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29 September 2023: Review Articles

Promoting Health in Pediatric Obesity: A Decade’s Research of Physical Activity’s Influence on Cardiometabolic Parameters

Monika Gesek 12ABCDEFG , Aleksandra D. Fornal 12ABCDEF* , Danuta Zarzycka 12ABCDEFG

DOI: 10.12659/MSM.940742

Med Sci Monit 2023; 29:e940742

Table 3 Qualitative analysis of the articles included in the review.

AuthorTitle of the articleResearch method research tool sampleAnalysis of the resultsLiterature number/ rangeMethodological quality
1Neil-Sztramko SE, et al. (2021)School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6 to 18Method: systematic reviewTools: CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, BIOSIS, SPORTDiscus, Sociological AbstractsSample: 89 articlesSchool-based physical activity interventions may improve physical fitness reported as VO max; they may result in a minor decrease in BMI z-scores, and may not affect BMI expressed in kg/m3071985–202090%
2Dietz P, et al. (2012)Influence of exclusive resistance training on body composition and cardiovascular risk factors in overweight or obese children: A systematic reviewMethod: systematic reviewTools: MEDLINE, SPORTDiscusSample: 6 articlesIndividually planned and supervised whole body resistance training of moderate or submaximal intensity in children appears to be safe and tends to have a positive effect on body composition491978–201160%
3Vasconcellos F, et al. (2014)Physical activity in overweight and obese adolescents: A systematic review of the effects on physical fitness components and cardiovascular risk factorsMethod: systematic reviewTools: PubMed, LILACS, Web of Science, Scopus (including Embase), SPORTDiscusSample: 24 articlesThe results indicate a positive effect of physical activity on changes in fat, waist circumference, SBP, insulin, LDL-C and total cholesterol, as well as minor changes in DBP and glucose891985–201380%
4Busnatu SS, et al (2022)Effects of exercise in improving cardiometabolic risk factors in overweight children: A systematic review and meta-analysisMethod: meta-analysis, systematic reviewTools: PubMed/Medline, Cochrane Library, and Google ScholarSample: 12 articlesPhysical interventions significantly improved several cardiometabolic risk factors, such as BMI, LDL, blood pressure and blood sugar831982–202190%
5Cesa CC, et al. (2022)Physical activity and cardiovascular risk factors in children: Meta-analysis of randomized clinical trialsMethod: meta-analysis of randomized clinical trialsTools: PubMed, EMBASE I Cochrane CENTRALSample: 17 studiesSince sports intervention programmes lasting more than 6 months are associated with lower blood pressure and triglyceride levels, they should be included in the programmes for the prevention of cardiovascular diseases in school-age children481995–202080%
6Ostman C, et al. (2017)Clinical outcomes of exercise training in type 1 diabetes: A systematic review and meta-analysisMethod: meta-analysis, systematic reviewTools: MEDLINE search strategy, Cochrane Controlled Trials Registry, CINAHL, SPORTDiscus and Science Citation IndexSample: 15 studiesExercise training improves insulin doses, waist circumference, LDL and triglycerides in children361980–201690%
7Pinheiro G, et al. (2021)Blood pressure in children: Association with anthropometric indicators, body composition, cardiorespiratory fitness and physical activityMethod: cross-sectional studyTools: Guidelines for Measurement and Tests of PROESP-BrSample: 215 children aged 6–12 yearsModerate or intense physical activity, cardiovascular and respiratory performance, anthropometric variables, age, gender and maturity are important predictors of blood pressure variability in children282002–202175%
8Tarp J, et al. (2018)Physical activity intensity, bout duration, and cardiometabolic risk markers in children and adolescentsMethod: cross-sectional studyTools: secondary data from the International Physical Activity Database for Children (ICAD)Sample: 38 306 observations in 29 734 persons aged 4–18 years)Time spent on increasing physical activity is favourably associated with markers of cardiometabolic risk in adolescents601985–201867%
9Grace J, et al. (2021)Effect of physical activity and nutrition education on body mass index, blood pressure and biochemical variables in overweight and obese adolescentsMethod: quasi-experimentTools: Borg RPE scale, Calculator of American Academy of PaediatricsSample: 129 children aged 13–16 years10 weeks of physical activity and nutritional education in adolescents with overweight and obesity significantly lowered BMI and showed tendencies to lower blood pressure and LDL-C401985–2020100%
