Physical Activity, Fitness, and Sedentariness with MEtabolic, VAscular, and Cardiac health in pediatric population (PAFSMEVAC)
Finnish Cultural Foundation
The PAFSMEVAC project aims to:
- Improve understanding of the development of cardiovascular, metabolic, and arterial diseases from childhood until young adulthood.
- Identify critical time period of significant deviation from physiology to pathology during growth and maturation.
- Simulate potential intervention effects in situation were randomized clinical trials are lacking in apparently healthy children and adolescents.
- Examine mechanistic cross-talk within modifiable risk factors and non-modifiable risk factors to inform potentially effective intervention strategies.
- Investigate causal inferences in risk factors relationships that prospectively influence cardiac, metabolic, and arterial health from childhood through young adulthood.
- Discover novel risk factors for several paediatric diseases such as hypertension, insulin resistance (type 2 diabetes), obesity, premature cardiac damage, atherosclerosis, dyslipidaemia in which several intervention strategies have had limited success.
- To fill knowledge gaps identified by the World Health Organization and other global public health agencies through the provision of substantial scientific evidence useful in updating health guidelines in primarily preventing non-communicable diseases.
Modifiable risk factors are total cholesterol, triglyceride, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, insulin resistance (glucose and insulin), blood pressure, heart rate, low-grade inflammation, obesity, body composition (fat mass and muscle mass), sedentary time, light physical activity, moderate-to-vigorous physical activity, smoking habit, cardiorespiratory fitness. Risk factors where measured during clinic visit from childhood starting at age 7 years and repeated either yearly or bi-annually until age 17 years. Young adulthood assessments occurred at age 24 years clinic visit, the 30-year clinic visit is currently ongoing (2022 – 2024).
The major study outcomes are: arterial stiffness (carotid-femoral pulse wave velocity), carotid intima-media thickness, carotid elasticity or distensibility, left ventricular concentric and eccentric hypertrophy, left ventricular diastolic function, left ventricular filling pressure, etc. These cardiac and vascular outcomes were measured both in adolescence (age 17 years) and young adulthood (age 24 years).
Data and Population Size:
Data for urFIT-child research project are drawn from the Avon Longitudinal Study of Parents and Children (ALSPAC), also known as Children of the 90s, a world-leading UK ongoing birth cohort study. More than 14,000 pregnant women were recruited from April 1991 through December 1992 and 14,901 foetuses arising from the pregnancy, and their partners have been followed up intensively over three decades. The ALSPAC study website contains details of all the data that are available (http://www.bristol.ac.uk/alspac/researchers/our-data/).
Population who attended specific clinic visits:
Clinic visit Population sample size
@Age 7 years: 8 290
@Age 8 years: 7 488
@Age 9 years: 7 722
@Age 10+ years: 7 557
@Age 11+ years: 7 153
@Age 12+ years: 6 832
@Age 13+ years: 6 147
@Age 15+ years: 5 515
@Age 17+ years: 5 081
@Age 24+ years: 4 026
@Age 30+ years: ongoing
To disseminate findings in high impact and leading scientific journals in addition to providing simple texts (press release) understandable to the general population and tax payers who have funded the research. This evidence would be helpful in updating public health recommendation from childhood to enable a healthier life course.
Atherosclerosis may be stopped if lipid screening and dyslipidemia intervention begin in adolescenceConsistently elevated lipids and dyslipidemia in early life were associated with worsening subclinical atherosclerosis but simulated lipid treatment…
Weight gain from childhood with optimal muscle-to-fat mass ratio may be a sign of excellent vascular healthHigh body fat from childhood was not associated with progressive vascular damage in young adulthood, a paper published in Hypertension Research…
Arterial stiffness raises blood pressure in adolescents via insulin resistanceIn the young population, arterial stiffness, an emerging risk factor for hypertension, indirectly raises blood pressure via an increase in insulin…
Blood pressure greater than 130/85 mmHg can cause heart damage in adolescents – the risk gets doubled in 7 yearsElevated blood pressure and hypertension can cause early cardiac damage during adolescence which is worsened by young adulthood, a paper published in…
The urFIT-child project research proposals are listed below but not limited to:
Cardiorespiratory fitness, adiposity and lean mass in relation to arterial structure and function from childhood to adulthood
Associations between sedentary time and physical activity with arterial function and structure from childhood to adulthood
Associations of cardiorespiratory fitness, body composition, physical activity and sedentary time with cardiometabolic risks
Youth Vascular Consortium
Agbaje AO, Zachariah JP, Tuomainen TP. Arterial Stiffness but not Carotid Intima-Media Thickness Progression Precede Premature Structural and Functional Cardiac Damage in Youth: A 7-Year Temporal and Mediation Longitudinal Study. Atherosclerosis 2023 August 3. https://doi.org/10.1016/j.atherosclerosis.2023.117197
Agbaje AO. Adolescents Cholesterol Passport: A Universal Pediatric Lipid Screening Tool to Combat Atherosclerosis – the World’s Deadliest Scourge. Front Pediatr. 2023 June 19;11. doi: 10.3389/fped.2023.1228483
Agbaje AO. Longitudinal Mediating effect of Fatmass and Lipids on Sedentary Time, Light PA, and MVPA with Inflammation in Youth. J Clin Endocrinol Metab. 2023 Jun 13:dgad354. doi: 10.1210/clinem/dgad354. Epub ahead of print. PMID: 37310686.
