Youth Physical Activity Linked to Small Differences in Later Cardiometabolic Risk Markers

A harmonized individual participant data meta-analysis in JAMA Pediatrics examined prospective associations between accelerometer-measured physical activity, sedentary time, and cardiometabolic markers in youth. The analysis included 14 cohorts with 12,874 participants, aged 5.0–17.9 years at baseline, followed for a mean of 3.1 years. Outcomes included BMI, insulin, glucose, LDL cholesterol, triglycerides, systolic blood pressure, and composite risk scores.

Each SD increase in moderate-to-vigorous activity, equivalent to 26 minutes daily, was associated with lower insulin (−0.24 µIU/mL; 95% CI, −0.38 to −0.10), LDL cholesterol (−1.54 mg/dL; 95% CI, −1.93 to −0.77), and triglycerides (−1.77 mg/dL; 95% CI, −2.65 to −0.88). Composite risk scores were also lower. There was no association with BMI, while systolic blood pressure was slightly higher by 0.25 mm Hg. Vigorous activity showed similar associations but no association with systolic blood pressure.

Higher sedentary time was not associated with a worse cardiometabolic profile and was associated with lower glucose and systolic blood pressure. These observational findings suggest modest associations between activity and selected risk markers, rather than established causal benefits or effects on clinical outcomes. Associations were weak, sensitive to modeling choices, and heterogeneous across sex, BMI, age, and follow-up duration. Individual participant data were available from eight of 12 eligible studies; full text was unavailable for this assessment.