Sedentary time in children linked to heart damage in young adulthood

 WELLNEWS

Victor Dumaguing MD

Amsterdam, Netherlands : Hours of inactivity during childhood could be setting the stage for heart attacks and strokes later in life, according to research presented at ESC Congress 2023.1 The study found that sedentary time accumulated from childhood to young adulthood was associated with heart damage – even in those with normal weight and blood pressure.
    “All those hours of screen time in young people add up to a heavier heart, which we know from studies in adults raises the likelihood of heart attack and stroke,”2 said study author Dr. Andrew Agbaje of the University of Eastern Finland, Kuopio, Finland. “Children and teenagers need to move more to protect their long-term health.”
    This was the first study to investigate the cumulative effect of smartwatch-assessed sedentary time in young people and cardiac damage later in life. It was conducted as part of the Children of the 90s study, which began in 1990/1991 and is one of the world’s largest cohorts with lifestyle measurements from birth.3
    At 11 years of age, children wore a smartwatch with an activity tracker for seven days. This was repeated at 15 years of age and again at 24 years of age. The weight of the heart’s left ventricle was assessed by echocardiography, a type of ultrasound scan, at 17 and 24 years of age and reported in grams relative to height (g/m2.7). The researchers analysed the association between sedentary time between 11 and 24 years of age and heart measurements between 17 and 24 years of age after adjusting for factors that could influence the relationship including age, sex, blood pressure, body fat, smoking, physical activity and socioeconomic status.
    The study included 766 children, of whom 55% were girls and 45% were boys. At 11 years of age, children were sedentary for an average of 362 minutes a day, rising to 474 minutes a day in adolescence (15 years of age), and 531 minutes a day in young adulthood (24 years of age). This means that sedentary time increased by an average of 169 minutes (2.8 hours) a day between childhood and young adulthood.
    Each one-minute increase in sedentary time from 11 to 24 years of age was associated with a 0.004 g/m2.7 increase in left ventricular mass between 17 to 24 years of age. When multiplied by 169 minutes of additional inactivity this equates to a 0.7 g/m2.7 daily rise – the equivalent of a 3 gram increase in left ventricular mass between echocardiography measurements at the average height gain. A previous study in adults found that a similar increase in left ventricular mass (1 g/m2.7) over a seven-year period was associated with a two-fold increased risk of heart disease, stroke, and death.4
    Dr. Agbaje said: “Children were sedentary for more than six hours a day and this increased by nearly three hours a day by the time they reached young adulthood. Our study indicates that the accumulation of inactive time is related to heart damage regardless of body weight and blood pressure. Parents should encourage children and teenagers to move more by taking them out for a walk and limiting time spent on social media and video games. As Martin Luther King Jr. once said, ‘If you can't fly, run. If you can't run, walk. If you can't walk, crawl. But by all means keep moving
    From a Filipino perspective, your columnist shares the nostalgic experience of fellow baby-boomers who went to elementary and secondary schools with memories of playing outside the house with a lot of physical activity like patintero, hide and seek, and being assigned cleaners of the classroom- energetic playful scrubbing the floor, erasing the blackboards at the end of the day. Oh well, as the song goes, ‘those were the days my friend”,

WELLNEWS

Victor Dumaguing MD

Smokers who start below age 20 are more addicted and find it difficult to quit

AMSTERDAM, Netherlands --  Researchers urge governments to raise the legal age to purchase cigarettes to 22 years or higher as study finds it becomes less addictive and easier to quit as people get older. The research is presented at ESC Congress August 25-28, 2023 attended by 30,000+ doctors, researchers, and other health professionals from 175 countries making it the biggest annual professional convention in the world.
    In 2020, more than one in five people worldwide used tobacco. Tobacco kills up to half of its users. Smokers below the age of 50 years have a five-fold higher risk of developing cardiovascular disease compared with their non-smoking peers. The legal age to purchase tobacco is 18 years old in many countries but in some nations there are no age restrictions. It is estimated that nearly 9 out of 10 adults who smoke cigarettes daily first try smoking by age 18, and 99% first try smoking by age 26.
    This study examined the relationship between the age of smoking initiation, nicotine dependence and smoking cessation.     The study included smokers who had visited a smoking cessation clinic in Japan. Participants completed the Fagerström test for nicotine dependence (FTND) which asks questions such as “How soon after you wake up do you smoke your first cigarette?”, “Do you find it difficult to refrain from smoking in places where it is forbidden” and “How many cigarettes per day do you smoke?”. Scores for each answer were added up for a total score indicating a nicotine dependency of low (score 1-2), low to moderate (3-4), moderate (5-7) or high (8 or higher).
    Participants were divided into two groups based on the age they started smoking (less than 20 years old and 20 years or older); 20 years was used as the cut-off as it is the legal smoking age in Japan. Carbon monoxide in the breath was measured to indicate the number of cigarettes smoked in the past 24 hours. Smoking cessation was defined as no tobacco smoking in the past seven days and an exhaled carbon monoxide level less than 7 ppm.
    The researchers analysed the associations between nicotine dependency and successful smoking cessation according to the age participants started smoking. The analyses were adjusted for sex and age at the time of attending the smoking cessation clinic.
    The study included 1,382 smokers, of whom 30% were women. The average age when attending the smoking cessation clinic for the first time was 58 years. Some 556 smokers started smoking before age 20 (early starters), while 826 smokers were 20 years of age or older when they began smoking (late starters).
    Early starters reported a higher number of cigarettes per day (25) compared with late starters, who smoked 22 cigarettes per day. Those who started early had higher respiratory carbon monoxide levels compared with those who started late (19 vs. 16.5 ppm, respectively) and higher FTND scores (7.4 vs. 6.3, respectively). Less than half of early starters (46%) successfully quit smoking compared with 56% of late starters, for an odds ratio of 0.711 after adjusting for sex, age at clinic visit and smoking cessation aids – indicating that early starters were 30% less likely to successfully kick the habit compared with late starters.
    Participants were further divided into four groups according to the age they commenced smoking (17 years or less, 18 to 19, 20 to 21, and 22 or older). In the four groups, FTND scores were 7.5, 7.2, 6.7 and 6.0, respectively, showing that those who start smoking aged 22 or older were even less nicotine dependent.
    Study author Dr. Koji Hasegawa of the National Hospital Organization Kyoto Medical Center, Kyoto, Japan said: “Our results show that starting smoking early is linked with higher nicotine dependency, even in young adulthood. The study indicates that increasing the legal age to buy tobacco to 22 years or older could lead to a reduction in the number of people addicted to nicotine and at risk of adverse health consequences