Open Access Highly Accessed Research article

Physical activity and clustered cardiovascular disease risk factors in young children: a cross-sectional study (the IDEFICS study)

David Jiménez-Pavón12*, Kenn Konstabel3, Patrick Bergman4, Wolfgang Ahrens5, Hermann Pohlabeln5, Charalampos Hadjigeorgiou6, Alfonso Siani7, Licia Iacoviello8, Dénes Molnár9, Stefaan De Henauw10, Yannis Pitsiladis11, Luis A Moreno1 and On behalf of the IDEFICS consortium

Author Affiliations

1 Department of Physiotherapy and Nursing, School of Health Sciences, University of Zaragoza, Zaragoza, Spain

2 GENUD: (Growth, Exercise, NUtrition and Development) Research Group, Department of Physiotherapy and Nursing, Faculty of Health Sciences, University of Zaragoza, Avd. Domingo Miral s/n, 50009, Zaragoza, Spain

3 Research Centre National Institute for Health Development, Tallinn, Estonia

4 Department of Sport Sciences, Linnaeus University, Kalmar, Sweden

5 Bremen Institute for Preventive Research and Social Medicine, University of Bremen, Bremen, Germany

6 Research & Education Institute of Child Health, Strovolos, Cyprus

7 National Research Council, Institute of Food Sciences (ISA-CNR), Unit of Epidemiology and Population Genetics, Avellino, Italy

8 Fondazione di Ricerca e Cura ‘Giovanni Paolo II’, Università Cattolica del Sacro Cuore, Campobasso, Italy

9 Department of Paediatrics, University of Pécs, Pécs, Hungary

10 Department of Public Health, Gent University, Ghent, Belgium

11 Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, UK

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BMC Medicine 2013, 11:172  doi:10.1186/1741-7015-11-172

Published: 30 July 2013



The relevance of physical activity (PA) for combating cardiovascular disease (CVD) risk in children has been highlighted, but to date there has been no large-scale study analyzing that association in children aged ≤9 years of age. This study sought to evaluate the associations between objectively-measured PA and clustered CVD risk factors in a large sample of European children, and to provide evidence for gender-specific recommendations of PA.


Cross-sectional data from a longitudinal study in 16,224 children aged 2 to 9 were collected. Of these, 3,120 (1,016 between 2 to 6 years, 2,104 between 6 to 9 years) had sufficient data for inclusion in the current analyses. Two different age-specific and gender-specific clustered CVD risk scores associated with PA were determined. First, a CVD risk factor (CRF) continuous score was computed using the following variables: systolic blood pressure (SBP), total triglycerides (TG), total cholesterol (TC)/high-density lipoprotein cholesterol (HDL-c) ratio, homeostasis model assessment of insulin resistance (HOMA-IR), and sum of two skinfolds (score CRFs). Secondly, another CVD risk score was obtained for older children containing the score CRFs + the cardiorespiratory fitness variable (termed score CRFs + fit). Data used in the current analysis were derived from the IDEFICS (‘Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS’) study.


In boys <6 years, the odds ratios (OR) for CVD risk were elevated in the least active quintile of PA (OR: 2.58) compared with the most active quintile as well as the second quintile for vigorous PA (OR: 2.91). Compared with the most active quintile, older children in the first, second and third quintiles had OR for CVD risk score CRFs + fit ranging from OR 2.69 to 5.40 in boys, and from OR 2.85 to 7.05 in girls.


PA is important to protect against clustering of CVD risk factors in young children, being more consistent in those older than 6 years. Healthcare professionals should recommend around 60 and 85 min/day of moderate-to-vigorous PA, including 20 min/day of vigorous PA.

Please see related commentary: webcite.

Accelerometers; Cardiovascular disease risk factors; Physical activity; Younger children