Department of Environmental Medicine, Institute of Public Health (C.A.G.T., L.I.R., C.D., P.G., F.N., T.K.J.), and Institute of Sports Science and Clinical Biomechanics (A.G., M.R.-L., L.B.A.), University of Southern Denmark, 5000 Odense C, Denmark; and Department of Biostatistics (K.D.S., T.S.), University of Copenhagen, 1353 Copenhagen, Denmark.
Our objective was to explore whether childhood exposure to perfluorinated and polyfluorinated compounds (PFCs), widely used stain- and grease-repellent chemicals, is associated with adiposity and markers of glycemic control.
Body mass index, skinfold thickness, waist circumference, leptin, adiponectin, insulin, glucose, and triglyceride concentrations were assessed in 8- to 10-year-old children in 1997 in a subset of the European Youth Heart Study, Danish component. Plasma PFC concentrations were available from 499 children. Linear regression models were performed to determine the association between PFC exposure and indicators of adiposity and markers of glycemic control.
There was no association between PFC exposures and adiposity or markers of glycemic control in normal-weight children. Among overweight children, an increase of 10 ng perfluorooctane sulfonic acid/mL plasma was associated with 16.2% (95% confidence interval [CI], 5.2%-28.3%) higher insulin concentration, 12.0% (95% CI, 2.4%-22.4%) higher ß-cell activity, 17.6% (95% CI, 5.8%-30.8%) higher insulin resistance, and 8.6% (95% CI, 1.2%-16.5%) higher triglyceride concentrations, and an increase of 10 ng perfluorooctanoic acid/mL plasma was associated with 71.6% (95% CI, 2.4%-187.5%) higher insulin concentration, 67.5% (95% CI, 5.5%-166.0%) higher ß-cell function, 73.9% (95% CI, 0.2%-202.0%) higher insulin resistance, and 76.2% (95% CI, 22.8%-153.0%) higher triglyceride concentrations.
Increased PFC exposure in overweight 8- to 10-year-old children was associated with higher insulin and triglyceride concentrations. Chance findings may explain some of our results, and due to the cross-sectional design, reverse causation cannot be excluded. The findings therefore need to be confirmed in longitudinal studies.
Persistent organic pollutants (POPs) have metabolic disrupting abilities and are suggested to contribute to the obesity epidemic. We investigated whether serum concentrations of POPs at 8-10 years of age were associated with subsequent development of overweight at age 14-16 and 20-22 years.
The study was based on data from the European Youth Heart Study, Danish component (1997). Concentrations of several polychlorinated biphenyls (PCBs) and the organochlorine pesticides p,p-dichlorodiphenyldichloroethylene (DDE) and hexachlorobenzene (HCB) were measured in serum from children aged 8-10 years (n = 509). Information on BMI z-scores, waist circumference and % body fat were collected at clinical examinations at ages 8-10, 14-16 and 20-22 years. Multiple linear regression analyses were performed taking potential confounders into account.
Overall, POP serum concentrations were low: median SPCB 0.18 µg/g lipid, DDE 0.04 µg/g lipid and HCB 0.03 µg/g lipid. POPs were generally not associated with weight gain at 14-16 and 20-22 years of age, except for an inverse association among the highest exposed girls at 20-22 years of age, which might possibly be explained by multiple testing or residual confounding.
This study suggests that, in a low exposed population, childhood serum concentrations of PCB, DDE, and HCB are not associated with subsequent weight gain.
Associations between objectively measured physical activity intensity in childhood and measures of subclinical cardiovascular disease in adolescence: prospective observations from the European Youth Heart Study.
No prospective studies have investigated the association between physical activity (PA) and carotid subclinical cardiovascular disease across childhood. Therefore, the primary aim was to investigate the association between PA intensity across childhood and carotid intima media thickness (cIMT) and stiffness in adolescence. Second, we included a clustered cardiovascular disease risk score as outcome.
This was a prospective study of a sample of 254 children (baseline age 8-10 years) with a 6-year follow-up. The mean exposure and the change in minutes of moderate-and-vigorous and vigorous PA intensity were measured using the Actigraph activity monitor. Subclinical cardiovascular disease was expressed as cIMT, carotid arterial stiffness and secondarily as a metabolic risk z-score including the homoeostasis model assessment score of insulin resistance, triglycerides, total cholesterol to high-density lipoprotein ratio, inverse of cardiorespiratory fitness, systolic blood pressure and the sum of four skinfolds.
