The combined effect of physical activity and sedentary behaviors on a clustered cardio-metabolic risk score: The Helena study

Tara Rendo-Urteaga, Augusto César Ferreira De Moraes, Tatiana Sadalla Collese, Yannis Manios, María Hagströmer, Michael Sjöström, Anthony Kafatos, Kurt Widhalm, Jérémy Vanhelst, Ascensión Marcos, Marcela González-Gross, Stefaan De Henauw, Donatella Ciarapica, Jonatan R. Ruiz, Vanesa España-Romero, Dénes Molnár, Heráclito B. Carvalho, Luis A. Moreno

Research output: Contribution to journalArticle

22 Citations (Scopus)


Background/objective Increased physical activity (PA) and decreased sedentary behaviors (SBs) may have beneficial effects on cardio-metabolic risk in adolescents. The aim of this study was to examine the associations between independent/combined effects of PA and SB with individual/clustered cardio-metabolic risk factors. Methods A sample of 769 adolescents (12.5-17.5 years) from the HELENA cross-sectional study (Healthy Lifestyle in Europe by Nutrition in Adolescence) and with valid data on metabolic risk factors were included. Results Concerning moderate-to-vigorous-PA (MVPA) and vigorous-PA (VPA), measured with accelerometers, girls tended to do more MVPA (36%) and VPA (114%) than boys. Unadjusted analyses show a positive association between "PA ≥ 60 min/d; SB ≥ 2 h" and the ratio TC/HDL-c (β = 0.27; 95%CI 0.01 to 0.52; p < 0.05), and a negative association between "MVPA ≥ 60 min/d; SB < 2 h" with the 4Skinfolds (β = - 0.32; 95%CI - 0.61 to - 0.02; p < 0.05). Moreover, "SB ≥ 2 h/d" was associated with increased cardio-metabolic risk (PR 1.59; 95%CI 1.05 to 2.39; p < 0.05), while "PA ≥ 60 min/d; SB < 2 h" had a protective effect against cardio-metabolic risk (PR 0.48; 95%CI 0.25 to 0.91; p < 0.05). After adjustment for potential confounders, a positive association between SB and 4Skinfolds was shown (β = 0.28; 95%CI 0.04 to 0.53; p < 0.05). Furthermore, VO2max (mL/kg/min) tends to increase in those participants who do higher VPA and less SB (p = 0.042), and there was a protective effect of "VPA ≥ 30 min/d; SB < 2 h" against cardio-metabolic risk (PR 0.24; 95%CI 0.07 to 0.85; p < 0.05). Conclusion The current study suggests that adolescents should be encouraged to decrease sedentary lifestyle and increase physical activity, especially vigorous physical activity, in order to reduce cardio-metabolic risk.

Original languageEnglish
Pages (from-to)186-195
Number of pages10
JournalInternational Journal of Cardiology
Publication statusPublished - May 1 2015



  • Adolescents
  • Cardiometabolic risk
  • Physical activity
  • Sedentary lifestyle

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Rendo-Urteaga, T., De Moraes, A. C. F., Collese, T. S., Manios, Y., Hagströmer, M., Sjöström, M., Kafatos, A., Widhalm, K., Vanhelst, J., Marcos, A., González-Gross, M., De Henauw, S., Ciarapica, D., Ruiz, J. R., España-Romero, V., Molnár, D., Carvalho, H. B., & Moreno, L. A. (2015). The combined effect of physical activity and sedentary behaviors on a clustered cardio-metabolic risk score: The Helena study. International Journal of Cardiology, 186, 186-195.