Physical Activity, Body Mass Index, and Clustered Metabolic Risk in U.S. Adolescents: 2007-2012 Nhanes

Background: While studies to date have shown that children and adolescents who meet the current physical activity (PA) recommendations and maintain a healthy body weight demonstrate significantly lower cardiometabolic risk, there are some studies that suggest that the relationship between PA and metabolic risk may be mediated by adiposity. The aim of the present study was to examine variation in clustered metabolic risk (cMetS) in adolescents classified as not overweight/active (NOA), not overweight/not active (NONA), overweight/active (OA), and overweight/not active (ONA). Methods: The sample included adolescent participants (n = 875; 12-17 years) of the 2007-2012 National Health and Nutrition Examination Survey (NHANES). The cMetS score included triglycerides, high-density lipoprotein cholesterol, fasting plasma glucose, and mean arterial pressure. Age- and sex-specific body mass index (BMI) percentiles were utilized; overweight was defined as BMI percentile ≥85th. Activity data included self-reported frequency of moderate-to-vigorous PA. Adolescents reporting ≥60 min/day of PA were considered "active." General linear models, adjusted for age, sex, and race-ethnicity, were used. A 6-year fasting sample weight was applied to the analyses to ensure representativeness of the data. Results: The cMetS scores were significantly (P < 0.05) higher in OA and ONA adolescents compared to NOA (β = 1.08 and β = 1.57, respectively). In ONA males, cMetS was significantly (P < 0.01) higher compared to NOA males. In OA and ONA females, cMetS scores were significantly higher compared to the referent group (P < 0.01 for both). Conclusions: The cMetS scores were increased in overweight adolescents compared to those who were not overweight, regardless of their reported activity level.