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Clustered metabolic risk and leisure-time physical activity in adolescents: effect of dose?
  1. Katja Pahkala1,2,
  2. Olli J Heinonen2,3,
  3. Hanna Lagström4,
  4. Paula Hakala5,
  5. Maarit Hakanen1,
  6. Miika Hernelahti2,
  7. Soile Ruottinen1,
  8. Lauri Sillanmäki1,
  9. Tapani Rönnemaa6,
  10. Jorma Viikari6,
  11. Olli T Raitakari1,7,
  12. Olli Simell1,4,8
  1. 1Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
  2. 2Paavo Nurmi Centre, Sports & Exercise Medicine Unit, Department of Physiology, University of Turku, Turku, Finland
  3. 3Department of Physical Activity and Health, University of Turku, Turku, Finland
  4. 4Turku Institute for Child and Youth Research, Turku, Finland
  5. 5Research Department, Social Insurance Institution, Turku, Finland
  6. 6Department of Medicine, University of Turku, Turku, Finland
  7. 7Department of Clinical Physiology, University of Turku, Turku, Finland
  8. 8Department of Pediatrics, University of Turku, Turku, Finland
  1. Correspondence to Katja Pahkala, Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Kiinamyllynkatu 10, FI-20520 Turku, Finland; katja.pahkala{at}


Objectives The authors studied the association of leisure-time physical activity (LTPA) with clustered and individual metabolic risk factors in adolescents taking into account diet and pubertal status. The authors also studied whether screen time was associated with clustered risk.

Methods Self-reported LTPA and screen time, lipids, lipoproteins, apolipoproteins, high-sensitivity C reactive protein, blood pressure, body mass index (BMI), pubertal status and diet were assessed in 13-year-old adolescents (n=542) participating in an atherosclerosis prevention study (Special Turku Coronary Risk Factor Intervention Project for Children). Activity groups were formed according to sex-specific LTPA index tertile cut-off points. BMI, high-density lipoprotein cholesterol (HDL-C), triglycerides and blood pressure comprised the cluster.

Results An increase in LTPA was associated with a decreased risk for clustered metabolic risk in girls. When sedentary and highly active adolescents were compared, an increase in LTPA decreased clustering of risk factors in boys as well. Little extra benefit on clustered risk was obtained by increasing LTPA from 30 MET h/week (eg, 4–5 h/week bicycling or playing soccer) to 50 MET h/week (eg, 7–8 h/week bicycling or playing soccer). LTPA was beneficially associated with BMI, HDL-C, systolic blood pressure and HDL-C/total cholesterol in girls and HDL-C in boys. Diet and pubertal status were similar in all activity groups. In girls, screen time >2 h/day was associated with an increased risk for clustered risk, independent of LTPA.

Conclusion Sedentary adolescents had an increased risk for clustered metabolic risk compared with physically more active peers. Only minor extra benefit was obtained when LTPA increased over 30 MET h/week. Focus in the prevention of clustered risk should especially be on avoiding sedentary lifestyle.

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  • Funding The present study was supported by Finnish Ministry of Education; Finnish Cultural Foundation; Juho Vainio Foundation; Finnish Cardiac Research Foundation; Academy of Finland (grant 206374); Sigrid Juselius Foundation; Special Governmental Grants for Health Sciences Research, Turku University Hospital; Yrjö Jahnsson Foundation; C.G. Sundell Foundation; Foundation for Pediatric Research and Turku University Foundation.

  • Competing interests None.

  • Ethics approval Ethics approval was provided by the Joint Commission on Ethics of the Turku University and the Turku University Central Hospital.

  • Provenance and peer review Not commissioned; externally peer reviewed.