The Longitudinal Association of Cardiorespiratory Fitness and Adiposity With Clustered Cardiometabolic Risk: A Mediation Analysis (2024)

ABEP. Brazilian Economic Classification Criteria [Internet]. Published 2012. http://www.abep.org/criterio-brasil

Search Google Scholar
Export Citation

Andersen LB, Lauersen JB, Brønd JC, etal. A new approach to define and diagnose cardiometabolic disorder in children. J Diabetes Res. 2015;2015:1–10. doi:

Andersen LB, Sardinha L, Froberg K, Riddoch CJ, Page AS, Anderssen SA. Fitness, fatness and clustering of cardiovascular risk factors in children from Denmark, Estonia and Portugal: the European Youth Heart Study. Int J Pediatr Obes. 2008;3(suppl 1):58–66. doi:

Bergmann G, Bergmann M, De Castro A, etal. Use of the 6-minute walk/run test to predict peak oxygen uptake in adolescents. Rev Bras Ativ Fis Saúde. 2014;19(1):64–73.

Search Google Scholar
Export Citation

Bergmann GG, Bergmann MLA, Castro AAM, etal. Prediction of peak oxygen uptake in adolescents from 9 minutes run/walk test. Gazzetta Medica Ital Arch per le Sci Mediche. 2015;174(1–2):15–22.

Search Google Scholar
Export Citation

Brand C, Dias AF, Fochesatto CF, etal. The role of body fat in the relationship of cardiorespiratory fitness with cardiovascular risk factors in Brazilian children. Mot Rev de Educ Fis. 2018;24(4):e101811. doi:

Brand C, Gaya ACA, Dias AF, etal. The role of adiposity in the relationship between physical fitness with cardiometabolic risk factors, adipocytokines and inflammation in children. Sport Sci Health. 2021;17(1):127–36. doi:

Brand C, Martins CMDL, Lemes VB, etal. Effects and prevalence of responders after a multicomponent intervention on cardiometabolic risk factors in children and adolescents with overweight/obesity: action for health study. J Sports Sci. 2020;38(6):682–91. PubMed ID: 32050850 doi:

Brand C, Reuter CP, Gaya AR, etal. Association between cardiorespiratory fitness and cardiometabolic risk factors in Brazilian children and adolescents: the mediating role of obesity parameters. Paediatr Int Child Health. 2020;41(2):93–102. doi:

10.

Castro-Piñero J, Ortega FB, Ruiz JR. Adiposity and cardiovascular risk in children and adolescents: implications of the amount of fat carried and where. Mayo Clin Proc. 2019;94(10):1928–30. PubMed ID: 31585576 doi:

11.

Cohen J. Statistical Power Analysis for the Behavioral Sciences. 2nd ed. Lawrence Erlbaum Associates; 1988.

Search Google Scholar
Export Citation

12.

Cole DA, Maxwell SE. Testing mediational models with longitudinal data: questions and tips in the use of structural equation modeling. J Abnorm Psychol. 2003;112(4):558–77. PubMed ID: 14674869 doi:

13.

Cook S, Weitzman M, Auinger P, Nguyen M, Dietz WH. Prevalence of a metabolic syndrome phenotype in adolescents: findings from the third national health and nutrition examination survey, 1988–1994. Arch Pediatr Adolesc Med. 2003;157(8):821–7. PubMed ID: 12912790 doi:

14.

Cristi-Montero C, Courel-Ibáñez J, Ortega FB, etal. Mediation role of cardiorespiratory fitness on the association between fatness and cardiometabolic risk in European adolescents: the HELENA study. J Sport Health Sci. 2021;10(3):360–7. PubMed ID: 33993922 doi:

15.

Dias KA, Ingul CB, Tjønna AE, etal. Effect of high-intensity interval training on fitness, fat mass and cardiometabolic biomarkers in children with obesity: a randomised controlled trial. Sports Med. 2018;48(3):733–46. PubMed ID: 28853029 doi:

16.

Díez-Fernández A, Sánchez-López M, Mora-Rodríguez R, Notario-Pacheco B, Torrijos-Niño C, Martínez-Vizcaíno V. Obesity as a mediator of the influence of cardiorespiratory fitness on cardiometabolic risk: a mediation analysis. Diabetes Care. 2014;37(3):855–62. PubMed ID: 24198304 doi:

17.

