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Zhang PP, Wang YX, Gu JY, Xu M, Zhou Y, Wang HJ, Lau PWC, Wang H, Li L. Cardiorespiratory fitness attenuates the association between fatness and cardiometabolic risk in Chinese children. Front Endocrinol (Lausanne) 2024; 15:1361447. [PMID: 38812818 PMCID: PMC11133549 DOI: 10.3389/fendo.2024.1361447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 04/17/2024] [Indexed: 05/31/2024] Open
Abstract
Background Childhood obesity tends to persist into adulthood, predisposing individuals to cardiometabolic risk (CMR). This study aims to investigate the mediating role of cardiorespiratory fitness (CRF) in the associations between multiple fatness indicators and individual CMR markers and clustered CMR-score, and explore sex differences. Methods We recruited 1,557 children (age: 8 to 10, male/female: 52.7%/47.3%) in September 2022 in Ningbo, China. Physical examinations, overnight fasting blood test, and CRF was evaluated. The CMR-score was calculated by summing age- and sex-specific z scores of four CMR markers, including mean arterial blood pressure, triglycerides, the total cholesterol to high-density lipoprotein cholesterol ratio, and homeostatic model assessment for insulin resistance. Generalized linear mixed models were used to identify the associations, mediation analyses were performed to dissect the function of CRF. Results Partial correlation analyses revealed positive associations between high fatness indicators (including body mass index [BMI], BMI z score, body fat mass index [BFMI] and waist-to-height ratio [WHtR]) and increased CMR markers, whereas high CRF was associated with decreased CMR markers (all P < 0.05). In the mediation analyses, CRF emerged as a partial mediator, attenuating the relationship between four fatness indicators and CMR-score. Specifically, CRF mediated 6.5%, 7.7%, 5.3%, and 12.5% of the association between BMI, BMI z score, BFMI, WHtR and CMR-score (all P < 0.001). And the mediating effects of CRF between WHtR and four individual CMR markers was particularly robust, ranging from 10.4% to 21.1% (all P < 0.05). What's more, CRF mediates the associations between WHtR and CMR-score more pronounced in girls than boys with a mediation effect size of 17.3% (P < 0.001). Conclusion In Chinese children, CRF partially mitigates the adverse effects of fatness on CMR, underscoring the significance of enhancing CRF in children.
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Affiliation(s)
- Ping-Ping Zhang
- Ningbo Center for Healthy Lifestyle Research, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - You-Xin Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Jia-Yin Gu
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Miao Xu
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Ye Zhou
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Hai-Jun Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Patrick W C. Lau
- Department of Sport, Physical Education & Health, Hong Kong Baptist University, Hong Kong, Hong Kong SAR, China
- Laboratory of Exercise Science and Health, Beijing Normal University-Hong Kong Baptist University United International College (UIC), Zhuhai, Guangzhou, China
| | - Hui Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Li Li
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China
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Dykstra BJ, Griffith GJ, Renfrow MS, Mahon AD, Harber MP. Cardiorespiratory and Muscular Fitness in Children and Adolescents with Obesity. Curr Cardiol Rep 2024; 26:349-357. [PMID: 38460068 DOI: 10.1007/s11886-024-02036-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/27/2024] [Indexed: 03/11/2024]
Abstract
PURPOSE OF REVIEW Examine the current state of literature related to the impact of obesity in children and adolescents on health-related physical fitness and the resultant cardiometabolic disease risk. RECENT FINDINGS Cardiorespiratory fitness of children and adolescents has declined over the past few decades which corresponds with an increase in obesity rates. Children with obesity are more likely to have low cardiorespiratory fitness which is associated with higher cardiometabolic disease risk and poorer mental health. The impact of obesity on muscular fitness in children and adolescents is more difficult to ascertain, but in general measures of physical function are lower in children with obesity which has also been associated with higher cardiometabolic disease risk. Components of health-related physical fitness are trending negatively in children and adolescents and appear to be related to the increase in prevalence of obesity. The resultant cardiometabolic disease risk has also risen which suggests a greater disease burden in the future. These disparaging findings highlight the need for aggressive interventions to improve physical fitness in children and adolescents.
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Affiliation(s)
| | - Garett J Griffith
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Anthony D Mahon
- Human Performance Laboratory, Ball State University, Muncie, IN, USA
| | - Matthew P Harber
- Clinical Exercise Physiology, Ball State University, Muncie, IN, 47306, USA.
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA.
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La Grasta Sabolic L, Pozgaj Sepec M, Valent Moric B, Cigrovski Berkovic M. Association between cardiorespiratory fitness level and insulin resistance in adolescents with various obesity categories. World J Diabetes 2023; 14:1126-1136. [PMID: 37547583 PMCID: PMC10401457 DOI: 10.4239/wjd.v14.i7.1126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/22/2023] [Accepted: 06/02/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND An association between cardiorespiratory fitness (CRF) and insulin resistance in obese adolescents, especially in those with various obesity categories, has not been systematically studied. There is a lack of knowledge about the effects of CRF on insulin resistance in severely obese adolescents, despite their continuous rise.