10Macdonald-Wallis C, et al. (2017)A longitudinal study of the associations of children’s body mass index and physical activity with blood pressureMethod: longitudinal studyTools: −Sample: 2047 children aged 6 and 9 years and one or both parentsBMI in children may be a risk factor for the development of hypertension471990–201675%
11Sadoh WE, et al. (2016)Physical activity, body mass index and blood pressure in primary school pupils attending private schoolsMethod: cross-sectional studyTools: questionnaire assessing physical activity among childrenSample: 353 primary school studentsPhysical activity may lead to lower average blood pressure in physically active students compared to students who are not independent of body mass index.Obesity and overweight students were more likely to have hypertension than healthy students211985–201658%
12Wiersma R, et al. (2020)Adiposity and high blood pressure during childhood: A prospective analysis of the role of physical activity intensity and sedentary time in the GECKO Drenthe CohortMethod: cohort studyTools: ActiGraph GT3XSample: 947 children aged 5–6 years and 10–11 yearsPhysical activity in childhood has a marginal effect on obesity or blood pressure in the later years of a child’s life641981–202083%
13Poeta LS, et al. (2013)Effects of physical exercises and nutritional guidance on the cardiovascular risk profile of obese childrenMethod: clinical control studyTools: −Sample: 44 children aged 8–11 yearsThe physical exercise and nutritional guidance programme, in addition to the regular clinical treatment, was effective in reducing BMI, total cholesterol, LDL-V, diastolic arterial pressure and carotid intima-media thickness301962–201070%
14Pepera G, et al. (2022)Associations between cardiorespiratory fitness, fatness, hemodynamic characteristics, and sedentary behavior in primary school-aged childrenMethod: clinical studyTools: HELENA questionnaoireSample: 105 children aged 6–12 yearsChildren with optimal BMI tend to present better CRF results than obese and overweight children. Sedentary lifestyle is associated with lower CRF in school-age children451984–202190%
15Martínez-Vizcaíno V, et al. (2014)Gender differences on the effectiveness of a school-based physical activity intervention for reducing cardiometabolic risk: a cluster randomized trialMethod: randomized control studyTools: MOVI-2 programmeSample: 712 children aged 8–10 yearsA safe and effective way to reduce obesity in both sexes and improve the cardiometabolic risk profile in girls is an out-of-school intervention based on uncompetitive physical activity482003–201282%
16Nqweniso S, et al. (2021)Physical activity and risk factors of cardio-metabolic diseases in South African childrenMethod: cross-sectional studyTools: results of KaziAfya researchSample: 832 children aged 5–8 years and 9–13 yearsLow levels of physical activity are associated with increased cardiovascular risk factors. Higher CRF, VPA and MVPA were negatively associated with lower body fat percentage and a lower risk of concentrated cardiovascular disease451983–202075%
17Ramezani A, et al. (2017)Effects of three methods of exercise training on cardiovascular risk factors in obese boysMethod: clinical trialTools: Exercise Training ProtocolSample: 60 children with obesity aged 8–12 yearsThe results of this study show that three routines of regular exercise over 8 weeks, including resistance training (50–75% 1RM) and endurance training (50–75% of target heart rate) had a desired effect on BMI, serum glucose and lipid profile risk factors392000–201670%
18Moschonis G, et al. (2013)“Leaner and less fit” children have a better cardiometabolic profile than their “heavier and more fit” peers: The Healthy Growth StudyMethod: cross-sectional studyTools: standardised questionnaire of free time physical activity, endurance 20-m shuttle run test (ERT)Sample: 1222 boys and 1188 girls aged 9–13 yearsSlender and less fit boys and girls had better cardiometabolic risk profiles than their heavier and more athletic peers, which probably suggests a greater importance of a slim figure over fitness in children in terms of cardiometabolic health benefits401955–201267%
19Pablos A, et al. (2017)Effectiveness of a school-based program focusing on diet and health habits taught through physical exerciseMethod: clinical studyTools: Inventory of Healthy Habits (IHH) questionnaireSample: 158 primary school studentsThe School Physical Activity Program (HHP) has initiated a significant improvement in the incidence of normal total cholesterol levels, blood pressure and BMI521989–201760%
