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Krzywda K, Teson KM, Watson JS, Goudar S, Forsha D, Wagner JB, White DA. Peak Oxygen Consumption (V̇O 2peak ) Recovery Delay in a Pediatric Fontan Population. Med Sci Sports Exerc 2023; 55:1961-1967. [PMID: 37418236 DOI: 10.1249/mss.0000000000003247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2023]
Abstract
PURPOSE The purpose of this study is to identify predictors and correlates of VO2RD in youth with Fontan. METHODS Cardiopulmonary exercise test data was used from a single center, cross-sectional study of children and adolescents (age, 8-21 yr) with Fontan physiology. The VO2RD was determined using time (s) to <90% of V̇O 2peak and categorized as "low" (≤10 s) or "high" (≥10 s). t Tests and χ 2 analysis were used to compare continuous and categorical variables, respectively. RESULTS The analysis sample included 30 adolescents with Fontan physiology (age, 14.2 ± 2.4 yr; 67% male) with either right ventricular (RV) dominant (40%) or co/left ventricular (Co/LV) dominant (60%) systemic ventricular morphology. There were no differences in V̇O 2peak between the high and low VO2RD groups (high = 1.3 ± 0.4 L·min -1 ; low = 1.3 ± 0.3 L·min -1 ; P = 0.97). VO2RD in participants with RV dominance was significantly greater than in patients with Co/LV dominance (RV = 23.8 ± 15.8 s; Co/LV = 11.8 ± 16.1 s; P = 0.03). CONCLUSIONS V̇O 2peak was not correlated with VO2RD when analyzed as high/low VO2RD groups. However, morphology of the systemic single ventricle (RV vs Co/LV) may be related to rate of recovery in V̇O 2 after a peak cardiopulmonary exercise test.
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Affiliation(s)
| | | | - Jessica S Watson
- Ward Family Heart Center, Children's Mercy Kansas City, Kansas City, MO
| | - Suma Goudar
- Children's National Heart Institute, Department of Pediatrics, Washington, DC
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Borkertienė V, Valonytė-Burneikienė L. Normal Weight 6-12 Years Boys Demonstrate Better Cognitive Function and Aerobic Fitness Compared to Overweight Peers. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58030423. [PMID: 35334599 PMCID: PMC8953475 DOI: 10.3390/medicina58030423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/02/2022] [Accepted: 03/12/2022] [Indexed: 11/20/2022]
Abstract
Background and Objectives: This study evaluated and compared the cognitive function (CF) and aerobic fitness (AF) of 15 normal-weight (NW) and 15 overweight (OW) children, aged 6−12 years. In addition, the relationship between CF and AF was evaluated. Materials and Methods: The ANAM4 battery was used to evaluate CF, and a constant treadmill walking exercise (6 km/h for 6 min) and a progressive treadmill exercise (modified Balke test) were used to assess pulmonary oxygen uptake (VO2). Results: The OW children displayed worse attention and visual tracking (88.95 ± 4.45% and 93.75 ± 3.16%), response inhibition (90.27 ± 1.54% and 93.67 ± 2%), and speed of processing (93.65 ± 1.5% and 94.4 ± 1.54%) than the NW children (p < 0.05). The VO2 max was higher and the time constant of VO2 kinetics was shorter in NW children (56.23 ± 3.53 mL/kg/min and 21.73 ± 1.57 s, respectively) than in OW children (45.84 ± 1.89 mL/kg/min and 33.46 ± 2.9 s, respectively; p < 0.05). Conclusion: The OW children aged 6−12 years demonstrated poorer CF and lower AF than their NW peers. An association between AF and CF indicators was identified in both groups.
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Affiliation(s)
- Vaida Borkertienė
- Department of Health and Rehabilitation, Lithuanian Sports University, LT-44221 Kaunas, Lithuania
- Correspondence: ; Tel.: +370-6111-0072
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Fitzgerald DA. The weighty issue of obesity in paediatric respiratory medicine. Paediatr Respir Rev 2017; 24:4-7. [PMID: 28797888 DOI: 10.1016/j.prrv.2017.06.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 06/01/2017] [Indexed: 11/26/2022]
Abstract
Some have observed that developed world is fat and getting fatter. This is even extending into the developing world, and it is important to appreciate that the consequences of childhood obesity last into adulthood and are associated with premature death. From the paediatric respiratory perspective, the deposition of excess adipose tissue in the thoraco-abdominal region begins early in life and is believed to alter diaphragm mobility and chest wall expansion, reduce lung compliance, and result in a rapid shallow breathing pattern with an increased work of breathing and reduction in maximum ventilatory capacity. This results in respiratory symptoms of exertional dyspnoea related to deconditioning which may present as exercise limitation, leading to confusion with common lung diseases such as asthma. The manifestations of the increasingly prevalent problems of overweight and obesity in young people and their interaction with common conditions of asthma and obstructive sleep apnoea will be discussed.
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Affiliation(s)
- Dominic A Fitzgerald
- Department of Respiratory Medicine, The Children's Hospital at Westmead, Sydney, Australia; Discipline Child & Adolescent Health, Sydney Medical School, University of Sydney, Sydney, Australia.
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Ruangnapa K, Sritippayawan S, Sanguanrungsirikul S, Deerojanawong J, Prapphal N. Exercise intolerance in obese children and adolescents. ASIAN BIOMED 2017. [DOI: 10.5372/1905-7415.0805.341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Abstract
Background: Abnormal lung function has been reported in the obese population and is associated with the severity of obesity.
Objectives: To identify abnormal lung function in obese children and adolescents, and examine the cardiopulmonary response of those who have abnormal lung functions during exercise, and to reveal predictors of exercise intolerance in this population.
Methods: Fifty obese participants aged 8–18 years (56% male; mean age 13.2 ± 2.0 years; mean BMI 33.0 ± 3.6 kg/m2, mean BMI z score 3.1 ± 0.3) underwent spirometry, lung volume evaluation, and a cardiopulmonary exercise test.
Results: Lung function abnormalities and exercise intolerance because of pulmonary limitations were found in 36% and 74% of the participants, respectively. A comparison of participants with normal and abnormal lung functions revealed a lower breathing reserve and a higher ventilatory equivalent for CO2 production (VE/VCO2) during exercise in those who had lung function abnormalities (18 ± 15 vs 30±10%, P <0.001 and 30.3 ± 3.3 vs 29.6 ± 3.1; P = 0.02, respectively). Exercise intolerant participants had a higher BMI z score compared with those who were not (3.1 ± 0.3 vs 2.9 ± 0.3; P = 0.03). BMI z score ≥ 2.84 had an 80% sensitivity and 67% specificity for predicting exercise intolerance in this population.
Conclusions: Evaluations of lung function and exercise capacity should be included in the follow-up planning for obese children and adolescents. A BMI z score ≥ 2.84 was most sensitive for predicting exercise intolerance in this population.