AIM To investigate the association between CRF and insulin resistance in obese adolescents, with special emphasis on severely obese adolescents.
METHODS We performed a prospective, cross-sectional study that included 200 pubertal adolescents, 10 years to 18 years of age, who were referred to a tertiary care center due to obesity. According to body mass index (BMI), adolescents were classified as mildly obese (BMI 100% to 120% of the 95th percentile for age and sex) or severely obese (BMI ≥ 120% of the 95th percentile for age and sex or ≥ 35 kg/m2, whichever was lower). Participant body composition was assessed by bioelectrical impedance analysis. A homeostatic model assessment of insulin resistance (HOMA-IR) was calculated. Maximal oxygen uptake (VO2max) was determined from submaximal treadmill exercise test. CRF was expressed as VO2max scaled by total body weight (TBW) (mL/min/kg TBW) or by fat free mass (FFM) (mL/min/kg FFM), and then categorized as poor, intermediate, or good, according to VO2max terciles. Data were analyzed by statistical software package SPSS (IBM SPSS Statistics for Windows, Version 24.0). P < 0.05 was considered statistically significant.
RESULTS A weak negative correlation between CRF and HOMA-IR was found [Spearman’s rank correlation coefficient (rs) = -0.28, P < 0.01 for CRFTBW; (rs) = -0.21, P < 0.01 for CRFFFM]. One-way analysis of variance (ANOVA) revealed a significant main effect of CRF on HOMA-IR [F(2200) = 6.840, P = 0.001 for CRFTBW; F(2200) = 3.883, P = 0.022 for CRFFFM]. Subsequent analyses showed that obese adolescents with poor CRF had higher HOMA-IR than obese adolescents with good CRF (P = 0.001 for CRFTBW; P = 0.018 for CRFFFM). Two-way ANOVA with Bonferroni correction confirmed significant effect of interaction of CRF level and obesity category on HOMA-IR [F(2200) = 3.292, P = 0.039 for CRFTBW]. Severely obese adolescents had higher HOMA-IR than those who were mildly obese, with either good or poor CRF. However, HOMA-IR did not differ between severely obese adolescents with good and mildly obese adolescents with poor CRF.
CONCLUSION CRF is an important determinant of insulin resistance in obese adolescents, regardless of obesity category. Therefore, CRF assessment should be a part of diagnostic procedure, and its improvement should be a therapeutic goal.
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Affiliation(s)
- Lavinia La Grasta Sabolic
- Department of Pediatric Endocrinology and Diabetology, University Hospital Centre Sestre milosrdnice, Zagreb 10000, Croatia
- School of Medicine, Catholic University, Zagreb 10000, Croatia
| | - Marija Pozgaj Sepec
- Department of Pediatric Endocrinology and Diabetology, University Hospital Centre Sestre milosrdnice, Zagreb 10000, Croatia
| | - Bernardica Valent Moric
- Department of Pediatric Endocrinology and Diabetology, University Hospital Centre Sestre milosrdnice, Zagreb 10000, Croatia
| | - Maja Cigrovski Berkovic
- Department for Sport and Exercise Medicine, Faculty of Kinesiology University of Zagreb, Zagreb 10000, Croatia
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Maffeis C, Olivieri F, Valerio G, Verduci E, Licenziati MR, Calcaterra V, Pelizzo G, Salerno M, Staiano A, Bernasconi S, Buganza R, Crinò A, Corciulo N, Corica D, Destro F, Di Bonito P, Di Pietro M, Di Sessa A, deSanctis L, Faienza MF, Filannino G, Fintini D, Fornari E, Franceschi R, Franco F, Franzese A, Giusti LF, Grugni G, Iafusco D, Iughetti L, Lera R, Limauro R, Maguolo A, Mancioppi V, Manco M, Del Giudice EM, Morandi A, Moro B, Mozzillo E, Rabbone I, Peverelli P, Predieri B, Purromuto S, Stagi S, Street ME, Tanas R, Tornese G, Umano GR, Wasniewska M. The treatment of obesity in children and adolescents: consensus position statement of the Italian society of pediatric endocrinology and diabetology, Italian Society of Pediatrics and Italian Society of Pediatric Surgery. Ital J Pediatr 2023; 49:69. [PMID: 37291604 DOI: 10.1186/s13052-023-01458-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 04/18/2023] [Indexed: 06/10/2023] Open
Abstract
This Position Statement updates the different components of the therapy of obesity (lifestyle intervention, drugs, and surgery) in children and adolescents, previously reported in the consensus position statement on pediatric obesity of the Italian Society of Pediatric Endocrinology and Diabetology and the Italian Society of Pediatrics. Lifestyle intervention is the first step of treatment. In children older than 12 years, pharmacotherapy is the second step, and bariatric surgery is the third one, in selected cases. Novelties are available in the field of the medical treatment of obesity. In particular, new drugs demonstrated their efficacy and safety and have been approved in adolescents. Moreover, several randomized control trials with other drugs are in process and it is likely that some of them will become available in the future. The increase of the portfolio of treatment options for obesity in children and adolescents is promising for a more effective treatment of this disorder.
