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To verify the role of the combination of fitness and fatness in the relationship between physical activity (PA) and cardiometabolic risk in children and adolescents. This is a cross-sectional study performed with 2786 children and adolescents (6 to 17 years). Fitness was determined by the cardiorespiratory fitness (CRF) six-minute walking and running test. Waist circumference (WC) was considered a fatness indicator. A selfreported questionnaire was used to determine PA practice, whereas the clustered cardiometabolic risk score (cMetS) was calculated by summing z-scores of triglycerides, total cholesterol/HDL-C ratio, systolic blood pressure, glucose, and WC. Considering the combination of CRF (fitness) and WC (fatness), the following phenotypes were created: Fit/Unfat, Fit/Fat, Unfit/Unfat and Unfit/Fat. Moderation analyses were tested using linear regression models. Significant interactions were found between PA and Unfit/Fat category (ß = -0.001; p = 0.001) only for adolescents. The interaction observed in the Unfit/Fat phenotype indicated that adolescents who practise PA for 330 minutes per week presented lower cMetS compared to those who do not practise or practise for 60 minutes respectively. The combination of fitness and fatness moderates the relationship between PA and cardiometabolic risk, suggesting that adolescents, particularly those who are less fit and present high adiposity, should be encouraged to engage in regular PA to improve their metabolic health.

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AIM: To verify the association between ideal sleep time and physical literacy components while also considering multiple mediators, such as quality of life and obesity, using a sample of adolescents. METHODS: This cross-sectional study consisted of 470 adolescents aged 11-17 years from southern Brazil. Sleep time, health-related quality of life, and physical literacy components (i.e., physical education enjoyment, sports participation, sedentary behavior, moderate to vigorous physical activity, sex, and age) were evaluated through self-reported questionnaires. In addition, body mass index (BMI), and waist circumference were determined. The theoretical/statistical support of the structural equation model was evaluated according to fit parameters and strength of association. RESULTS: A direct association was observed between more sleep time and lower levels of obesity. The obesity indicators also had a negative association with HqOL, and HqOL had a positive association with physical literacy. The indirect associations indicated that the ideal sleep time was positively associated with HqOL and physical literacy components, considering the negative mediation effect of obesity. The model explains physical literacy in 31% of the variance (R = 0.31). CONCLUSION: There was an indirect association between ideal sleep duration and quality of life and between both variables with physical literacy. These relationships occur even considering the negative influence of obesity. Therefore, a child who sleeps adequately has a higher likelihood of being physically active, regardless of obesity, potentially enhancing overall quality of life across various domains.

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PURPOSE: The aim of this study was to examine the interaction between screen time and cardiorespiratory fitness (CRF) in their longitudinal association with waist circumference (WC) during a follow-up of 3 years from childhood to adolescence. METHODS: Observational 3-year longitudinal study with 401 students (224 females), seven to 15 years of age at baseline. The CRF was evaluated by estimating peak oxygen uptake (VO2peak) from an indirect field-based test and body mass index. Screen time was assessed using self-reported questionnaires. Moderation analyses were tested using a multiple linear regression model with adjustments for sex, age, puberty stage, and ethnicity. RESULTS: A statistically significant interaction term was observed (B = -0.0003; 95% CI: -0.007; -0.0001). Since screen time was contextualized as the independent variable, the results show that relationship between screen time and WC varies across different CRF levels. CONCLUSION: The findings suggest that higher CRF can attenuate the harmful association that increased sedentary behavior might have on abdominal adiposity.

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BACKGROUND: The behavior of anthropometrics and the relationship with genetic factors through a long-term perspective should be better explored. This study aims to verify the odds of maintaining the nutritional status classification after three years, according to the rs9939609 polymorphism (FTO gene). METHODS: It was a retrospective longitudinal study with 355 schoolchildren (7-17 years). Body mass index, body-fat percentage (BF%), and waist circumference (WC) were measured at baseline and follow-up. The FTO gene was evaluated from blood collection and genotyping performed by real-time polymerase chain reaction. Odds ratios and 95% confidence intervals were calculated. RESULTS: For those homozygous with the A allele, the odds of being at less favorable classification at follow-up were 2.29 (1.24; 4.22) and 4.05 (2.08; 7.86) times higher than expected for BF% and WC, respectively, whereas the odds of being in the more favorable classification at follow-up were 0.34 (0.12; 0.93) and 0.11 (0.01; 0.78) for BF% and WC, respectively. The odds of being at less favorable classification were higher for AA carriers with less favorable classification at baseline for BF% and WC compared to AT and TT carriers. CONCLUSIONS: Schoolchildren with a genetic predisposition to obesity and unfavorable anthropometric profile at baseline had more chances of maintaining their nutritional status after three years of follow-up.

