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Saidj S, Ruchat SM, Henderson M, Tremblay A, Mathieu ME. Physiological response during exercise is preserved in children exposed to a suboptimal gestational environment. Obesity (Silver Spring) 2024; 32:1551-1557. [PMID: 39045675 DOI: 10.1002/oby.24049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 04/05/2024] [Accepted: 04/06/2024] [Indexed: 07/25/2024]
Abstract
OBJECTIVE This study investigated whether exposure to suboptimal gestational factors (SGFs) alters mechanical efficiency (ME) and substrate oxidation during rest and exercise in children as a mechanism contributing to obesity. METHODS Data from the Quebec Adiposity and Lifestyle Investigation in Youth cohort were used. Children aged 8 to 10 years performed an incremental maximal cycling test with indirect calorimetry. Their ME was measured during submaximal and maximal effort. The substrate oxidation during rest and submaximal effort was also computed. ME and substrate oxidation results between children exposed to each SGF during pregnancy (gestational diabetes mellitus: n = 68; hypertensive disorders: n = 49; maternal smoking: n = 77) and nonexposed children (n = 370) were compared. RESULTS No difference was observed for ME during submaximal (F[3,540] = 0.46, p = 0.713) and maximal effort (F[3,545] = 0.86, p = 0.463) between exposed and nonexposed children. The percentage contributions of lipids and carbohydrates did not differ during rest (F[3,545] =1.68, p = 0.169) or submaximal exercise (F[3,544] = 0.31, p = 0.534) between exposed and nonexposed children. CONCLUSIONS Children exposed to investigated SGFs display a similar physiological response regarding ME and substrate oxidation during rest and exercise compared to nonexposed children. Future studies should confirm these novel results and continue investigating other research avenues to explain the higher risk of obesity in this population.
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Affiliation(s)
- Soraya Saidj
- School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Stephanie-May Ruchat
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
| | - Mélanie Henderson
- Azrieli Research Center, Sainte-Justine University Hospital Center, Montréal, Québec, Canada
- Department of Pediatrics, Faculty of Medicine, Université de Montréal, Montreal, Québec, Canada
- School of Public Health, Université de Montréal, Montreal, Québec, Canada
| | - Angelo Tremblay
- Department of Kinesiology, Faculty of Medicine, Université de Laval, Québec City, Québec, Canada
| | - Marie-Eve Mathieu
- School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
- Azrieli Research Center, Sainte-Justine University Hospital Center, Montréal, Québec, Canada
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Martínez-Zamora MD, Martín-Martínez C, Martínez-de-Quel Ó, Valenzuela PL. Influence of Preterm Birth and Low Birthweight on Physical Fitness: A Systematic Review, Meta-Analysis, and Meta-Regression. Sports Med 2024; 54:1907-1919. [PMID: 38709451 PMCID: PMC11258071 DOI: 10.1007/s40279-024-02026-z] [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] [Accepted: 03/25/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND Preterm birth and low birthweight (LBW) might be associated with reduced physical fitness, although evidence remains inconclusive. OBJECTIVE To examine the influence of preterm birth and LBW on physical fitness, as well as to assess whether variables such as gestational age, birthweight, or age at assessment moderate these effects. METHODS PubMed, Scopus, and PsycINFO were systematically searched from inception to 7 December 2023 for case-control and cohort studies analyzing the association between preterm birth or LBW (or gestational age or birthweight as continuous variables) with at least one physical fitness-related outcome (i.e., cardiorespiratory fitness (CRF), muscle strength, flexibility, speed, agility). Random-effects meta-analysis and meta-regression models were used to estimate the pooled effect size, as well as to examine potential associations between the magnitude of the effect and gestational age, birthweight, or age at assessment. RESULTS Fifty-two studies (n = 920,603 participants, average age ranging from 4.7 to 34.4 years) were included. Preterm birth was associated with reduced CRF (standardized mean difference (SMD) = -0.38, 95% confidence interval (CI) = -0.51 to -0.25) and muscle strength (SMD = -0.44, 95% CI = -0.79 to -0.08). LBW was associated with reduced CRF (SMD = -0.40, 95% CI = -0.64 to -0.17), muscle strength (SMD = -0.18, 95% CI = -0.24 to -0.13), flexibility (SMD = -0.11, 95% CI = -0.22 to -0.01), and agility (SMD = -0.99, 95% CI = -1.91 to -0.07). Meta-regression analyses showed that a lower gestational age or birthweight were associated with larger reductions in physical fitness, whereas no consistent association was found for the age at assessment. CONCLUSION Both preterm birth and LBW seem associated with reduced physical fitness regardless of age, with larger reductions overall observed in individuals with lower gestational age or birthweight. These findings might support the implementation of preventive strategies (e.g., fitness monitoring and physical exercise interventions) in these populations through the life course. PROSPERO registration: CRD42021231845.
