Accelerometer-based sedentary time and physical activity from childhood through young adulthood with progressive cardiac changes: a 13-year longitudinal study

Abstract

Aims: Longitudinal evidence on the relationship of sedentary time (ST), light-intensity physical activity (LPA), and moderate-to-vigorous-intensity physical activity (MVPA) with changes in cardiac structure and function in the paediatric population is scarce. This evidence is clinically important due to the impact ST can have on the long-term prognosis of healthy young population in the lifetime continuum. This prospective observational study examined the relationships of cumulative ST, LPA, and MVPA from childhood with longitudinal changes in cardiac structure and function.

Methods and results: This is a secondary analysis from the Avon Longitudinal Study of Parents and Children, UK birth cohort of 1682 children aged 11 years. Participants who had at least one follow-up timepoints accelerometer-measured ST, LPA, and MVPA over a period of 13 years and repeated echocardiography-measured cardiac structure and function at ages 17- and 24-year clinic visit were included. Left ventricular mass indexed for height2.7 (LVMI2.7) and left ventricular (LV) diastolic function from mitral E/A ratio (LVDF) were computed. Among 1682 children (mean [SD] age, 11.75 [0.24] years; 1054 [62.7%] females), the cumulative one-min/day increase in ST from ages 11 to 24 years was associated with progressively increased LVMI2.7 {effect estimate 0.002 g/m2.7 [confidence interval (CI) 0.001-0.003], P < 0.001}, irrespective of sex, obesity, and hypertensive status. Cumulative one-min/day increase in LPA was associated with a decreased LVMI2.7 (-0.005 g/m2.7 [-0.006 to -0.003], P < 0.0001) but an increased LVDF. Cumulative one-minute/day increase in MVPA was associated with progressively increased LVMI2.7 (0.003 g/m2.7 [0.001-0.006], P = 0.015).

Conclusion: ST contributed +40% to the 7-year increase in cardiac mass, MVPA increased cardiac mass by +5%, but LPA reduced cardiac mass by -49%. Increased ST may have long-term pathologic effects on cardiac structure and function during growth from childhood through young adulthood; however, engaging in LPA may enhance cardiac health in the young population.

Keywords: Health guidelines; Health promotion; Hypertension; Left ventricular hypertrophy; Movement behaviour; Obesity; Paediatrics.

Graphical Abstract

Figure 1

Flowchart of Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort participants. ST, sedentary time, LPA, light-intensity physical activity; MVPA, moderate-to-vigorous-intensity physical activity; LVDF, left ventricular diastolic function; LVFP, left ventricular filling pressure; LVM, left ventricular mass; RWT, relative wall thickness.

Figure 2

Unadjusted linear, cubic, and quadratic regression plots of cumulative sedentary time, light-intensity physical activity, and moderate-to-vigorous-intensity physical activity (min/day) from ages 11 to 24 years with progressive increase in left ventricular mass (g/m^2.7) from ages 17 to 24 years. Linear regression is solid line, quadratic regression is short dash line, and cubic regression is long dash line.