cardiorespiratory fitness in children and adolescents Idoia - - PowerPoint PPT Presentation

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cardiorespiratory fitness in children and adolescents Idoia - - PowerPoint PPT Presentation

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THE POWER OF PROGRAMMING 2014 International Conference on Developmental Origins of Adiposity and Long-Term Health March 13-15, Munich, Germany Exclusive breastfeeding duration and cardiorespiratory fitness in children and adolescents Idoia

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Exclusive breastfeeding duration and cardiorespiratory fitness in children and adolescents

Idoia Labayen*, Jonatan R Ruiz*, Francisco B Ortega, Helle M Loit, Jaanus Harro, Inga Villa, Toomas Veidebaum, and Michael Sjöström

University of the Basque Country, Spain Karolinska Institutet, Sweden, University of Granada, Granada, Spain National Institute for Health Development, Tallinn, Estonia Institute of Public Health, Tartu, Estonia *idoia.labayen@ehu.es; ruizj@ugr.es

THE POWER OF PROGRAMMING 2014 International Conference on Developmental Origins of Adiposity and Long-Term Health March 13-15, Munich, Germany

Note: for non-commercial purposes only

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Benefits of breast feeding

Exclusive breastfeeding duration and cardiorespiratory fitness in children and adolescents

ESPGHAN Committee on Nutrition: Carlo Agostoni et al 2009

  • WHO
  • ESPGHAN
  • FISPGHAN
  • ENeA
  • Early Nutrition Academy
  • US Agency for Healthcare Research and Quality
  • Dutch State Institute for Nutrition and Health
  • Otitis meida
  • GI infections
  • Respiratory infections
  • Atopy
  • Atopic dermatitis
  • Asthma
  • Type 1 diatebes
  • Type 2 diabetes
  • Cardiovascular diesease
  • High blood pressure
  • Cholesterol
  • Intelligence
  • Motor development
  • Etc.

Institutions

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3

Ruiz et al. BJSM 2009

Cardiorespiratory Musculoskeletal

Health

Later in life

Childhood and adolescence

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To examine the association of exclusive breastfeeding duration with fitness in children and adolescents and to test the role of body composition and sociodemographic factors in this relation

Aim

Exclusive breastfeeding duration and cardiorespiratory fitness in children and adolescents

Labayen et al. AJCN 2012

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1025 children (9-10 years) and 971 adolescents (15-16 years) from Sweden and Estonia (EYHS)

Participants Exposures

Breast feeding

Labayen et al. AJCN 2012

METHODS

  • Was your child fed completely on breast milk for any length of time—that is,

without complementary formula feeds? (Categories provided for response were yes or no)

  • For how long was your child breastfed? (Categories provided for response were

<1 month, 1–3 months, >3–6 months, and >6 months)

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1025 children (9-10 years) and 971 adolescents (15-16 years) from Sweden and Estonia (EYHS)

Participants

Cardiorespiratory fitness

Exposures

Breast feeding

Main outcome

Anthropometry, birth weight, smoking, physical activity, maternal education, and mother’s BMI

Confounding factors

Labayen et al. AJCN 2012

METHODS

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1.70 1.75 1.80 1.85 1.90 1.95 2.00 Model 1 Model 2 Model 3 Model 4 Fitness (L/min) P<0.001 P<0.001 P=0.001 P=0.011

Model 1: adjusted for country, age, sex, and pubertal status Model 2: model 1 plus BMI Model 3: model 1 plus fat mass, and fat-free mass Model 4: model 1 plus birth weight and maternal BMI and educational level

Cardiorespiratory fitness and never vs. ever breastfed

Never breastfed Ever breastfed

RESULTS

Labayen et al. AJCN 2012

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Model 1: adjusted for country, age, sex, and pubertal status Model 2: model 1 plus BMI Model 3: model 1 plus fat mass, and fat-free mass Model 4: model 1 plus birth weight and maternal BMI and educational level