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Affiliation(s)
| | | | - Óscar Martínez-de-Quel
- Faculty of Education, Complutense University of Madrid, Madrid, Spain.
- Faculty of Sciences for Physical Activity and Sport (INEF), Polytechnic University of Madrid, C/Martín Fierro, 7, 28040, Madrid, Spain.
| | - Pedro L Valenzuela
- Department of Systems Biology, University of Alcalá, Madrid, Spain.
- Physical Activity and Health Research Group (PaHerg), Instituto de Investigación Hospital 12 de Octubre ('imas12'), Centro de Actividades Ambulatorias, 7ª Planta, Bloque D, Av. de Córdoba s/n, 28041, Madrid, Spain.
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Tamai K, Nishihara M, Hirata K, Shiraishi J, Hirano S, Fujimura M, Yano S, Kanazawa T, Kitajima H. Physical fitness of non-disabled school-aged children born with extremely low birth weights. Early Hum Dev 2019; 128:6-11. [PMID: 30392918 DOI: 10.1016/j.earlhumdev.2018.10.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 10/06/2018] [Accepted: 10/20/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND The assessment of long-term outcomes in survivors born with extremely low birth weights (ELBWs) has become increasingly important. However, little has been reported on the physical fitness of non-disabled school-aged children born with ELBWs. AIMS To assess the physical fitness of non-disabled school-aged children born with ELBWs. STUDY DESIGN Retrospective cohort study. SUBJECTS We analyzed 169 ELBW infants without cerebral palsy or intellectual disability (based on the Wechsler Intelligence Scale for Children-Third Edition (WISC-III) Full Scale intelligence quotient (IQ) test < 70). OUTCOME MEASURES Physical fitness was assessed using the grip strength, sit-up repetitions, sit & reach, side steps, standing long jump, and softball throw tests. T-scores were calculated using national survey data. RESULTS The T-scores for the grip strength, sit-up repetitions, sit & reach, side steps, standing long jump, softball throw tests, and the overall T-score were 43.7 ± 7.5, 44.2 ± 10.5, 46.0 ± 9.7, 40.9 ± 8.0, 40.0 ± 9.8, 42.4 ± 8.1, and 42.9 ± 5.5, respectively. After adjusting for other age-related factors, the height (SD score), WISC-III Performance IQ score, and percent predicted forced vital capacity (FVC) independently predicted the overall T-scores. Their standardized partial regression coefficients (β) were 0.334 (p = 0.009), 0.190 (p = 0.022), and 0.187 (p = 0.032), respectively. CONCLUSIONS Our cohort's physical fitness at approximately 8 years of age was significantly impaired compared to average Japanese children of the same age. Height, FVC, and Performance IQ independently predicted physical fitness, with height being the strongest predictor.
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Affiliation(s)
- Kei Tamai
- Department of Neonatal Medicine, Osaka Women's and Children's Hospital, 840 Murodo-cho, Izumi, Osaka 594-1101, Japan; Department of Neonatology, Okayama Medical Center, National Hospital Organization, 1711-1 Tamasu, Kita-ku, Okayama, Okayama 701-1192, Japan.
| | - Masahiro Nishihara
- Department of Neonatal Medicine, Osaka Women's and Children's Hospital, 840 Murodo-cho, Izumi, Osaka 594-1101, Japan
| | - Katsuya Hirata
- Department of Neonatal Medicine, Osaka Women's and Children's Hospital, 840 Murodo-cho, Izumi, Osaka 594-1101, Japan
| | - Jun Shiraishi
- Department of Neonatal Medicine, Osaka Women's and Children's Hospital, 840 Murodo-cho, Izumi, Osaka 594-1101, Japan.
| | - Shinya Hirano
- Department of Neonatal Medicine, Osaka Women's and Children's Hospital, 840 Murodo-cho, Izumi, Osaka 594-1101, Japan.
| | - Masanori Fujimura
- Department of Neonatal Medicine, Osaka Women's and Children's Hospital, 840 Murodo-cho, Izumi, Osaka 594-1101, Japan.
| | - Suguru Yano
- Department of Education, Faculty of Health and Physical Education, Wakayama University, 930 Sakaedani, Wakayama, Wakayama 640-8510, Japan.
| | - Tadahiro Kanazawa
- Department of Comparative and Developmental Psychology, Faculty of Human Sciences, Osaka University, 1-1 Yamadaoka, Suita, Osaka 565-0871, Japan.
| | - Hiroyuki Kitajima
- Department of Neonatal Medicine, Osaka Women's and Children's Hospital, 840 Murodo-cho, Izumi, Osaka 594-1101, Japan.