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Affiliation(s)
- Kanokpan Ruangnapa
- Division of Pulmonology and Critical Care, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Thailand
| | - Suchada Sritippayawan
- Division of Pulmonology and Critical Care, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Rama IV Rd., Bangkok 10330, Thailand
| | | | - Jitladda Deerojanawong
- Division of Pulmonology and Critical Care, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Thailand
| | - Nuanchan Prapphal
- Division of Pulmonology and Critical Care, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Thailand
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Sustained improvements in fitness and exercise tolerance in obese adolescents after a 12 week exercise intervention. Obes Res Clin Pract 2016; 10:178-88. [DOI: 10.1016/j.orcp.2015.04.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 03/30/2015] [Accepted: 04/02/2015] [Indexed: 12/26/2022]
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Pozzo J, Fournier P, Lairez O, Vervueren PL, Delmas C, Elbaz M, Carrie D, Galinier M, Roncalli J. Obesity Paradox: Origin and best way to assess severity in patients with systolic HF. Obesity (Silver Spring) 2015; 23:2002-8. [PMID: 26337500 DOI: 10.1002/oby.21216] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 06/12/2015] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Obesity in patients with heart failure (HF) is a factor of better prognosis, supposedly partly because of the particular epidemiology of HF in this population. This study expected to compare the parameters of severity and mortality in patients with and without obesity, to better understand the origin of this paradox. METHODS Two hundred twenty-two patients with nonischemic HF and systolic dysfunction were divided into two groups according to their body mass index (≥ 30 vs. < 30 kg/m(2), respectively) and explored for functional parameters and prognosis. RESULTS B-type natriuretic peptide (BNP) levels were lower and peak oxygen consumption higher in patients with obesity. Patients with obesity had a better prognosis than patients without obesity with a 4-year mortality of 11.1% and 26.4%, respectively (P = 0.009). By univariate analysis, obesity was associated with a reduced risk of death: HR 0.52 [0.28-0.99]. This protective effect was no longer present after adjusting for VO2max and BNP level. CONCLUSIONS The obesity paradox is probably partly due to an overestimation of the severity of HF in patients with obesity because of the multifactorial nature of their dyspnea. Obesity no longer has a protective effect after adjustment for the usual prognostic parameters of HF.
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Affiliation(s)
- Joffrey Pozzo
- Department of Cardiology - CARDIOMET institute, University Hospital of Toulouse, France
- Cardiac Imaging Center, Toulouse University Hospital, France
- Medical School of Rangueil, University Paul Sabatier, Toulouse, France
| | - Pauline Fournier
- Department of Cardiology - CARDIOMET institute, University Hospital of Toulouse, France
- Cardiac Imaging Center, Toulouse University Hospital, France
| | - Olivier Lairez
- Department of Cardiology - CARDIOMET institute, University Hospital of Toulouse, France
- Cardiac Imaging Center, Toulouse University Hospital, France
- Medical School of Rangueil, University Paul Sabatier, Toulouse, France
- Department of Nuclear Medicine, University Paul Sabatier, Toulouse, France
- INSERM/Universite Paul Sabatier UMR 1048, Institutdes Maladies Métaboliques et Cardiovasculaires (I2MC), Toulouse, France
| | - Paul-Louis Vervueren
- Department of Cardiology - CARDIOMET institute, University Hospital of Toulouse, France
- Cardiac Imaging Center, Toulouse University Hospital, France
- Medical School of Rangueil, University Paul Sabatier, Toulouse, France
| | - Clement Delmas
- Department of Cardiology - CARDIOMET institute, University Hospital of Toulouse, France
- Cardiac Imaging Center, Toulouse University Hospital, France
- Medical School of Rangueil, University Paul Sabatier, Toulouse, France
| | - Meyer Elbaz
- Department of Cardiology - CARDIOMET institute, University Hospital of Toulouse, France
- Cardiac Imaging Center, Toulouse University Hospital, France
- Medical School of Rangueil, University Paul Sabatier, Toulouse, France
| | - Didier Carrie
- Department of Cardiology - CARDIOMET institute, University Hospital of Toulouse, France
- Cardiac Imaging Center, Toulouse University Hospital, France
- Medical School of Purpan, University Paul Sabatier, Toulouse, France
| | - Michel Galinier
- Department of Cardiology - CARDIOMET institute, University Hospital of Toulouse, France
- Cardiac Imaging Center, Toulouse University Hospital, France
- Medical School of Rangueil, University Paul Sabatier, Toulouse, France
- INSERM/Universite Paul Sabatier UMR 1048, Institutdes Maladies Métaboliques et Cardiovasculaires (I2MC), Toulouse, France
| | - Jerome Roncalli
- Department of Cardiology - CARDIOMET institute, University Hospital of Toulouse, France
- Cardiac Imaging Center, Toulouse University Hospital, France
- Medical School of Rangueil, University Paul Sabatier, Toulouse, France
- INSERM/Universite Paul Sabatier UMR 1048, Institutdes Maladies Métaboliques et Cardiovasculaires (I2MC), Toulouse, France
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Longitudinal changes of cycling peak power in overweight and normal weight boys. Sci Sports 2015. [DOI: 10.1016/j.scispo.2014.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Wisén AG, Mao P, Christiansen L, Saltin B. Validation of a submaximal versus a maximal exercise test in obese individuals. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2015. [DOI: 10.3109/21679169.2014.1003963] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Robinson PD. Obesity and its impact on the respiratory system. Paediatr Respir Rev 2014; 15:219-26. [PMID: 25092493 DOI: 10.1016/j.prrv.2014.06.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 06/26/2014] [Indexed: 11/27/2022]
Abstract
Obesity has complex and incompletely understood effects upon the respiratory system in childhood, which differs in some aspects to those seen in adults. There is increasing evidence that excess adiposity will impact negatively upon static and dynamic respiratory function as measured through lung volumes, lung compartment mechanics, measures of airway function and exercise capability to varying degrees. Further information is needed to better understand the effects in children, and the importance of onset and duration of obesity on subsequent outcomes. Consensus about how best to express adiposity is also an essential part of this process and fat distribution is another important factor. From a clinical standpoint this creates challenges in distinguishing a deconditioned obese young person from a non-atopic asthmatic because of symptom overlap and lung function testing results, including responses seen during airway challenges. There is evidence to support the role of weight loss in achieving normalisation of lung function parameters, but as always with obesity there are enormous challenges in realising this goal for many subjects.
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Affiliation(s)
- Paul D Robinson
- Department of Respiratory Medicine, The Children's Hospital at Westmead, Sydney, New South Wales, Australia; Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Australia.
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Maciejczyk M, Szymura J, Gradek J, Cempla J, Więcek M. Physiological response is similar in overweight and normoweight boys during cycling: a longitudinal study. ACTA PHYSIOLOGICA HUNGARICA 2014; 101:236-249. [PMID: 24901083 DOI: 10.1556/aphysiol.101.2014.2.12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The purpose of this study was to determine whether metabolic cost is similar in overweight and normoweight children when workload during exercise on a cycle-ergometer is adjusted relative to an objectively determined second ventilatory threshold (VT2) or the maximal workload (Pmax). The tests were conducted every 2 years: first at the age of 10 years and the third test at around the age of 14 years. The levels of maximal oxygen consumption (VO(2)max), Pmax, and the VT2 were determined by means of graded tests on a cycle ergometer. The main test consisted of two 6-minute exercises of submaximal constant intensity (below and above VT2) performed on a cycle ergometer, with a 4-minute recovery between efforts. The workload during cycling was adjusted individually for each participant and adjusted to the values determined in the graded test: workload at VT2 and Pmax. Physiological response (absolute and relative to free-fat mass oxygen uptake, heart rate, pulmonary ventilation, tidal volume, and breathing frequency) is similar in overweight and normoweight boys when workload on a cycle ergometer is adjusted to VT2. The only significant intergroup difference was seen in relative to body mass oxygen intake.
