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Objective: The main aim of the present study was to examine the association between the Dietary Inflammatory Index (DII®) and academic performance in children., Design: School-based cross-sectional study. The DII was calculated based on dietary information obtained from a single 24h dietary recall. Academic performance was assessed by school records provided by the administrative services (i.e. Maths and Language)., Setting: Porto area (Portugal)., Subjects: A total of 524 children (277 girls) aged 11·56 (sd 0·86) years., Results: The DII was associated with academic indicators (standardized β values ranging from -0·121 to -0·087; all P<0·05). Significant differences were found between quartiles of the DII (P<0·05); children in the fourth quartile had significantly lower scores in all academic indicators compared with children in the first quartile (score differences ranging from -0·377 to -0·292) after adjustment for potential confounders., Conclusions: The inflammatory potential of diet may negatively influence academic performance. Children should avoid the consumption of a pro-inflammatory diet and adhere to a more anti-inflammatory diet to achieve academic benefits.

Purpose: The dietary guidelines for the consumption of a variety of fruits and vegetables have been recognized as an important factor for achieving healthy eating patterns to reduce the risk of chronic disease throughout the lifespan. Our aim is to assess the association between fruit and vegetable variety and low-grade inflammation in adolescents., Methods: This cross-sectional analysis was conducted with 412 adolescents (ages 14.4 ± 1.7 years; 52% girls). The consumption of a variety of fruits and vegetables was assessed with a food-frequency questionnaire, considering the number of individual/category of fruit or vegetable intake at least once month, and categorized into tertiles. Blood samples were collected to determine C-reactive protein (CRP), interleukin-6 (IL-6), complement component 3 (C3), and 4 (C4). We created categories of lower or higher (inflammatory state) for each biomarker, considering sex- and age-adjusted median values. Then, we computed an overall inflammatory score, by adding all points awarded wherein one point was assigned if biomarker was higher or zero if lower, and created categories of 0-1 or 2-4 biomarkers above the median. The odds ratio (OR) and 95% interval confidence (95% CI) were calculated from binary logistic regression to estimate the magnitude of association between fruit and vegetable variety and inflammatory biomarkers., Results: Adolescents with a greater variety of vegetable consumption (≥13 categories/month) had lower odds of having a higher CRP (OR 0.31, 95% CI 0.15-0.64, p trend  = 0.004) when compared to those with lower variety consumption (≤6 categories/month), independent of vegetable quantity intake. However, a greater variety of fruit consumption (≥12 categories/month) had higher odds of having a higher IL-6 (OR 4.41, 95% CI 1.67-11.71, p trend  = 0.012), C3 (OR 3.30, 95% CI 1.23-8.86, p trend  = 0.047), and inflammatory score (OR 4.90, 95% CI 1.62-14.86, p trend  = 0.017), when compared to those with lower variety consumption (≤9 categories/month), independent of fruit quantity intake, only for girls., Conclusions: The consumption of a variety of vegetables is inversely associated with lower CRP. This finding supports the current dietary guidelines regarding the consumption of a variety of vegetables. The role of fruit variety in low-grade inflammation should be further studied.