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Is willingness to exercise programmed in utero? Reviewing sedentary behavior and the benefits of physical activity in intrauterine growth restricted individuals. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2018. [DOI: 10.1016/j.jpedp.2018.03.016] [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] Open
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Bischoff AR, Cunha FDS, Dalle Molle R, Maróstica PJC, Silveira PP. Is willingness to exercise programmed in utero? Reviewing sedentary behavior and the benefits of physical activity in intrauterine growth restricted individuals. J Pediatr (Rio J) 2018; 94:582-595. [PMID: 29476706 DOI: 10.1016/j.jped.2017.12.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 12/06/2017] [Accepted: 12/15/2017] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE The literature suggests that a fetus will adapt to surrounding adversities by optimizing its use of energy to improve survival, ultimately leading to the programming of the individual's energy intake and expenditure. While recent reviews focused on the fetal programming of energy intake and food preferences, there is also some evidence that fetal adversity is associated with diminished physical activity levels. Therefore, we aimed to review (a) the evidence for an association between being born with intrauterine growth restriction and sedentarism over the life-course and (b) the potential benefits of physical activity over cardiometabolic risk factors for this population. SOURCES PubMed, Scielo, Scopus and Embase. SUMMARY OF FINDINGS Most clinical studies that used objective measures found no association between intrauterine growth restriction and physical activity levels, while most studies that used self-reported questionnaires revealed such relationships, particularly leisure time physical activity. Experimental studies support the existence of fetal programming of physical activity, and show that exposure to exercise during IUGR individuals' life improves metabolic outcomes but less effect was seen on muscle architecture or function. CONCLUSIONS Alterations in muscle strength and metabolism, as well as altered aerobic performance, may predispose IUGR individuals to be spontaneously less physically active, suggesting that this population may be an important target for preventive interventions. Although very heterogeneous, the different studies allow us to infer that physical activity may have beneficial effects especially for individuals that are more vulnerable to metabolic modifications such as those with IUGR.
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Affiliation(s)
- Adrianne Rahde Bischoff
- University of Toronto, Department of Pediatrics, Division of Neonatology, Toronto, Canada; Hospital for Sick Children, Toronto, Canada.
| | - Fábio da Silva Cunha
- Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Pediatria, Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Porto Alegre, RS, Brazil
| | - Roberta Dalle Molle
- Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Pediatria, Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Porto Alegre, RS, Brazil
| | - Paulo José Cauduro Maróstica
- Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Pediatria, Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Porto Alegre, RS, Brazil
| | - Patrícia Pelufo Silveira
- Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Pediatria, Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Porto Alegre, RS, Brazil; McGill University, Douglas Mental Health University Institute, Ludmer Centre for Neuroinformatics and Mental Health, Montreal, Canada
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Edwards MO, Kotecha SJ, Lowe J, Watkins WJ, Henderson AJ, Kotecha S. Effect of preterm birth on exercise capacity: A systematic review and meta-analysis. Pediatr Pulmonol 2015; 50:293-301. [PMID: 29889363 DOI: 10.1002/ppul.23117] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Accepted: 09/10/2014] [Indexed: 12/12/2022]
Abstract
BACKGROUND Survivors of preterm-birth have increased prevalence of respiratory, cardiovascular, and neurological diseases in later life however, the overall impact of prematurity on cardiorespiratory exercise capacity is unclear. OBJECTIVE We, therefore, systematically reviewed the literature on cardiorespiratory exercise capacity in survivors of preterm birth. METHODOLOGY Relevant studies up to March 2013 were searched using eight electronic health databases. Studies reporting exercise capacity in participants born preterm (<37 weeks) were included. The main outcome of interest was oxygen uptake (V˙O2max) at maximal exercise. Data were categorized into four groups: (i) preterm-born subjects including those with or without bronchopulmonary dysplasia (BPD) but excluding study groups biased towards BPD; (ii) preterm-born subjects (BPD excluded); (iii) preterm-born subjects who had BPD28 (defined as oxygen dependency at 28 days of life) in infancy; (iv) preterm born subjects with BPD36 (oxygen dependency at 36 weeks post menstrual age) in infancy. RESULTS From 9,341 abstracts, 22 included publications reported V˙O2max in ml/kg/min from 685 preterm and 680 term-born subjects. Overall 20 studies reported results for preterm-born subjects including BPD; 14 studies for the preterm group excluding BPD; 10 studies for the BPD28 group; and 8 studies for BPD36 group. The mean differences (95% CI) for the four groups were -2.20 (-3.70, -0.70) ml/kg/min; -2.26 (-4.44, -0.07 ml/kg/min; -3.04 (-5.48, -0.61) ml/kg/min, and -3.05 (-5.93, -0.18) ml/kg/min, respectively. CONCLUSION Despite marked deficits in spirometry, preterm-born children have a marginally decreased V˙O2max, which is unlikely to be of great clinical significance. Pediatr Pulmonol. 2015; 50:293-301. © 2014 Wiley Periodicals, Inc.
