Introduction
This study examines the dose–response relationship between moderate-to-vigorous physical
activity and cardiometabolic measures in adolescents.
Methods
Cross-sectional spline analyses were performed using 2003–2016 National Health and
Nutrition Examination Survey data among adolescents (aged 12–19 years, N=9,195) on
objectively measured (2003–2006) and self-reported (2007–2016) weekly mean minutes
of moderate-to-vigorous physical activity and cardiometabolic measures (systolic and
diastolic blood pressure, total cholesterol, high-density lipoprotein, BMI, and cardiorespiratory
fitness). Inflection points were determined for nonlinear relationships.
Results
For objective moderate-to-vigorous physical activity, female adolescents had significant
nonlinear associations with inflection points at 90 minutes/week for BMI percentile
and systolic blood pressure. Male adolescents had inflection points at 150 weekly
minutes of objective activity for BMI percentile and cardiorespiratory fitness. BMI
percentile was about 7% lower for female and male adolescents at 150 weekly minutes
of objectively measured moderate-to-vigorous physical activity than at 0 minutes.
For self-reported moderate-to-vigorous physical activity, inflection points were at
375 minutes/week (diastolic blood pressure for female adolescents) and 500 minutes/week
(systolic blood pressure for male adolescents).
Conclusions
Among several significant dose–response relationships between physical activity and
cardiometabolic health in adolescents, consistent and often nonlinear relationships
were identified for BMI, with inflection points at 90–150 minutes of objective moderate-to-vigorous
physical activity. Notable differences in associations and linearity were identified
by sex and physical activity measure (objective or self-reported). These results support
calls for any increase in physical activity among adolescents and suggest that recommendations
closer to the adult guidelines of 150 weekly minutes of physical activity may be health
promoting and more attainable for youth than the current recommendation of 420 weekly
minutes.
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