Background: Low muscular fitness (MF) and low-grade inflammation has been linked to insulin resistance (IR)., Objective: To evaluate the associations between MF and a clustered score of inflammatory biomarkers on IR and to investigate the combined impact of MF and inflammation on IR in adolescents., Methods: This is a cross-sectional analysis with 529 adolescents (267 girls) aged 12 to 18 years. Pubertal stage, socioeconomic status, adherence to the Mediterranean diet, cardiorespiratory fitness, and waist circumference were assessed. Standing long-jump and isometric handgrip dynamometry were used as indicators of MF. Continuous score of clustered inflammatory biomarkers (InflaScore) (sum of Z-scores of C-reactive protein, C3, C4, fibrinogen, and leptin) and IR (homeostasis model assessment of insulin resistance [HOMA-IR] estimated from fasting serum insulin and glucose) were assessed., Results: HOMA-IR and fasting insulin were positively associated with InflaScore and negatively associated with MF, independently of age, sex, pubertal stage, socioeconomic status, adherence to the Mediterranean diet, cardiorespiratory fitness, and waist circumference. Adolescents classified as High InflaScore/Unfit showed significantly higher HOMA-IR when compared than those with High InflaScore/Fit and those with Low InflaScore/Fit (F (3,519)  = 4.761, P < .003), after adjustments for potential confounders. Unfit adolescents with high InflaScore had the highest odds of expressing high HOMA-IR (odds ratio, OR = 2.40, 95% confidence interval [CI]: 1.2-5.6) and insulin risk (2.53 95% CI, 1.5-5.9) when compared to those of the Low InflaScore/Fit group, after adjustments for potential confounders., Conclusion: Higher levels of MF seem to minimize the deleterious effect of inflammation on IR., (© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Purpose: Then objective of this study was to evaluate the ability of several nontraditional cardiometabolic and inflammatory biomarkers in identifying high cardiometabolic risk in adolescents., Methods: A cross-sectional study was conducted with 529 Portuguese adolescents (267 girls) aged 14.3 ± 1.7 years. A clustered cardiometabolic risk score (body fat percentage, systolic blood pressure, ratio of total cholesterol to high-density lipoprotein cholesterol, triglycerides, homeostatic model assessment of insulin resistance, and negative values of cardiorespiratory fitness) was computed. The nontraditional cardiometabolic biomarkers assessed were complement factors (C3 and C4), C-reactive protein (CRP), fibrinogen, leptin, white blood cells (WBCs), albumin, interleukin-6, and a clustered score of inflammatory biomarkers (InflaScore) (C3, C4, CRP, fibrinogen, and leptin)., Results: Receiver operating characteristic curves analyses showed that C3, C4, CRP, fibrinogen, leptin, and the InflaScore were able to present discriminatory ability in identifying an unfavorable cardiometabolic profile in both girls and boys (p <.01 for all). Logistic regression analyses showed that C3, C4, CRP, fibrinogen, leptin, the InflaScore (in both sexes), and WBC (boys) were associated with high cardiometabolic risk, independent of age, pubertal stage, socioeconomic status, or adherence to a Mediterranean diet (p <.05 for all)., Conclusions: C3, C4, CRP, fibrinogen, and leptin were associated with high cardiometabolic risk in both sexes and WBC in boys. In addition, the clustered inflammatory biomarkers seem to have a better diagnostic accuracy in identifying an unfavorable cardiometabolic profile than single biomarkers. Such biomarkers may have utility in motivating health professionals, public health workers, and adolescents' families toward lifestyle changes, improving prevention efforts early in life., (Copyright © 2017 The Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

High muscular fitness (MF) and high adherence to the Southern European Atlantic Diet (the SEADiet) have been associated with several positive metabolic outcomes. The purpose of the present study was two-fold: (i) to explore the independent associations between MF and C-reactive protein (CRP) levels; and (ii) to investigate the combined impact of MF and SEADiet on the CRP levels in a sample of adolescents. A cross-sectional school-based study was conducted on 463 adolescents (272 girls) aged 15-18 years, from the Portuguese Azorean Archipelago. Anthropometric indicators (stature, body mass, waist circumference (WC)) were measured by standardized protocols and pubertal stages were assessed by Tanner criteria. Blood samples were taken after an overnight fast. MF was assessed by the curl-up and push-up tests (from the Fitnessgram test battery). Adherence to the SEADiet was assessed with a semi-quantitative food frequency questionnaire. Linear regression models showed that MF was inversely associated with hs-CRP (unstandardized B = -0.127; p < .009), after adjustments for age, sex, and pubertal stage, adherence of SEADiet, total energy intake and low-energy reporter and WC. Analysis of covariance (ANCOVA) showed a significant difference between the low adherence of SEADiet with low MF group and those with a high adherence of SEADiet and high MF (p < .05) (F (5, 453)  = 2.238, p = .040). Our results showed that MF is inversely associated with hs-CRP. In addition, the adolescents with Low adherence of SEADiet/Low MF group had high levels of hs-CRP compared those who with high adherence of SEADiet/high MF group.