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Affiliation(s)
- Claudio Maffeis
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University of Verona, Verona, Italy
| | - Francesca Olivieri
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University of Verona, Verona, Italy.
| | - Giuliana Valerio
- Department of Movement Sciences and Wellbeing, Parthenope University of Naples, Naples, Italy
| | - Elvira Verduci
- Deparment of Pediatrics, Department of Health Science, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
| | - Maria Rosaria Licenziati
- Department of Neurosciences, Neuro-Endocrine Diseases and Obesity Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Valeria Calcaterra
- Department of Pediatrics, Vittore Buzzi Children's Hospital, Milan, Italy
- Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - Gloria Pelizzo
- Department of Pediatric Surgery, Vittore Buzzi Children's Hospital, Milan, Italy
| | - Mariacarolina Salerno
- Department of Traslational Medical Sciences, Section of Pediatrics, University of Naples Federico II, Naples, Italy
| | - Annamaria Staiano
- Department of Traslational Medical Sciences, Section of Pediatrics, University of Naples Federico II, Naples, Italy
| | | | - Raffaele Buganza
- Pediatric Endocrinology Unit, Department of Public Health and Pediatric Sciences, University of Turin, Turin, Italy
| | - Antonino Crinò
- Autoimmune Endocrine Diseases Unit, Bambino Gesù Children Hospital, IRCCS, Rome, Italy
| | | | - Domenico Corica
- Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy
| | - Francesca Destro
- Department of Pediatric Surgery, Vittore Buzzi Children's Hospital, Milan, Italy
| | - Procolo Di Bonito
- Department of Internal Medicine, S. Maria Delle Grazie Hospital, Naples, Pozzuoli, Italy
| | - Mario Di Pietro
- Pediatric and Neonatal Unit, Hospital of Teramo and Atri, Teramo, Italy
| | - Anna Di Sessa
- Department of Woman, Child and General and Specialized Surgery, University of Campania L. Vanvitelli, Naples, Italy
| | - Luisa deSanctis
- Department of Sciences of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Maria Felicia Faienza
- Department of Precision and Regenerative Medicine and Ionan Area, University of Bari, Bari, Italy
| | | | - Danilo Fintini
- Refernce Center for Prader Willi Syndrome, Endocrinology and Diabetology Unit, Bambino Gesù Children Hospital, IRCCS, Rome, Italy
| | - Elena Fornari
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University of Verona, Verona, Italy
| | | | - Francesca Franco
- Pediatric Department, Azienda Sanitaria Universitaria del Friuli Centrale, Hospital of Udine, Udine, Italy
| | - Adriana Franzese
- Department of Traslational Medical Sciences, Section of Pediatrics, University of Naples Federico II, Naples, Italy
| | - Lia Franca Giusti
- Italian Society for Pediatric Endocrinology and Diabetology (SIEDP), Lucca, Italy
| | - Graziano Grugni
- Division of Auxology, Istituto Auxologico Italiano, IRCCS, Verbania, Italy
| | - Dario Iafusco
- Department of Woman, Child and General and Specialized Surgery, University of Campania L. Vanvitelli, Naples, Italy
| | - Lorenzo Iughetti
- Department of Medical and Surgical Sciences of Mother, Children and Adults, Pediatric Unit, University of Modena and Reggio Emilia, Modena, Italy
| | - Riccardo Lera
- Italian Society for Pediatric Endocrinology and Diabetology (SIEDP), Alessandria, Italy
| | | | - Alice Maguolo
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University of Verona, Verona, Italy
| | - Valentina Mancioppi
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University of Verona, Verona, Italy
| | - Melania Manco
- Research Area for Multifactorial Diseases, Children's Hospital Bambino Gesù, Rome, Italy
| | | | - Anita Morandi
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University of Verona, Verona, Italy
| | - Beatrice Moro
- UOSD Diabetology, Complesso Ai Colli, AULSS 6 Euganea, Padua, Italy
| | - Enza Mozzillo
- Department of Traslational Medical Sciences, Section of Pediatrics, University of Naples Federico II, Naples, Italy
| | - Ivana Rabbone
- Division of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
| | - Paola Peverelli
- Department of Pediatrics and Gynecology, Hospital of Belluno, Belluno, Italy
| | - Barbara Predieri
- Department of Medical and Surgical Sciences of Mother, Children and Adults, Pediatric Unit, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Stefano Stagi
- Department of Health Sciences, University of Florence, Meyer Children's Hospital IRCCS, Florence, Italy
| | - Maria Elisabeth Street
- Department of Medicine and Surgery, Unit of Paediatrics, University of Parma, University Hospital of Parma, Parma, Italy
| | - Rita Tanas
- Italian Society for Pediatric Endocrinology and Diabetology (SIEDP), Ferrara, Italy
| | - Gianluca Tornese
- Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
| | - Giuseppina Rosaria Umano
