Open Access Highly Accessed Study protocol

Follow-up in healthy schoolchildren and in adolescents with DOWN syndrome: psycho-environmental and genetic determinants of physical activity and its impact on fitness, cardiovascular diseases, inflammatory biomarkers and mental health; the UP&DOWN Study

José Castro-Piñero1*, Ana Carbonell-Baeza1, David Martinez-Gomez2, Sonia Gómez-Martínez3, Verónica Cabanas-Sánchez2, Catalina Santiago4, Ana M Veses3, Fernando Bandrés5, Ana Gonzalez-Galo1, Félix Gomez-Gallego4, Oscar L Veiga2, Jonatan R Ruiz6, Ascensión Marcos3 and the UP&DOWN Study Group

Author Affiliations

1 Department of Physical Education, School of Education, University of Cádiz, Puerto Real, Spain

2 Department of Physical Education, Sports and Human Movement, Faculty of Teacher Training and Education, Autonomous University of Madrid, Madrid, Spain

3 Immunonutrition Research Group. Department of Metabolism and Nutrition. Institute of Food Science and Technology and Nutrition (ICTAN), Spanish National Research Council (CSIC), Madrid, Spain

4 School of Doctoral Studies & Research, European University, Madrid, Spain

5 Department of Toxicology and Health Sanitary, Complutense University of Madrid, Madrid, Spain

6 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

For all author emails, please log on.

BMC Public Health 2014, 14:400  doi:10.1186/1471-2458-14-400

Published: 25 April 2014



An objective diagnosis of sedentary behaviour as well as of the physical activity and fitness levels in youth and to better understand how lifestyle is associated with cardiovascular disease risk factors and other phenotypes is of clinical and public health interest, and might be informative for developing intervention studies focused on the promotion of physical activity in these population. The aim of this methodological paper is to describe the design and assessment in the UP&DOWN study.


The UP&DOWN study is a multi-center follow-up design where 2225 Spanish primary and secondary schoolchildren from Cadiz and Madrid, respectively, as well as 110 Spanish adolescents with Down syndrome from Madrid and Toledo were recruited to be assessed. Nine main measurement categories are assessed: i) socio-demographic and early determinants; ii) environmental determinants; iii) physical activity and sedentary behaviour; iv) health-related fitness; v) blood pressure and resting heart rate; vi) mental health; vii) dietary patterns; viii) blood samples; and ix) genetic analysis. During the 3-yr follow-up study, socio-demographic and early determinants, and genetic analysis are only assessed in the first year. Blood sampling is assessed in the first year and the third year (2nd follow-up), and all the other measurements are assessed every year.


The findings of the UP&DOWN study may help the Health Information Systems and policy makers to identify the target population for primary prevention and health promotion policies, and to develop and test preventive strategies. Moreover, these data will allow following the trends at population level, as well as to modify/adapt/create new evidence-based physical activity guidelines at national level. The findings will also serve as a scientific platform for interventional studies.