Key result
Greater childhood adiposity is linked to ~3-second slower heart rate recovery per skinfold increment.
Why the study?
Research on the association between cardiovascular fitness and metabolic risk is limited in preschool children, and simple validated fitness measures in this age group are lacking.
Cohort (n=272)
No
In 5-year-old children, a slower heart rate recovery time after a 3-minute step test is positively associated with increased adiposity, suggesting its potential as a simple, non-invasive fitness and cardiovascular risk tool in preschoolers.
May support simple step testing for preschool fitness assessment; leaves open prospective validation before clinical adoption.
BACKGROUND: Cardiovascular fitness is strongly linked with metabolic risk; however, research is limited in preschool children. Although there is currently no simple validated measure of fitness in preschool children, heart rate recovery has been highlighted as an easily accessible and non-invasive predictor of cardiovascular risk in school-aged children and adolescents. We aimed to investigate whether heart rate recovery was associated with adiposity and blood pressure in 5-year-olds. STUDY DESIGN: This is a secondary analysis of 272 5-year-olds from the ROLO (Randomised cOntrol trial of LOw glycaemic index diet in pregnancy to prevent recurrence of macrosomia) Kids study. Three-minute step tests were completed by 272 participants to determine heart rate recovery duration. Body mass index (BMI), circumferences, skinfold thickness, heart rate, and blood pressure were collected. Independent t-tests, Mann-Whitney U, and Chi-square tests were used to compare participants. Linear regression models examined associations between heart rate recovery and child adiposity. Confounders included child sex, age at study visit, breastfeeding, and perceived effort in the step test. RESULTS: The median (IQR) age at the study visit was 5.13 (0.16) years. 16.2% (n = 44) had overweight and 4.4% (n = 12) had obesity based on their BMI centile. Boys had a quicker mean (SD) heart rate recovery after the step test than girls (112.5 (47.7) seconds vs. 128.8 (62.5) seconds, p = 0.02). Participants with a slower recovery time (> 105 s) had higher median (IQR) sum of skinfolds (35.5 (11.8) mm vs. 34.0 (10.0) mm, p = 0.02) and median (IQR) sum of subscapular and triceps skinfold (15.6 (4.4) mm vs. 14.4 (4.0) mm, p = 0.02) compared to participants with a quicker recovery time. After adjusting for confounders (child sex, age at study visit, breastfeeding, effort in the step test), linear regression analyses revealed heart rate recovery time after stepping was positively associated with sum of skinfolds (B = 0.034, 95% CI: 0.01, 0.06, p = 0.007). CONCLUSION: Child adiposity was positively associated with heart rate recovery time after the step test. A simple stepping test could be used as a non-invasive and inexpensive fitness tool in 5-year-olds. Additional research is needed to validate the ROLO Kids step test in preschool children.
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Geraghty et al. (2023) conducted a cohort in Healthy children (mothers with history of macrosomic delivery) (n=272). Heart rate recovery time after a 3-minute step test vs. Quicker heart rate recovery time (< 105 s) was evaluated on Sum of skinfolds (adiposity) (B = 0.034, 95% CI 0.01-0.06, p=0.007). Heart rate recovery time after a 3-minute step test was positively associated with child adiposity, where each 1-cm increment in sum of skinfold thickness corresponded to a 3.4-second increase in recovery time.
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