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Affiliation(s)
- M Maciejczyk
- University School of Physical Education Institute of Biomedical Sciences al. Jana Pawła II 78 31-571 Kraków Poland
| | - J Szymura
- University School of Physical Education Department of Clinical Rehabilitation Krakow Poland
| | - J Gradek
- University School of Physical Education Institute of Sport, Department of Athletics Krakow Poland
| | - J Cempla
- University School of Physical Education Institute of Biomedical Sciences al. Jana Pawła II 78 31-571 Kraków Poland
| | - M Więcek
- University School of Physical Education Institute of Biomedical Sciences al. Jana Pawła II 78 31-571 Kraków Poland
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Gomes KB, Carletti L, Perez AJ. Desempenho em teste cardiopulmonar de adolescentes: peso normal e excesso de peso. REV BRAS MED ESPORTE 2014. [DOI: 10.1590/1517-86922014200301879] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUÇÃO: Sabe-se que o excesso de peso interfere no desempenho físico do cotidiano do adolescente e, consequentemente, na aptidão física e na capacidade cardiorrespiratória.OBJETIVO: O estudo objetivou identificar e comparar os valores das variáveis cardiorrespiratórias no limiar anaeróbico ventilatório (LAV) de adolescentes com peso normal e excesso de peso.MÉTODOS: A amostra foi composta por 140 adolescentes de ambos os sexos entre 10 e 14 anos, escolares do município de Vitória, ES, Brasil. Foram mensuradas massa corporal e estatura para cálculo do índice de massa corporal (IMC). Os adolescentes foram divididos em grupo peso normal (GPN) e grupo excesso de peso (GEP), realizaram um eletrocardiograma de repouso e um teste cardiopulmonar de exercício em esteira ergométrica (Inbrasport Super ATL) utilizando o ergoespirômetro MedGraphics Corporation e o protocolo de rampa. O LAV foi identificado pelo método V-slope e/ou equivalente ventilatório de oxigênio (VE/VO2). Foram analisadas as seguintes variáveis no LAV: consumo de oxigênio (VO2LAV ml.kg-1.min-1), frequência cardíaca (FCLAV bpm), percentuais do consumo máximo de oxigênio (%VO2máxLAV) e da FC máxima (%FCmáxLAV), e velocidade (VelLAV km/h), além do consumo máximo de oxigênio (VO2máxml.kg-1.min-1) e FC máxima (FCmáx). Foi realizado teste t de Studentnas comparações entre os grupos, considerando p<0,05 para significância estatística.RESULTADOS: O GPN apresentou valores significativamente maiores no LAV para VO2ml.kg-1.min-1 (20,0 ±6,4 vs 15,8 ±5,7) e velocidade (7,1 ±0,9km/h vs 6,2 ±1,1km/h), e para o VO2máx (44,6 ±7,6 vs 36,0 ±6,4) quando comparado ao GEP.CONCLUSÃO: Os dados sugerem que adolescentes com excesso de peso apresentam prejuízo na aptidão cardiorrespiratória não somente ao nível máximo, mas também ao nível submáximo (LAV) quando comparados aos adolescentes com peso normal.
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Evans CA, Selvadurai H, Baur LA, Waters KA. Effects of obstructive sleep apnea and obesity on exercise function in children. Sleep 2014; 37:1103-10. [PMID: 24882905 DOI: 10.5665/sleep.3770] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
STUDY OBJECTIVES Evaluate the relative contributions of weight status and obstructive sleep apnea (OSA) to cardiopulmonary exercise responses in children. DESIGN Prospective, cross-sectional study. Participants underwent anthropometric measurements, overnight polysomnography, spirometry, cardiopulmonary exercise function testing on a cycle ergometer, and cardiac doppler imaging. OSA was defined as ≥ 1 obstructive apnea or hypopnea per hour of sleep (OAHI). The effect of OSA on exercise function was evaluated after the parameters were corrected for body mass index (BMI) z-scores. Similarly, the effect of obesity on exercise function was examined when the variables were adjusted for OAHI. SETTING Tertiary pediatric hospital. PARTICIPANTS Healthy weight and obese children, aged 7-12 y. INTERVENTIONS N/A. MEASUREMENTS AND RESULTS Seventy-one children were studied. In comparison with weight-matched children without OSA, children with OSA had a lower cardiac output, stroke volume index, heart rate, and oxygen consumption (VO2 peak) at peak exercise capacity. After adjusting for BMI z-score, children with OSA had 1.5 L/min (95% confidence interval -2.3 to -0.6 L/min; P = 0.001) lower cardiac output at peak exercise capacity, but minute ventilation and ventilatory responses to exercise were not affected. Obesity was only associated with physical deconditioning. Cardiac dysfunction was associated with the frequency of respiratory-related arousals, the severity of hypoxia, and heart rate during sleep. CONCLUSIONS Children with OSA are exercise limited due to a reduced cardiac output and VO2 peak at peak exercise capacity, independent of their weight status. Comorbid OSA can further decrease exercise performance in obese children.
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Affiliation(s)
- Carla A Evans
- The Children's Hospital at Westmead Clinical School, Discipline of Paediatrics & Child Health, Faculty of Medicine, The University of Sydney NSW Australia
| | - Hiran Selvadurai
- The Children's Hospital at Westmead Clinical School, Discipline of Paediatrics & Child Health, Faculty of Medicine, The University of Sydney NSW Australia ; The Department of Respiratory Medicine, The Children's Hospital at Westmead, Westmead NSW Australia
| | - Louise A Baur
- The Children's Hospital at Westmead Clinical School, Discipline of Paediatrics & Child Health, Faculty of Medicine, The University of Sydney NSW Australia ; Weight Management Service, The Children's Hospital at Westmead, Westmead NSW Australia
| | - Karen A Waters
- The Children's Hospital at Westmead Clinical School, Discipline of Paediatrics & Child Health, Faculty of Medicine, The University of Sydney NSW Australia ; The Department of Respiratory Medicine, The Children's Hospital at Westmead, Westmead NSW Australia
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Maciejczyk M, Szymura J, Cempla J, Gradek J, Więcek M, Bawelski M. Respiratory compensation point during incremental test in overweight and normoweight boys: is it useful in assessing aerobic performance? A longitudinal study. Clin Physiol Funct Imaging 2013; 34:56-63. [PMID: 23789614 DOI: 10.1111/cpf.12064] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Accepted: 06/04/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Marcin Maciejczyk
- Institute of Biomedical Sciences; University School of Physical Education in Krakow; Krakow Poland
| | - Jadwiga Szymura
- The Department of Clinical Rehabilitation; University School of Physical Education in Krakow; Krakow Poland
| | - Jerzy Cempla
- Institute of Biomedical Sciences; University School of Physical Education in Krakow; Krakow Poland
| | - Joanna Gradek
- The Department of Theory and Methodology of Athletics; University School of Physical Education; Kraków Poland
| | - Magdalena Więcek
- Institute of Biomedical Sciences; University School of Physical Education in Krakow; Krakow Poland
| | - Marek Bawelski
- Institute of Biomedical Sciences; University School of Physical Education in Krakow; Krakow Poland
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Shultz SP, Browning RC, Schutz Y, Maffeis C, Hills AP. Childhood obesity and walking: guidelines and challenges. ACTA ACUST UNITED AC 2011; 6:332-41. [PMID: 21780867 DOI: 10.3109/17477166.2011.590202] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The development and maintenance of excess body mass in many children is partly attributable to levels of physical activity that are lower than the recommended 60 minutes/day. Walking is a recommended form of physical activity for obese children, due to its convenience and perceived ease of adoption. Unfortunately, studies that have used objective physical activity assessment continue to report low step counts and levels of physical activity in obese children. This may be due to physiological and/or biomechanical factors that make walking more difficult for obese children. The purpose of this review is to highlight the current recommended and measured levels of physical activity for children and to discuss the physiological and biomechanical challenges of walking for obese children that may help explain why these children are not meeting physical activity goals.
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Affiliation(s)
- Sarah P Shultz
- Institute of Health and Biomedical Innovation, Queensland University of Technology , Brisbane, QLD , Australia.
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Dencker M, Wollmer P, Karlsson MK, Lindén C, Andersen LB, Thorsson O. Body fat, abdominal fat and body fat distribution related to VO2PEAKin young children. ACTA ACUST UNITED AC 2011; 6:e597-602. [DOI: 10.3109/17477166.2010.526612] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Abstract
This review addresses the impact of obesity on paediatric physical functioning utilizing the World Health Organization International Classification of Functioning, Disability and Health Framework (ICF). The ICF encompasses functioning (as it relates to all body functions and structures), activities (undertaking a particular task) and participation (in a life situation) with disability referring to impairments in body functions/structures, activity restrictions or participation limitations. Electronic databases were searched for peer-reviewed studies published in English prior to May 2009 that examined aspects of physical functioning in children (≤18 years). Eligible studies (N = 104) were ranked by design and synthesized descriptively. Childhood obesity was found to be associated with deficits in function, including impaired cardiorespiratory fitness and performance of motor tasks; and there was some limited evidence of increased musculoskeletal pain and decrements in muscle strength, gait and balance. Health-related quality of life and the subset of physical functioning was inversely related to weight status. However, studies investigating impacts of obesity on wider activity and participation were lacking. Further research utilizing the ICF is required to identify and better characterize the effects of paediatric obesity on physical function, activity and participation, thereby improving targets for intervention to reduce disability in this population.
