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Developmental Trajectories of Body Mass Index, Waist Circumference, and Aerobic Fitness in Youth: Implications for Physical Activity Guideline Recommendations (CHAMPS Study-DK)

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Abstract

Objectives

Describe the trajectories of body mass index (BMI), waist circumference, and aerobic fitness in children and identify different outcomes of guideline-recommended physical activity (PA) in a subset of active children.

Methods

We recruited students from 10 public primary schools and obtained repeated measures of BMI, waist circumference, and aerobic fitness over 30 months. Aerobic fitness was measured with the Andersen test. We objectively measured physical activity behaviour with accelerometers and classified children as ‘physically active’ when they achieved ≥ 60 min of moderate-to-vigorous PA per day (guideline concordance). Univariate trajectories of BMI, waist circumference, and aerobic fitness were calculated for all children, and we constructed a multi-trajectory model comprising all outcomes in the subgroup of physically active children. The construct validity of all models was investigated by examining for between-group differences in cardiovascular disease risk factors obtained from fasting blood samples.

Results

Data from 1208 children (53% female) with a mean (SD) age of 8.4 (1.4) years were included. The univariate trajectory models identified three distinct trajectories for BMI, waist circumference, and aerobic fitness. The multi-trajectory model classified 9.1% of physically active children as following an ‘overweight/obese/low fitness’ trajectory. There were moderate-to-large differences in cardiovascular risk factors between all trajectory groups (p < 0.001; d = 0.4–1.20).

Conclusion

We identified distinct developmental trajectories of BMI, waist circumference, and aerobic fitness in children. Nearly one in 10 children who met PA guideline recommendations followed an unfavourable health trajectory. Health-related PA recommendations may be insufficient for some children.

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Acknowledgements

The authors gratefully acknowledge the valuable work of numerous students who assisted with data collection in the CHAMPS study DK. We also thank the participating children, their parents, and teachers in the schools involved in the project. We are grateful for the cooperation with The Svendborg Project, Sport Study Sydfyn, and the Municipality of Svendborg. Finally, we wish to acknowledge members of the CHAMPS-study DK not listed as co-authors in this paper: E. Jespersen, M. Heidemann, C.T. Rexen, and C. Franz.

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Authors and Affiliations

  1. Faculty of Kinesiology, University of New Brunswick, Fredericton, Canada

    Jeffrey J. Hébert & Martin Sénéchal

  2. School of Psychology and Exercise Science, Murdoch University, Murdoch, Australia

    Jeffrey J. Hébert & Timothy Fairchild

  3. Cardiometabolic Exercise and Lifestyle Laboratory, Faculty of Kinesiology, University of New Brunswick, Fredericton, Canada

    Martin Sénéchal

  4. Department of Sports Science and Clinical Biomechanics, Exercise Epidemiology, Center for Research in Childhood Health, Faculty of Health Science, University of Southern Denmark, Odense, Denmark

    Niels Christian Møller, Heidi Klakk & Niels Wedderkopp

  5. Center for Applied Health Science, University College Lillebælt, Odense, Denmark

    Heidi Klakk

  6. The Orthopedic Department, Hospital of Southwestern Jutland, Esbjerg, Denmark

    Niels Wedderkopp

  7. Department of Regional Health Research, University of Southern Denmark, Odense, Denmark

    Niels Wedderkopp

Authors
  1. Jeffrey J. Hébert
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  2. Martin Sénéchal
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  3. Timothy Fairchild
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  4. Niels Christian Møller
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  5. Heidi Klakk
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  6. Niels Wedderkopp
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Corresponding author

Correspondence to Jeffrey J. Hébert.

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Conflict of interest

The authors have nothing to disclose.

Funding

The CHAMPS-study DK was funded by the TRYG Foundation, University College Lillebaelt, University of Southern Denmark, The Nordea Foundation, The IMK foundation, The Region of Southern Denmark, The Egmont Foundation, The A.J. Andersen Foundation, The Danish Rheumatism Association, Østifternes Foundation, Brd. Hartmann’s Foundation, TEAM Denmark, The Danish Chiropractor Foundation, and The Nordic Institute of Chiropractic and Clinical Biomechanics. The funding sources played no role in the design, conduct, or reporting of this study.

Author contributions

JJH, MS, TF, and NW conceived the research questions and designed the analysis. NCM, HK, and NW acquired data. JJH conducted the data analysis and drafted the original manuscript. All authors interpreted the data, provided critical revisions of the manuscript, and approved the final version to be published.

Data Availability

Data are available from the CHAMPS Study Steering Committee upon reasonable request. Legal and ethical restrictions apply. Interested parties may contact Dr. Niels Christian Møller (nmoller@health.sdu.dk), and the following information will be required at the time of application: a description of how the data will be used, securely managed, and permanently deleted.

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Hébert, J.J., Sénéchal, M., Fairchild, T. et al. Developmental Trajectories of Body Mass Index, Waist Circumference, and Aerobic Fitness in Youth: Implications for Physical Activity Guideline Recommendations (CHAMPS Study-DK). Sports Med 50, 2253–2261 (2020). https://doi.org/10.1007/s40279-020-01335-3

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