Cardiovascular Journal of Africa: Vol 30 No 3 (May/June 2019)

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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 30, No 3, May/June 2019 138 AFRICA
Cardiovascular Topics
The Amsterdam Growth and Health Longitudinal Study:
how important is physical activity in youth for later
health? (ELS 33)
Han CG Kemper, Kotsedi Dan Monyeki
Abstract
Background: Three important results came from the
Amsterdam Growth and Health Longitudinal Study
(AGAHLS). This study followed three birth cohorts (1962,
1963 and 1964) of boys and girls in the Amsterdam region
in the Netherlands. The follow-up period was 25 years, with
10 measurements from age 12 to 42 years. The main purpose
of the AGAHLS was to detect changes in health and lifestyle
over time during the teenage and young adult period.
Methods: In total, 617 subjects were recruited from two
secondary schools in Amsterdam and Purmerend. We meas-
ured aerobic fitness (VO2 peak), bone mineral density (BMD),
obesity from body mass index (BMI) and body fatness from
the sum of four skinfolds (S4S). Daily physical activity (DPA)
was measured from heart rate, pedometers and an interview.
Daily food intake (DFI) was measured by a cross-check
dietary history interview.
Results: Longitudinal data analyses revealed that: (1) aero-
bic fitness, as measured by direct measurement of maximal
oxygen uptake (VO2 max), increased more significantly in the
physically active percentile (P > 75) of males and females
than in the physically inactive percentile (P < 25), (2) BMD,
as measured with dual X-ray absorptiometry (DEXA) in the
wrist, hip and lumbar region, showed that physical activity
in youth with a high mechanical load on the bones (mostly
weight bearing) increased bone formation in the hip and
lumbar region of males and females in adulthood, (3) the
longitudinal relationship between DPA and DFI with the
development of overweight and obesity (measured from BMI
and S4S) showed that more DPA resulted in significantly
lower fat mass, but no relationship could be demonstrated
with DFI .
Conclusion: The main conclusion from this 25-year longi-
tudinal research is that the promotion of physical activity
(including physical education and sport) in adolescence can
potentially be a strong tool to prevent chronic diseases and
reduce healthcare costs later in life.
Keywords: longitudinal study, physical activity, food intake, aero-
bic fitness, bone health, body fatness
Submitted 8/4/18, accepted 31/10/18
Published online 24/5/19
Cardiovasc J Afr 2019; 30: 138–141
DOI: 10.5830/CVJA-2018-057
The assumptions and results about working mechanisms in the
complex relationships between health and physical activity are
derived from the Amsterdam Growth and Health Longitudinal
Study (AGAHLS). 1 This study reached a longitudinal follow up
of 25 to 30 years in a group of 617 males and females, measuring
health and lifestyle over the period from 12 to 42 years of age.1
In Table 1, an overview is given of the measurements that were
carried out on the 10 time points during the study period.2
The participants were recruited from two schools. Pupils
from one school in Amsterdam participated in a four-year
annual repeat study (longitudinal design). In the other school,
in Purmerend, the Netherlands, the pupils were measured only
once during the first four years (cross-sectional design). Later
these participants ( n = 202) were also measured longitudinally.
Table 2 is a flow chart of the attending participants from the two
schools over time. 2
The main outcomes, with a description of methods, statistical
analyses (generalised estimation equations) and results over the
adolescent (12 to 18 years), young adult (18 to 27 years) and
adult periods (27 to 37 years) are published elsewhere.3-5
The main purpose of the AGAHLS was to detect changes
in health and lifestyle over time during the teenage and young
adult periods. In this article, we determined the longitudinal
relationship between daily physical activity (DPA), measured
by heart rate integrators [converted to metabolic (MET) scores],
pedometers and a cross-check activity interview, and daily
food intake (DFI), measured by a cross-check dietary history
interview on one hand, and aerobic fitness (VO2 peak), bone
mineral density (BMD) and body fatness on the other hand.
Methods
Only the relevant measurements are described here, such as
VO2 peak, BMD, body fatness and obesity. Other measures such
as anthropometrics (height, weight, skinfolds, bone diameters,
Amsterdam Public Health Academic Research Institute,
Vrije Universiteit, Amsterdam, the Netherlands
Han CG Kemper, PhD,
Department of Physiology and Environmental Health,
University of Limpopo, Polokwane, South Africa
Kotsedi Dan Monyeki, PhD, MPH,