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Affiliation(s)
- M D Tsiros
- Nutritional Physiology Research Centre, Sansom Institute for Health Research, University of South Australia, Adelaide, Australia
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Dencker M, Bugge A, Hermansen B, Froberg K, Andersen LB. Aerobic fitness in prepubertal children according to level of body fat. Acta Paediatr 2010; 99:1854-60. [PMID: 20670311 DOI: 10.1111/j.1651-2227.2010.01952.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM The purpose of this study was to investigate the relationship between maximum oxygen uptake (VO(2PEAK) ) and body fat in young children on a population-based level. METHODS Participants were 586 children (311 boys and 275 girls) aged 6.8±0.4 years, recruited from a population-based cohort. VO(2PEAK) was measured by indirect calorimetry during a maximal exercise test. Percent body fat (BF%) was estimated from skinfold measurements. RESULTS Significant relationships existed between BF% and absolute values of VO(2PEAK) (mL/min), VO(2PEAK) scaled by body weight (mL/min/kg) and VO(2PEAK) by allometric scaling (mL/min/kg(0.71) ), whereas no relationships were detected for VO(2PEAK) scaled to fat-free mass (FFM) (mL/min/FFM). Person correlation coefficients for boys were 0.26, -0.38, -0.19 and -0.01 NS and for girls 0.33, -0.42, -0.21 and -0.03 NS, respectively. Significant differences in VO(2PEAK) existed between different quartiles of BF%, with the exception when VO(2PEAK) was scaled to FFM. CONCLUSION Our findings document the coexistence of two known risk factors for disease at a young age on a population-base and confirms that VO(2PEAK) was scaled to FFM represents a body fat independent way of expressing fitness.
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Affiliation(s)
- Magnus Dencker
- Department of Clinical Physiology, Skåne University Hospital, Malmö, Sweden.
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McMurray RG, Ondrak KS. Effects of being overweight on ventilatory dynamics of youth at rest and during exercise. Eur J Appl Physiol 2010; 111:285-92. [DOI: 10.1007/s00421-010-1651-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2010] [Indexed: 01/03/2023]
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Tsang TW, Kohn MR, Chow CM, Fiatarone Singh MA. Kung fu training improves physical fitness measures in overweight/obese adolescents: the "martial fitness" study. J Obes 2010; 2010:672751. [PMID: 20798764 PMCID: PMC2925099 DOI: 10.1155/2010/672751] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2009] [Revised: 03/08/2010] [Accepted: 04/08/2010] [Indexed: 12/16/2022] Open
Abstract
Aim. To examine the efficacy of a six-month Kung Fu (KF) program on physical fitness in overweight/obese adolescents. Methods. Subjects were randomly assigned to the KF or sham exercise (Tai Chi, TC) control group. Physical measurements in cardiovascular fitness and muscle fitness occurred at baseline and after 6 months of training thrice weekly. Results. Twenty subjects were recruited. One subject was lost to follow-up, although overall compliance to the training sessions was 46.7 +/- 27.8%. At follow-up, the cohort improved in absolute upper (P = .002) and lower (P = .04) body strength, and upper body muscle endurance (P = .02), without group differences. KF training resulted in significantly greater improvements in submaximal cardiovascular fitness (P = .03), lower body muscle endurance (P = .28; significant 95% CI: 0.37-2.49), and upper body muscle velocity (P = .03) relative to TC training. Conclusions. This short-term KF program improved submaximal cardiovascular fitness, lower body muscle endurance, and muscle velocity, in overweight/obese adolescents with very low baseline fitness.
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Affiliation(s)
- Tracey W. Tsang
- Exercise, Health & Performance Faculty Research Group, The University of Sydney, Lidcome, NSW 2141, Australia
- Brain Dynamics Centre, The University of Sydney Medical School and Westmead Millennium Institute, Westmead, NSW 2145, Australia
- *Tracey W. Tsang:
| | - Michael R. Kohn
- Centre for Research into Adolescents' Health, The Children's Hospital at Westmead, Westmead, NSW 2145, Australia
| | - Chin Moi Chow
- Exercise, Health & Performance Faculty Research Group, The University of Sydney, Lidcome, NSW 2141, Australia
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Milano GE, Leite N. Comparação das variáveis cardiorrespiratórias de adolescentes obesos e não obesos em esteira e bicicleta ergométrica. REV BRAS MED ESPORTE 2009. [DOI: 10.1590/s1517-86922009000500003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
O objetivo deste estudo foi investigar o consumo máximo de oxigênio (VO2max) em adolescentes obesos e não obesos em esteira e bicicleta ergométrica. O estudo foi transversal e descritivo com a amostra de 54 indivíduos obesos (23 meninos e 31 meninas) e 33 não obesos (16 meninos e 17 meninas) com idade entre 10 e 16 anos. Utilizou-se o critério dos Centers for Disease Control and Prevention (CDC, 2000) para a classificação do índice de massa corporal (IMC). Foram avaliados o peso, estatura, índice de massa corporal (IMC) e IMC-escore Z. Para avaliação cardiorrespiratória foi realizado teste máximo em esteira e bicicleta ergométrica. Foram avaliados a frequência cardíaca máxima (FCmax), coeficiente respiratório (RER), consumo máximo de oxigênio (VO2max), tempo total de teste (TT) e carga final (w) na bicicleta ergométrica. Utilizou-se o teste de t de Student para a comparação dos ergômetros. Nas análises dos grupos, utilizou-se a ANOVA fatorial. Considerou-se significante p < 0,05. Os resultados revelaram que o peso, IMC e IMC-escore Z foram maiores nos obesos. Os valores de VO2max absoluto (l.min-1) foram mais altos nos obesos, em ambos os gêneros, na esteira, sem diferenças entre os grupos na bicicleta. Entretanto, o VO2max relativo ao peso corporal (ml.kg-1.min-1) foi menor no grupo obeso e nas meninas, em ambos os ergômetros. A carga de trabalho na bicicleta foi similar entre os obesos e não obesos. Concluiu-se que os obesos apresentaram valores de VO2max mais baixos que os não obesos em ambos os ergômetros. Entretanto, o fato de o indivíduo obeso na bicicleta suportar a mesma carga final que o não obeso sugere-se que a bicicleta pode ser indicado como o melhor ergômetro para obesos.