Agbaje AO. Arterial stiffness preceding metabolic syndrome in 3,862 adolescents: a mediation and temporal causal longitudinal birth cohort study. Am J Physiol Heart Circ Physiol. 2023 Jun 1;324(6):H905-H911. doi: 10.1152/ajpheart.00126.2023.
Agbaje AO. Does arterial stiffness mediate or suppress the associations of blood pressure with cardiac structure and function in adolescents?. Am J Physiol Heart Circ Physiol. June 1 2023;324(6):H776-H781. doi: 10.1152/ajpheart.00094.2023.
Agbaje AO. Associations of accelerometer-based sedentary time, light physical activity and moderate-to-vigorous physical activity with resting cardiac structure and function in adolescents according to sex, fat mass, lean mass, BMI, and hypertensive status. Scand J Med Sci Sports. 2023 Apr 10. doi: 10.1111/sms.14365. Epub ahead of print. PMID: 37035905.
Agbaje AO. Longitudinal Left Ventricular Mass Indexing for DEXA-Measured Lean Mass and Fat Mass: Novel Normative Reference Centiles in Post-Pubertal Adolescents and Young Adults. American Journal of Physiology-Heart and Circulatory Physiology 2023, Apr 1;324(4):H571-H577. https://doi.org/10.1152/ajpheart.00045.2023
Agbaje AO, Barker AR, Tuomainen TP. Cumulative muscle mass and blood pressure but not fat mass drives arterial stiffness and carotid intima-media thickness progression in the young population and is unrelated to vascular organ damage. Hypertension Research April 1 2023;46:984–999. doi: 10.1038/s41440-022-01065-1.
Agbaje AO. Elevated Blood Pressure and Worsening Cardiac Damage During Adolescence. The Journal of Pediatrics. 2023 Mar 3:S0022-3476(23)00132-4. doi: 10.1016/j.jpeds.2023.02.018.
Agbaje AO, Zachariah JP, Bamsa O, Odili AN, and Tuomainen T-P. Cumulative insulin resistance and hyperglycaemia with arterial stiffness and carotid IMT progression in 1779 adolescents: A 9-Year Longitudinal Cohort Study. American Journal of Physiology-Endocrinology and Metabolism 2023 Mar 1;324(3):E268-E278. https://doi.org/10.1152/ajpendo.00008.2023
Agbaje AO, Barmi S, Sansum KM, Baynard T, Barker AR, and Tuomainen T-P. Temporal longitudinal associations of carotid-femoral pulse wave velocity and carotid intima-media thickness with resting heart rate and inflammation in youth. Journal of Applied Physiology 2023 Mar 1;134(3):657-666. https://doi.org/10.1152/japplphysiol.00701.2022
Agbaje AO, Lloyd-Jones DM, Magnussen CG, Tuomainen T-P. Cumulative Dyslipidemia with Arterial Stiffness and Carotid IMT Progression in Asymptomatic Adolescents: A Simulated Intervention Longitudinal Study Using Temporal Inverse Allocation Model. Atherosclerosis Jan 1 2023;364:39-48. https://doi.org/10.1016/j.atherosclerosis.2022.11.011
Agbaje AO. Cardiorespiratory Fitness in Adolescence: A Telescope into Future Cardiovascular Health. Eur J Prev Cardiol. 2022 Dec 13:zwac298. doi: 10.1093/eurjpc/zwac298.
Andrew O Agbaje, Justin P Zachariah, and Tomi-Pekka Tuomainen. Arterial Stiffness and Carotid Intima-Media Thickness Progression Preceding Worsening Left Ventricular Hypertrophy and Diastolic Dysfunction in Youth: A Temporal Causal Longitudinal Study. Circulation 2022, Oct 30. doi/10.1161/circ.146.suppl_1.13679
Agbaje AO. To prevent hypertension in Africans: do we need to eat more vegetables? Eur J Prev Cardiol. 2022 Oct 10:zwac233. doi: 10.1093/eurjpc/zwac233.