20Fridolfsson J, et al. (2021)High-intensity activity is more strongly associated with metabolic health in children compared to sedentary time: a cross-sectional study of the I.Family cohortMethod: cross-sectional studyTools: IDEFICS Metabolic Syndrome Score ToolSample: 2592 children aged 8–11 yearsThe results suggest a higher physical actibity corresponding to the intensity of at least brisk walking with the inclusion of intense exercise, rather than limited sitting time, which is of greater importance for metabolic health in children481984–202167%
21Delgado-Floody P, et al. (2019)Influence of Mediterranean diet adherence, physical activity patterns, and weight status on cardiovascular response to cardiorespiratory fitness test in Chilean school childrenMethod: cross-sectional studyTools: Multistage Fitness (Beep) test, standing long jump testSample: 605 children aged 12.00±1.23 yearsOverweight children had lower physical fitness, and a higher percentage of them had high blood pressure. Decreased SBP was associated with cardiovascular strength and performance411988–201775%
22Carson V, et al. (2019)Compositional analyses of the associations between sedentary time, different intensities of physical activity, and cardiometabolic biomarkers among children and youth from the United StatesMethod: cross-sectional studyTools: National Health and Nutrition Examination SurveySample: 2544 children and adolescents aged 6–17 yearsThe composition of ST, LPA, MPA and VPA in this large representative sample of children and adolescents was significantly related to many aspects of cardiometabolic health, also suggesting that compositions with more time for more intense activities may be superior in some aspects of cardiometabolic health312002–201967%
23Kamal NN, Ragy MM (2012)The effects of exercise on CRP, insulin, leptin and some cardiometabolic risk factors in Egyptian children with or without metabolic syndromeMethod: clinical trialTools: absentSample: 93 children aged od 8 do 12 yearsAfter 12 weeks of exercise, both groups of children with obesity, with and without metabolic syndrome, showed reduced body weight, BMI and CRP levels, and increased HDL-C levels411972–200960%
24Brzeziński M, et al. (2020)“PoZdro!” as an example of a successful multicenter programme for obesity management and healthy lifestyle promotion in children and adolescents – programme protocol and preliminary results from the first intervention siteMethod: multicentre clinical trialTools: diet diaries, approved structured interviewSample: 603 children aged 13 yearsPreliminary results show that the participants observed a noticeable change in the body weight index and body fat content during the two-year intervention process101992–201875%
25D’Agostino EM, et al. (2018)Effect of participation in a park-based afterschool programme on cardiovascular disease risk among severely obese youthMethod: cohort studyTools: fitness tests and a test of knowledge about health and well-beingSample: children aged 6–14 yearsThe findings provide evidence of a significant improvement in the risk of cardiovascular disease in adolescents with obesity after attending an after-school programme at the park for at least a year321986–201883%
26Fam B, et al. (2013)Association between Physical activity and metabolic risk factors in adolescents: Tehran lipid and glucose studyMethod: cross-sectional studyTools: interview questionnaireSample: 777 adolescents aged 12–18 yearsThe results of this study confirm the association between physical activity and some individual MetS components, such as waist circumstance and HDL-C271996–201267%
27Plavsic L, et al. (2020)Effects of high-intensity interval training and nutrition advice on cardiometabolic markers and aerobic fitness in adolescent girls with obesityMethod: randomized control clinical trialTools: medical recordsSample: 44 adolescents with obesity aged 13–19 yearsThe 12-week HIIT intervention combined with nutritional counseling led to improvements in some anthropometric and biochemical parameters such as BMI, BMI-SDS, WC, WtHR, glucose and insulin during OGTT and insulin sensitivity compared to the non-training group431984–201973%
28Howie EK, et al. (2020)Physical activity trajectories from childhood to late adolescence and their implications for health in young adulthoodMethod: cohort studyTools: International Physical Activity Questionnaire (IPAQ), the Short-Form 12 Health Survey (SF-20)Sample: 2868 participants aged respectively 8, 10, 14, 17, 20 and 22Selected directions of physical activity show clear associations with a variety of physical and mental health interventions in early adulthood, including obesity, cardiometabolic health, depression and cognitive performance351998–201975%