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Brunetto AF, Roseguini BT, Silva BM, Hirai DM, Ronque EV, Guedes DP. Limiar de variabilidade da freqüência cardíaca em adolecentes obesos e não-obesos. REV BRAS MED ESPORTE 2008. [DOI: 10.1590/s1517-86922008000200012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A obesidade na adolescência está associada à disfunção simpato-vagal cardíaca em repouso, embora existam poucas informações sobre a resposta autonômica durante o exercício nestes adolescentes. OBJETIVO: Comparar a modulação autonômica durante teste de esforço físico dinâmico incremental em amostras de adolescentes obesos e não-obesos, e analisar a relação entre o limiar de variabilidade da freqüência cardíaca (LiVFC) e o limar ventilatório (LV). MÉTODOS: Dez adolescentes obesos e 19 adolescentes não-obesos do sexo masculino com idades entre 13 e 18 anos foram submetidos à teste de esforço físico progressivo máximo em esteira rolante para estudo da variabilidade da freqüência cardíaca (VFC) e para identificação do LV. A VFC foi estudada mediante análise do desvio-padrão da variabilidade instantânea batimento-a-batimento (SD1) da Plotagem de Poincaré. O LiVFC foi identificado na intensidade de esforço físico em que o SD1 atingiu valor menor que 3 ms. RESULTADOS: O índice SD1 diminuiu progressivamente em ambos os grupos até aproximadamente 50-60% do VO2pico, sendo que os adolescentes obesos apresentaram valores significativamente menores (p<0,001) somente na intensidade relativa a 20% do VO2pico, Os adolescentes obesos apresentaram valores relativos (mL.kg-1.min-1) de VO2pico e LV significativamente menores (p<0,05) que os adolescentes não-obesos. Em ambos os grupos, não foram observadas diferenças significativas entre o ponto de ocorrência do LV e do LiVFC, expressos em valores relativos e absolutos de VO2. Contudo, não foram encontradas correlações significativas entre o ponto de ocorrência do LV e do LiVFC, tanto em valores relativos quanto em valores absolutos de VO2. CONCLUSÕES: A obesidade na adolescência parece não estar associada à alteração da modulação autonômica durante o exercício físico. Torna-se possível determinar o LiVFC mediante análise da Plotagem de Poincaré em adolescentes obesos e não-obesos. Entretanto, a ausência de associação estatística entre o LiVFC e o LV demonstra que parece não haver relação causal entre estes eventos.
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Bellissimo N, Thomas SG, Goode RC, Anderson GH. Effect of short-duration physical activity and ventilation threshold on subjective appetite and short-term energy intake in boys. Appetite 2007; 49:644-51. [PMID: 17537539 DOI: 10.1016/j.appet.2007.04.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2006] [Revised: 02/27/2007] [Accepted: 04/16/2007] [Indexed: 10/23/2022]
Abstract
The purpose of this investigation was twofold: (1) to examine the role of low- to moderate-intensity, short-duration physical activity on subjective appetite and (2) to identify the role of and associations between ventilation threshold (VeT) and energy intake at a pizza lunch 30 min after glucose and whey protein drinks in normal weight boys. In 14 boys (age: 12.5+/-0.4 years) subjective appetite was measured before and after a 12 min walking protocol designed to determine physical fitness based on the VeT. On a separate occasion food intake (FI) and subjective appetite were measured in response to sweetened preloads of either a SPLENDA Sucralose control, glucose or whey protein made up to 250 ml with water, given in random order to each boy, 2h after a standardized breakfast. Subjective average appetite and prospective food consumption scores increased after physical activity. VeT was positively associated with FI at a pizza lunch consumed 30 min after glucose and whey protein drinks. Glucose and whey protein reduced FI similarly at lunch compared with control. In conclusion, appetite is increased by low- to moderate-intensity, short-duration physical activity and FI following glucose and protein preloads is positively associated with fitness levels in boys.
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Affiliation(s)
- Nick Bellissimo
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, FitzGerald Building, 150 College St., Toronto, Ont., Canada M5S 3E2
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Berndtsson G, Mattsson E, Marcus C, Larsson UE. Age and gender differences in VO2max in Swedish obese children and adolescents. Acta Paediatr 2007; 96:567-71. [PMID: 17391472 DOI: 10.1111/j.1651-2227.2007.00139.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
AIM To describe age and gender differences in estimated maximum oxygen uptake (VO2max) and participation in organized physical activity in Swedish obese children and adolescents, and compare the results with an age-matched reference group representative of the general population. METHODS Two hundred and nineteen obese children (102 boys, 117 girls, aged 8-16 years, Body Mass Index (BMI) 24.3-57.0 kg.m-2) performed a submaximal bicycle ergometry test and an interview concerning participation in organized physical activity. RESULTS The obese children had lower relative VO2max (p<0.001) than the reference group. In contrast to the reference group no age or gender differences were detected in the obese children aged 11-13 years and 14-16 years. With increased age (after 11 years) the obese children participated less in organized physical activity than the reference group (p<0.001). In obese adolescents, participation in organized physical activity in leisure time explained 7% and BMI 45% of the variance in relative VO2max. CONCLUSION The obese children had lower relative VO2max, and participated less in organized physical activity than the reference group. The variance in relative VO2max was primarily explained by BMI. Obese adolescents, especially boys, were found to be at risk of physical inactivity.
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Affiliation(s)
- G Berndtsson
- Karolinska Institutet, Department of Neurobiology, Care Sciences, and Society, Division of Physiotherapy, Huddinge, and Karolinska University Hospital, SE 141 86 Huddinge and SE 171 76 Solna, Sweden.
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Loftin M, Sothern M, VanVrancken C, O'Hanlon A, Udall J. Effect of obesity status on heart rate peak in female youth. Clin Pediatr (Phila) 2003; 42:505-10. [PMID: 12921451 DOI: 10.1177/000992280304200604] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of this study was to compare heart rate peak in obese (n = 43) and normal weight (n = 45) female youth. Heart rate (HR) peak was significantly lower (p < or = 0.05) in the obese group as compared to the normal weight group (192.3 +/- 9.3, 203.4 +/- 7.6), and VO2 (L x min(-1)) peak similar between groups (1.77 +/- 0.53, 1.97 +/- 0.60). Bivariate correlations for heart rate peak with body weight, percent fat, and body mass index yielded the following: -0.53, -0.54, and -0.57. These findings agree with the adult data indicating low HR peak in obese individuals. Further research is needed to explore physiologic factors that may lead to reduced HR peak in obese female youth.
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Affiliation(s)
- Mark Loftin
- Department of Human Performance and Health Promotion, University of New Orleans, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana 70148, USA
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Volpe Ayub B, Bar-Or O. Energy cost of walking in boys who differ in adiposity but are matched for body mass. Med Sci Sports Exerc 2003; 35:669-74. [PMID: 12673152 DOI: 10.1249/01.mss.0000058355.45172.de] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE To compare the energy cost of treadmill walking, in pairs of obese and lean adolescents who were matched for total body mass. METHODS Metabolic energy expenditure was determined at 67, 83, and 100 m.min-1, in nine obese and nine nonobese 11- to 18-yr-old boys. Total adiposity and fat distribution in the trunk and limbs were assessed using DXA. RESULTS There were no intergroup differences in the net (exercise minus rest) energy cost at the two lower speeds, but the obese boys expended more energy at 100 m.min-1 (12%, P < 0.05). Heart rate was consistently higher in the obese boys: 18% at 67 m.min-1, 22% at 83 m.min-1, and 28% at 100 m.min-1. Pooling all subjects together, body mass, rather than adiposity, was the main predictor of energy cost: 89.1%, 76.3%, and 62.1% (P < 0.05 for all) of the total variance at 67, 83, and 100 m.min-1, respectively. The variance explained by total body fat was only 2.1%, 8.4%, and 16%, respectively. There was no relationship between [OV0312]O(2net) and the proportion of fat in body segments. CONCLUSION It is total body mass, more than adiposity (total and regional) per se, that affects the energy cost of locomotion in obese boys.
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Affiliation(s)
- Beatriz Volpe Ayub
- Childrens' Exercise and Nutrition Centre, McMaster University, Hamilton, Ontario, Canada
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Deforche B, Lefevre J, De Bourdeaudhuij I, Hills AP, Duquet W, Bouckaert J. Physical fitness and physical activity in obese and nonobese Flemish youth. OBESITY RESEARCH 2003; 11:434-41. [PMID: 12634442 DOI: 10.1038/oby.2003.59] [Citation(s) in RCA: 181] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To assess different aspects of physical fitness and physical activity in obese and nonobese Flemish youth. RESEARCH METHODS AND PROCEDURES A random sample of 3214 Flemish schoolchildren was selected and divided into an "obese" and "nonobese" group based on body mass index and sum of skinfolds. Physical fitness was assessed by the European physical fitness test battery. Physical activity was estimated by a modified version of the Baecke Questionnaire. RESULTS Obese subjects had inferior performances on all tests requiring propulsion or lifting of the body mass (standing-broad jump, sit-ups, bent-arm hang, speed shuttle run, and endurance shuttle run) compared with their nonobese counterparts (p < 0.001). In contrast, the obese subjects showed greater strength on handgrip (p < 0.001). Both groups had similar levels of leisure-time physical activity; however, nonobese boys had a higher sport index than their obese counterparts (p < 0.05). DISCUSSION Results of this study show that obese subjects had poorer performances on weight-bearing tasks, but did not have lower scores on all fitness components. To encourage adherence to physical activity in obese youth, it is important that activities are tailored to their capabilities. Results suggest that weight-bearing activities should be limited at the start of an intervention with obese participants and alternative activities that rely more on static strength used.