- Department of Woman, Child and General and Specialized Surgery, University of Campania L. Vanvitelli, Naples, Italy
| | - Malgorzata Wasniewska
- Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy
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A Meta-Analysis of Sampled Maximal Aerobic Capacity Data for Boys Aged 11 Years Old or Less Obtained by Cycle Ergometry. Life (Basel) 2023; 13:life13020276. [PMID: 36836634 PMCID: PMC9967809 DOI: 10.3390/life13020276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 12/14/2022] [Accepted: 12/22/2022] [Indexed: 01/20/2023] Open
Abstract
The aim of this study was to develop distributions of VO2max based on measured values that exist in the literature in prepubertal boys using cycle ergometry. PRISMA guidelines were followed in conducting this research. One database was searched for peak and maximal VO2 values in healthy boys with mean age under 11 years old. Data were split into articles reporting absolute and relative VO2max values and analyzed accordingly. Multilevel models grounded in Bayesian principles were used. We investigated associations between VO2max and body mass, year of the study, and country of origin. Differences in "peak" and "maximal" VO2 were assessed. Absolute VO2max (Lmin-1) increases with age (P ~100%) but mean relative VO2max does not change (P ~100%). Absolute VO2max is higher in more recent studies (P = 95.7 ± 0.3%) and mean relative VO2max is lower (P = 99.6 ± 0.1%). Relative VO2max in the USA is lower compared with boys from other countries (P = 98.8 ± 0.2%), but there are no differences in absolute values. Mean aerobic capacity estimates presented as "peak" values are higher than "maximal" values on an absolute basis (P = 97.5 ± 0.3%) but not on a relative basis (P = 99.6 ± 0.1%). Heavier boys have lower cardiorespiratory fitness (P ≈ 100%), and body mass seems to be increasing faster with age in the USA compared with other countries (P = 92.3 ± 0.3%). New reference values for cardiorespiratory fitness are presented for prepubertal boys obtained with cycle ergometry. This is new, as no reference values have been determined so far based on actual measured values in prepubertal boys. Aerobic capacity normalized to body weight does not change with age. Cardiorespiratory fitness in prepubertal boys is declining, which is associated with increasing body mass over the last few decades. Lastly, this study did not find any statistically significant difference in the sample's mean aerobic capacity estimates using the "peak" and "maximum" distinctions identified in the literature.
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Wadey CA, Barker AR, Stuart G, Tran DL, Laohachai K, Ayer J, Cordina R, Williams CA. Scaling Peak Oxygen Consumption for Body Size and Composition in People With a Fontan Circulation. J Am Heart Assoc 2022; 11:e026181. [PMID: 36515232 PMCID: PMC9798799 DOI: 10.1161/jaha.122.026181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background Peak oxygen consumption (peak V̇O2$$ \dot{\mathrm{V}}{\mathrm{O}}_2 $$) is traditionally divided ("ratio-scaled") by body mass (BM) for clinical interpretation. Yet, it is unknown whether ratio-scaling to BM can produce a valid size-independent expression of peak V̇O2$$ \dot{\mathrm{V}}{\mathrm{O}}_2 $$ in people with a Fontan circulation. Furthermore, people with a Fontan circulation have deficits in lean mass, and it is unexplored whether using different measures of body composition may improve scaling validity. The objective was to assess the validity of different scaling denominators (BM, stature, body surface area, fat-free mass, lean mass, and appendicular lean mass using ratio and allometric scaling). Methods and Results Eighty-nine participants (age: 23.3±6.7 years; 53% female) with a Fontan circulation had their cardiorespiratory fitness and body composition measured by cardiopulmonary exercise testing and dual-energy x-ray absorptiometry. Ratio and allometric (log-linear regression) scaling was performed and Pearson correlations assessed scaling validity. Scaling denominators BM (r=-0.25, P=0.02), stature (r=0.46, P<0.001), and body surface area (0.23, P=0.03) were significantly correlated with their respective ratio-scaled expressions of peak V̇O2$$ \dot{\mathrm{V}}{\mathrm{O}}_2 $$, but fat-free mass, lean mass, or appendicular lean mass were not (r≤0.11; R2=1%). Allometrically expressed peak V̇O2$$ \dot{\mathrm{V}}{\mathrm{O}}_2 $$ resulted in no significant correlation with any scaling denominator (r=≤0.23; R2=≤4%). Conclusions The traditional and accepted method of ratio-scaling to BM is invalid because it fails to create a size-independent expression of peak V̇O2$$ \dot{\mathrm{V}}{\mathrm{O}}_2 $$ in people with a Fontan circulation. However, ratio-scaling to measures of body composition (fat-free mass, lean mass, and appendicular lean mass) and allometric techniques can produce size-independent expressions of peak V̇O2$$ \dot{\mathrm{V}}{\mathrm{O}}_2 $$ in people with a Fontan circulation.