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Affiliation(s)
- Martin O Edwards
- Department of Child Health, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Sarah J Kotecha
- Department of Child Health, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - John Lowe
- Department of Child Health, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - W John Watkins
- Department of Child Health, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - A John Henderson
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Sailesh Kotecha
- Department of Child Health, School of Medicine, Cardiff University, Cardiff, United Kingdom
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Exercise Capacity after Extremely Preterm Birth. Development from Adolescence to Adulthood. Ann Am Thorac Soc 2014; 11:537-45. [DOI: 10.1513/annalsats.201309-311oc] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Svedenkrans J, Henckel E, Kowalski J, Norman M, Bohlin K. Long-term impact of preterm birth on exercise capacity in healthy young men: a national population-based cohort study. PLoS One 2013; 8:e80869. [PMID: 24324639 PMCID: PMC3855651 DOI: 10.1371/journal.pone.0080869] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Accepted: 10/09/2013] [Indexed: 11/18/2022] Open
Abstract
Background Increasing numbers of survivors of preterm birth are growing into adulthood today. Long-term health-effects of prematurity are still poorly understood, but include increased risk for diabetes, obesity and cardiovascular diseases in adult life. To test if reduced physical fitness may be a link in the causal chain of preterm birth and diseases in later life, the association of preterm birth and adult exercise capacity was investigated. The hypothesis was that preterm birth contributes independently of other risk factors to lower physical fitness in adulthood. Methods and Findings Population-based national cohort study of all males conscripting for military service in 1993–2001 and born in Sweden 1973–1983, n = 218,820. Data were retrieved from the Swedish Conscript Register, the Medical Birth Register and the Population and Housing Census 1990. Primary outcome was the results from maximal exercise test (Wmax in Watt) performed at conscription. Association to perinatal and socioeconomic risk factors, other co-variates and confounders were analysed. General linear modelling showed that preterm birth predicted low Wmax in a dose-response related pattern, with 25 Watt reduction in Wmax for the lowest gestational ages, those born ≤27 weeks. Low birth weight for gestational age also independently predicted low Wmax compared to normal and high birth weight (32 Watt reduction for those with a birth weight Standard Deviation Score <2). Low parental education was significantly associated with reduced Wmax (range 17 Watt), as well as both low and high current BMI, with severe obesity resulting in a 16 Watt deficit compared to Wmax top performance. Conclusion Being born preterm as well as being born small for gestational age predicts low exercise capacity in otherwise healthy young men. The effect size of being born preterm equal or exceed that of other known risk factors for unfitness in adults, such as low parental education and overweight.
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Affiliation(s)
- Jenny Svedenkrans
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Neonatology, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Ewa Henckel
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Neonatology, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Jan Kowalski
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Mikael Norman
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Neonatology, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Kajsa Bohlin
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Neonatology, Karolinska University Hospital Huddinge, Stockholm, Sweden
- * E-mail:
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Siebel AL, Carey AL, Kingwell BA. Can exercise training rescue the adverse cardiometabolic effects of low birth weight and prematurity? Clin Exp Pharmacol Physiol 2013; 39:944-57. [PMID: 22882133 DOI: 10.1111/j.1440-1681.2012.05732.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Being born preterm and/or small for gestational age are well-established risk factors for cardiometabolic disease in adulthood. Physical activity has the potential to mitigate against the detrimental cardiometabolic effects of low birth weight from two perspectives: (i) maternal exercise prior to and during pregnancy; and (ii) exercise during childhood or adulthood for those born small or prematurely. Evidence from epidemiological birth cohort studies suggests that the effects of moderate-intensity physical activity during pregnancy on mean birth weight are small, but reduce the risk of either high or low birth weight infants. In contrast, vigorous and/or high-intensity exercise during pregnancy has been associated with reduced birth weight. In childhood and adolescence, exercise ability is compromised in extremely low birth weight individuals (< 1000 g), but only marginally reduced in those of very low to low birth weight (1000-2500 g). Epidemiological studies show that the association between birth weight and metabolic disease is lost in physically fit individuals and, consistently, that the association between low birth weight and metabolic syndrome is accentuated in unfit individuals. Physical activity intervention studies indicate that most cardiometabolic risk factors respond to exercise in a protective manner, independent of birth weight. The mechanisms by which exercise may protect low birth weight individuals include restoration of muscle mass, reduced adiposity and enhanced β-cell mass and function, as well as effects on both aerobic and anaerobic muscle metabolism, including substrate utilization and mitochondrial function. Vascular and cardiac adaptations are also likely important, but are less well studied.
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Affiliation(s)
- Andrew L Siebel
- Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
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Tybur JM, Bryan AD, Hooper AEC. An Evolutionary Perspective on Health Psychology: New Approaches and Applications. EVOLUTIONARY PSYCHOLOGY 2012. [DOI: 10.1177/147470491201000508] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Although health psychologists' efforts to understand and promote health are most effective when guided by theory, health psychology has not taken full advantage of theoretical insights provided by evolutionary psychology. Here, we argue that evolutionary perspectives can fruitfully inform strategies for addressing some of the challenges facing health psychologists. Evolutionary psychology's emphasis on modular, functionally specialized psychological systems can inform approaches to understanding the myriad behaviors grouped under the umbrella of “health,” as can theoretical perspectives used by evolutionary anthropologists, biologists, and psychologists (e.g., Life History Theory). We detail some early investigations into evolutionary health psychology, and we provide suggestions for directions for future research.