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Affiliation(s)
- Benedicte Deforche
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
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Brandou F, Dumortier M, Garandeau P, Mercier J, Brun JF. Effects of a two-month rehabilitation program on substrate utilization during exercise in obese adolescents. DIABETES & METABOLISM 2003; 29:20-7. [PMID: 12629444 DOI: 10.1016/s1262-3636(07)70003-4] [Citation(s) in RCA: 80] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND We assessed the impact of an exercise and diet program for two weeks in a specialized institute and six weeks at home on body composition and exercise metabolism in obese adolescents. METHODS Fourteen obese adolescents took part in the two-week training course and seven continued exercise and diet at home. The substrate crossover point and the maximal fat oxidation point (Lipox max) were determined before and after the program, using indirect calorimetry. Individualized exercise training at Lipox max was programmed over the two months. RESULTS At the end of the two-week program, all adolescents showed a decrease in weight (p<0.001). Only the seven subjects who continued exercise training at home showed improved exercise fat use (increased crossover point of 17% +/- 3 (p<0.005) and Lipox max of 12.5% +/- 1.5 (p<0.005)). CONCLUSION The teenagers who had performed this targeted regular training for two months exhibit an increase in their ability to oxidize lipids at exercise. This increase is no longer found in those treated by diet alone. The efficiency of this targeted training protocol based on calorimetry for the treatment of teenager obesity will require longer studies on greater samples of subjects.
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Affiliation(s)
- F Brandou
- Service Central de Physiologie Clinique, Unité CERAMM (Centre d'Exploration et de Réadaptation des Anomalies Métaboliques et Musculaires), CHU Lapeyronie, Montpellier, France
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Chen W, Lin CC, Peng CT, Li CI, Wu HC, Chiang J, Wu JY, Huang PC. Approaching healthy body mass index norms for children and adolescents from health-related physical fitness. Obes Rev 2002; 3:225-32. [PMID: 12164476 DOI: 10.1046/j.1467-789x.2002.00064.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Current body mass index (BMI) norms for children and adolescents are developed from a reference population that includes obese and slim subjects. The validity of these norms is influenced by the observed secular increase in body weight and BMI. We hypothesized that the performance of children in health-related physical fitness tests would be negatively related to increased BMIs, and therefore fitness tests might be used as criteria for developing a more appropriate set of BMI norms. We evaluated the existing data from a nation-wide fitness survey for students in Taiwan (444 652 boys and 433 555 girls) to examine the relationship between BMI and fitness tests. The fitness tests used included: an 800/1600-m run/walk; a standing long jump; bent-leg curl-ups; and a sit-and-reach test. The BMI percentiles developed from the subgroup whose test scores were better than the 'poor' quartile in all four tests were compared with those of the whole population and linked to the adult criteria for overweight and obesity. The BMIs were significantly related to the results of fitness testing. A total of 43% of students had scores better than the poorest quartile in all of their tests. The upper BMI percentile curves of this fitter subgroup were lower than those of the total population. The 85th and 95th BMI percentile values of the fitter 18-year-old-students (23.7 and 25.5 kg m(-2) for boys; 22.6 and 24.6 kg m(-2) for girls) linked well with the adult cut-off points of 23 and 25 kg m(-2), which have been recommended as the Asian criteria for adult overweight and obesity. Hence, the BMI norms for children and adolescents could be created from selected subgroups that have better physical fitness. We expect that the new norms based on this approach will be used not only to assess the current status of obesity or overweight, but also to encourage activity and exercise.
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Affiliation(s)
- W Chen
- Department of Pediatrics, China Medical College and Hospital, Taichung, Taipei, Taiwan.
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LeMura LM, Maziekas MT. Factors that alter body fat, body mass, and fat-free mass in pediatric obesity. Med Sci Sports Exerc 2002; 34:487-96. [PMID: 11880814 DOI: 10.1097/00005768-200203000-00016] [Citation(s) in RCA: 109] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study was to quantify the effects of exercise treatment programs on changes in body mass, fat-free mass, and body fat in obese children and adolescents. METHODS By using the meta-analytic approach, studies that met the following criteria were included in our analyses: 1) at least six subjects per group; 2) subject groups consisting of children in the 5- to 17-yr age range; 3) pretest and posttest values for either body mass, percent body fat, or fat-free mass (FFM); 4) used exercise as a mode of treatment (e.g., walking, jogging, cycle ergometry, high-repetition resistance exercise, and combinations); 6) training programs >or= 3 wk; 7) full-length publications (not conference proceedings); 8) apparently "healthy" children (i.e., free from endocrine diseases and disorders); and 9) published studies in English language journals only. RESULTS A total of 120 investigations were located that addressed the issue of exercise as a method of treatment in pediatric obesity. Of those, 30 met our criteria for inclusion. Across all designs and categories, fixed-effects modeling yielded significant decreases in the following dependent variables: 1) percent body fat (mean = 0.70 +/- 0.35; 95% CI = 0.21 to 1.1); 2) FFM (mean = 0.50 +/- 0.38; 95% CI = 0.03 to 0.57); 3) body mass (mean = 0.34 +/- 0.18; 95% CI = 0.01 to 0.46); 4) BMI (mean = 0.76 +/- 0.55; 95% CI = 4.24 to 1.7), and 5) VO2max (mean = 0.52 +/- 0.16; 95% CI = 0.18 to 0.89), respectively. Significant differences were found as a function of the type intervention groups (exercise vs exercise + behavioral modification; P < 0.04); body composition assessment methods (skinfold vs hydrostatic weighing, DEXA, and total body water; P < 0.006); exercise intensity (60-65%, vs >or= 71% VO2max; P < 0.01); duration (<or= 30 min vs > 30 min; P < 0.03); and mode (aerobic vs aerobic + resistance training; P < 0.02). Stepwise linear regression suggested that initial body fat levels (or body mass), type of treatment intervention, exercise intensity, and exercise mode accounted for most of the variance associated with changes in body composition after training. CONCLUSIONS Exercise is efficacious for reducing selected body composition variables in children and adolescents. The most favorable alterations in body composition occurred with 1) low-intensity, long-duration exercise; 2) aerobic exercise combined with high-repetition resistance training; and 3) exercise programs combined with a behavioral-modification component.
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Affiliation(s)
- Linda M LeMura
- Exercise Physiology Laboratory, Graduate Program in Exercise Science, Bloomsburg University of Pennsylvania, Bloomsburg, PA 17815, USA.
