title: Body Composition Indices and Single and Clustered Cardiovascular Disease Risk Factors in Adolescents: Providing Clinical-Based Cut-Points.
abstract: The aims of the present study in adolescents were 1) to examine how various body composition-screening tests relate to single and clustered cardiovascular disease (CVD) risk factors, 2) to examine how lean mass and body fatness (independently of each other) relate to clustered CVD risk factors, and 3) to calculate specific thresholds for body composition indices associated with an unhealthier clustered CVD risk. We measured 1089 European adolescents (46.7% boys, 12.5-17.49years) in 2006-2007. CVD risk factors included: systolic blood pressure, maximum oxygen uptake, homeostasis model assessment, C-reactive protein (n=748), total cholesterol/high density lipoprotein cholesterol and triglycerides. Body composition indices included: height, body mass index (BMI), lean mass, the sum of four skinfolds, central/peripheral skinfolds, waist circumference (WC), waist-to-height ratio (WHtR) and waist-to-hip ratio (WHR). Most body composition indices are associated with single CVD risk factors. The sum of four skinfolds, WHtR, BMI, WC and lean mass are strong and positively associated with clustered CVD risk. Interestingly, lean mass is positively associated with clustered CVD risk independently of body fatness in girls. Moderate and highly accurate thresholds for the sum of four skinfolds, WHtR, BMI, WC and lean mass are associated with an unhealthier clustered CVD risk (all AUC>0.773). In conclusion, our results support an association between most of the assessed body composition indices and single and clustered CVD risk factors. In addition, lean mass (independent of body fatness) is positively associated with clustered CVD risk in girls, which is a novel finding that helps to understand why an index such as BMI is a good index of CVD risk but a bad index of adiposity. Moderate to highly accurate thresholds for body composition indices associated with a healthier clustered CVD risk were found. Further studies with a longitudinal design are needed to confirm these findings.
authors.affiliation: Children's Health and Exercise Research Centre (CHERC), Sport and Health Sciences, University of Exeter, Exeter, UK; GENUD "Growth, Exercise, NUtrition and Development" Research Group, University of Zaragoza, Zaragoza, Spain. Electronic address: l.a.gracia-marco@exeter.ac.uk.
authors.forename: Luis
authors.initials: L
authors.lastname: Gracia-Marco
authors.affiliation: GENUD "Growth, Exercise, NUtrition and Development" Research Group, University of Zaragoza, Zaragoza, Spain; Facultad de Ciencias de la Salud, Universidad de Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain; School of Medicine of the University of São Paulo-Department of Preventive Medicine, São Paulo, SP, Brazil.
authors.forename: Luis A
authors.initials: LA
authors.lastname: Moreno
authors.affiliation: PROFITH "PROmoting FITness and Health through physical activity" Research Group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain; Unit for Preventive Nutrition, Department of Bioscience and Nutrition, Karolinska Institute, Huddinge, Sweden.
authors.forename: Jonatan R
authors.initials: JR
authors.lastname: Ruiz
authors.affiliation: PROFITH "PROmoting FITness and Health through physical activity" Research Group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain; Unit for Preventive Nutrition, Department of Bioscience and Nutrition, Karolinska Institute, Huddinge, Sweden.
authors.forename: Francisco B
authors.initials: FB
authors.lastname: Ortega
authors.affiliation: GENUD "Growth, Exercise, NUtrition and Development" Research Group, University of Zaragoza, Zaragoza, Spain; School of Medicine of the University of São Paulo-Department of Preventive Medicine, São Paulo, SP, Brazil.
authors.forename: Augusto César Ferreira
authors.initials: AC
authors.lastname: de Moraes
authors.affiliation: Unité Inserm U995 & Université Lille Nord de France, Lille, France; Centre d'Investigation Clinique, CIC-9301-Inserm-CH&U, Lille, France.
authors.forename: Frederic
authors.initials: F
authors.lastname: Gottrand
authors.affiliation: Agricultural Research Council, Food and Nutrition Research Centre (CRA-NUT), Rome, Italy.
authors.forename: Romana
authors.initials: R
authors.lastname: Roccaldo
authors.affiliation: Immunonutrition Group, Institute of Food Science and Technology and Nutrition, ICTAN-CSIC, C/Jose Antonio Novais 10, 28040 Madrid, Spain.
authors.forename: Ascensión
authors.initials: A
authors.lastname: Marcos
authors.affiliation: Immunonutrition Group, Institute of Food Science and Technology and Nutrition, ICTAN-CSIC, C/Jose Antonio Novais 10, 28040 Madrid, Spain.
authors.forename: Sonia
authors.initials: S
authors.lastname: Gómez-Martínez
authors.affiliation: Institut Pasteur de Lille & Inserm U 744 & Université Lille Nord de France, 1 rue de Pr Calmette, 59019 Lille Cedex, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Dallongeville
authors.affiliation: Department of Social Medicine, Preventive Medicine and Nutrition Clinic, School of Medicine, University of Crete, Crete, Greece.
authors.forename: Anthony
authors.initials: A
authors.lastname: Kafatos
authors.affiliation: Department of Paediatrics, University of Pécs, Pécs, Hungary.
authors.forename: Denes
authors.initials: D
authors.lastname: Molnar
authors.affiliation: Departamento de Pediatría, Hospital Clínico Universitario "Lozano Blesa", San Juan Bosco, Zaragoza, Spain.
authors.forename: Gloria
authors.initials: G
authors.lastname: Bueno
authors.affiliation: Department of Public Health, Ghent University, Ghent, Belgium.
authors.forename: Stefaan
authors.initials: S
authors.lastname: de Henauw
authors.affiliation: Department of Paediatrics and Adolescents Medicine, Division of Clinical Nutrition, Medical University of Vienna, Vienna, Austria; Private Medical University Salzburg, Department of Pediatrics, Salzburg, Austria.
authors.forename: Kurt
authors.initials: K
authors.lastname: Widhalm
authors.affiliation: Childhood Nutrition Research Centre, Institute of Child Health, University College London, London, UK.
authors.forename: Jonathan C
authors.initials: JC
authors.lastname: Wells
mesh_terms: D050154:Adiposity; D000293:Adolescent; D017668:Age of Onset; D000886:Anthropometry; D001823:Body Composition; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D063766:Pediatric Obesity / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors
keywords: Adolescence; C-reactive protein; Cardiovascular risk; Fat mass; Fitness; Lean mass