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Affiliation(s)
- Joshua M. Tybur
- Department of Social and Organizational Psychology, VU University Amsterdam, Amsterdam, the Netherlands
| | - Angela D. Bryan
- Department of Psychology and Neuroscience, University of Colorado, Boulder, Colorado, USA
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Response to an aerobic training intervention in young adults depends on ponderal index at birth. J Dev Orig Health Dis 2012; 3:424-32. [PMID: 25084295 DOI: 10.1017/s2040174412000177] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Poor fetal growth is associated with later-life changes in adult body composition and decrements in muscle strength and morphology. Few studies have investigated the association of poor fetal growth with whole-body exercise. The purpose of this study was to investigate the association of poor fetal growth with the maximal oxygen consumption (VO(2)max), lactate levels during exercise and the response to aerobic training. Thirty-six college-aged men and women (aged 20.8 ± 0.3 years), born to term (37-42 weeks gestation), were recruited to participate in an 8-week training program. Participants comprised two groups, high ponderal index (HIGHPI) and low ponderal index (LOWPI) (n = 18/group), identified as falling above and below the 10th percentile of the ponderal index (g/cm(3))-for-gestational age distribution, respectively. The HIGHPI and LOWPI were matched pair-wise on age, sex, body mass index and pre-study physical activity patterns. The LOWPI and HIGHPI did not differ significantly before training, after training or with a change (Δ) in training VO(2)max (l/min or ml/min kg/fat-free mass (FFM)). However, LOWPI had significantly lower pre-training lactate levels at similar levels of relative work output (P = 0.016), and significantly smaller decreases in lactate at a fixed level of absolute work after training (P = 0.044). These differences were independent of pre-training aerobic fitness, the change in fitness with training, diet and fuel substrate choice. The lower lactate of untrained LOWPI subjects during exercise could reflect metabolic reprograming due to intrauterine growth restriction, or could be secondary to muscle morphological and/or fiber-type distribution changes that also associate with poor fetal growth.
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Moura-Dos-Santos M, Wellington-Barros J, Brito-Almeida M, Manhães-de-Castro R, Maia J, Góis Leandro C. Permanent deficits in handgrip strength and running speed performance in low birth weight children. Am J Hum Biol 2012; 25:58-62. [DOI: 10.1002/ajhb.22341] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Revised: 10/04/2012] [Accepted: 10/10/2012] [Indexed: 11/10/2022] Open
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Narang I. Review Series: What goes around, comes around: childhood influences on later lung health?: Long-term follow-up of infants with lung disease of prematurity. Chron Respir Dis 2010; 7:259-69. [DOI: 10.1177/1479972310375454] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The incidence of live preterm birth is increasing and concomitantly the survival of preterm babies has increased over the last 30 years due to advances in neonatal care. Bronchopulmonary dysplasia (BPD) is a chronic respiratory disease that develops as a consequence of perinatal and/or neonatal lung injury following preterm birth and the pathology has also changed with changes in neonatal care. There are data suggesting that there is increased respiratory morbidity of ex-preterm subjects in childhood. It is only now that large populations of preterm subjects are reaching adulthood and may be at risk of persistent respiratory morbidity. This review will summarize the current knowledge in adulthood of respiratory sequelae following preterm birth; specifically it will review respiratory symptoms, pulmonary function, exercise capacity and structural lung disease as determined by high resolution computed tomography scans in ex-preterm survivors with and without BPD. Whether prematurity-related lung disease is associated with chronic obstructive airways disease will be discussed.
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Affiliation(s)
- Indra Narang
- Division of Respiratory Medicine, Hospital for Sick Children, Toronto, Ontario, Canada,
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Andersen LG, Ängquist L, Gamborg M, Byberg L, Bengtsson C, Canoy D, Eriksson JG, Eriksson M, Järvelin MR, Lissner L, Nilsen TI, Osler M, Overvad K, Rasmussen F, Salonen MK, Schack-Nielsen L, Tammelin TH, Tuomainen TP, Sørensen TIA, Baker JL. Birth weight in relation to leisure time physical activity in adolescence and adulthood: meta-analysis of results from 13 nordic cohorts. PLoS One 2009; 4:e8192. [PMID: 20016780 PMCID: PMC2790716 DOI: 10.1371/journal.pone.0008192] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2009] [Accepted: 11/02/2009] [Indexed: 11/19/2022] Open
Abstract
Background Prenatal life exposures, potentially manifested as altered birth size, may influence the later risk of major chronic diseases through direct biologic effects on disease processes, but also by modifying adult behaviors such as physical activity that may influence later disease risk. Methods/Principal Findings We investigated the association between birth weight and leisure time physical activity (LTPA) in 43,482 adolescents and adults from 13 Nordic cohorts. Random effects meta-analyses were performed on categorical estimates from cohort-, age-, sex- and birth weight specific analyses. Birth weight showed a reverse U-shaped association with later LTPA; within the range of normal weight the association was negligible but weights below and above this range were associated with a lower probability of undertaking LTPA. Compared with the reference category (3.26–3.75 kg), the birth weight categories of 1.26–1.75, 1.76–2.25, 2.26–2.75, and 4.76–5.25 kg, had odds ratios of 0.67 (95% confidence interval: 0.47, 0.94), 0.72 (0.59, 0.88), 0.89 (0.79, 0.99), and 0.65 (0.50, 0.86), respectively. The shape and strength of the birth weight-LTPA association was virtually independent of sex, age, gestational age, educational level, concurrent body mass index, and smoking. Conclusions/Significance The association between birth weight and undertaking LTPA is very weak within the normal birth weight range, but both low and high birth weights are associated with a lower probability of undertaking LTPA, which hence may be a mediator between prenatal influences and later disease risk.