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Affiliation(s)
- Curtis A. Wadey
- Children’s Health & Exercise Research Centre (CHERC)Public Health and Sport Science, Faculty of Health and Life Sciences, University of ExeterExeterUnited Kingdom
| | - Alan R. Barker
- Children’s Health & Exercise Research Centre (CHERC)Public Health and Sport Science, Faculty of Health and Life Sciences, University of ExeterExeterUnited Kingdom
| | - Graham Stuart
- Bristol Congenital Heart Centre, The Bristol Heart Institute, University Hospitals Bristol NHS Foundation TrustBristolUnited Kingdom
| | - Derek L. Tran
- Central Clinical School, The University of SydneyCamperdownNew South Wales,Department of CardiologyRoyal Prince Alfred HospitalCamperdownNew South Wales,Heart Research Institute, Charles Perkins Centre, The University of SydneyCamperdownNew South Wales
| | - Karina Laohachai
- Central Clinical School, The University of SydneyCamperdownNew South Wales,Department of CardiologyRoyal Prince Alfred HospitalCamperdownNew South Wales,Heart Research Institute, Charles Perkins Centre, The University of SydneyCamperdownNew South Wales
| | - Julian Ayer
- Central Clinical School, The University of SydneyCamperdownNew South Wales,Department of CardiologyRoyal Prince Alfred HospitalCamperdownNew South Wales,Heart Research Institute, Charles Perkins Centre, The University of SydneyCamperdownNew South Wales
| | - Rachael Cordina
- Central Clinical School, The University of SydneyCamperdownNew South Wales,Department of CardiologyRoyal Prince Alfred HospitalCamperdownNew South Wales,Heart Research Institute, Charles Perkins Centre, The University of SydneyCamperdownNew South Wales
| | - Craig A. Williams
- Children’s Health & Exercise Research Centre (CHERC)Public Health and Sport Science, Faculty of Health and Life Sciences, University of ExeterExeterUnited Kingdom
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Agbaje AO. Mediating role of body composition and insulin resistance on the association of arterial stiffness with blood pressure among adolescents: The ALSPAC study. Front Cardiovasc Med 2022; 9:939125. [PMID: 36119740 PMCID: PMC9481230 DOI: 10.3389/fcvm.2022.939125] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 08/15/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundEmerging evidence among adolescents suggests that arterial stiffness temporally precedes elevated blood pressure/hypertension in the casual pathway. It remains unknown whether insulin resistance and body composition mediate this relationship. Therefore, we examined the mediating role of total fat mass, lean mass, and insulin resistance in the association between arterial stiffness and blood pressure among adolescents.Materials and methodsWe studied 3,764 participants, aged 17 years from the Avon Longitudinal Study of Parents and Children (ALSPAC) United Kingdom birth cohort. Arterial stiffness accessed with Vicorder device measured carotid-femoral pulse wave velocity (cfPWV), body composition was measured by dual-energy Xray Absorptiometry, blood pressure by Omron device, and homeostatic model assessment of insulin resistance (HOMA-IR) was computed. Data were analysed with structural equation models mediation path analyses and adjusted for cardiometabolic and lifestyle factors.ResultsAmong 1,678 [44.6%] male and 2,086 [55.4%] female participants, higher cfPWV was directly and independently associated with higher systolic and diastolic blood pressure, irrespective of the mediator [Standardized regression coefficient (β) = 0.248–0.370, p for all = 0.002]. Lean mass [β = 0.010; p = 0.026; 3.3% mediation] and HOMA-IR [β = 0.004; p = 0.033; 1.1% mediation] but not total fat mass [β < 0.0001; p = 0.615; 0% mediation] partly mediated the association of cfPWV with systolic blood pressure after full adjustments. Similarly, lean mass [β = –0.004; p = 0.021; 1.4% mediation] and HOMA-IR [β = 0.007; p = 0.039; 2.8% mediation] but not total fat mass [β = –0.002; p = 0.665; 0.7% mediation] partly mediated the association of cfPWV with diastolic blood pressure.ConclusionAttenuating insulin resistance may be a potentially valuable strategy in lowering higher blood pressure precipitated by higher arterial stiffness.
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Haapala EA, Tompuri T, Lintu N, Viitasalo A, Savonen K, Lakka TA, Laukkanen JA. Is low cardiorespiratory fitness a feature of metabolic syndrome in children and adults? J Sci Med Sport 2022; 25:923-929. [DOI: 10.1016/j.jsams.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 05/18/2022] [Accepted: 08/02/2022] [Indexed: 11/29/2022]
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AGBAJE ANDREWO, BARKER ALANR, TUOMAINEN TOMIPEKKA. Cardiorespiratory Fitness, Fat Mass, and Cardiometabolic Health with Endothelial Function, Arterial Elasticity, and Stiffness. Med Sci Sports Exerc 2022; 54:141-152. [PMID: 34334718 PMCID: PMC8677603 DOI: 10.1249/mss.0000000000002757] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE This study aimed to determine whether estimated cardiorespiratory fitness (CRF), fat mass (FM), lean mass (LM), and adiponectin bidirectionally associate with arterial function and structure and if CRF mediates the relationship between cardiometabolic health and arterial outcomes in 9- to 11-yr-old children drawn from the Avon Longitudinal Study of Parents and Children birth cohort, United Kingdom. METHODS Brachial artery flow-mediated dilation (FMD), distensibility coefficient (DC), and carotid-radial pulse wave velocity (PWV) were measured by ultrasonography; CRF was measured during the submaximal ergometer test; total FM, trunk FM, and LM were measured by dual-energy x-ray absorptiometry; plasma adiponectin was measured by enzyme assay; and cardiometabolic health was computed based on the International Diabetes Federation criteria for diagnosing metabolic syndrome. We tested bidirectionality by including CRF, FM, LM, and adiponectin as exposures and FMD, DC, and PWV as outcomes, alternatively. RESULTS Among 5566 participants (2816 (51%) girls; median age, 9.75 yr), CRF per body mass0.21 was directly related to DC (β (95% confidence interval) = 0.004 (<0.0001 to 0.008); P = 0.046), whereas CRF per LM0.54 was inversely associated with PWV (-0.034 (-0.063 to -0.003); 0.032) after adjusting for covariates. These associations remained in bidirectional analyses. Total FM, trunk FM, and LM were bidirectionally and positively associated with FMD and DC. Total FM and trunk FM but not LM had bidirectional and inverse associations with PWV. Adiponectin was not related to FMD, DC, or PWV. CRF partially mediated the associations of cardiometabolic health with FMD (1.5% mediation), DC (12.1% mediation), and PWV (3.5% mediation). CONCLUSIONS Associations of poor cardiometabolic health with adverse arterial structure and function in childhood may be mitigated by increasing CRF. Higher CRF was associated with better arterial structure whereas higher total FM and trunk FM were associated with better arterial function and structure. In the reverse analysis, healthy arterial structure and function were independently associated with increased total FM and trunk FM, suggesting an "arterial paradox."
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Affiliation(s)
- ANDREW O. AGBAJE
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, FINLAND
| | - ALAN R. BARKER
- Children’s Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, Exeter, UNITED KINGDOM
| | - TOMI-PEKKA TUOMAINEN
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, FINLAND
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10
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Rollo S, Fraser BJ, Seguin N, Sampson M, Lang JJ, Tomkinson GR, Tremblay MS. Health-Related Criterion-Referenced Cut-Points for Cardiorespiratory Fitness Among Youth: A Systematic Review. Sports Med 2021; 52:101-122. [PMID: 34468952 DOI: 10.1007/s40279-021-01537-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND Cardiorespiratory fitness (CRF), which reflects the overall aerobic capacity of the cardiovascular, respiratory, and muscular systems, is significantly related to health among youth. OBJECTIVE The aim of this systematic review was to identify health-related criterion-referenced cut-points for CRF among youth aged 5-17 years. METHODS A systematic search of two electronic databases (MEDLINE and SPORTDiscus) was conducted in September 2020. Only peer-reviewed studies that developed health-related criterion-referenced cut-points for CRF among youth were eligible provided they included (1) youth aged 5-17 years from the general population; (2) at least one quantitative assessment of CRF (e.g., peak oxygen uptake [[Formula: see text]O2peak]); (3) at least one quantitative assessment of health (e.g., cardiometabolic risk); (4) a criterion for health; and (5) a quantitative analysis (e.g., receiver operating characteristic [ROC] curve) of at least one health-related cut-point for CRF. A narrative synthesis was used to describe the results of the included studies. RESULTS Collectively, 29 included studies developed health-related criterion-referenced cut-points for CRF among 193,311 youth from 23 countries. CRF cut-points, expressed as [Formula: see text]O2peak, estimated using the 20-m shuttle run test, demonstrated high discriminatory ability (median area under the curve [AUC] ≥ 0.71) for both cardiometabolic and obesity risk. Cut-points derived from maximal cycle-ergometer tests demonstrated moderate discriminatory ability (median AUC 0.64-0.70) for cardiometabolic risk, and low discriminatory ability for early subclinical atherosclerosis (median AUC 0.56-0.63). Cut-points for CRF using submaximal treadmill exercise testing demonstrated high discriminatory ability for cardiometabolic risk, but only moderate discriminatory ability for obesity risk. CRF cut-points estimated using submaximal step testing demonstrated high discriminatory ability for cardiometabolic risk and moderate discriminatory ability for high blood pressure, while those for the 9-min walk/run test demonstrated moderate-to-high discriminatory ability for obesity risk. Collectively, CRF cut-points, expressed as [Formula: see text]O2peak, demonstrated moderate-to-high discriminatory ability (median AUC ≥ 0.64) for cardiometabolic risk, obesity risk, and high blood pressure. CONCLUSIONS Currently, there is too wide a range of health-related criterion-referenced cut-points for CRF among youth to suggest universal age- and sex-specific thresholds. To further inform the development of universal cut-points, there is a need for additional research, using standardized testing protocols and health-risk definitions, that examines health-related criterion-referenced cut-points for CRF that are age, sex, and culturally diverse. CLINICAL TRIALS REGISTRATION PROSPERO registration number: CRD42020207458.
