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J Sport Health Sci. 2019 Jan;8(1):55-62. doi: 10.1016/j.jshs.2018.03.004. Epub 2018 Mar 27.

Cardiometabolic risk through an integrative classification combining physical activity and sedentary behavior in European adolescents: HELENA study.

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IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso 2340000, Chile.
PROmoting FITness and Health through physical activity research group (PROFITH), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada 18001, Spain.
Department of Nutrition and Food Science, University of the Basque Country, UPV/EHU, Vitoria 01001, Spain.
Department of Health and Human Performance, School of Health Sciences, University of Zaragoza, Zaragoza 50001, Spain.
ImFine Research Group, Facultad de Ciencias de la Actividad Física y del Deporte-INEF, Universidad Politécnica de Madrid, Madrid 28001, Spain.
Lille Inflammation Research International Center, University of Lille, Lille 59000, France.
Department of Nutrition and Dietetics, Harokopio University, Athens 10431, Greece.



This study aims to compare adolescents' cardiometabolic risk score through an integrative classification of physical activity (PA), which involves the combination of moderate-to-vigorous physical activity (MVPA) and sedentary behavior (SB).


A cross-sectional study derived from the Healthy Lifestyle in Europe by Nutrition in Adolescence Cross-Sectional Study database (2006-2008) was conducted in adolescents (n = 548; boys, 47.3%; 14.7 ± 1.2 years) from 10 European cities. MVPA and SB were objectively measured using accelerometry. Adolescents were divided into 4 categories according to MVPA (meeting or not meeting the international recommendations) and the median of SB time (above or below sex- and age-specific median) as follows: High-SB & Inactive, Low-SB & Inactive, High-SB & Active, and Low-SB & Active. A clustered cardiometabolic risk score was computed using the homeostatic model assessment, systolic blood pressure, triglycerides, total cholesterol/high-density lipoprotein cholesterol, sum 4 skinfolds, and cardiorespiratory fitness (CRF). Analyses of covariance were performed to discern differences on cardiometabolic risk scores among PA categories and each health component.


The cardiometabolic risk score was lower in adolescents meeting the MVPA recommendation and with less time spent in SB in comparison to the high-SB & Inactive group (p < 0.05). However, no difference in cardiometabolic risk score was established between High-SB or Low-SB groups in inactive adolescents. It is important to note that CRF was the only variable that showed a significant modification (higher) when children were compared from the category of physically inactive with "active" but not from high- to low-SB.


Being physically active is the most significant and protective outcome in adolescents to reduce cardiometabolic risk. Lower SB does not exhibit a significant and extra beneficial difference.


Accelerometry; Cardiovascular disease; Exercise; Metabolic disease; Sedentary lifestyles

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