The impact of sports participation on medication costs among adolescents: ABCD growth study

Abstract

The economic impact of physical activity has been extensively investigated among adults, but few studies have analyzed this issue in pediatric populations. To analyze the relationship of costs attributed to medicine use with the time spent in different intensities of physical activity and sports participation among adolescents. A sample of 92 adolescents were tracked for 28 weeks. The main outcome was the overall cost attributed to medicine use (assessed weekly [US$]). Independent variables were moderate-to-vigorous physical activity outside sports and sportive moderate-to-vigorous physical activity, assessed in three time points (baseline, 14 weeks and 28 weeks) using accelerometers (min/day). A total of 53 boys and 39 girls, with a mean age of 14.54 (1.96) years, were evaluated. Sedentary time (rho=0.217 [95%CI: 0.006 to 0.420]) and moderate-to-vigorous physical activity+Sportive moderate-to-vigorous physical activity (− 0.250 [95%CI:−0.447 to−0.130]) were related to costs attributed to medicine use. When the multivariate model considered sedentary time as a covariate, the relationship between moderate-to-vigorous physical activity+Sportive moderate-to-vigorous physical activity and costs attributed to medicine use became non-significant (beta=− 0.007 [95%CI:−0.017 to 0.004]; p-value=0.206). The time spent in moderate-to-vigorous physical activity was inversely related to the medication costs accumulated through the follow-up period, while sedentary time appears to counteract these benefits.

Keywords

sports training - healthcare costs - youth athletes - sedentary lifestyle - physical exercise

