title: Relations of total physical activity and intensity to fitness and fatness in children: the European Youth Heart Study.
abstract: BACKGROUND
  It is unclear how the amount and intensity of physical activity (PA) are associated with cardiovascular fitness (CVF) and body fatness in children.
  
  
  OBJECTIVE
  We aimed to examine the associations of total PA and intensity levels to CVF and fatness in children.
  
  
  METHODS
  A cross-sectional study of 780 children aged 9-10 y from Sweden and Estonia was conducted. PA was measured by accelerometry and was expressed as min/d of total PA, moderate PA, and vigorous PA. CVF was measured with a maximal ergometer bike test and was expressed as W/kg. Body fat was derived from the sum of 5 skinfold-thickness measurements. Multiple regression analysis was used to determine the degree to which variance in CVF and body fat was explained by PA, after control for age, sex, and study location.
  
  
  RESULTS
  Lower body fat was significantly associated with higher levels of vigorous PA, but not with moderate or total PA. Those children who engaged in >40 min vigorous PA/d had lower body fat than did those who engaged in 10-18 min vigorous PA/d. Total PA, moderate PA, and vigorous PA were positively associated with CVF. Those children who engaged in >40 min vigorous PA/d had higher CVF than did those who accumulated <18 min vigorous PA/d.
  
  
  CONCLUSIONS
  The results suggest that PA of vigorous intensity may have a greater effect on preventing obesity in children than does PA of lower intensity, whereas both total and at least moderate to vigorous PA may improve children's CVF.
authors.affiliation: Unit for Preventive Nutrition, Department of Biosciences and Nutrition at NOVUM, Karolinska Institutet, Huddinge, Sweden.
authors.forename: Jonatan R
authors.initials: JR
authors.lastname: Ruiz
authors.forename: Nico S
authors.initials: NS
authors.lastname: Rizzo
authors.forename: Anita
authors.initials: A
authors.lastname: Hurtig-Wennlöf
authors.forename: Francisco B
authors.initials: FB
authors.lastname: Ortega
authors.forename: Julia
authors.initials: J
authors.lastname: Wärnberg
authors.forename: Michael
authors.initials: M
authors.lastname: Sjöström
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism; D001823:Body Composition / Q000502:physiology; D002648:Child; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D004957:Estonia / Q000453:epidemiology; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009765:Obesity / Q000453:epidemiology* / Q000378:metabolism*; D010809:Physical Fitness / Q000502:physiology*; D012044:Regression Analysis; D012737:Sex Factors; D012885:Skinfold Thickness; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors