Cross-Sectional Associations of Objectively-Measured Physical Activity and Sedentary Time with Body Composition and Cardiorespiratory Fitness in Mid-Childhood: The PANIC Study

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 finegrained 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.