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SUTER, E. and M. R. HAWES. Relationship of physical activity, body fat, diet, and blood lipid profile in youths 10–15 yr. Med. Sci. Sports Exerc., Vol. 25, No. 6, pp. 748–754, 1993. The relationship between risk factors for CHD such as physical activity, cardiovascular fitness, subcutaneous body fat, dietary intake characteristics, age, and sex with the blood lipid profile was examined in 39 boys and 58 girls aged 10–15 yr. In boys, a high level of physical activity was related to higher concentrations of HDL-C (r = 0.32, P < 0.05), as well as to lower concentrations of VLDL-C, total triglycerides (TG), and the ratio of total cholesterol (TC) to HDL-C (r = −0.42; −0.40, both P < 0.01; and −0.37, P < 0.05). A high sum of 10 skinfolds (≥10SF) was related to a higher ratio of TC/HDL-C (r = 0.35; P < 0.05). In girls, physical activity was positively related to HDL-C (r = 0.29; P < 0.05). The ≥10SF showed a negative association with Apo A-I and HDL-C (r = −0.26, −0.29, both P < 0.05) and a positive association with apolipoprotein B (Apo B) (r = 0.28, P < 0.05). Cardiovascular fitness was not significantly related to any of the blood lipid concentrations, in either boys or girls. Intake of saturated fats and dietary cholesterol was positively related to TC levels in boys, but the associations failed to reach statistical significance (r = 0.34 and r = 0.31, P > 0.05) due to the small sample size (N = 32). In multivariate analysis of blood lipid levels, physical activity was a significant and independent predictor of HDL-C, Apo A-I, TG, and VLDL-C while ≥10SF, dietary intake characteristics, and cardiovascular fitness did not contribute appreciable information to the variance observed. However, the interaction term of ≥10SF*Sex increased significantly the variance explained in TG and VLDL-C levels. In addition, age was a significant negative predictor for HDL-C and Apo A-I levels. These results suggest an association independent of gender, between a high level of physical activity and a more favorable lipid profile in children aged 10 to 15 yr. However, sex seems to be an important modifier of the relationship between ≥10SF and TG or VLDL-C levels. The present study confirms that the associations between beneficial lifestyle habits and blood lipid profile generally described in adults are already evident in children. Since there is an increasing evidence that risk factor levels have a fair persistency over years; promotion of physical acticity at adolescent age seems to be warranted.