No associations were observed between PA intensity variables and cIMT or carotid arterial stiffness (p>0.05). Neither change in PA intensity (moderate-and-vigorous nor vigorous) nor mean minutes of moderate-and-vigorous PA intensity was associated to the metabolic risk z-score in adolescence (p>0.05). However, a significant inverse association was observed between mean minutes of vigorous PA and the metabolic risk z-score in adolescence independent of gender and biological maturity (standard ß=-0.19 p=0.007).
A high mean exposure to, or changes in, minutes spent at higher PA intensities across childhood was not associated to cIMT or stiffness in the carotid arteries in adolescence. Our observations suggest that a high volume of vigorous PA across childhood independently associated with lower metabolic cardio vascular disease risk in adolescence.
A large proportion of a child's day is spent at school interacting with certain physical surroundings, teachers, and school friends. Thus, schools could have a marked impact on establishing physical activity habits. The aim of the present study was to assess between-school variation in physical activity, aerobic fitness, and organized sports participation. Altogether, we tested 1766 nine- and fifteen-year-old children attending 242 school classes at 35 different schools in Denmark in 1997-2003. The intra-class correlation coefficient (ICC) for objectively assessed physical activity ranged between 0.06 and 0.18 depending on the dimension of physical activity and the time considered (i.e. school time vs. leisure time). For aerobic fitness, an ICC of 0.10 was observed, whereas that for organized sports participation ranged between 0.01 and 0.10 depending on the age group. Studying between-school variation in physical activity provides information about the extent to which children adjust their physical activity habits according to the social and environmental circumstances that they share, and helps to plan future school-based physical activity studies, especially in terms of sample size and power calculation.
Raised blood pressure (BP) response during exercise independently predicts future hypertension. Subjects with higher BP in childhood also have elevated BP later in life. Therefore, the factors related to the regulation of exercise BP in children needs to be well understood. We hypothesized that physiological cardiovascular disease (CVD) risk factors would influence BP response during exercise in children and adolescents. This is a cross-sectional study of 439 Danish third-grade children and 364 ninth-grade adolescents. Systolic blood pressure (SBP) was measured with sphygmomanometer during a maximal aerobic fitness test. Examined CVD risk factors were high-density lipoprotein (HDL)- and low-density lipoprotein (LDL)-cholesterol, triglyceride, homeostasis model of assessment of insulin resistance (HOMA-IR) score, body mass index (BMI), waist circumference, and aerobic fitness. A random effect model was used to test the hypotheses. In boys, HOMA-IR score and BMI were positively related to SBP response during exercise (ß = 1.03, P = 0.001, and ß = 0.58, P = 0.017, respectively). The effects sizes of HOMA-IR score and BMI and the significance levels only changed slightly (ß = 0.91, P = 0.004, and ß = 0.43, P = 0.08, respectively) when the two variables were added in the same model. A significant positive association was observed between aerobic fitness and SBP response in girls (ß = 3.13 and P = 0.002). HOMA-IR score and BMI were found to be positively related to the SBP response in male children and youth. At least partly, adiposity and insulin sensitivity seem to influence exercise SBP through different mechanisms. The positive relationship observed between aerobic fitness and SBP response in girls remains unexplainable for us, although post hoc analyses revealed that it was the case in the ninth graders only.
Childhood overweight has noticeable psychological and social consequences for the child and leads to an increased risk of mortality and morbidity later in life. With the high prevalence of overweight in children and adolescents, it is important to identify effective approaches for the prevention and treatment of overweight in children and young individuals. The primary aim of the study is to assess the effect of an intensive day-camp intervention on body mass index (BMI) in overweight children.
The Odense Overweight Intervention Study is a semi-blinded randomized controlled trial. Overweight children from the Municipality of Odense, Denmark, were invited to participate in the trial. Based on power calculations 98 participants were found to be sufficient to randomize in order to find an effect of minimum 1.5 BMI points. Gender-stratified concealed block randomization with a ratio of 1:1 and random block sizes of two, four, and six ensured balance between study arms. The intervention consisted of a six-week multi-component day camp including increased physical activity, healthy diet and health education followed by 46 weeks of family-based habitual intervention. The standard care arm was offered two weekly hours of physical activity training for six weeks. The outcomes were measured at baseline and at six-week and 52-week follow-ups. Furthermore, BMI will be assessed again at 48-month follow-up. Test personnel were kept blinded. The intervention effect will be evaluated using mixed model analyses. During 2012 and 2013, 115 children were enrolled in the study. Fifty-nine children were randomized to the day-camp intervention arm and 56 to the standard intervention arm.