Background: Overweight and obesity have been associated with a pro-inflammatory state. We aimed to assess the ability of different measures of overall and abdominal adiposity for identifying adverse levels of inflammatory and metabolic markers in adolescents., Methods: This is a cross-sectional analysis with 529 Portuguese adolescents (267 girls), mean age 14.3 ± 1.7 years. Weight, height, sitting height, waist circumference (WC), and body fat percentage (BF%) were measured; and BMI, waist-to-height ratio (WHtR), and waist-to-sitting-height ratio (WsHtR) were calculated. We measured C-reactive protein (CRP), fibrinogen, erythrocyte sedimentation rate (ESR), complements C3 and C4, leptin, and adiponectin levels. Receiver operating characteristic (ROC) curves were used to estimate the ability of the adiposity measures to discriminate between low/high values of biomarkers., Results: The highest areas under the ROC curves were presented by BF% for fibrinogen and complement C3 in both sexes and for ESR, complement C4, and adiponectin only in girls; by BMI for CRP in girls and for leptin in both sexes; by WHtR for leptin in both sexes and for CRP, fibrinogen, and adiponectin only in girls; by waist circumference for CRP, fibrinogen, and complement C3 only in boys and for complement C4 in girls; and by WsHtR for complement C3 in girls; p < 0.05 for all., Conclusions: The measures that more often presented discriminatory power were, for overall adiposity, BF% in both sexes, and for abdominal adiposity, WHtR in girls and WC in boys. However, small differences in discriminatory capabilities don't allow us to clearly defend the adoption of a single measure above all others.

Background/objectives: The dietary inflammatory index (DII) is a tool to measure the diet's inflammatory potential and has been used with adults to predict low-grade inflammation. The present study aims to assess whether this dietary score predicts low-grade inflammation in adolescents.Subjects/methods: The sample comprises 329 adolescents (55.9% girls), aged 12-18 years, from LabMed Physical Activity Study. DII score was calculated based on a food-frequency questionnaire and categorized into tertiles. We collected blood samples to determine the follow inflammatory biomarkers: C-reactive protein (CRP), interleukin-6 (IL-6), complement component 3 (C3), and 4 (C4). In addition we calculated an overall inflammatory biomarker score. Odds ratios (OR) and 95% confidence intervals (95%CI) were computed from binary logistic regression models.Results: DII score, comparing first with third tertile, was positively associated with IL-6 in crude model (OR = 1.88, 95%CI:1.09-3.24, p trend = 0.011) and in fully adjusted (for biological and lifestyle variables) (OR = 3.38, 95%CI:1.24-9.20, p trend = 0.023). Also, DII score was positively associated with C4, when fully adjusted (OR = 3.12, 95%CI:1.21-8.10, p trend = 0.016). DII score was negatively associated with C3 in crude model, comparing first with second but not with third tertile, and no significant associations in fully adjusted model were observed, although a trend was found (OR = 1.71, 95%CI:0.63-4.66, p trend = 0.044). No significant associations were observed between DII score and CRP. However, DII score was positively associated with the overall inflammatory biomarker score, when fully adjusted (OR = 5.61, 95%CI:2.00-15.78, p trend = 0.002).Conclusions: DII score can be useful to assess the diet's inflammatory potential and its association with low-grade inflammation in adolescents. [ABSTRACT FROM AUTHOR]

