PreAdolescent CardioMetabolic Associations and Correlates : PACMAC : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in School of Sport and Exercise at Massey University, Wellington, New Zealand
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Date
2018
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Massey University
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Abstract
Cardiovascular disease is typically associated with adults; however,
atherosclerosis often initiates during preadolescence and has been linked to
cardiometabolic risk factors. Preceding cardiometabolic risk factors include lifestyle
factors: body fatness, physical fitness, physical [in]activity, sedentary behaviour,
nutrition, and sleep. No known study has comprehensively assessed simultaneous
associations among lifestyle factors with cardiometabolic risk factors in preadolescent
children.
A multicentred cross-sectional study design was utilised to investigate lifestyle
factor associations with cardiometabolic risk factors in a sample of 392 children aged 8
to 10 years. Participants were recruited from primary schools located in the Wellington,
Canterbury, and Otago regions in New Zealand. Data collection was carried out over 5
days between 09:00 a.m. and 12:00 p.m. at each location.
The first objective assessed the associations among physical fitness, physical
[in]activity, sedentary behaviour, nutrition, and sleep with body fatness indicators (body
fat percentage, fat mass index, body mass index, and waist-to-hip ratio). Results
indicated nutrition independently associated with body fat percentage (p < 0.05),
whereas cardiorespiratory fitness significantly associated with all four body fatness
indicators (p < 0.05).
The second objective assessed the associations among body fatness, physical
fitness, physical [in]activity, sedentary behaviour, nutrition, and sleep with
cardiometabolic factors (blood pressure, cholesterol, vascular, and carbohydrate-
metabolic). Results indicated body fat percentage associated with the blood pressure
factor (p < 0.05); sedentary minutes, social jetlag, and Fruit and Vegetables pattern
associated with the cholesterol factor (all p < 0.05); sedentary minutes and Processed Food pattern associated with the vascular factor (both p < 0.05); and cardiovascular
fitness (V̇O₂max) and handgrip strength associated with the carbohydrate-metabolic
factor (both p < 0.001). Accordingly, body fatness, physical fitness, nutrition, and sleep
all associated with at least one cardiometabolic factor.
Cardiorespiratory fitness associated with cardiometabolic health and was the key
finding in Objective 1; therefore, physical fitness may be the most important lifestyle
factor. However, as nutrition, sleep, sedentary behaviour, and body fatness also
associated with cardiometabolic health, it appears one specific lifestyle factor does not
entirely explain cardiometabolic health in preadolescent children, and thus a multimodal
approach for health is required for this population.
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Keywords
Cardiovascular system, Diseases, Risk factors, Children, Health and hygiene, New Zealand