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Török K, Szelényi Z, Pórszász J, Molnár D. Low physical performance in obese adolescent boys with metabolic syndrome. Int J Obes (Lond) 2001; 25:966-70. [PMID: 11443493 DOI: 10.1038/sj.ijo.0801646] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2000] [Revised: 12/15/2000] [Accepted: 01/29/2001] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To assess cardiorespiratory exercise function in obese children with and without metabolic syndrome (MS). DESIGN Comparing three groups of subjects with different cardiovascular risk profiles. SUBJECTS Twenty-two MS (body weight (mean+/-s.d.) 97.3+/-15.3 kg; age (mean+/-s.d.) 14.2+/-1.9 y), 17 obese (82.6+/-15.7 kg; 14.2+/-2.6 y) and 29 normal weight control (64.3+/-8.5 kg; 15.3+/-1.0 y) boys. MEASUREMENTS Exercise duration (ED), resting heart rate (HR(0)), peak heart rate (HR(peak)), physical working capacity at 170 beat/min (PWC-170), peak oxygen consumption (VO(2peak)) and the lactic acidosis threshold (LAT) were determined on treadmill, using a continuous ramp protocol. RESULTS ED (MS (mean+/-s.d.); 655+/-86 s; obese 703+/-64 s; control 750+/-0 s) in absolute value and PWC-170 normalised for body weight (139+/-40 w; 177+/-40 w; 211+/-40 w) were significantly shorter and lower in the MS group, as compared to obese and control groups (P<0.05). VO(2peak) (2.2+/-0.4 l/min; 2.4+/-0.5 l/min; 2.9+/-0.4 l/min) and LAT (1.3+/-0.4 l/min; 1.5+/-0.4 l/ min; 1.8+/-0.4 l/min) normalised for body weight, were significantly shorter and lower in the MS group, as compared to control group (P<0.05). HR(0) was significantly higher (P<0.05) in MS group than in obese and control groups (88+/-12 bpm; obese 78+/-10 bpm; 73+/-10 bpm). CONCLUSION Cardiorespiratory exercise performance capacity in MS boys are reduced. It still remains to be elucidated whether the metabolic alterations or the decreased physical activity is responsible for the observed reduction in cardiorespiratory performance.
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Affiliation(s)
- K Török
- Department of Paediatrics, University of Pécs, Pécs, Hungary.
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Goran M, Fields DA, Hunter GR, Herd SL, Weinsier RL. Total body fat does not influence maximal aerobic capacity. Int J Obes (Lond) 2000; 24:841-8. [PMID: 10918530 DOI: 10.1038/sj.ijo.0801241] [Citation(s) in RCA: 223] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The objective of this study was to examine the influence of body weight and body composition on aspects of aerobic fitness. Our hypothesis was that increased body weight, specifically increased fat mass (FM), would not limit VO2max relative to fat-free mass (FFM), but would reduce maximal and sub-maximal VO2max relative to body weight. DESIGN We used data from two ongoing studies. In Study 1 a cross-sectional analysis of 129 children across a wide spectrum of body composition was performed. In Study 2 we examined data from 31 overweight women before and after weight loss. METHODS VO2max was measured using a treadmill test. Sub-maximal aerobic capacity was evaluated with respiratory exchange ratio (RER), heart-rate (HR), and oxygen uptake relative to VO2max at a given workload (%VO2max). Body composition was assessed using dual energy X-ray absorptiometry (DXA) (Study 1) and a four-compartment model (Study 2). RESULTS In Study 1, FFM was the strongest determinant of VO2max (r=0.87; P<0.0001). After adjusting for FFM, there was no significant influence of FM on VO2max. After separating children into lean and obese sub-groups, absolute VO2max was significantly higher in the obese (1.24+/-0.27 vs 1.56+/-0.40) and VO2max relative to body weight was significantly lower (44.2+/-3.2 vs 32.0+/-4.1 ml/(kg-min)), whereas there was no significant difference when expressed relative to FFM (57.9+/-5.8 vs 59.2+/-4.9 ml/(kgFFM-min)). Sub-maximal aerobic capacity was significantly lower in the obese children, as indicated by a higher HR and %VO2max; time to exhaustion was significantly lower in the obese children (15.3+/-2.9 vs 11.1+/-2.1 min). In Study 2, FFM was also the strongest determinant of VO2max before and after weight loss. The relationship between VO2max and FFM was identical before and after weight loss so that VO2max relative to FFM was identical before and after weight loss (43.8+/-4.9 vs 45.5+/-6.4 ml/(kgFFM-min)). However, sub-maximal aerobic capacity was lower in the obese state, as indicated by a significantly higher RER (0.85+/-0.06 vs 0.79+/-0.05), HR (124+/-14 vs 102+/-11 bpm), and %VO2max (44% vs 36%). CONCLUSION The major influence of body weight on VO2max is explained by FFM; FM does not have any effect on VO2max. Fatness and excess body weight do not necessarily imply a reduced ability to maximally consume oxygen, but excess fatness does have a detrimental effect on submaximal aerobic capacity. Thus, fatness and VO2max should be considered independent entities.
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Affiliation(s)
- M Goran
- Division of Physiology and Metabolism, Department of Nutrition Sciences, and The Clinical Nutrition Research Unit University of Alabama at Birmingham, Birmingham, Alabama, USA
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Maffeis C, Schena F, Zaffanello M, Zoccante L, Schutz Y, Pinelli L. Maximal aerobic power during running and cycling in obese and non-obese children. Acta Paediatr 1994; 83:113-6. [PMID: 8193460 DOI: 10.1111/j.1651-2227.1994.tb12965.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The maximal aerobic capacity while running and cycling was measured in 22 prepubertal children (mean age +/- SD 9.5 +/- 0.8 years): 14 obese (47.3 +/- 10 kg) and 8 non-obese (31.1 +/- 6.1 kg). Oxygen consumption (VO2) and carbon dioxide production were measured by an open circuit method. Steady state VO2 was determined at different levels of exercise up to the maximal power on the cycloergometer (92 W in obese and 77 W in non-obese subjects) and up to the maximal running speed on the treadmill at a 2% slope (8.3 km/h in obese and 9.0 km/h in lean children). Expressed in absolute values, the VO2max in obese children was significantly higher than in controls (1.55 +/- 0.29 l/min versus 1.23 +/- 0.22 l/min, p < 0.05) for the treadmill test and comparable in the two groups (1.4 +/- 0.2 l/min versus 1.16 +/- 0.2 l/min, ns) for the cycloergometer test. When VO2max was expressed per kg fat free mass, the difference between the two groups disappeared for both tests. These data suggest that obese children had no limitation of maximal aerobic power. Therefore, the magnitude of the workload prescribed when a physical activity program is intended for the therapy of childhood obesity, it should be designed to increase caloric output rather than to improve cardiorespiratory fitness.
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Affiliation(s)
- C Maffeis
- Department of Pediatrics, University of Verona, Italy
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Sakamoto S, Ishikawa K, Senda S, Nakajima S, Matsuo H. The effect of obesity on ventilatory response and anaerobic threshold during exercise. J Med Syst 1993; 17:227-31. [PMID: 8254269 DOI: 10.1007/bf00996950] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
To facilitate making the physical fitness programs for obesity control, we investigated the effects of obesity on the ventilatory response during exercise and exercise tolerance. One hundred eighteen adults were divided into a normal group and fatty group by percentage of body fat. Each subject performed a submaximal exercise test under the gas-exchange measurement. The fatty group was inferior to the normal group in exercise tolerance. The respiratory mode, during exercise, in the fatty group was characterized by higher respiratory rate and less tidal volume compared with the normal group. This mode may result in increased dead space and therefore unavailable ventilation capacity. These data suggest that the characteristic respiratory mode in the fatty group was a factor in the lower exercise tolerance.
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Affiliation(s)
- S Sakamoto
- 2nd Department of Internal Medicine, Kagawa Medical School
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Abstract
The frequency, degree, and pattern of bronchial reactivity to exercise were compared in 13 obese and 14 control children, ages 6 to 10 years, with no history of asthma. Spirometry was performed before and every three minutes after a seven-minute exercise challenge on a treadmill. There were 11 obese children and 6 controls who had at least a 15% fall in at least one of three monitored pulmonary function parameters (P < .05). The group mean percentage falls in FEV1 and FEF25%-75% were significantly greater in the obese group than in the controls. The pattern of bronchospasm, occurring soon after the exercise challenge, is consistent with that found in the known asthmatic population. A significant correlation was found between triceps skin-fold thickness and degree of fall in FEF25%-75% (r = .55, P < .005). This study demonstrated that significantly greater frequency and degree of bronchospasm of the smaller airways occur in obese children, partially related to the amount of subcutaneous fat. Whether exercise-induced bronchospasm leads to exercise avoidance and obesity or whether obesity causes or enhances bronchial hyperreactivity to exercise requires further study.
