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Recommended levels and intensities of physical activity to avoid low-cardiorespiratory fitness in European adolescents: The HELENA study

Authors

  • David Martinez-Gomez,

    1. Unit for Preventive Nutrition, Department of Biosciences and Nutrition at NOVUM, Karolinska Institutet, Huddinge, Sweden
    2. Immunonutrition Research Group, Department of Metabolism and Nutrition, Instituto del Frío (IF), Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council, Madrid, Spain
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  • Jonatan R. Ruiz,

    1. Unit for Preventive Nutrition, Department of Biosciences and Nutrition at NOVUM, Karolinska Institutet, Huddinge, Sweden
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  • Francisco B. Ortega,

    1. Unit for Preventive Nutrition, Department of Biosciences and Nutrition at NOVUM, Karolinska Institutet, Huddinge, Sweden
    2. Department of Medical Physiology, Faculty of Medicine, Granada, Spain
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  • Jose A. Casajús,

    1. GENUD “Growth; Exercise, Nutrition and Development” research group, University School of Health Sciences, University of Zaragoza, Zaragoza, Spain
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  • Oscar L. Veiga,

    1. Department of Physical Education, Sport and Human Movement, Facultad de Formación del Profesorado y Educación, Universidad Autonoma de Madrid, Madrid, Spain
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  • Kurt Widhalm,

    1. Division of Nutrition and Metabolism, Department of Pediatrics, Medical University of Vienna, Vienna, Austria
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  • Yannis Manios,

    1. Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
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  • Laurent Béghin,

    1. CIC-9301-Inserm-CHRU of Lille, U995 and Faculty of Medicine, IMPRT, University Lille 2, Lille, France
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  • Marcela González-Gross,

    1. School of Sport Sciences, Universidad Politécnica de Madrid, Madrid, Spain
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  • Anthony Kafatos,

    1. Department of Social Medicine, School of Medicine, Preventive Medicine and Nutrition Clinic, Crete, Greece
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  • Vanesa España-Romero,

    1. Unit for Preventive Nutrition, Department of Biosciences and Nutrition at NOVUM, Karolinska Institutet, Huddinge, Sweden
    2. Department of Medical Physiology, Faculty of Medicine, Granada, Spain
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  • Denes Molnar,

    1. Department of Pediatrics, University of Pecs, Pécs-József, Hungary
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  • Luis A. Moreno,

    1. GENUD “Growth; Exercise, Nutrition and Development” research group, University School of Health Sciences, University of Zaragoza, Zaragoza, Spain
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  • Ascension Marcos,

    1. Immunonutrition Research Group, Department of Metabolism and Nutrition, Instituto del Frío (IF), Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council, Madrid, Spain
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  • Manuel J. Castillo,

    1. Department of Medical Physiology, Faculty of Medicine, Granada, Spain
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  • Michael Sjöström

    Corresponding author
    1. Unit for Preventive Nutrition, Department of Biosciences and Nutrition at NOVUM, Karolinska Institutet, Huddinge, Sweden
    • Michael Sjöström, Unit for Preventive Nutrition, Department of Biosciences and Nutrition at NOVUM, Karolinska Institutet, 14157 Huddinge, Sweden
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  • HELENA Study Group:Co-ordinator: Luis A. Moreno.Core Group members: Luis A. Moreno, Fréderic Gottrand, Stefaan DeHenauw, Marcela González-Gross, Chantal Gilbert. Steering Committee: Anthony Kafatos (President), Luis A. Moreno, ChristianLibersa, Stefaan De Henauw, Jackie Sánchez, Fréderic Gottrand, Mathilde Kersting, Michael Sjöstrom, Dénes Molnár, Marcela González-Gross, Jean Dallongeville, Chantal Gilbert, Gunnar Hall, Lea Maes, Luca Scalfi. Project Manager: Pilar Meléndez.