This study will provide novel information about the long-term health effects of an intense day-camp intervention program on overweight children, due to the design and the follow-up period. Moreover, it will add to the knowledge on designing and implementing feasible camp settings for preventing overweight in children.
NCT01574352 at http://clinicaltrials.gov on the 8th of March 2012.
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To examine the effects of a multi-component camp-based intervention on inflammatory markers and adipokines in children.
One hundred and fifteen children were recruited in Odense, Denmark (2012-2014). The participants were randomly allocated to either the day camp intervention arm (DCIA) or the standard intervention arm (SIA). The intervention for the DCIA consisted of a 6-week camp-based intervention and a 46-week family-based intervention. The SIA was offered one weekly physical activity session for 6 weeks and one educational meeting. C-reactive protein (CRP), monocyte chemoattractant protein-1 (MCP1), leptin, and adiponectin were measured in serum at baseline, 6 weeks and 52 weeks.
In comparison with the SIA, the reductions in CRP (P=0.003) and leptin (p
Head-to-head comparison of intensive lifestyle intervention (U-TURN) versus conventional multifactorial care in patients with type 2 diabetes: protocol and rationale for an assessor-blinded, parallel group and randomised trial.
Current pharmacological therapies in patients with type 2 diabetes (T2D) are challenged by lack of sustainability and borderline firm evidence of real long-term health benefits. Accordingly, lifestyle intervention remains the corner stone in the management of T2D. However, there is a lack of knowledge regarding the optimal intervention programmes in T2D ensuring both compliance as well as long-term health outcomes. Our objective is to assess the effects of an intensive lifestyle intervention (the U-TURN intervention) on glycaemic control in patients with T2D. Our hypothesis is that intensive lifestyle changes are equally effective as standard diabetes care, including pharmacological treatment in maintaining glycaemic control (ie, glycated haemoglobin (HbA1c)) in patients with T2D. Furthermore, we expect that intensive lifestyle changes will decrease the need for antidiabetic medications.
The study is an assessor-blinded, parallel group and a 1-year randomised trial. The primary outcome is change in glycaemic control (HbA1c), with the key secondary outcome being reductions in antidiabetic medication. Participants will be patients with T2D (T2D duration
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This longitudinal study aimed to examine if a Movability Index (MI), based on objectively measured built environment characteristics, was a determinant for objectively measured physical activity (PA) among young adults.
Data collected from 177 persons participating in the Danish part of the European Youth Hearth Study (EYHS) was used to examine the effect of the built environment on PA. A MI was developed using objectively measured built environment characteristics, and included residential density, recreational facilities, daily destinations and street connectivity.
Results showed a positive cross-sectional association between MI and PA. PA decreased from baseline to follow-up. MI increased, primarily due to participants relocating to larger cities. An increase in MI from baseline to follow-up was associated with a reduced decrease in PA for females.
Our findings suggest that the built environment is a determinant for PA, especially for females. The found gender differences might suggest the need to develop gender specific environmental indices in future studies. The validity of the measures can be further improved by creating domain specific PA measures as well as domain specific environmental indices and this can potentially reveal more specific built environment determinants for PA.
Little is known about health characteristics and the physical activity (PA) patterns in children attending preschools. The objective of this study was to describe the gender differences in relation to body mass index (BMI), motor skills (MS) and PA, including PA patterns by the day type and time of day. Additionally, the between-preschool variation in mean PA was estimated using the intraclass correlation.
We invited 627 children 5-6 years of age attending 43 randomly selected preschools in Odense, Denmark. Aiming and catching MS was assessed using subtests of the Movement Assessment Battery for Children (Second Edition) and motor coordination MS was assessed by the Kiphard-Schilling body coordination test, Körperkoordination Test für Kinder. PA was measured using accelerometry. The PA patterns were analysed using mixed models.
No gender differences in the BMI or norm-referenced MS risk classification, or the average weekly PA level or patterns of PA were observed. However, boys performed better in the aiming and catching score (p
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