29Gallardo-Escribano C, et al. (2021)Lifestyle modification improves insulin resistance and carotid intima-media thickness in a metabolically healthy obese prepubescent populationMethod: cross-sectional studyTools: food questionnaires relating to food frequency, questionnaires of compliance MedDietSample: 131 children aged 4–9 yearsResults show a decrease in both body weight and BMI in the whole population after 12 months of intervention. The most effective interventions to reduce weight in the pediatric population are those that involve dietary modification and regular physical activity332003–202083%
30Cuenca-García M, et al. (2012)Combined influence of healthy diet and active lifestyle on cardiovascular disease risk factors in adolescentsMethod: cross-sectional studyTools: HELENA-DIAT (Dietary Assessment Tool), Young Adolescents’ Nutrition Assessment on Computer (YANA-C), Diet Quality Index for Adolescents (DQI-A)Sample: 1513 children aged 12.5–17.5The combination of a healthy diet and an active lifestyle is associated with a healthier level of key cardovascular disease risk factors, such as cardiovascular and respiratory performance, obesity and blood lipid profile. Physical activity can reduce the harmful effects of an unhealthy diet441976–201367%
31Larouche R, et al. (2014)Active transportation and adolescents’ health: The Canadian Health Measures SurveyMethod: cross-sectional studyTools: modified Canadian Aerobic Fitness Test (mCAFT)Sample: 1016 adolescents aged 12–19Compared to adolescents who did not cycle, those who cycled ≥1 hour a week accumulated more light physical activity, had greater aerobic fitness and lower BMI, WC and ratio of total cholesterol to LDL-C; those who reported cycling711979–201483%
32Barker AR, et al. (2018)Physical activity, sedentary time, TV viewing, physical fitness and cardiovascular disease risk in adolescents: The HELENA studyMethod: cross-sectional studyTools: Family Affluence Scale (FAS), validated self-report sedentary behavior questionnaire, 20 m shuttle run testSample: 534 adolescents aged 12.5–17.5 yearsPhysical activity affects body composition and cardiometabolic risk421976–201667%
33Momoniyi MM, et al. (2020)“AMPE” exercise programme has positive effects on anthropometric and physiological parameters of school children: A pilot studyMethod: pilot studyTools:Sample: 78 children aged 9–12 yearsThe AMPE exercise program is effective because it reduces body weight and body mass index and improves the following parameters: SBP, DPB and heart rate202001–201978%
34Chansavang Y, et al. (2015)Feasibility of an after-school group-based exercise and lifestyle programme to improve cardiorespiratory fitness and health in less-active Pacific and Maori adolescentsMethod: feasibility studyTools: International Physical Activity Questionnaire (IPAQ)Sample: 18 secondary school studentsThe programme improved the results of VO max, SBP, HbA1c and intense and moderate physical activity261985–201460%
35Gonçalves R, et al. (2014)Association of body mass index and aerobic physical fitness with cardiovascular risk factors in childrenMethod: cross-sectional studyTools: 20 m shuttle run testSample: 290 children aged 6–10 yearsSignificant associations and an increased likelihood of cardiovascular risk factors have been shown in children with poorer oxygen performance and higher BMI291984–201058%
36Bustos-Barahona R, et al. (2020)Lifestyle associated with physical fitness related to health and cardiometabolic risk factors in Chilean school childrenMethod: cross-sectional studyTools: Kreece plus testSample: 582 children aged 10–13 yearsLifestyles of school-aged children are linked to CMR (i.e., abdominal obesity and hypertension) and health-related physical fitness, which requires promoting interventions to promote active lifestyles, including more physical activity weekly and less screen time during the day391988–202067%
37Kokkvoll AS, et al. (2019)No additional long-term effect of group vs individual family intervention in the treatment of childhood obesity – a randomized trialMethod: randomized control clinical trialTools: validated Andersen intermittent running testSample: 97 children aged 6–12 yearsAnalysis results from the combination of data from both intervention groups showed a decrease in BMI-SDS, improvements in total and LDL-C, CRF, and the incidence of hypertension301985–201882%
38Willis EA, et al. (2015)Length of moderate-to-vigorous physical activity bouts and cardio-metabolic risk factors in elementary school childrenMethod: latent profile analysisTools: Progressive Aerobic Cardiovascular Endurance Run (PACER), growth charts CDCSample: 396 second- and third-grade students aged 7.6±0.6 yearsLonger rather than shorter MVPA seizures are associated with reduced cardiovascular risk factors, especially lower BMI percentiles and WC in children401963–201367%
