Índice de Massa Corporal e Fatores de Risco Metabólico em Crianças e Adolescentes: O Papel da Atividade Física e da Aptidão Cardiorrespiratória

Abstract

Childhood and adolescent obesity has been increasing globally and is associated with health risks such as type 2 diabetes, hypertension, and cardiovascular disease. This study aimed to analyse the association between body mass index (BMI), cardiorespiratory fitness (CRF), and physical activity (PA) with cardiometabolic risk factors in adolescents. The sample consisted of 454 participants (238 females and 216 males) aged between 10 and 16 years. Most had a normal BMI (85.2%), with 13% classified as overweight and 1.8% as obese. Metabolic biomarkers such as glucose, lipid profile, blood pressure and a composite variable representing the sum of cardiometabolic risks were assessed. CRF was measured using the shuttle test and PA was assessed using Actigraph GT3X+ accelerometers, according to the protocols predefined. Statistical analyses revealed significant differences between genders and BMI categories for variables such as PA, CRF, and cardiometabolic risks. Overweight individuals had less favourable lipid profiles and higher total risk scores. Covariance analysis (ANCOVA), adjusted for BMI, confirmed that BMI is the main predictor of cardiometabolic risks, while CRF and PA showed no significant independent effects. It is concluded that obesity is the factor most strongly associated with the worsening of the cardiometabolic profile at an early age, regardless of PA and CRF levels. The results reinforce the need for primary prevention strategies focused on promoting healthy lifestyles, with an emphasis on school and community programmes that encourage regular PA and maintenance of CRF to reduce cardiometabolic risks and prevent chronic non-communicable diseases.