Objectively-measured and self-reported physical activity and fitness in relation to inflammatory markers in European adolescents: The HELENA Study

Martinez-Gomez, David; Gomez-Martinez, Sonia; Ruiz, Jonatan R.; Diaz, Ligia Esperanza; Ortega, Francisco B.; Widhalm, Kurt; Cuenca-Garcia, Magdalena; Manios, Yannis; De Vriendt, Tineke; Molnar, Denes; Huybrechts, Inge; Breidenassel, Christina; Gottrand, Frederic; Plada, Maria; Moreno, Sara; Ferrari, Marika; Moreno, Luis A.; Sjöström, Michael; Marcos, Ascension; HELENA Study Group,

doi:10.1016/j.atherosclerosis.2011.12.032

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Volume 221, Issue 1 , Pages 260-267, March 2012

Objectively-measured and self-reported physical activity and fitness in relation to inflammatory markers in European adolescents: The HELENA Study

David Martinez-Gomez
- Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council, Calle José Antonio Novais 10, 28040 Madrid, Spain
- Corresponding author. Tel.: +34 91 549 23 00x296/297; fax: +34 91 549 36 27.
Sonia Gomez-Martinez
- Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council, Calle José Antonio Novais 10, 28040 Madrid, Spain
Jonatan R. Ruiz
- Department of Physical Education and Sport, School of Sport Sciences, University of Granada, Granada, Spain
- Unit for Preventive Nutrition, Department of Biosciences and Nutrition at NOVUM, Karolinska Institutet, Huddinge, Sweden
Ligia Esperanza Diaz
- Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council, Calle José Antonio Novais 10, 28040 Madrid, Spain
Francisco B. Ortega
- Unit for Preventive Nutrition, Department of Biosciences and Nutrition at NOVUM, Karolinska Institutet, Huddinge, Sweden
- Department of Medical Physiology, Faculty of Medicine, Granada, Spain
Kurt Widhalm
- Division of Nutrition and Metabolism, Department of Pediatrics, Medical University of Vienna, Vienna, Austria
Magdalena Cuenca-Garcia
- Department of Medical Physiology, Faculty of Medicine, Granada, Spain
Yannis Manios
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
Tineke De Vriendt
- Department of Public Health, Faculty of Medicine and Health Sciences, De Pintelaan 185, 2 Blok A, 9000 Ghent, Belgium
- Research Foundation Flanders, Egmontstraat 5, 1000 Brussels, Belgium
Denes Molnar
- Department of Pediatrics, University of Pecs, Pécs, József A. str. 7, 7623, Hungary
Inge Huybrechts
- Department of Public Health, Faculty of Medicine and Health Sciences, De Pintelaan 185, 2 Blok A, 9000 Ghent, Belgium
Christina Breidenassel
- Department of Nutrition and Food Science, University of Bonn, 53115 Bonn, Germany
- Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences (INEF), Universidad Politécnica de Madrid, Spain
Frederic Gottrand
- INSERM U995, IFR114, Faculté de Médecine, Université Droit et Santé de Lille 2, Lille, France
Maria Plada
- Department of Social Medicine, School of Medicine, Preventive Medicine and Nutrition Clinic, Crete, Greece
Sara Moreno
- Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences (INEF), Universidad Politécnica de Madrid, Spain
Marika Ferrari
- INRAN (National Research Institute on Food and Nutrition), Via Ardeatina, 546, 00176 Roma, Italy
Luis A. Moreno
- GENUD “Growth; Exercise, Nutrition and Development” Research Group, University School of Health Sciences, University of Zaragoza, Zaragoza, Spain
Michael Sjöström
- Unit for Preventive Nutrition, Department of Biosciences and Nutrition at NOVUM, Karolinska Institutet, Huddinge, Sweden
Ascension Marcos
- Immunonutrition Research Group, Department of Metabolism and Nutrition, Institute of Food Science, Technology and Nutrition (ICTAN), Spanish National Research Council, Calle José Antonio Novais 10, 28040 Madrid, Spain
HELENA Study Group
- See Appendix A.

Received 18 July 2011; received in revised form 20 December 2011; accepted 20 December 2011. published online 20 January 2012.

Highlights

► Atherosclerotic lesions may form during younger years. ► Inflammation plays a key role in atherosclerosis development. ► Physical activity and fitness may be anti-inflammatory factors. ► Fitness plays a direct role on lessening inflammation in adolescence. ► Being active plays an indirect role on inflammation through fitness in adolescence.

Abstract

Objective

Atherogenesis involves an inflammatory process that occurs early in life even though clinical symptoms are not observed until adulthood. Two important protective factors for low-grade inflammation may be physical activity (PA) and fitness. We examined the independent associations of objective and subjective measurements of PA and fitness with low-grade inflammation in European adolescents.

Methods

A total of 1045 adolescents, aged from 12.5 to 17.5 years old from 10 European cities, were selected from the HELENA-Cross-Sectional Study. Objectively-measured and self-reported PA variables were obtained by accelerometry and the International PA Questionnaire for Adolescents, respectively. Overall, cardiorespiratory, muscular and motor fitness variables were assessed by standardized field-based fitness tests and the International Fitness Scale. C-reactive protein (CRP), complement factors 3 (C3) and 4 (C4), interleukin-6 and TNF-α inflammatory markers were measured.

Results

Objectively-measured vigorous PA was inversely associated with C3 (β=−0.094, P=0.021) but it did not remain significant after any objective fitness indicator was included in the model. Other objectively measured or self-reported assessments of PA were not significantly associated with inflammatory markers. All objective measures of fitness were inversely associated with CRP, C3 and C4, whereas only self-reported motor fitness remained significantly associated with C3, C4 and TNF-α. All these observations were independent of age, sex, city and body mass index or waist circumference.