Cardiorespiratory fitness and duration of breast feeding

1.76 1.80 1.84 1.88 1.92 1.96

Fitness (L/min) adjusted Model 1

P < 0.001

* ** **

Never <3months 3-6 months >6 months

Labayen et al. AJCN 2012

RESULTS

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1.60 1.70 1.80 1.90 2.00 2.10 2.20 2.30 2.40 2.50 never < 3 months 3-6 months > 6 months Normal weight Overweight P<0.001 P=0.002

Normal weight/overweight+obesity accoring to the International Obesity Task Force recommendations Confounders: country, sex, age, pubertal status, and body mass

Cardiorespiratory fitness and duration of breast feeding by weight status

Never <3months 3-6 months >6 months

Labayen et al. AJCN 2012

Fitness (L/min)

RESULTS

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Low/ high-SES: less than university education and university education, respectively Confounders: country, sex, age, pubertal status, and body mass

Cardiorespiratory fitness and duration of breast feeding by SES

Labayen et al. AJCN 2012

1.60 1.70 1.80 1.90 2.00 2.10 2.20 never < 3 months 3-6 months > 6 months Low SES High SES P <0.001 P =0.004 Fitness (L/min)

RESULTS

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Confounders: country, sex, age, pubertal status, and body mass

Cardiorespiratory fitness and duration of breast feeding by mother’s weight

Labayen et al. AJCN 2012

1.60 1.70 1.80 1.90 2.00 2.10 2.20 never < 3 months 3-6 months > 6 months Mother normal weight Mother overweight P =0.003 P <0.001

Never <3months 3-6 months >6 months

Fitness (L/min)

RESULTS

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1.60 1.70 1.80 1.90 2.00 2.10 2.20 never < 3 months 3-6 months > 6 months Low BW tertile Middle BW tertile High BW tertile P =0.001 P =0.017 P =0.004

Confounders: country, sex, age, pubertal status, and body mass

Cardiorespiratory fitness and duration of breast feeding by BW

Labayen et al. AJCN 2012

Never <3months 3-6 months >6 months

Fitness (L/min)

RESULTS

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Longer exclusive breastfeeding has a beneficial effect

  • n cardiorespiratory fitness in children and adolescents

Conclusions

Because early infant-feeding patterns are potentially modifiable, a better understanding of the possible programming effect of exclusive breastfeeding on cardiorespiratory fitness is of public health interest

Exclusive breastfeeding duration and cardiorespiratory fitness in children and adolescents

Labayen et al. AJCN 2012

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Thanks for your attention

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1.60 1.70 1.80 1.90 2.00 2.10 2.20 2.30 2.40 2.50 never < 3 months 3-6 months > 6 months Low FFM High FFM P<0.001 P=0.013

Low/high FFM: below or above the sex- and age group–specific median

Cardiorespiratory fitness and duration of breast feeding by FFM

REULTS

Never <3months 3-6 months >6 months

Labayen et al. AJCN 2012

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16

Cardiorespiratory fitness

Gender Age (years) Weight (kg) Initial work rate (W) Δ Work rate (W)

Girls & boys 9-10 < 30 20 20 Girls & boys 9-10 > 30 25 25 Girls 15-16

  • 40

40 Boys 15-16

  • 50

50

METHODS Test protocol

  • Watt: W1+ (W2  t/180)
  • VO2max (L/min): 12 x W + 5 x body weight (kg)

Variables

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Anthropometry

METHODS Weight Height Skinfold thickness

  • BMI
  • % Overweight/Obese
  • % Body fat (Slaugher et al.)
  • FFM

Variables

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Physical Activity (PA)

  • 4 consecutive days
  • 10 hrs/day

METHODS Test protocol

  • Total PA (counts/min)
  • Moderate + Vigorous PA >3 METs (min/day)

Variables

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Cardiorespiratory fitness: marker of health

19 <5 6 7 8 9 10 11 12 >13 METS

Cardiorespiratory Fitness

Very Low Low Medium High Very high

1 2 3 4 5

Relative Risk of Mortality

Blair et al. JAMA 1989

Adults 10,224 men and 3120 women