Relationship Between Youth Cardiometabolic Health And Physical Activity In Medical Records

PURPOSE: It is recommended that children engage in at least 60 minutes of physical activity (PA) and limit screen time to 2 hours each day. The purpose of this study is to investigate if children meeting PA or screen time recommendations have better cardiometabolic health than children not meeting the recommendations. Incorporating this type of screening information into primary care may help identify youth who may be at risk for adverse cardiometabolic health and may benefit from individualized health behavior counseling. METHODS: This cross-sectional study used data from electronic medical records (EMRs) between January 1, 2013 and December 30, 2017 from children (2-18 years) who attended at least one well child visits and were assessed for ≥1 cardiometabolic risk factor. Cardiometabolic risk factors included systolic and diastolic blood pressure, glycated hemoglobin, alanine transaminase, systolic and diastolic blood pressure, high-density lipoprotein, low-density lipoprotein, total cholesterol, and/or triglycerides. PA and screen time were patient/caregiver reported. Logistic regression analyses were used to assess meeting recommendations and the prevalence of abnormal cardiometabolic risk factors and patient characteristics. RESULTS: Analyses included EMRs from 63,676 well child visits by 30,698 unique patients (49.3% female; 41.7% Black, 31.5% Hispanic). Models that included data from all visits indicated children meeting PA recommendations had reduced risk for abnormal blood pressure (OR = 0.91, 95%CI 0.86, 0.97; p = 0.002), glycated hemoglobin (OR = 0.83, 95%CI 0.75 to 0.91; p < 0.001), alanine transaminase (OR = 0.85, 95%CI 0.79-0.92; p < 0.001), high-density lipoprotein (OR = 0.88, 95%CI 0.82, 0.95; p < 0.001), and triglyceride values (OR = 0.89, 95%CI 0.83, 0.96; p < 0.001). Meeting screen time recommendations was not associated with abnormal cardiometabolic risk factors. CONCLUSIONS: Clinicians have a unique opportunity to impact health and provide counseling on lifestyle behaviors. Results support the benefits of PA on cardiometabolic health in children. Further, single-time questions within EMRs can support clinicians in identifying youth at risk for adverse modifiable cardiometabolic risk factors associated with not meeting PA recommendations. Dr. Bethany Forseth received salary support from the National Institutes of Health for research not directly related to this project (F32DK128982).