Fritz MS, MacKinnon DP. Required sample size to detect the mediated effect. Psychol Sci. 2007;18(3):233–9. PubMed ID: 17444920 doi:

18.

García-Hermoso A, Ramírez-Vélez R, García-Alonso Y, Alonso-Martínez AM, Izquierdo M. Association of cardiorespiratory fitness levels during youth with health risk later in life: a systematic review and meta-analysis. JAMA Pediatr. 2020;174(10):952–60. doi:

19.

Gutin B. Diet vs exercise for the prevention of pediatric obesity: the role of exercise. Int J Obes. 2011;35(1):29–32. doi:

20.

Hayes AF. Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-Based Approach. 3rd ed. The Guilford Press; 2022.

Search Google Scholar
Export Citation

21.

Kelishadi R, Mirmoghtadaee P, Najafi H, Keikha M. Systematic review on the association of abdominal obesity in children and adolescents with cardio-metabolic risk factors. J Res Med Sci. 2015;20(3):294–307. PubMed ID: 26109978

Search Google Scholar
Export Citation

22.

Kennedy AB, Lavie CJ, Blair SN. Fitness or fatness which is more important? JAMA. 2018;319(3):231–2. PubMed ID: 29340689 doi:

23.

Kriemler S, Zahner L, Schindler C, etal. Effect of school based physical activity programme (KISS) on fitness and adiposity in primary schoolchildren: cluster randomised controlled trial. BMJ. 2010;340:c785. doi:

24.

Lang JJ, Larouche R, Tremblay MS. The association between physical fitness and health in a nationally representative sample of Canadian children and youth aged 6 to 17years. Health Promot Chronic Dis Prev Can. 2019;39(3):104–11. PubMed ID: 30869473 doi:

25.

Lavie CJ, Kokkinos P, Ortega FB. Survival of the fittest—Promoting fitness throughout the life span. Mayo Clin Proc. 2017;92(12):1743–5. PubMed ID: 29157531 doi:

26.

Lee H, Cashin AG, Lamb SE, etal. A guideline for reporting mediation analyses of randomized trials and observational studies: the AGReMA statement. JAMA. 2021;326(11):1045–56. PubMed ID: 34546296 doi:

27.

Lima RA, Andersen LB, Soares FC, Kriemler S. The causal pathway effects of a physical activity intervention on adiposity in children: the KISS Study cluster randomized clinical trial. Scand J Med Sci Sports. 2020;30(9):1685–91. PubMed ID: 32501613 doi:

28.

Lima RA, Bugge A, Ersbøll AK, Stodden DF, Andersen LB. The longitudinal relationship between motor competence and measures of fatness and fitness from childhood into adolescence. J Pediatr. 2019;95(4):482–8. PubMed ID: 29782811 doi:

29.

Mintjens S, Menting MD, Daams JG, van Poppel MNM, Roseboom TJ, Gemke RJBJ. Cardiorespiratory fitness in childhood and adolescence affects future cardiovascular risk factors: a systematic review of longitudinal studies. Sports Med. 2018;48(11):2577–605. PubMed ID: 30144022 doi:

30.

Ortega FB, Ruiz JR, Labayen I, Lavie CJ, Blair SN. The fat but fit paradox: what we know and don’t know about it. Br J Sports Med. 2018;52(3):151–3. PubMed ID: 28583992 doi:

31.

Pan H, Liu S, Miao D, Yuan Y. Sample size determination for mediation analysis of longitudinal data. BMC Med Res Methodol. 2018;18(1):32. PubMed ID: 29580203 doi:

32.

Perez‐Bey A, Ruiz JR, Ortega FB, etal. Bidirectional associations between fitness and fatness in youth: a longitudinal study. Scand J Med Sci Sports. 2020;30(8):1483–96. PubMed ID: 32297361 doi:

33.