A O Agbaje, D M Lloyd-Jones, C G Magnussen, T P Tuomainen. Cumulative dyslipidaemia from mid-adolescence through young adulthood with carotid intima-media thickness progression: a 9-year longitudinal study. European Heart Journal, 2022 Oct 2:43(Supplement_2,); ehac544.2350, https://doi.org/10.1093/eurheartj/ehac544.2350
A O Agbaje, S Barmi, K M Sansum, T Baynard, A R Barker, T P Tuomainen. Does arterial stiffness progression temporally precede higher low-grade inflammation in adolescents? Causal longitudinal evidence using auto-regressive cross-lagged structural equation models. European Heart Journal, 2022 Oct 2:43(Supplement_2,);ehac544.2247. https://doi.org/10.1093/eurheartj/ehac544.2247
A O Agbaje, D M Lloyd-Jones, C G Magnussen, T P Tuomainen. Simulated intervention and optimal timing for attenuating dyslipidaemia-related atherosclerotic progression in the young: a temporal inverse allocation analysis of the ALSPAC cohort. European Heart Journal, 2022 Oct 2:43(Supplement_2,); ehac544.2352, https://doi.org/10.1093/eurheartj/ehac544.2352
A O Agbaje, S Barmi, K M Sansum, T Baynard, A R Barker, T P Tuomainen. Temporal causal longitudinal associations of high-sensitivity C-reactive protein with carotid intima-media thickness progression in adolescents: the ALSPAC birth cohort study. European Heart Journal, 2022 Oct 2:43(Supplement_2,); ehac544.2246, https://doi.org/10.1093/eurheartj/ehac544.2246
A O Agbaje, J P Zachariah, O Bamsa, A N Odili, T P Tuomainen. Cumulative hyperinsulinemia, hyperglycaemia, and insulin resistance from mid-adolescence through young adulthood with carotid intima-media thickness progression: a 9-year longitudinal study. European Heart Journal, 2022 Oct 2:43(Supplement_2,);ehac544.2414, https://doi.org/10.1093/eurheartj/ehac544.2414
A O Agbaje, D M Lloyd-Jones, C G Magnussen, T P Tuomainen. Longitudinal associations of cumulative dyslipidaemia from mid-adolescence through young adulthood with arterial stiffness progression: the ALSPAC study. European Heart Journal, 2022 Oct 2:43(Supplement_2,);ehac544.2351, https://doi.org/10.1093/eurheartj/ehac544.2351
Agbaje AO. Mediating role of body composition and insulin resistance on the association of arterial stiffness with blood pressure among adolescents: The ALSPAC study. Front. Cardiovasc. Med. 2022: 9:939125. doi: 10.3389/fcvm.2022.939125
Agbaje AO. Arterial stiffness precedes hypertension and metabolic risks in youth: a review. J Hypertens. 2022 Oct 1;40(10):1887-1896. . doi: 10.1097/HJH.0000000000003239.
Agbaje AO, Barker AR, Mitchell GF, Tuomainen TP. Effect of Arterial Stiffness and Carotid Intima-Media Thickness Progression on the Risk of Dysglycemia, Insulin Resistance, and Dyslipidemia: a Temporal Causal Longitudinal Study. Hypertension. 2022 Mar;79(3):667-678. doi: 10.1161/HYPERTENSIONAHA.121.18754.
Agbaje AO, Barker AR, Tuomainen TP. Effects of Arterial Stiffness and Carotid Intima-Media Thickness Progression on the Risk of Overweight/Obesity and Elevated Blood Pressure/Hypertension: a Cross-Lagged Cohort Study. Hypertension. 2022 Jan;79(1):159-169. doi: 10.1161/HYPERTENSIONAHA.121.18449.
Agbaje AO, Barker AR, Tuomainen TP. Cardiorespiratory Fitness, Fat Mass, and Cardiometabolic Health with Endothelial Function, Arterial Elasticity, and Stiffness. Med Sci Sports Exerc. 2022 Jan 1;54(1):141-152. doi: 10.1249/MSS.0000000000002757.
Central Finnish Cultural Foundation
Jenny and Antti Wihuri Foundation
The North Savo regional Finnish Cultural Foundation
Orion Research Foundation sr
Aarne Koskelo Foundation
Antti and Tyyne Soininen Foundation
Paavo Nurmi Foundation
Yrjö Jahnsson Foundation
Finnish Foundation for Cardiovascular Research
Pediatric Research Foundation
Ida Montin Foundation
Eino Räsänen Fund
Matti and Vappu Maukonen Fund