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Affiliation(s)
- Scott Rollo
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Rd, Ottawa, ON, K1H 8L1, Canada. .,School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
| | - Brooklyn J Fraser
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Nick Seguin
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Rd, Ottawa, ON, K1H 8L1, Canada.,Department of Health Sciences, Carleton University, Ottawa, ON, Canada
| | - Margaret Sampson
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Rd, Ottawa, ON, K1H 8L1, Canada
| | - Justin J Lang
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Rd, Ottawa, ON, K1H 8L1, Canada.,Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Grant R Tomkinson
- Department of Education, Health and Behavior Studies, University of North Dakota, Grand Forks, ND, USA.,Alliance for Research in Exercise, Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Mark S Tremblay
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Rd, Ottawa, ON, K1H 8L1, Canada.,School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.,Department of Health Sciences, Carleton University, Ottawa, ON, Canada.,Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
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11
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Raghuveer G, Hartz J, Lubans DR, Takken T, Wiltz JL, Mietus-Snyder M, Perak AM, Baker-Smith C, Pietris N, Edwards NM. Cardiorespiratory Fitness in Youth: An Important Marker of Health: A Scientific Statement From the American Heart Association. Circulation 2020; 142:e101-e118. [PMID: 32686505 DOI: 10.1161/cir.0000000000000866] [Citation(s) in RCA: 220] [Impact Index Per Article: 55.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Cardiorespiratory fitness (CRF) refers to the capacity of the circulatory and respiratory systems to supply oxygen to skeletal muscle mitochondria for energy production needed during physical activity. CRF is an important marker of physical and mental health and academic achievement in youth. However, only 40% of US youth are currently believed to have healthy CRF. In this statement, we review the physiological principles that determine CRF, the tools that are available to assess CRF, the modifiable and nonmodifiable factors influencing CRF, the association of CRF with markers of health in otherwise healthy youth, and the temporal trends in CRF both in the United States and internationally. Development of a cost-effective CRF measurement process that could readily be incorporated into office visits and in field settings to screen all youth periodically could help identify those at increased risk.
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12
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Haapala EA, Wiklund P, Lintu N, Tompuri T, Väistö J, Finni T, Tarkka IM, Kemppainen T, Barker AR, Ekelund U, Brage S, Lakka TA. Cardiorespiratory Fitness, Physical Activity, and Insulin Resistance in Children. Med Sci Sports Exerc 2020; 52:1144-1152. [PMID: 31764464 PMCID: PMC7358077 DOI: 10.1249/mss.0000000000002216] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
PURPOSE Few studies have investigated the independent and joint associations of cardiorespiratory fitness (CRF) and body fat percentage (BF%) with insulin resistance in children. We investigated the independent and combined associations of CRF and BF% with fasting glycemia and insulin resistance and their interactions with physical activity (PA) and sedentary time among 452 children age 6 to 8 yr. METHODS We assessed CRF with a maximal cycle ergometer exercise test and used allometrically scaled maximal power output (Wmax) for lean body mass (LM) and body mass (BM) as measures of CRF. The BF% and LM were measured by dual-energy X-ray absorptiometry, fasting glycemia by fasting plasma glucose, and insulin resistance by fasting serum insulin and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR). The PA energy expenditure, moderate-to-vigorous PA (MVPA), and sedentary time were assessed by combined movement and heart rate sensor. RESULTS Wmax/LM was not associated with glucose (β = 0.065, 95% confidence interval [CI] = -0.031 to 0.161), insulin (β = -0.079, 95% CI = -0.172 to 0.015), or HOMA-IR (β = -0.065, 95% CI = -0.161 to 0.030). Wmax/BM was inversely associated with insulin (β = -0.289, 95% CI = -0.377 to -0.200) and HOMA-IR (β = -0.269, 95% CI = -0.359 to -0.180). The BF% was directly associated with insulin (β = 0.409, 95% CI = 0.325 to 0.494) and HOMA-IR (β = 0.390, 95% CI = 0.304 to 0.475). Higher Wmax/BM, but not Wmax/LM, was associated with lower insulin and HOMA-IR in children with higher BF%. Children with higher BF% and who had lower levels of MVPA or higher levels of sedentary time had the highest insulin and HOMA-IR. CONCLUSIONS Children with higher BF% together with less MVPA or higher levels of sedentary time had the highest insulin and HOMA-IR. Cardiorespiratory fitness appropriately controlled for body size and composition using LM was not related to insulin resistance among children.
