher CMD risk score), and thus a CRF polynomial term was added, which was also associated (beta = 0.19, p < 0.001) with the CMD risk score. Significant associations were not found with sleep or dietary variables. Conclusion: The findings indicate that increasing CRF and decreasing sedentary behavior may be important public health targets in preadolescent children.