Cross-sectional associations of objectively-measured physical activity and sedentary time with body composition and cardiorespiratory fitness in mid-childhood: The PANIC study

Paul J. Collings, Kate Westgate, Juuso Väistö, Katrien Wijndaele, Andrew J. Atkin, Eero A. Haapala, Niina Lintu, Tomi Laitinen, Ulf Ekelund, Soren Brage, Timo A. Lakka

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Background: The minimum intensity of physical activity (PA) that is associated with favourable body composition and cardiorespiratory fitness (CRF) remains unknown. 

Objective: To investigate cross-sectional associations of PA and sedentary time (ST) with body composition and CRF in mid-childhood. 

Methods: PA, ST, body composition and CRF were measured in a population-based sample of 410 children (aged 7.6 ± 0.4 years). Combined heart-rate and movement sensing provided estimates of PA energy expenditure (PAEE, kJ/kg/day) and time (min/day) at multiple fine-grained metabolic equivalent (MET) levels, which were also collapsed to ST and light PA (LPA), moderate PA (MPA) and vigorous PA (VPA). Fat mass index (FMI, kg/m(2)), trunk fat mass index (TFMI, kg/m(2)) and fat-free mass index (FFMI, kg/m(2.5)) were derived from dual-energy X-ray absorptiometry. Maximal workload from a cycle ergometer test provided a measure of CRF (W/kg FFM). Linear regression and isotemporal substitution models were used to investigate associations. 

Results: The cumulative time above 2 METs (221 J/min/kg) was inversely associated with FMI and TFMI in both sexes (p < 0.001) whereas time spent above 3 METs was positively associated with CRF (p ≤ 0.002); CRF increased and adiposity decreased dose-dependently with increasing MET levels. ST was positively associated with FMI and TFMI (p < 0.001) but there were inverse associations between all PA categories (including LPA) and adiposity (p ≤ 0.002); the magnitude of these associations depended on the activity being displaced in isotemporal substitution models but were consistently stronger for VPA. PAEE, MPA and to a greater extent VPA, were all positively related to CRF (p ≤ 0.001). 

Conclusions: PA exceeding 2 METs is associated with lower adiposity in mid-childhood, whereas PA of 3 METs is required to benefit CRF. VPA was most beneficial for fitness and fatness, from a time-for-time perspective, but displacing any lower-for-higher intensity may be an important first-order public health strategy. Clinical trial registry number (website): NCT01803776 (

Original languageEnglish
Pages (from-to)769–780
Number of pages12
JournalSports Medicine
Issue number4
Early online date24 Aug 2016
Publication statusPublished - Apr 2017

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