    • 1.Universidad de Zaragoza (Spain) Luis A. Moreno, Jesús Fleta, José A. Casajús, Gerardo Rodríguez, ConcepciónTomás, María I. Mesana, Germán Vicente-Rodríguez, AdoraciónVillarroya, Carlos M. Gil, Ignacio Ara, Juan Revenga, CarmenLachen, Juan Fernández Alvira, Gloria Bueno, Aurora Lázaro, Olga Bueno, Juan F. León, Jesús equation image Garagorri, Manuel Bueno, Juan Pablo Rey López, Iris Iglesia, Paula Velasco, and Silvia Bel.
    • 2.Consejo Superior de Investigaciones Científicas (Spain) Ascensión Marcos, Julia Wärnberg, Esther Nova, Sonia Gómez, Esperanza Ligia Díaz, Javier Romeo, Ana Veses, Mari Angeles Puertollano, Belén Zapatera, Tamara Pozo, and David Martinez-Gomez.
    • 3.Université de Lille 2 (France) Laurent Beghin, Christian Libersa, Frédéric Gottrand, Catalina Iliescu, and Juliana Von Berlepsch.
    • 4.Research Institute of Child Nutrition Dortmund, Rheinische Friedrich-Wilhelms-Universität Bonn (Germany) Mathilde Kersting, Wolfgang Sichert-Hellert, and Ellen Koeppen.
    • 5.Pécsi Tudományegyetem (University of Pécs) (Hungary) Dénes Molnar, Eva Erhardt, Katalin Csernus, Katalin Török, Szilvia Bokor, Mrs. Angster, Enikö Nagy, Orsolya Kovács, and Judit Répasi.
    • 6.University of Crete School of Medicine (Greece) Anthony Kafatos, Caroline Codrington, María Plada, Angeliki Papadaki, Katerina Sarri, Anna Viskadourou, Christos Hatzis, Michael Kiriakakis, George Tsibinos, Constantine Vardavas Manolis Sbokos, Eva Protoyeraki, and Maria Fasoulaki.
    • 7.Institut für Ernährungs- und Lebensmittelwissenschaften—Ernährungphysiologie. Rheinische Friedrich Wilhelms Universität (Germany) Peter Stehle, Klaus Pietrzik, Marcela González-Gross, Christina Breidenassel, Andre Spinneker, Jasmin Al-Tahan, Miriam Segoviano, Anke Berchtold, Christine Bierschbach, Erika Blatzheim, Adelheid Schuch, and Petra Pickert.
    • 8.University of Granada (Spain) Manuel J. Castillo Garzón, Ángel Gutiérrez Sáinz, Francisco B. Ortega Porcel, Jonatan Ruiz Ruiz, Enrique García Artero, Vanesa España Romero, David Jiménez Pavón, Cristóbal Sánchez Muñoz, Victor Soto, Palma Chillón, Jose M. Heredia, Virginia Aparicio, Pedro Baena, Claudia M. Cardia, and Ana Carbonell.
    • 9.Istituto Nazionalen di Ricerca per gli Alimenti e la Nutrizione (Italy) Davide Arcella, Giovina Catasta, Laura Censi, Donatella Ciarapica, Marika Ferrari, Cinzia Le Donne, Catherine Leclerq, Luciana Magrì, Giuseppe Maiani, Rafaela Piccinelli, Angela Polito, Raffaela Spada, and Elisabetta Toti.
    • 10.University of Napoli “Federico II” Dept of Food Science (Italy) Luca Scalfi, Paola Vitaglione, and Concetta Montagnese.
    • 11.Ghent University (Belgium) Ilse De Bourdeaudhuij, Stefaan De Henauw, Tineke De Vriendt, Lea Maes, Christophe Matthys, Carine Vereecken, Mieke de Maeyer, Charlene Ottevaere, and Inge Huybrechts.
    • 12.Medical University of Vienna (Austria) Kurt Widhalm, Katharina Phillipp, Sabine Dietrich, Birgit Kubelka, and Marion Boriss-Riedl.
    • 13.Harokopio University (Greece) Yannis Manios, Eva Grammatikaki, Zoi Bouloubasi, Tina Louisa Cook, Sofia Eleutheriou, Orsalia Consta, George Moschonis, Ioanna Katsaroli, George Kraniou, Stalo Papoutsou, Despoina Keke, Ioanna Petraki, Elena Bellou, Sofia Tanagra, Kostalenia Kallianoti, Dionysia Argyropoulou, Katerina Kondaki, Stamatoula Tsikrika, and Christos Karaiskos.
    • 14.Institut Pasteur de Lille (France) Jean Dallongeville and Aline Meirhaeghe.
    • 15.Karolinska Institutet (Sweden) Michael Sjöstrom, Patrick Bergman, María Hagströmer, Lena Hallström, Mårten Hallberg, Eric Poortvliet, Julia Wärnberg, Nico Rizzo, Linda Beckman, Anita Hurtig Wennlöf, Emma Patterson, Lydia Kwak, Lars Cernerud, Per Tillgren, and Stefaan Sörensen.
    • 16.Asociación de Investigación de la Industria Agroalimentaria (Spain) Jackie Sánchez-Molero, Elena Picó, Maite Navarro, Blanca Viadel, José Enrique Carreres, Gema Merino, Rosa Sanjuán, María Lorente, María José Sánchez, and Sara Castelló.
    • 17.Campden BRI (United Kingdom) Chantal Gilbert, Sarah Thomas, Elaine Allchurch, and Peter Burguess.
    • 18.SIK—Institutet foer Livsmedel och Bioteknik (Sweden) Gunnar Hall, Annika Astrom, Anna Sverkén, and Agneta Broberg.
    • 19.Meurice Recherche and Development asbl (Belgium) Annick Masson, Claire Lehoux, Pascal Brabant, Philippe Pate, and Laurence Fontaine.
    • 20.Campden and Chorleywood Food Development Institute (Hungary) Andras Sebok, Tunde Kuti, and Adrienn Hegyi.
    • 21.Productos Aditivos SA (Spain) Cristina Maldonado and Ana Llorente.
    • 22.Cárnicas Serrano SL (Spain) Emilio García.
    • 23.Cederroth International AB (Sweden) Holger von Fircks, Marianne Lilja Hallberg, and Maria Messerer.
    • 24.Lantmännen Food R&D (Sweden) Mats Larsson, Helena Fredriksson, Viola Adamsson, and Ingmar Börjesson.
    • 25.European Food Information Council (Belgium) Laura Fernández, Laura Smillie, and Josephine Wills.
    • 26.Universidad Politécnica de Madrid (Spain) Marcela González-Gross, Agustín Meléndez, Pedro J. Benito, Javier Calderón, David Jiménez-Pavón, Jara Valtueña, Paloma Navarro, Alejandro Urzanqui, Ulrike Albers, Raquel Pedrero, and Juan José Gómez Lorente.