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Affiliation(s)
- Lise Geisler Andersen
- Institute of Preventive Medicine, Center for Health and Society, Copenhagen University Hospital, Copenhagen, Denmark
| | - Lars Ängquist
- Institute of Preventive Medicine, Center for Health and Society, Copenhagen University Hospital, Copenhagen, Denmark
| | - Michael Gamborg
- Institute of Preventive Medicine, Center for Health and Society, Copenhagen University Hospital, Copenhagen, Denmark
| | - Liisa Byberg
- Department of Surgical Sciences, Orthopaedics, Uppsala University, Uppsala, Sweden
- Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
| | - Calle Bengtsson
- Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Dexter Canoy
- The Northwest Institute for Bio-Health Informatics, School of Community-Based Medicine, The University of Manchester, Manchester, United Kingdom
- Institute of Health Sciences and Biocenter Oulu, University of Oulu, Oulu, Finland
| | - Johan G. Eriksson
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- National Institute of Health and Welfare, Helsinki, Finland
- Helsinki University Central Hospital, Helsinki, Finland
- Vasa Central Hospital, Vasa, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Marit Eriksson
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Marjo-Riitta Järvelin
- Institute of Health Sciences and Biocenter Oulu, University of Oulu, Oulu, Finland
- Department of Epidemiology and Public Health, Imperial College London, London, United Kingdom
- Department of Child and Adolescent Health, National Institute of Health and Welfare, Helsinki, Finland
| | - Lauren Lissner
- Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Tom I. Nilsen
- Human Movement Science Programme, Norwegian University of Science and Technology, Trondheim, Norway
| | - Merete Osler
- Research Centre for Prevention and Health, Glostrup University Hospital, Glostrup, Denmark
- Institute of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Kim Overvad
- Department of Cardiology and Department of Clinical Epidemiology, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark
| | - Finn Rasmussen
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Minna K. Salonen
- Diabetes Prevention Unit, Department of Health Promotion and Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland
| | - Lene Schack-Nielsen
- Institute of Preventive Medicine, Center for Health and Society, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Human Nutrition, Faculty of Life Science, University of Copenhagen, Frederiksberg, Denmark
| | - Tuija H. Tammelin
- Finnish Institute of Occupational Health, Oulu, Finland
- LIKES - Research Center for Sport and Health Sciences, Jyväskylä, Finland
| | | | - Thorkild I. A. Sørensen
- Institute of Preventive Medicine, Center for Health and Society, Copenhagen University Hospital, Copenhagen, Denmark
| | - Jennifer L. Baker
- Institute of Preventive Medicine, Center for Health and Society, Copenhagen University Hospital, Copenhagen, Denmark
- * E-mail:
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15
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Narang I, Baraldi E, Silverman M, Bush A. Airway function measurements and the long-term follow-up of survivors of preterm birth with and without chronic lung disease. Pediatr Pulmonol 2006; 41:497-508. [PMID: 16617446 DOI: 10.1002/ppul.20385] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This seventh paper in a review series on different aspects of chronic lung disease following preterm birth focuses on the current knowledge of respiratory symptoms, airway function, airway hyperresponsiveness, and exercise capacity from childhood to adulthood. This paper further considers the long-term implications of these studies for both future research and clinical practice.
