The Effect of Cardiometabolic Factors, Body Composition, Cardiorespiratory Fitness, Sedentary Time, and Physical Activity on Arterial and Cardiac Structure and Function in Children and Adolescents and Young Adults

  • Oluwatosin Andrew Agbaje

Student thesis: Doctoral Thesis

Abstract

Over the past 7 years, I have independently conducted research to understand the physiological effect of cardiometabolic factors and obesity on cardiovascular indices and also how physical activity and exercise is associated with these indices in children and adolescents, using cohort data from Finland (maximum study participants n = 506) and the United Kingdom (UK) (maximum study participants is n = 14,901). I am a physician by background, I studied medicine and surgery at the University of Benin, Edo State, Nigeria from 2006 – 2014. I graduated with a distinction in mental health or psychiatric medicine. I then worked as both a volunteer (6 months) and full-time employed (18 months) physician from 2014 – 2016 in Southern Nigeria. During my medical practice, I was interested in paediatrics, especially preventive rather than curative medicine. Thus, I proceeded to the University of Eastern Finland, Kuopio, Finland in Autumn 2016 for a Master’s degree programme in Public Health – Epidemiology Track, to acquire research skills that could be employed in preventive medicine. A 30-ECTS Master’s thesis was a sine qua non to completing the Master’s degree program (120-ECTS), so, I requested data from a University of Eastern Finland research group with paediatric data to provide answers to my research questions. The Master’s thesis, which was completed in Spring 2018, was graded excellent (distinction) and the submitted thesis was later published as an article (Paper #9, Appendix 1) which is included in this commentary. In 2020, I undertook a 9-month intensive training on the Principles and Practice of Clinical Research at the T.H. Chan School of Public Health, Harvard University, United States. Importantly, I completed the highly intensive course and achieved the maximum possible score 1,000/1,000 (distinction).
I have continued conducting physiological, epidemiological, and preventive research across the field of cardiometabolic, vascular, and cardiac health in the young population and collaborated extensively across the globe. Currently, I am the principal investigator of the “understanding fitness and
cardiometabolic health in little darlings (urFIT-child)” research group and the first author of all the publications included in this commentary. I am a consistent reviewer for over 35 journals in cardiovascular, metabolic, and sports medicine, such as the European Heart Journal, Journal of the American College of Cardiology, Diabetes Care, Circulation Research, Arteriosclerosis, Thrombosis, and Vascular Biology, Journal of Clinical Endocrinology & Metabolism, Medicine & Science in Sports & Exercise, Scandinavian Journal of Medicine & Science in Sports, Pediatric Exercise Science, etc. I am also a professional member of several cardiovascular and sports medicine international associations. Recently, I was appointed to serve on the editorial board of the Arteriosclerosis, Thrombosis, and Vascular Biology, as well as the Pediatric Exercise Science editorial board.
In the last few years, I have received the following awards; Communicator of the Year Award 2022 of the University of Eastern Finland, Reviewer of the Year Award 2021/2022 of the European Journal of Preventive Cardiology, Young Investigator Fellowship Award 2022 of the European Atherosclerosis Society, Paul Dudley White International Scholar 2022 Award of the American Heart
Association, Jeremiah and Rose Stamler Research 2022 Award Finalist for New Investigators at the Epi Lifestyle Annual Scientific Sessions of the American Heart Association, Paul Dudley White International Scholar 2021 Award of the American Heart Association, Jeremiah and Rose Stamler Research 2021 Award Finalist for New Investigators at the Epi Lifestyle Annual Scientific Sessions of the American Heart Association. Recently, I was an invited guest lecturer at the largest mother and child center in Canada – CHU Sainte-Justine Mother and Child University Hospital Center, Canada where I spoke on the determinants of carotid intima-media thickness and arterial stiffness in pediatrics. I am a member of the scientific writing group of the Atherosclerosis, Hypertension, and Obesity in Youth subcommittee of the American Heart Association. Lastly, I was recently appointed an Honorary Research Fellow at the Children’s Health and Exercise Research Centre (CHERC), Faculty of Health and Life Sciences, University of Exeter, Exeter, UK.
In the presented coherent body of research undertaken over 7 years, I have employed advanced statistical techniques in large cohort data sets from the Avon Longitudinal Study of Parents and Children (ALSPAC) in the UK and Physical Activity and Nutrition in Children in Finland. This led to novel information being published which provides novel insight into previously unclear relationships between body composition and metabolic factors, with vascular and cardiac structure and function, using both cross-sectional and longitudinal analyses. Furthermore, the importance of higher cardiorespiratory fitness and physical activity (particularly, time spent sedentary, in light physical activity, and moderate-to-vigorous physical activity) in vascular and cardiac health was also established. This commentary systematically and coherently summarises how these findings significantly contribute novel information to progress the knowledge base and proposes avenues for future research studies. Table 1 summarises the eleven articles (Appendix 1) included in the commentary. Of these, nine were published using data from the ALSPAC UK birth cohort with a sample size of 14,901 children at one year of birth, and two were published using data from the Physical Activity and Nutrition in Children primary school cohort of 506 children from Finland. All data measurements, cohort descriptions, and statistical analyses were extensively described in the published articles (Appendix 1). I independently developed the study ideas, and hypotheses, applied for access to respective data, analysed all data, wrote the initial drafts of all manuscripts, invited co- authors, reviewed all drafts before finalisation, responded to all reviewers’ queries, acquired funding for the projects, and handled all correspondence with various journal editorial offices.
I did not participate in data collection for the studies, however, I did adhere to the stipulated guidelines for data access. Employing standardised methodology for secondary (novel) analysis of existing data from databases using an epidemiology lens has been tremendously helpful in enhancing public health messages and providing novel evidence such as the recent UK biobank study that showed that light- intensity physical activity may be more effective than moderate-to-vigorous physical activity in preventing the risk of incident Parkinson’s diseases.1 With regards to the ALSPAC data, a proposal was submitted to the ALSPAC executive committee in 2020 detailing the research to be undertaken and the variables needed. This proposal was approved (B3455) and posted on the ALSPAC webpage. Cardiorespiratory fitness, adiposity and lean mass in relation to arterial structure and function from childhood to adulthood. https://proposals.epi.bristol.ac.uk/?q=node/130051. The proposal was later
expanded to include data on physical activity and sedentary behaviour.
https://proposals.epi.bristol.ac.uk/?q=node/130309. Thereafter, data user agreement forms were signed, and payments were made to the University of Bristol, UK before the data was securely transferred to our team at the University of Eastern Finland. Access to the Physical Activity and Nutrition in Children data from Finland was granted, free of charge, after signing a data use agreement as part of my Master’s thesis project.
Date of Award8 Mar 2024
Original languageEnglish
Awarding Institution
  • University of Portsmouth
SupervisorZoe Saynor (Supervisor) & Ant Shepherd (Supervisor)

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