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Secondary cardiovascular disease is the main cause of mortality in congenital heart disease (CHD) patients. The cardiovascular risk could be widely prevented with adherence to a healthy lifestyle; however, clusters of lifestyle behaviors related to atherosclerosis risk factors in children and adolescents with CHD remain unclear. We aimed to describe the clusters of lifestyle behaviors of children and adolescents with CHD and to evaluate their association with atherosclerosis risk factors. We conducted a cross-sectional study on 227 children and adolescents with CHD (median age:10.02 [IQR:7.08-13.02] years). Dietary intake, physical activity (PA), and sedentary behavior (SB) were evaluated. Clusters of lifestyle behaviors were determined using a two-step cluster analysis. Atherosclerosis risk factors evaluated include body fat mass, central obesity, blood pressure, lipid parameters, glucose, C-reactive protein, and carotid intima-media thickness (cIMT). Multiple logistic regressions were used. The "unhealthy: high SB + low PA" cluster was associated with elevated body fat mass, central obesity, and elevated cIMT. Furthermore, the "unhealthy: low PA + unhealthy eating habits" cluster was associated with elevated body fat mass, central obesity, and elevated glucose. The unhealthier lifestyle behavior clusters were associated with atherosclerosis risk factors in children and adolescents with CHD. Multidisciplinary strategies to promote healthy behaviors are needed to prevent cardiovascular disease in later life.

Purpose: Sedentary behavior (SB) has been shown to be associated with unhealthy outcomes in children, and it is not clear whether children living with human immunodeficiency virus (HIV) engage in different patterns of SB compared with healthy children. This cross-sectional study aimed to compare patterns of SB between children living with HIV and a healthy control group., Methods: A group of children with HIV and a paired control group wore accelerometers for 1 week and answered a questionnaire with items related to television viewing habits and computer usage. Accelerometer-derived and self-reported SB were compared between children living with HIV and controls and between treatment-based and viral load subgroups., Results: A total of 130 children (of which 53% are girls with a mean age of 12.1 y) participated in the study with 65 in each group. Children in the control group exhibited significantly more objectively measured SB daily when compared with the HIV group (515 vs 490 min/d, respectively), but no differences were found between the treatment-based and viral load subgroups. Children with HIV watched more television on weekdays, compared with the control group (P < .05). No other differences were found in comparisons of self-reported SB between the control and HIV and the treatment-based or viral load subgroups., Conclusion: Children living with HIV spend less time being sedentary than those in the healthy control group. Future studies are important for clarifying the causes and consequences of these differences.

Background: Identifying factors associated with physical activity (PA) is useful in planning interventions and policies. The aim of this study was to identify sociodemographic, biological, and psychosocial factors associated with PA performed in school settings., Methods: Data collected for the present study included gender, age, socioeconomic status, body fat percentage, aerobic fitness, self-efficacy, attitudes, peer and parental support, and perception of school environment. Dependent variables were light-intensity PA (LPA) and moderate-to-vigorous-intensity PA (MVPA) performed during school time, recesses, and physical education (PE) classes. Multiple regression analyses were performed., Results: Participating adolescents ( n  = 567, 53% female, 12.9 ± 5.3 years) spent 5% of school time in MVPA and 27% in LPA, 15% of recesses in MVPA and 44% in LPA, and 16% of PE classes in MVPA and 41% in LPA. Boys engaged in more MVPA in all categories. Age was inversely related with MVPA and LPA in all periods, whereas body fat percentage was inversely related with MVPA in school time and PE classes. Attitude was inversely related with MVPA in all periods and with LPA in recesses. Considering PA to be good and enjoyable was positively associated with MVPA in school time., Conclusion: Adolescents spent little time in PA during school. Future interventions should implement enjoyable activities at school.