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Affiliation(s)
- Indra Narang
- Department of Paediatric Respiratory Medicine, Royal Brompton Hospital, London, UK
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16
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Vrijlandt EJLE, Gerritsen J, Boezen HM, Grevink RG, Duiverman EJ. Lung function and exercise capacity in young adults born prematurely. Am J Respir Crit Care Med 2006; 173:890-6. [PMID: 16456146 DOI: 10.1164/rccm.200507-1140oc] [Citation(s) in RCA: 193] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Limited information is available about the long-term outcome of lung function and exercise capacity in young adults born prematurely. OBJECTIVE To determine long-term effects of prematurity on lung function (volumes, diffusing capacity) and exercise capacity in ex-preterms compared with healthy peers. METHODS In a prospective cohort study, children born with a gestational age of less than 32 wk and/or a birth weight under 1,500 g were followed up for 19 yr. Participants (n=42; mean gestational age, 30 wk, and mean birth weight, 1,246 g) and healthy term control subjects (n=48) were recruited for lung function and exercise tests. MEASUREMENTS Spirometry, bodybox (TLC(box)), diffusing capacity (Dl(CO)), bicycle ergometer test. MAIN RESULTS Preterm birth was associated with lower FEV(1) (preterms, 95% predicted, vs. controls, 110% predicted; p<0.001), DL(CO)sb (88% predicted vs. 96% predicted, p=0.003), and exercise capacity (load, 185 vs. 216 W; p<0.001; anaerobic threshold: mean, 1,546 vs. 1,839 ml/min; p<0.001) compared with control subjects at follow-up. No differences between the groups were found in TLC(box), peak oxygen consumption (Vo(2)), and breathing reserve. No significant differences in lung function and exercise parameters were found between preterms with and without bronchopulmonary dysplasia. CONCLUSIONS Long-term effects of prematurity were airway obstruction and a lower CO diffusing capacity compared with control subjects, although mean lung function parameters were within the normal range. Ex-preterms had a lower exercise level, which could not be explained by impaired lung function or smoking habits, but might be due to impaired physical fitness.
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Affiliation(s)
- Elianne J L E Vrijlandt
- Department of Pediatric Pulmonology, Beatrix Children's Hospital Groningen, The Netherlands.
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17
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Hebestreit H, Schrank W, Schrod L, Strassburg HM, Kriemler S. Head size and motor performance in children born prematurely. Med Sci Sports Exerc 2003; 35:914-22. [PMID: 12783038 DOI: 10.1249/01.mss.0000069511.15027.06] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE The objective of this study was to determine the relationship between head circumference (HC) and motor performance in 6- to 12-yr-old children born prematurely (PRE: birthweight < or = 1500 g, gestational age < or = 32 wk) and in children born at term (CON). METHODS Thirty-three PRE and 21 CON without an apparent neurological deficit participated in this study. HC was measured on the day of testing and was rated as small HC (SHC, HC more than 1 SD below the 50th percentile of reference data) or as normal HC (NHC). Subjects were examined by an experienced neuropediatrician, and whole-body coordination was assessed by the Körper-Koordinationstest für Kinder (KTK). Peak exercise performance was determined by a Wingate test and an incremental cycling test to volitional fatigue. Net oxygen cost of cycling was measured during four different tasks lasting 5-7 min each. Subjects pedaled at an intensity corresponding to 30% and 60% of peak oxygen uptake ([OV0312]O(2peak)) at a cadence of 36 and 76 rpm, respectively. RESULTS Prematures with SHC showed no statistically significant difference in their neurological examination and whole-body coordination compared with prematures with NHC. Wingate test performance and [OV0312]O(2peak) relative to body mass were similar among SHC, NHC, and CON. In SHC, but not in NHC and CON, net oxygen cost of cycling increased significantly (P < 0.05) when cadence was increased from 36 to 76 rpm. CONCLUSION At the age of 6-12 yr, SHC have a higher oxygen cost of cycling in exercise tasks requiring high velocity, which might be explained-at least in part-by an impaired neural control of intra- and intermuscular coordination.
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18
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Abstract
PURPOSE The purpose of this study was to investigate health-related fitness and physical activity levels of seven-to 10-year-old children with histories of preterm birth. METHODS Twenty-two children, aged seven to 10 years, that were born five to 10 weeks preterm were recruited into the study and matched based on age, gender, race, and body mass index to control group subjects who were born full term. Components of health-related fitness, body composition, flexibility, muscular strength and endurance, cardiorespiratory endurance, and physical activity levels were examined. RESULTS No differences were found between the groups in total skinfold measures, flexibility, peak O2 consumption, or level of reported physical activity. There were significant differences in all subtests of the Bruininks-Oseretsky Test of Motor Proficiency (p < 0.001). CONCLUSIONS Although significant differences in motor proficiency were found by school age the children born preterm did not demonstrate activity limitations or participation restrictions. Physical therapists can advise parents of children born five to 10 weeks preterm that in all probability their school-age child will not be limited in sport team or physical activity involvement and can achieve expected levels of cardiovascular fitness.
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Affiliation(s)
- Lana R Svien
- Department of Physical Therapy, University of South Dakota, Vermillion, SD 57069, USA.
