Fat mass, physical condition and cardiovascular risk in children


Maintaining a healthy fat mass may improve cardiovascular health during childhood according to findings published in Scientific reports.

Globally, over 100 million children are obese and over 200 million children are overweight. Fitness and body composition are closely related. A more favorable cardiovascular disease (CVD) risk profile in children has been associated with physical fitness and cardiorespiratory fitness; however, the fitness association may or may not be influenced by consideration of accurately measured body composition, and the body composition association may or may not be influenced by consideration of fitness. Researchers sought to investigate independent associations between fitness and body composition and CVD risk factors in children.

To do this, the researchers conducted a cross-sectional study involving 411 children (200 girls, 211 boys) from the general population of Östergötland, Sweden. Participants were 9.5 ± 0.1 years of age and their data came from the SPINACH (Studies of Prospective Health Determinants in Infancy and Childhood) study which was conducted between 2016 and 2020. This study included measures of composition body, physical condition and health outcomes. . Some participants provided a blood sample for CVD risk factor testing (175, comparable to 236 other children [average BMI {17.0 vs 16.9}, age {9.6 vs. 9.5 years}, sex distribution {55.1% vs. 46.6% boys}, and maternal educational attainment {80.5% vs. 75.0% university degree}]).

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Body composition and fitness were strongly associated, highlighting the need for mutual adjustments when studying their independent associations with CVD risk factors. BMI, body fat percentage, and fat mass index were all positively associated with systolic and diastolic blood pressure, homeostatic model assessment of insulin resistance (HOMA-IR), and score. metabolic syndrome (all β≥0.229; P ≤ 0.001), using unadjusted linear regression analyses. Adjustments for covariates (age, sex, mother’s education level, mother’s BMI), lean body mass, and physical condition did not affect these associations. Fat-free mass had weak associations with CVD risk factors and no statistically significant association after adjustments (all P >.27). Better motor fitness and better cardiorespiratory fitness were associated with a lower HOMA-IR score and a lower metabolic syndrome score (all β≤-0.158; P ≤ 0.039) down to adjustments for covariates and body composition when no significant association was measured.

Limitations of the study that have been noted include the cross-sectional design, the high proportion of mothers with a university degree, and the lack of data regarding pubertal status.

The researchers concluded, after adjusting for covariates and fitness, that higher BMI and body fat are associated with CVD risk factors. “[A]Associations with BMI were generally as strong as with accurately measured fat mass, which may have implications given the ease of measuring BMI in children,” the researchers wrote. “However, fat-free mass did not have beneficial associations with CVD risk factors that support the idea that promotion of cardiovascular health in childhood might be focused on excess fat mass and not on fat-free mass.”


Henriksson P, Sandborg J, Henström M, et al. Body composition, fitness and cardiovascular risk factors in 9-year-old children. Scientific representative. Published online February 17, 2022. doi:10.1038/s41598-022-06578-w


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