Pérez-Bey A, Segura-Jiménez V, Fernández-Santos JR, etal. The influence of cardiorespiratory fitness on clustered cardiovascular disease risk factors and the mediator role of body mass index in youth: the UP&DOWN study. Pediatr Diabetes. 2019;20(1):32–40. PubMed ID: 30468012

Search Google Scholar
Export Citation

34.

Poitras VJ, Gray CE, Borghese MM, etal. Systematic review of the relationships between objectively measured physical activity and health indicators in school-aged children and youth. Appl Physiol Nutr Metab. 2016;41(6 suppl 3):S197–239. doi:

35.

PROESP-BR. Manual de Aplicação de Medidas e Testes, Normas e Critérios de Avaliação. [Internet]. Published 2009. https://www.ufrgs.br/proesp/

Search Google Scholar
Export Citation

36.

PROESP-BR. Manual de Testes e Avaliação [Internet]. Published 2012. https://www.ufrgs.br/proesp/

Search Google Scholar
Export Citation

37.

Quadros TMB, Gordia AP, Silva LR. Anthropometry and clustered cardiometabolic risk factors in young people: a systematic review. Rev Paul Pediatr. 2017;35(3):340–50. PubMed ID: 28977298 doi:

38.

Reuter CP, Brand C, Silveira JFC, etal. Reciprocal longitudinal relationship between fitness, fatness, and metabolic syndrome in Brazilian children and adolescents: a 3-year longitudinal study. Pediatr Exerc Sci. 2021;33(2):74–81. PubMed ID: 33857920 doi:

39.

Ross R, Blair SN, Arena R, etal. Importance of assessing cardiorespiratory fitness in clinical practice: a case for fitness as a clinical vital sign: a scientific statement from the American Heart Association. Circulation. 2016;134(24):653–99. doi:

40.

Seo YG, Lim H, Kim Y, etal. The effect of a multidisciplinary lifestyle intervention on obesity status, body composition, physical fitness, and cardiometabolic risk markers in children and adolescents with obesity. Nutrients. 2019;11(1):137. doi:

41.

Silveira JF, Reuter CP, Welser L, etal. Tracking of cardiometabolic risk in a Brazilian schoolchildren cohort: a 3-year longitudinal study. J Sports Med Phys Fitness. 2021;61(7):997–1006. doi:

42.

Sociedade Brasileira de Cardiologia, Sociedade Brasileira de Hipertensão, Sociedade Brasileira de Nefrologia. VI Diretrizes Brasileiras de Hipertensão. Arq Bras Cardiol. 2010;1(suppl 1):1–51.

Search Google Scholar
Export Citation

43.

Stavnsbo M, Resaland GK, Anderssen SA, etal. Reference values for cardiometabolic risk scores in children and adolescents: suggesting a common standard. Atherosclerosis. 2018;278:299–306. PubMed ID: 30477756 doi:

44.

Stodden DF, Langendorfer SJ, Goodway JD, etal. A developmental perspective on the role of motor skill competence in physical activity: an emergent relationship. Quest. 2008;60(2):290–306. doi:

45.

Stoner L, Pontzer H, Barone Gibbs B, etal. Fitness and fatness are both associated with cardiometabolic risk in preadolescents. J Pediatr. 2020;217:39–45.e1. PubMed ID: 31759583 doi:

46.

Umer A, Kelley GA, Cottrell LE, Giacobbi P, Innes KE, Lilly CL. Childhood obesity and adult cardiovascular disease risk factors: a systematic review with meta-analysis. BMC Public Health. 2017;17(1):683. PubMed ID: 28851330 doi:

47.

Valeri L, VanderWeele TJ. Mediation analysis allowing for exposure–mediator interactions and causal interpretation: theoretical assumptions and implementation with SAS and SPSS macros. Psychol Methods. 2013;18(2):137. PubMed ID: 23379553 doi:

48.

Welser L, Lima RA, Silveira JFC, etal. Cardiometabolic risk factors in children and adolescents from southern Brazil: comparison to international reference values. J Pediatr Endocrinol Metab. 2021;34(10):1237–46. PubMed ID: 34237809 doi:

The Longitudinal Association of Cardiorespiratory Fitness and Adiposity With Clustered Cardiometabolic Risk: A Mediation Analysis (2024)

References