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19
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Bartlett DJ, Kneale Fanning JE. Relationships of equipment use and play positions to motor development at eight months corrected age of infants born preterm. Pediatr Phys Ther 2003; 15:8-15. [PMID: 17057426 DOI: 10.1097/01.pep.0000051693.49199.41] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of this study was to determine the relationship between both use of infant equipment and play positions and motor development of infants born preterm who were classified as high risk. Subjects were 60 parent-infant dyads attending a developmental follow-up clinic. METHODS Parents reported the duration of infant equipment use and the predominant positions in which their infants played in the previous month. Infants were assessed using the Alberta Infant Motor Scale (AIMS). RESULTS Equipment use was not related to motor development; however, the duration of carrying was negatively related to the sit subscale of the AIMS (r = -0.31, p < 0.05). As a group, the infants in this sample spent more time in the relatively less active play positions of sitting and supine than in the positions of prone and standing. CONCLUSIONS Therapists should consider the use of equipment and specific play positions to enhance motor development of infants born preterm and work with parents to promote an understanding of the importance of providing their infants with opportunities to develop early motor competencies.
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Affiliation(s)
- Doreen J Bartlett
- School of Physical Therapy, Faculty of Health Sciences, Elborn College, University of Western Ontario, London, Ontario, Canada.
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20
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Abstract
With the increase in survival rates of children born prematurely, issues related to their active pursuits and responses to exercise have been gaining increasing attention. In some preterm children with an extremely low birthweight, bronchopulmonary dysplasia or cerebral palsy exercise capacity may be limited, especially in tasks requiring good neuromotor coordination. Deficiencies in aerobic and anaerobic performance, strength and coordination may even occur in children without overt manifestations of a neuromuscular or pulmonary disease. However, as a rule, children born prematurely may engage in physical activities and competitive sports without limitations. Exercise is safe in almost all such children as long as precautions are taken to avoid exercise-induced bronchoconstriction. However, to date there are no studies that have determined the efficacy of training. A wide variety of activities should be encouraged in all children born prematurely at an early age, to support the development of skills and to compensate for the possible effects of their premature birth on coordination.
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Affiliation(s)
- H Hebestreit
- Children's Hospital, Julius-Maximilians University, Würzburg, Germany.
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21
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Abstract
Prematurely born children have reduced peak VO2 compared with their peers, inferentially attributed to ventilatory limitation. The primary purpose of this study was to compare exercise ventilation and cardiac output in a sample of childhood survivors of lung disease of prematurity with those of a control group to elucidate reasons for lower peak VO2. A secondary aim was to describe and compare the ventilatory response to incremental exercise. Thirty-two children, aged 8-9 y, were recalled for lung function and progressive exercise tests. Fifteen of them also performed submaximal exercise with measurement of cardiac output (indirect [CO2] Fick) and physiologic dead space. Results were compared with those of term-born, age- and sex-matched, control children. Pulmonary function tests showed mild airflow limitation. Peak VO2 was lower in prematurely born children compared with control children, and was correlated with lean body mass. Their heart rate-VO2 relationship and stroke volume were similar to that of term-born control children. Children with a history of bronchopulmonary dysplasia and hyaline membrane disease as infants exhibited greater exercise hyperpnea than did healthy control children, because of higher breathing frequency, and maintained lower end-tidal PCO2 during submaximal exercise. Physiologic dead space normalized for body weight was similar in preterm and term-born children. Lower peak VO2 in this population is not caused by cardiopulmonary factors, but is best predicted by lean body mass. Ventilation did not limit exercise performance, although it appears that breathing during exercise is regulated differently in prematurely born children than in term-born children.
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Affiliation(s)
- P T Pianosi
- Department of Pediatrics and Child Health, University of Manitoba, Children's Hospital of Winnipeg, Canada
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22
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Keller H, Bar-Or O, Kriemler S, Ayub BV, Saigal S. Anaerobic performance in 5- to 7-yr-old children of low birthweight. Med Sci Sports Exerc 2000; 32:278-83. [PMID: 10694107 DOI: 10.1097/00005768-200002000-00005] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE This study was intended to determine whether anaerobic muscle performance is deficient in 5- to 7-yr-old children of extremely low birthweight (ELBW, 500-999 g) and very low birthweight (VLBW, 1000-1499 g). METHODS Fourteen ELBW and 20 VLBW children were compared with 24 normal birthweight (NBW, >2500 g) term controls. Peak (PP) and mean (MP) muscle power were determined by the Wingate anaerobic test. Bioimpedance analysis and anthropometry were done to assess fat-free mass (FFM) and lean cross-sectional area of the thigh and calf. RESULTS The ELBW group had significantly lower MP and PP, compared with the VLBW and, in particular, with the NBW group. This lower performance was apparent also when values were corrected for total body mass (MP) and FFM (MP and PP), but not when corrected for cross-sectional area of thigh and calf. CONCLUSION The lower anaerobic muscle performance in ELBW children may be partly due to their smaller muscle mass, but may also reflect a low percentage of fast-twitch muscle fibers, low muscle phosphagen content, or deficiency in motor control.
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Affiliation(s)
- H Keller
- Children's Exercise and Nutrition Centre and Children's Hospital at Hamilton Health Sciences Corporation, Department of Pediatrics, McMaster University, ON, Canada
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