Abstract

Objectives:

The purpose of this study was to determine the sex-specific physical activity (PA) intensity thresholds that best discriminate between unhealthy/healthy cardiorespiratory fitness (CRF).

Methods: Participants included 1,808 adolescents (964 girls), aged 12.5–17.5 years, from the HELENA study. We measured PA by accelerometer and calculated the time spent at light, moderate, vigorous, and moderate-to-vigorous (MVPA) intensities. CRF was assessed by the 20-m shuttle-run test. Adolescents were dichotomized (unhealthy/healthy) based on sex- and age-specific FITNESSGRAM standards. Receiver operating characteristic (ROC) analysis was used to determine thresholds that best discriminate between CRF categories.

Results: ROC analyses revealed that the PA thresholds that best discriminate between unhealthy/healthy CRF were ≥152, ≥33, ≥13, and ≥52 min/day in light, moderate, vigorous, and MVPA, respectively. In boys, the PA thresholds associated with a healthy CRF were ≥37, ≥19, and ≥56 min/day in moderate, vigorous, and MVPA, respectively, whereas in girls were ≥152, ≥34, ≥12, and ≥51 min/day in light, moderate, vigorous, and MVPA, respectively. Spending at least 60 min/day in MVPA was also associated with a healthy CRF (odds ratios: 1.75, 1.94, and 1.57, all P < 0.05, for the whole sample, boys, and girls, respectively).

Conclusions: This study shows sex- and intensity-specific PA thresholds to discriminate between adolescents with a healthy CRF from those with a less favorable or unhealthy CRF level. Journal of Hospital Medicine. Society of Hospital Medicine. Am. J. Hum. Biol., 2010. © 2010 Wiley-Liss, Inc.

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