Physical activity is important in obesity prevention, but the effectiveness of different physical activity modalities remains to be determined among children. The main purpose of this study was to compare the effects of a 6-month soccer programme and a traditional physical activity programme on changes in body composition, cardiometabolic risk factors, inflammatory and oxidative markers, cardiorespiratory fitness and perceived psychological status in obese boys. Eighty-eight boys (8–12 years; BMI > +2 standard deviations of WHO reference values) participated in one of three groups: soccer, traditional activity and control. Soccer and traditional activity programmes involved 3 sessions per week for 60–90 min at an average intensity of 70–80% of maximal heart rate. Control group participated in activities of normal daily living. All boys participated in school physical education, two sessions per week of 45–90-min. Measurements were taken at baseline and after 6 months, and included body size and composition, cardiometabolic risk factors, inflammatory and oxidative markers, cardiorespiratory fitness and perceived psychological status. Physical activity and dietary intake were assessed before and immediately following the intervention. The three groups had similar characteristics at baseline. After 6 months, both intervention groups had significantly lower relative fatness (% fat), waist circumference and total cholesterol, and higher cardiorespiratory fitness, self-esteem, perceived physical competence and attraction to physical activity compared with control group. In conclusion, physical activity interventions over 6 months positively influenced several indicators of health status among obese boys. The results also suggested that soccer has the potential as an effective tool for the prevention and reduction of childhood obesity and associated consequences. [ABSTRACT FROM PUBLISHER]

Background Our primary aim was to investigate the associations that components of metabolic syndrome and physical activity have with cardiac autonomic nervous system activity as estimated by heart rate variability (HRV) in young adults free of metabolic abnormalities. We also aimed to identify predictors of 3-year changes in HRV. Methods Physical activity was assessed annually in 163 healthy participants over 3 years (2008-2010). Components of metabolic syndrome measured annually were; waist circumference, systolic blood pressure, high-density lipoprotein, triglycerides, glucose, and C-reactive protein. A linear mixed regression model was used to assess associations between HRV, metabolic syndrome components and physical activity. Linear regression was used to identify predictors of changes in HRV. Results Metabolic syndrome components were negatively associated with HRV indices and higher heart rate, while physical activity was associated with higher HRV and lower heart rate. Physical activity and inflammation were predictors of positive and negative changes in HRV indices, respectively. Conclusions In participants without significant metabolic abnormalities, metabolic syndrome components were still associated with less favourable HRV profiles. Physical activity and inflammation were both able to predict changes in HRV, albeit in different directions. It appears that the process of autonomic dysfunction starts at a young age and may be mediated in part by inflammation. Metabolic syndrome prevalence is increasing in younger populations; promoting the metabolic and autonomic benefits of exercise remains imperative. Copyright © 2012 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the association between dairy product consumption and metabolic and inflammatory biomarkers in Portuguese adolescents, and whether the association differed by weight status. A cross-sectional study was conducted during the school year 2011/2012 with 412 Portuguese adolescents (52.4% girls) in 7th and 10th grade (aged 12 to 18 years old). The World Health Organization cutoffs were used to categorize adolescents as non-overweight (NW) or overweight (OW). Blood samples were collected to analyze C-reactive protein (CRP), interleukin-6 (IL-6), leptin, and adiponectin. Dairy product intake was evaluated using a food frequency questionnaire. Participants were divided by tertiles according to the amount of dairy product consumed. The associations between dairy product consumption with metabolic and inflammatory biomarkers were evaluated using generalized linear regression models with logarithmic link and gamma distribution and adjusted for potential confounders. The majority of adolescents were NW (67.2%). NW adolescents had lower IL-6, CRP, and leptin concentration than their counterparts (p < 0.05, for all comparisons). Higher levels of total dairy product and milk intake were inversely associated with IL-6 (P for trend <0.05, for all) in NW adolescents, but not in OW adolescents. NW adolescents in the second tertile of yogurt consumption had lower level of IL-6 compared to those in the first tertile (p = 0.004). Our results suggest an inverse association between total dairy product and milk intake and serum concentrations of IL-6 only among NW adolescents. [ABSTRACT FROM AUTHOR]