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Affiliation(s)
- T A Kaplan
- Department of Pediatrics, School of Medicine, University of Miami, Florida 33101
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Baraldi E, Monciotti C, Filippone M, Santuz P, Magagnin G, Zanconato S, Zacchello F. Gas exchange during exercise in diabetic children. Pediatr Pulmonol 1992; 13:155-60. [PMID: 1437329 DOI: 10.1002/ppul.1950130306] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The purpose of this study was to evaluate the cardiorespiratory and metabolic response to exercise in 33 children, aged 9 to 15 years, affected by type I diabetes mellitus, in comparison with 47 age-, sex-, weight-, and height-matched healthy children. All diabetic children were on a mixed split-dose insulin regimen, consisting of both regular and long-acting insulin in the morning and evening. The last insulin injection was administered on average 6 hours before the test. The mean duration of diabetes mellitus was 5.0 +/- 3.1 years. The metabolic control was evaluated on the basis of HbA1 levels (mean, 8.9 +/- 1.8%). Pulmonary function tests and progressive exercise tests on the treadmill were performed. Gas exchange, ventilation, and heart rate (HR) were monitored during the tests. The O2 pulse (VO2/HR) was calculated. There was no difference in the baseline oxygen uptake (VO2) between the diabetic children and the control group. VO2 peak was significantly lower (P less than 0.01) in the diabetic adolescents (41.2 +/- 5.9 mL/min/kg) compared to control subjects (46.3 +/- 9.6 mL/min/kg) and it was achieved at an earlier (P less than 0.01) time of run (7.5 +/- 1.8 vs. 9.1 +/- 2.8 min). Anaerobic threshold and minute ventilation were similar in the two groups. The O2 pulse throughout the test was significantly lower (ANOVA, P less than 0.001) in the diabetic group compared to the controls. No differences were found in resting and post-exercise spirometric values. In conclusion, our study shows that well-controlled diabetic adolescents have a reduced working capacity.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- E Baraldi
- Department of Pediatrics, University of Padova, Italy
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Baraldi E, Zanconato S, Zorzi C, Santuz P, Benini F, Zacchello F. Exercise performance in very low birth weight children at the age of 7-12 years. Eur J Pediatr 1991; 150:713-6. [PMID: 1915482 DOI: 10.1007/bf01958761] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Fifteen very low birth weight children, 9 appropriate for gestational age (AGA, mean birth weight 1302 +/- 164 g) and 6 small for gestational age children (SGA, mean birth weight 1263 +/- 117 g), were studied at the age of 7-12 years, and compared to a group of 26 healthy, age-, sex-, and height-matched children born at term. None of the VLBW children had developed chronic bronchopulmonary disease. Pulmonary function tests and progressive exercise tests on a treadmill were performed. Forced vital capacity, forced expiratory volume at 1 s and forced expiratory flow between 25% and 75% of vital capacity were normal for all subjects. No differences were found in maximum oxygen consumption, anaerobic threshold and maximal heart rate between the AGA and SGA children and the respective controls. Both in the AGA and SGA subgroups, the pre-exercise oxygen uptake results were comparable to those of the controls. In the SGA subgroup the energy cost of running was significantly higher with respect to the controls, while no difference was found between the AGA and the control children. In conclusion, children with birth weight less than 1501 g have normal values of aerobic fitness. In SGA children the efficiency of running is slightly reduced.
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Affiliation(s)
- E Baraldi
- Department of Paediatrics, University of Padua, Italy
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Bonzel KE, Wildi B, Weiss M, Schärer K. Spiroergometric performance of children and adolescents with chronic renal failure. Pediatr Nephrol 1991; 5:22-8. [PMID: 2025532 DOI: 10.1007/bf00852834] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Maximal physical performance (Wmax), maximal oxygen consumption (VO2max), maximal carbon dioxide production (VCO2max) and blood lactate (L) levels were measured in 34 paediatric patients with chronic renal failure (CRF) and 25 controls by spiroergometric testing on a bicycle ergometer. No patient was treated with erythropoietin. The workload was increased step-wise by 0.5 W/3 min up to a Wmax determined from the attainment of VO2max. In patients on conservative treatment (CT), on haemodialysis (HD) and after transplantation (TP) median Wmax per kilogram body weight was reduced to 76%, 73% and 73% of controls (C), respectively. In CT and HD patients VO2max and VCO2max were decreased to an even higher extent. The ventilatory anaerobic threshold, calculated from the levelling off of the respiratory equivalent (VE/VO2) during increasing workload, was only slightly higher in patients than in C when related to Wmax (NS). The physiological rise in L during exercise was blunted in CRF; 72% of patients on CT or HD did not exceed the expected threshold L level of 4 mmol/l; after TP the L changes normalized. The findings indicate that most children and adolescents with CRF are able to attain maximal physical performance but both the aerobic and the anaerobic capacity are often reduced. Preliminary findings indicate that treatment of renal anaemia with erythropoietin is able to considerably improve Wmax and VO2max in paediatric HD patients.
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Affiliation(s)
- K E Bonzel
- Department of Paediatrics, University of Heidelberg, Federal Republic of Germany
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Baraldi E, Montini G, Zanconato S, Zacchello G, Zacchello F. Exercise tolerance after anaemia correction with recombinant human erythropoietin in end-stage renal disease. Pediatr Nephrol 1990; 4:623-6. [PMID: 2128459 DOI: 10.1007/bf00858638] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The aim of this study was to evaluate the effect of correction of chronic anaemia on the physical performance and the cardiovascular response to effort in children with end-stage renal disease (ESRD) maintained by haemodialysis. Seven patients (mean age 13.9 years) underwent triangular-type treadmill exercise testing before [haemoglobin (Hb) 6.3 +/- 0.9 g/dl] and after (Hb 11.2 +/- 1.2 g/dl) anaemia correction with recombinant human erythropoietin (rHuEPO). After treatment, the work-load reached, the peak oxygen uptake and average ventilatory anaerobic threshold (VAT) values were significantly increased (P less than 0.01, P less than 0.001, P less than 0.05 respectively). VAT values, expressed as a percentage of normal values, increased from 55.7 +/- 16.6% to 82.4 +/- 21%. This improvement correlated well with the increase in Hb (r = 0.79). Oxygen pulse also increased significantly, when tested after anaemia correction. In conclusion, these data demonstrate that when the anaemia of children with ESRD is corrected with rHuEPO, there is a clear improvement in aerobic work capacity and effort tolerance.
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Affiliation(s)
- E Baraldi
- Department of Paediatrics, University of Padua, Italy
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Abstract
Treadmill stress testing was carried out according to the Bruce protocol on 14 non-hyperinsulinaemic and 11 hyperinsulinaemic obese children and on 43 age-matched controls. The obese groups were matched for body weight, body composition, physical activity and plasma lipid values. Body composition was calculated on the basis of four skinfold measurements. Exercise duration and physical working capacity corrected for body weight and lean body mass were decreased in the obese children (P less than 0.01). The hyperinsulinaemic obese children had lower physical working capacities (in absolute values and when corrected for body weight and lean body mass) than the non-hyperinsulinaemic obese children (P less than 0.05). The exercise period was not significantly different in the two obese subgroups. While fasting plasma insulin levels showed a significant negative correlation with exercise duration and relative physical working capacity in the obese children, the anthropometric parameters did not. It is suggested that the decreased physical fitness in obese children is further aggravated in those with hyperinsulinaemia.
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Affiliation(s)
- D Molnàr
- Department of Paediatrics, University Medical School of Pécs, Hungary
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