Publication History

Received: 22 January 2025

Accepted after revision: 30 April 2025

Accepted Manuscript online:
30 April 2025

Article published online:
12 June 2025

• References

• 1 Silva CLJ, José da Silva L, Renato Azevedo M, Matsudo S, Silva Lopes G. Association between levels of physical activity and use of medication among older women (Associação entre nível de atividade física e uso de medicamentos entre mulheres idosas). Cad Saude Publica 2012; 28: 463-471
• 2 Pitanga FJG, Beck CC, Pitanga CPS. Physical activity and reducing sedentary behavior during the coronavirus pandemic. Arq Bras Cardiol 2020; 114: 1058-1060
• 3 Fernandes RA, Mantovani AM, Codogno JS, Turi-Lynch BC, Pokhrel S, Anokye N. The relationship between lifestyle and costs related to medicine use in adults. Arq Bras Cardiol 2019; 112 (06) 749-755
• 4 Holstein BE, Toftager M, Román JEI, Madsen KR. Mental Health and Medicine Use for Headache: A Nationally Representative Study of Adolescents in Denmark. Pharmacoepidemiol Drug Saf 2024; 33 (10) e70031
• 5 Pisarska A, Ostaszewski K. Use of medicines to alleviate negative emotional states among adolescents attending Special Education Centres. J Prev Med Hyg 2023; 64 (02) E178-E187
• 6 Lynch KR, Anokye NK, Vlachopoulos D, Barbieri FA, Turi-Lynch BC, Codogno JS. et al. Impact of sports participation on incidence of bone traumatic fractures and health-care costs among adolescents: ABCD–Growth Study. Phys Sportsmed 2020; 48 (03) 298-303
• 7 Torres W, de Moraes Chagas LG, Fernandes RA. et al. Relationship between vigorous physical activity and health care costs among adolescents: ABCD Growth Study. BMC Pediatr 2022; 22: 141
• 8 Ding D, Kolbe-Alexander T, Nguyen B, Katzmarzyk PT, Pratt M, Lawson KD. The economic burden of physical inactivity: A systematic review and critical appraisal. Br J Sports Med 2017; 51: 1392-1409
• 9 Duijvestijn M, de Wit GA, van Gils PF, Wendel-Vos G. Impact of physical activity on healthcare costs: a systematic review. BMC Health Serv Res 2023; 23: 572
• 10 Pratt M, Norris J, Lobelo F, Roux L, Wang G. The cost of physical inactivity: Moving into the 21st century. Br J Sports Med 2014; 48 (03) 171-173
• 11 Ranasinghe PD, Pokhrel S, Anokye NK. Economics of physical activity in low-income and middle- income countries: A systematic review. BMJ Open 2021; 11: e037784
• 12 Bull FC, Al-Ansari SS, Biddle S, Borodulin K, Buman MP, Cardon G. et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med 2020; 54 (24) 1451-1462
• 13 Guedes DP, Zuppa MA. Adherence to Combined Healthy Movement Behavior Guidelines among Adolescents: Effects on Cardiometabolic Health Markers. Int J Environ Res Public Health 2022; 19: 14
• 14 Guthold R, Stevens GA, Riley LM, Bull FC. Global trends in insufficient physical activity among adolescents: a pooled analysis of 298 population-based surveys with 1·6 million participants. Lancet Child Adolesc Health 2020; 4 (01) 23-35
• 15 Caspersen CJ, Powell KE, Christenson GM. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep 1985; 100 (02) 126-31 http://www.ncbi.nlm.nih.gov/pubmed/3920711
• 16 Hulteen RM, Smith JJ, Morgan PJ. et al. Global participation in sport and leisure-time physical activities: A systematic review and meta-analysis. Prev Med (Baltim) 2017; 95: 14-25
• 17 Caine DJ. Are kids having a rough time of it in sports?. Br J Sports Med 2010; 44: 1-3
• 18 Moore SA, McKay HA, Macdonald H. et al. Enhancing a somatic maturity prediction model. Med Sci Sports Exerc 2015; 47 (08) 1755-1764
• 19 Williams DP, Going SB, Lohman TG. et al. Body fatness and risk for elevated blood pressure, total cholesterol, and serum lipoprotein ratios in children and adolescents. Am J Public Health 1992; 82 (03) 358-63
• 20 Agostinete RR, Fernandes RA, Narciso PH, Maillane-Vanegas S, Werneck AO, Vlachopoulos D. Categorizing 10 Sports According to Bone and Soft Tissue Profiles in Adolescents. Med Sci Sports Exerc 2020; 52 (12) 2673-2681
• 21 Cayres-Santos SU, Urban JB, Barbosa MF, Lemes IR, Kemper HCG, Fernandes RA. Sports participation improves metabolic profile in adolescents: ABCD growth study. Am J Hum Biol 2020; 32 (05) 23387
• 22 Gómez-Bruton A, González-Agüero A, Gómez-Cabello A, Matute-Llorente A, Casajús JA, Vicente-Rodríguez G. Swimming and bone: Is low bone mass due to hypogravity alone or does other physical activity influence it. Osteoporos Int 2016; 27 (05) 1785-1793
• 23 Mielke GI, Hallal PC, Rodrigues GBA, Szwarcwald CL, Santos FV, Malta DC. Prática de atividade física e hábito de assistir à televisão entre adultos no Brasil: Pesquisa Nacional de Saúde 2013. Epidemiol Serv Saude 2015; 24 (02) 277-286
• 24 Conroy DE, Hedeker D, McFadden HG. et al. Lifestyle intervention effects on the frequency and duration of daily moderate-vigorous physical activity and leisure screen time. Health Psychol 2017; 36 (04) 299-308
• 25 Siervo M, Gan J, Fewtrell MS, Cortina-Borja M, Wells JCK. Acute effects of video-game playing versus television viewing on stress markers and food intake in overweight and obese young men: A randomised controlled trial. Appetite 2018; 120: 100-108
• 26 Sutherland RL, Campbell EM, Lubans DR. et al. The Physical Activity 4 Everyone Cluster Randomized Trial: 2-Year Outcomes of a School Physical Activity Intervention Among Adolescents. Am J Prev Med 2016; 51 (02) 195-205
• 27 Ekelund U, Brage S, Froberg K, Harro M, Anderssen SA, Sardinha LB. TV Viewing and Physical Activity Are Independently Associated with Metabolic Risk in Children: The European Youth Heart Study Methods and Findings. PLoS Med 2006; 3: e488. http://www.theactigraph.com
• 28 Shourie F, Ghasemi B, Shafizadeh A, Bagherian S, Verhagen E. The effect of exercise therapy as a tool for preventing and treating musculoskeletal disorders among school-aged children: a randomised controlled trial. BMC Musculoskelet Disord 2024; 25: 381
• 29 Espirito Santo CM, Santos VS, Kamper SJ, Williams CM, Miyamoto GC, Yamato TP. Overview of the economic burden of musculoskeletal pain in children and adolescents: a systematic review with meta-analysis. Pain 2024; 165 (02) 296-323
• 30 Maillane-Vanegas S, Torres W, Cardoso JR, Gimunová M, Verhagen E, Fernandes RA. Musculoskeletal Pain in Adolescents Engaged in Impact and Nonimpact Sports—ABCD Growth Study. Pediatr Exerc Sci 2024; 23: 1-7 Epub ahead of print. PMID: 39442914
• 31 Lynch KR, Kemper H, Turi-Lynch B. et al. Impact sports and bone fractures among adolescents. J Sports Sci 2017; 35 (24) 2421-2426