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BACKGROUND: A better understanding of how cardiorespiratory fitness (CRF) and adiposity interact to associate with arterial blood pressure over time remains inconclusive. Thus, the aim of the present study was to examine whether changes in CRF moderates the association between body fat percentage (BF%) and arterial blood pressure in children and adolescents. METHODS: This is an observational longitudinal study with 407 children and adolescents aged 8-17 years followed-up for three years from a city in Southern Brazil. Participants were evaluated in 2011 and 2014. CRF was measured by validated field-based tests following the Projeto Esporte Brazil protocols and peak oxygen uptake (VO2peak) was estimated. BF% was determined by the measures of tricipital and subscapular skinfolds using equations according to sex. Systolic and diastolic blood pressure (SBP, DBP) were measured with a sphygmomanometer according to standard procedures. Moderation analyses included multiple linear regression models adjusted for sex, age, pubertal status, height, socioeconomic level, skin color, and the arterial blood pressure variable itself at baseline. RESULTS: It was observed a significant inverse association between VO2peak at baseline with SBP (ß = - 0.646 CI95% = - 0.976 - 0.316) and DBP (ß = - 0.649 CI95% = - 0.923 - 0.375) at follow-up and a positive association between BF% at baseline with SBP (ß = 0.274; CI95% = 0.094 0.455) and DBP (ß = 0.301; CI95% = 0.150 0.453) at follow-up. In addition, results indicated a significant interaction term between changes in VO2peak and BF% at baseline with both SBP (p = 0.034) and DBP at follow-up (p = 0.011), indicating that an increase of at least 0.35 mL/kg/min and 1.78 mL/kg/min in VO2peak attenuated the positive relationship between BF% with SBP and DBP. CONCLUSION: CRF moderates the relationship between BF% and SBP and DBP in children and adolescents.

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BACKGROUND: Genetic factors along with inadequate lifestyle habits are associated with the development of cardiometabolic alterations. Thus, the present study aimed to examine the role of sedentary behavior on the relationship between rs9939609 polymorphism (fat mass and obesity-associated gene-FTO) and cardiometabolic risk score according to cardiorespiratory fitness (CRF) levels in children and adolescents. METHODS: A cross-sectional study with 1215 children and adolescents (692 girls), aged between 6 and 17 years. Screen time as a marker of sedentary behavior was evaluated through a self-reported questionnaire and CRF was estimated using the 6-min walking and running test. The genotyping of the FTO rs9939609 polymorphism was performed using a real-time polymerase chain reaction. Clustered cardiometabolic risk score (cMetS) was calculated by summing z-scores of total cholesterol/high-density lipoprotein cholesterol ratio, triglycerides, glucose, systolic blood pressure, and waist circumference, and dividing it by five. Moderation analyses were tested using multiple linear regression models. RESULTS: The coefficient of the interaction term of FTO (rs9939609) and screen time indicated that screen time was a significant moderator on the relationship between FTO rs9939609 polymorphism and cMetS (p = 0.047) in children and adolescents classified with low CRF (ß = 0.001; 95% CI = 0.001; 0.002). It was observed a significant association between genotype risk (AA) of FTO polymorphism and cMetS, in participants that spent more than 378 min a day in front of screen-based devices (ß = 0.203; 95% CI = 0.000; 0.405). No interaction term was found for those with high CRF. CONCLUSIONS: High sedentary behavior seems to influence the relationship between genetic predisposition to obesity and cardiometabolic risk factors in children and adolescents with low CRF.

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BACKGROUND: A healthy lifestyle should be adopted by young people to maintain cardiometabolic health. AIM: To verify the prevalence and the integrated role of lifestyle habits in cardiometabolic risk factors according to sex in adolescents. SUBJECTS AND METHODS: Cross-sectional study developed with 1502 adolescents, aged 10-17 years. Lifestyle habits included physical activity, screen time and sleep duration evaluated through a questionnaire. Cardiometabolic risk score (CMRS) was calculated by summing z-scores, divided by 6. For statistical analyses, multivariable binary and multinomial logistic regression models were used. RESULTS: 80.7% of the boys classified with adverse CMRS presented physical inactivity, compared to normal CMRS. In girls, 42.6% showed inadequate sleep compared to normal CMRS. Boys classified as inactive showed higher odds for obesity, as well as altered triglycerides (TGs), and systolic blood pressure, risk for cardiorespiratory fitness (CRF), high waist circumference, and CMRS, compared to the active. A prolonged screen time increased the odds for altered glucose and decreased the odds for altered TGs. In girls, inadequate sleep duration presented higher odds for overweight, obesity, risk for CRF, and high CMRS, compared to adequate sleep. CONCLUSION: Physical activity for boys and sleep duration for girls are important to maintain healthy metabolic health amongst youth.

