Accelerometer-based cumulative sedentary time from childhood to adulthood with increased arterial stiffness and carotid intima-media thickness in youth: a 13-year longitudinal study
Authors : AO Agbaje, AR Barker, AJ Lewandowski, P Leeson, TP Tuomainen, et al. Finland.
Background:
Arterial stiffness and progression of carotid intima-media thickness (cIMT) have been associated with cardiovascular morbidity and mortality in adulthood. Arterial stiffness is a major risk factor for high blood pressure, hypertension, and insulin resistance in adolescents and young adults. It remains unclear whether cumulative sedentary time independently worsens arterial health in the pediatric population.
Purpose:
To investigate the longitudinal association of cumulative sedentary time from childhood to adulthood with arterial stiffness and changes in carotid intima-media thickness (cIMT) during postpubertal growth.
Methods:
From the Avon Longitudinal Study of Parents and Children (ALSPAC), UK birth cohort, 1399 children aged 11 years who had at least two follow-up time points, accelerometer-measured sedentary time over 13 years of follow-up, and complete cardiac monitoring .
Structural measures were included at the age of 17 years at the clinical visit. Sedentary time was assessed with the ActiGraph accelerometer worn for 4 to 7 days at clinic visits at ages 11, 15, and 24 years and categorized by sex into tertiles as low (reference), moderate, and high.
Carotid femoral pulse wave velocity ( cfPWV), a measure of arterial stiffness, and cIMT were assessed with Vicorder and ultrasound, respectively, at ages 17 and 24 years. Multivariable-adjusted associations were examined using generalized linear mixed-effects models and adjusted for sex,
Results:
Among 1339 participants (mean [SD] age, 11.75 [0.24] years; [54.6% female]), men spent an average of 358, 461, and 536 minutes/day sedentary at ages 11, 15 and 24 years old, respectively. The women spent 369, 484, and 525 minutes per day sedentary at ages 11, 15, and 24, respectively.
Carotid femoral pulse wave velocity (cfPWV) was significantly higher among men than women at ages 17 and 24 years.
Carotid intima-media thickness (cIMT) was greater in men than in women at age 17 years but not at age 24 years.
In a fully adjusted model, the highest tertile of sedentary time between ages 11 and 24 years was cumulatively associated with progressively greater changes in cfPWV (effect estimate 0.009 m/s [CI 0.006 – 0.012] p<0.001) among ages 17 and 24 years in the total cohort and women (0.047 m/s [CI 0.005 – 0.090] p=0.030), but not in men.
Conclusion: Cumulative increases in sedentary time during growth from childhood to adulthood were independently associated with progressive worsening of arterial stiffness in youth. |
Comments
Sedentary time in children linked to heart damage in early adulthood
Hours of inactivity during childhood could set the stage for heart attacks and strokes later in life, according to research presented at ESC Congress 2023. The study found that cumulative sedentary time from childhood to early adulthood was associated with heart damage, even in people with normal weight and blood pressure.
"All those hours of screen time in young people adds up to a heavier heart, which we know from studies in adults increases the likelihood of heart attack and stroke," said study author Dr. Andrew Agbaje. , from the University of Eastern Finland, Kuopio, Finland. “Children and adolescents need to move more to protect their long-term health.”
This was the first study to investigate the cumulative effect of sedentary time assessed with smartwatches in young people and heart damage later in life. It was conducted as part of the Children of the 90s study, which began in 1990/1991 and is one of the largest cohorts in the world with lifestyle measurements from birth. 3
At age 11, children wore a smartwatch with an activity tracker for seven days. This was repeated at age 15 and again at age 24. The weight of the left ventricle of the heart was assessed by echocardiography, a type of ultrasound, at ages 17 and 24 and reported in grams relative to height (g/m 2.7). The researchers looked at the association between sedentary time between ages 11 and 24 and heart measurements between ages 17 and 24 after adjusting for factors that could influence the relationship, such as age, sex, blood pressure , body fat, smoking, physical activity and socioeconomic status.
The study included 766 children, of which 55% were girls and 45% boys. At age 11, children were sedentary for an average of 362 minutes per day, increasing to 474 minutes per day in adolescence (age 15) and 531 minutes per day in young adulthood (age 24). This means that sedentary time increased by an average of 169 minutes (2.8 hours) per day between childhood and young adulthood.
Each one-minute increase in sedentary time between ages 11 and 24 was associated with a 0.004 g/m 2.7 increase in left ventricular mass between ages 17 and 24. When multiplied by 169 minutes of additional inactivity, this equates to a daily increase of 0.7 g/m 2.7, the equivalent of a 3 gram increase in left ventricular mass between echocardiography measurements with increasing average height. An earlier study in adults found that a similar increase in left ventricular mass (1 g/m 2.7 ) over a seven-year period was associated with a two-fold increased risk of heart disease, stroke and death.
Dr Agbaje said: “The children were sedentary for more than six hours a day and this increased by almost three hours a day as they reached adulthood. Our study indicates that the accumulation of inactive time is related to cardiac damage independently of body weight and blood pressure. Parents should encourage children and teens to move more by taking them for walks and limiting the time they spend on social media and video games. As Martin Luther King Jr. once said: ’If you can’t fly, run. If you can not run, walk. If you can not walk, crawl. But by all means keep moving.”