39Heshmat R, et al. (2016)Joint association of screen time and physical activity with cardiometabolic risk factors in a national sample of Iranian adolescents: The CASPIANIII StudyMethod: cross-sectional studyTools: author’s questionnaireSample: 5625 children and adolescents aged 10–18 yearsAdolescents with low physical activity/high screen time were shown to have higher BMI scores with, WC, LDL-C, SBP and DBP and lower HDL-C levels compared to other physical activity/screen time combinations. In contrast, patients with high physical activity/low screen time had the highest mean total serum cholesterol631987–201467%
40Verduci E, et al. (2015)Change in metabolic profile after 1-year nutritional-behavioral intervention in obese childrenMethod: clinical studyTools: standardized interview questionnaire, Feeding Frequency Questionnaire (FFQ)Sample: 90 children with obesity, age ≥6 yearsNutritional-behavioral interventions may improve the blood lipid profile and insulin sensitivity in children with obesity, and may benefit the metabolic syndrome491985–201570%
41Delgado-Floody P, et al. (2018)Psychosocial, physical and anthropometric variables in Chilean school children. A comparative study according to physical activity levelsMethod: comparative studyTools: PAQ-C questionnaire for children, TAE-Alumno test, The Body Shape QuestionnaireSample: 605 children aged 11–14 yearsThe main result of this study was that the results of children with lower physical activity values were noticeable in psychosocial, physical and anthropometric variables compared to those that performed physical activity401988–201860%
42D’Agostino EM, et al. (2017)Longitudinal analysis of cardiovascular disease risk profiles in neighbourhood poverty subgroups: 5-year results from an afterschool fitness programme in the USAMethod: longitudinal studyTools: Fit2Play study protocol, the Presidential Youth Fitness Programme testing protocol, modified sit and reach test, PACER testSample: 2264 children and adolescents (average age: 9.4 age)Results show that the youth programme can maintain or improve cardiovascular health in at-risk teens over 5 years of age, including blood pressure, weight status, and physical fitness411982–201775%
43Nişancı-Kılınç F, Çağdaş DN (2013)Diet and physical activity interventions do have effects on body composition and metabolic syndrome parameters in overweight and obese adolescents and their mothersMethod: clinical trialTools: Ozturk’s growth charts, Harpenden Skinfold Caliper, the charts of fat percentage percentilesSample: 19 adolescents with an average age of 12.52±2.85 years and their mothersNutritional and motor interventions affect body composition and metabolic syndrome parameters in adolescents with obesity and their mothers with overweight and obesity381993–201360%
44Vasconcellos F, et al. (2015)Health markers in obese adolescents improved by a 12-week recreational soccer program: a randomised controlled trialMethod: randomized control clinical trialTools: recreational soccer programme (RSP)Sample: 30 adolescents aged 12–17 yearsRecreational soccer performer 3 times a week during 12 weeks resulted in beneficial changes in body mass and composition, VOpeak, resting blood pressure, autonomic activity, plasma lipid and glukose profile, CRP and endothelial-dependent vasodilation441962–201473%
45Messiah SE, et al. (2016)Impact of a park-based afterschool program replicated over five years on modifiable cardiovascular disease risk factorsMethod: cohort studyTools: The Presidential Youth Fitness Programme protocol; the modified sit and reach test, PACER test. EmpowerMe4Life 9-item scale Sample: children aged 6–14 yearsPeople of normal body weight maintained a healthy BMI, overweight/obese people had reduced both BMI z-score and percentiles, all weight groups lowered blood pressure, improved fitness and knowledge about health and wellbeing521965–201675%
46Antunesn B de MM, et al. (2015)Effect of concurrent training on gender-specific biochemical variables and adiposity in obese adolescentsMethod: clinical trialTools:Sample: 25 adolescents aged 12–15 yearsSignificant increase in height and decrease in BMI (=0.002 and =0.017), BMI z-score (=0.033 and =0.004), FM% (=0.002 and =0.002), TFM% (=0.009 and =0.018), total cholesterol (=0.042 and =0.001) and LDL-C (=0.006 and =0.001) was found in the male and female groups, respectively, after 20 weeks of intervention when compared with baseline321999–201560%
