Physical Activity May Improve Cardiometabolic Health in children and adolescents: JAMA

For the establishment of robust prospective associations, a systematic review of literature up to December 2024 was carried out to identify prospective cohort studies within the framework of the International Children’s Accelerometry Database (ICAD) and international cohorts. Participant-level data were extracted and pooled into a network of secure servers where the data were harmonized and analyzed through mixed linear regression models using directed acyclic graphs to adjust for confounders.

In this meta-analysis, data from 14 prospective cohorts with 12,874 children’s participants (mean age at baseline, 10.4 years [range, 5.0–17.9]; 6,577 females [52%]) with a mean longitudinal follow-up period of 3.1 ± 2.0 years were used. Accelerometer-derived exposure metrics included MVPA, VPA, and total sedentary behavior with outcomes being changes in BMI, fasting insulin, fasting glucose, LDL cholesterol, triglycerides, systolic blood pressure, and standardized composite risk scores.

Key findings:

• Across 12,874 youth, harmonized analysis identified specific quantitative associations per 1-SD increase in device-measured physical activity.
• One SD increase in MVPA (equal to about 26 minutes per day) was prospectively associated with a decrease in fasting insulin levels (−0.24 µIU/mL; 95% CI, −0.38 to −0.10), decrease in LDL cholesterol levels (−1.54 mg/dL; 95% CI, −1.93 to −0.77), reduction in triglyceride levels (−1.77 mg/dL; 95% CI, −2.65 to −0.88), and improvement in the composite risk score (−0.04; 95% CI, −0.06 to −0.02).
• There was no prospective association between MVPA and BMI (0.00; 95% CI, −0.005 to 0.005), and MVPA was associated with an increase in systolic blood pressure (0.25 mm Hg; 95% CI, 0.04–0.46).
• VPA had similar metabolic effects but had no association with systolic blood pressure. Increased time spent being sedentary was not associated with cardiometabolic risk profile but unexpectedly was associated with decreased blood glucose (−0.36 mg/dL; 95% CI, −0.72 to 0.00) and decreased systolic blood pressure (−0.90 mm Hg; 95% CI, −1.22 to −0.58).

In summary, harmonized prospective data from more than 12,000 children and adolescents show that moderate to vigorous physical activity results in selective metabolic improvements without changing BMI trends. As can be seen from the conclusions drawn from this study, physical activity selectively impacts metabolic parameters and not the sedentary behavior.

Reference:

Husøy A, Dalene KE, Hansen BH, et al. Device-Measured Physical Activity, Sedentary Time, and Cardiometabolic Risk Markers in Youth: A Harmonized Individual Participant Data Meta-Analysis. JAMA Pediatr. Published online October 06, 2026. doi:10.1001/jamapediatrics.2026.5176