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BACKGROUND: Cardiorespiratory fitness (CRF) is considered a beneficial effect of physical activity (PA). PA and excessive screen time have implications for cardiometabolic risk. OBJECTIVE: To verify the association between screen time and CRF grouped by cardiometabolic risk factors. SUBJECTS AND METHODS: Cross-sectional study evaluated 1,253 schoolchildren (54.2% girls) aged seven to 17 years from southern Brazil. The outcomes were body mass index (BMI), waist circumference (WC), systolic blood pressure (SBP), and diastolic (DBP), glucose, and lipid profile. Exposure was a combined variable of self-reported screen time (television, video game, computer) and CRF. RESULTS: The main result is that CRF had a more consistent association with anthropometric factors than with metabolic variables. Low CRF students, regardless of screen time, showed a 15% increase in the risk of elevated WC (p < 0.001) and a 24% (<2 h screen time) and 19% (≥2 h) higher risk of overweight (p < 0.001). Second, the increase in SBP was associated with a combination of the two risk factors, ≥2 h screen time/low CRF was associated with a 7% increase in elevated SBP (p = 0.025). CONCLUSION: Low CRF was a risk factor for elevated BMI and WC, regardless of screen time. High screen time and low CRF were associated with higher SBP values.

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The aim of the present study was to verify whether the amount of sleep duration, screen time, and physical activity moderate the relationship between FTO rs9939609 polymorphism and waist circumference (WC) in children and adolescents. This is a cross-sectional study conducted with 1338 children and adolescents, aged between 6 and 17 years. Lifestyle habits were assessed through self-reported questionnaire. WC was measured on the narrowest part of the trunk between the last rib and the iliac crest. FTO rs9939609 polymorphism was genotyped by real time polymerase chain reaction. The PROCESS macro for the SPSS was used for moderation analyses, through multiple linear regression models. Results indicated significant interactions were found between sleep duration and screen time X FTO rs9939609, showing that these lifestyle behaviours are moderators in the relationship between a genetic predisposition for obesity and higher WC. For physical activity, there was no significant interaction. Therefore, sleeping more than 564 min a day (i.e. 9.4 h) and spending no more than 233 min in front of screen may counteract the genetic predisposition to obesity in children and adolescents.Highlights A healthy lifestyle may counteract the genetic predisposition to central obesity;Children and adolescents should sleep more than approximately 9 h (564 min) per day and spend less than approximately 4 h (233 min) per day in front of screens in order to counteract the genetic predisposition to central obesity conferred by the FTO gene variant.It is fundamental to promote actions for the adoption of a healthy lifestyle, including the importance of presenting adequate sleep habits and low screen time for a better cardiometabolic health and reduction of obesity.

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BACKGROUND: Given the important repercussions that sociodemographic factors can have on physical activity, especially in the field of leisure, and cardiometabolic risk, it seems relevant to analyze the implications of these variables on the relationship between physical activity in leisure time (LTPA) and cardiometabolic risk. In this sense, the present study aims to verify the moderating role of biologic and socioeconomic factors in the relationship between LTPA and cardiometabolic risk in adolescents in southern Brazil. METHODS: Cross-sectional study that included 1596 adolescents selected at random (58.2% girls), aged between 10 and 17 years. LTPA, biological and socioeconomic factors were assessed using a self-reported questionnaire and the cardiometabolic risk score (total cholesterol/HDL-c ratio, triglycerides, fasting glucose, systolic blood pressure, and waist circumference, considering the participant's age and sex) was included as an outcome. Associations and moderations were tested by multiple linear regression models. RESULTS: It was observed a positive interaction of LTPA and sex (p = 0.048) and LTPA and school system (p = 0.037), and negative interaction of LTPA and skin color (p = 0.040), indicating that these factors were moderators in the relationship between LTPA and clustered cardiometabolic risk score (cMetS) in adolescents. A reduction in cardiometabolic risk was observed according to the increase in weekly minutes of LTPA among boys, non-white adolescents, and students from municipal schools. CONCLUSIONS: The association between LTPA and cardiometabolic risk was moderated by sex, skin color, and school system in adolescents from southern Brazil.

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