47Horner K, et al. (2015)Effect of aerobic vs resistance exercise on pulse wave velocity, intima media thickness and left ventricular mass in obese adolescentsMethod: clinical trialTools: graded treadmill testSample: 66 children aged 12–18 yearsIn adolescents with obesity, CRF was significantly associated with cIMT and LVMI at baseline. Also, total fat and improvements in CRF after 3 months of aerobic and resistance exercise were noticed431988–201470%
48Moura BP, et al. (2019)Effects of isotemporal substitution of sedentary behavior with light-intensity or moderate-to-vigorous physical activity on cardiometabolic markers in male adolescentsMethod: cross-sectional studyTools: interview-based questionnaire, ActiGraph GT3X+Sample: 140 adolescents aged 14–18 yearsReplacing sedentary behavior with light-intensity physical activity showed positive results on metabolic (HDL-C and HOMA2-S) and physiological (SBP) indicators, while replacing sedentary behavior with MVPA was only associated with one obesity indicator (BF%)491972–201975%
49Ogawa M, et al. (2021)Comparative evaluation of obesity-related parameters in junior sumo wrestlers and children with obesityMethod: clinical studyTools:Sample: 70 children aged 9–17 yearsThe BMI z-score, obesity rate, WC (301976–202170%
50Mendoza JA, et al. (2012)General vs central adiposity and relationship to pediatric metabolic riskMethod: cross-sectional studyTools: National Health and Nutrition Examination Survey (NHANES)Sample: 2155 participants aged 6–19 yearsParticipants with more minutes of MVPA had lower SBP and higher HDL-C, daily minutes of MVPA were significantly associated with SBP, HDL-C and WC. WC significantly mediated the relationship between minutes of MVPA and CRP and HDL-C, and was independently associated with several metabolic risk factors, such as higher CRP, glycohemoglobin, fasting TG, fasting insulin, and lower HDL-C401986–201183%
51Aadland E, et al. (2020)Accelerometer epoch setting is decisive for associations between physical activity and metabolic health in childrenMethod: cross-sectional studyTools: Andersen intermittent running test, ActiGraph GT3X+Sample: 841 childrenThe explained variance in models of metabolic health improved when epoch durations decreased381972–201875%
52Gopinath B, et al. (2014)Activity behaviors in school children and subsequent 5-year change in blood pressureMethod: cohort studyTools: activity questionnairesSample: 821 children aged 6–11 yearsAdhering to the recommended guidelines of 60 minutes or more a day of physical activity in the long term was associated with an appreciable reduction in blood pressure 5 years later among school children. In contrast, higher levels of total screen time were prospectively associated with higher levels of blood pressure292008–201873%
53Aguilar-Cordero MJ, et al. (2020)Influence of physical activity on blood pressure in children with overweight/obesity: A randomized clinical trialMethod: randomized control clinical trialTools: clinical historySample: 98 childrenAn intervention based on physical activity and nutritional recommendations is shown to be effective in reducing hypertension in children with overweight or obesity292008–201873%
54Herbst A, et al. (2014)Impact of regular physical activity on blood glucose control and cardiovascular risk factors in adolescents with type 2 diabetes mellitus – a multicenter study of 578 patients from 225 centresMethod: multicentre clinical trialTools: Pediatric Quality Initiative (DPV)Sample: 578 children aged 10–20 years with type 2 diabetesAn intervention based on physical activity and nutritional recommendations is shown to be effective in reducing hypertension in children with overweight or obesity391991–201390%
55Nightingale CM, et al. (2018)The contribution of physical fitness to individual and ethnic differences in risk markers for type 2 diabetes in children: The Child Heart and Health Study in England (CHASE)Method: cross-sectional studyTools: 8-minute submaximal step testSample: 1445 children aged 9–10 yearsHigher VO max was associated with lower FMI, insulin, HOMA-IR, HbA1c, glucose, urate, CRP, triglycerides, LDL-C, blood pressure and higher HDL-C. Physical activity is associated with risk markers for T2D and cardiovascular diseases, which persist after adjustment for adiposity321980–201675%
BMI – body mass index; CRP – C-reactive protein; CRF – cardio-metabolic risk factors; DBP – diastolic blood pressure; HOMA-IR – homeostasis model assessment of insulin resistance; SBP – systolic blood pressure; LDL-C – low-density lipoprotein cholesterol; HDL-C – high-density lipoprotein cholesterol; LIPA – light-intensity physical activity; MVPA – moderate to vigorous physical activity; WC – waist circumference.

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750