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Affiliation(s)
| | | | - Niina Lintu
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, FINLAND
| | | | - Juuso Väistö
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, FINLAND
| | - Taija Finni
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, FINLAND
| | - Ina M Tarkka
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, FINLAND
| | - Titta Kemppainen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, FINLAND
| | - Alan R Barker
- Children's Health and Exercise Research Centre, University of Exeter, Exeter, UNITED KINGDOM
| | - Ulf Ekelund
- Norwegian School of Sports Science, Oslo, NORWAY
| | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UNITED KINGDOM
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13
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Haapala EA, Lee E, Laukkanen JA. Associations of cardiorespiratory fitness, physical activity, and BMI with arterial health in middle-aged men and women. Physiol Rep 2020; 8:e14438. [PMID: 32441423 PMCID: PMC7243195 DOI: 10.14814/phy2.14438] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 04/14/2020] [Accepted: 04/16/2020] [Indexed: 11/24/2022] Open
Abstract
We investigated the associations of cardiorespiratory fitness (CRF), physical activity (PA) with regard to aerobic and resistance training, and body mass index (BMI) with pulse wave velocity (PWV) and augmentation index (AIx) in middle-aged adults with at least one cardiovascular risk factor. A total of 84 (46 men and 38 women) participated in the study. Cardiorespiratory fitness was measured using a maximal graded exercise test on a cycle ergometer and was defined as maximal power output (Wmax ) normalized for body weight-0.35 . Participation in aerobic and resistance training was assessed by a detailed questionnaire and BMI was calculated as weight (kg)/[height (m2 )]. Pulse wave velocity and AIx were measured using an applanation tonometry before (pre), immediately after (post), and after 10 min (post10) of maximal exercise test. Cardiorespiratory fitness, PA, or BMI was not associated with PWV or AIx. Pulse wave velocity decreased significantly from pre to post10 among those in the highest third of CRF (mean difference=-0.793 m/s, 95% CI = -1.494 to -0.091, p = .023) and in normal weight participants (p = .084 for time*group interaction mean difference=-0.781 m/s, 95% CI = -1.496 to -0.066, p = .029), but not among those in the other thirds of CRF or overweight or obese participants. Participants who had regular resistance training had continuously higher AIx from pre to post10 than those who had no regular resistance training (mean difference = -1.98, 95% CI = -4.02 to 0.069, p = .058). In conclusion, exercise may decrease PWV and AIx. Our results suggest that positive arterial responses to exercise could be slightly improved in fit and normal weight individuals.
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Affiliation(s)
- Eero A. Haapala
- Faculty of Sport and Health SciencesUniversity of JyväskyläJyväskyläFinland
- Physiology, Institute of BiomedicineSchool of MedicineUniversity of Eastern FinlandKuopioFinland
| | - Earric Lee
- Faculty of Sport and Health SciencesUniversity of JyväskyläJyväskyläFinland
| | - Jari A. Laukkanen
- Faculty of Sport and Health SciencesUniversity of JyväskyläJyväskyläFinland
- Department of Internal MedicineCentral Finland Healthcare DistrictJyväskyläFinland
- Institute of Public Health and Clinical NutritionUniversity of Eastern FinlandKuopioFinland
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14
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Narimani M, Esmaeilzadeh S, Pesola AJ, Haapala EA, Heidari B, Azevedo LB. Allometrically scaled explosive strength, but not static strength or maximal oxygen uptake is associated with better central processing time in young males. J Sports Med Phys Fitness 2020; 60:947-956. [PMID: 32253892 DOI: 10.23736/s0022-4707.20.10273-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND We aimed to examine the associations of cardiorespiratory fitness (CRF), static strength and explosive strength with cognitive functions in young males. METHODS Eighty-six young males (age 16-24 years) participated in the study and took part in a number of tests including: static strength (grip strength test), explosive strength (Sargent jump test), and CRF (via direct measure of maximal oxygen uptake [VO2max]). Static strength and explosive strength were scaled by allometrically modeled skeletal muscle mass (SMM) and height while VO2max was scaled by SMM and body mass (BM). Cognition was assessed by inhibitory control, simple and choice reaction time tasks using computerized Cambridge Neuropsychological Test Battery (CANTAB). Central processing time was measured by surface electromyography changes in isometric contraction response to an audio stimulus. RESULTS VO2max scaled by BM (but not SMM), was associated with better central processing time and stop-signal reaction time (SSRT). Explosive strength was also associated with better central processing time independent of VO2max. However, static strength was not associated with cognition. CONCLUSIONS The results suggest that explosive strength is a better predictor of central processing than static strength or VO2max in young males. Longitudinal studies are needed to examine whether explosive strength training in youth would improve central processing time.
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Affiliation(s)
- Mohammad Narimani
- Department of Psychology, University of Mohaghegh Ardabili, Ardabil, Iran -
| | - Samad Esmaeilzadeh
- Department of Psychology, University of Mohaghegh Ardabili, Ardabil, Iran.,Active Life Lab, South-Eastern Finland University of Applied Sciences, Mikkeli, Finland
| | - Arto J Pesola
- Active Life Lab, South-Eastern Finland University of Applied Sciences, Mikkeli, Finland
| | - Eero A Haapala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Behrouz Heidari
- Department of Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
| | - Liane B Azevedo
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK
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15
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Leppänen MH, Haapala EA, Veijalainen A, Seppälä S, Oliveira RS, Lintu N, Laitinen T, Tarvainen MP, Lakka TA. Associations of cardiometabolic risk factors with heart rate variability in 6- to 8-year-old children: The PANIC Study. Pediatr Diabetes 2020; 21:251-258. [PMID: 31855297 DOI: 10.1111/pedi.12967] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 11/15/2019] [Accepted: 12/16/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Associations of cardiometabolic risk factors with heart rate variability (HRV) in children are unclear. We examined associations of cardiometabolic risk score (CRS) and individual cardiometabolic risk factors with HRV variables in 6- to 8-year-olds. METHODS The participants were a population-based sample of 443 children participating in baseline measurements of the Physical Activity and Nutrition in Children trial. Cardiometabolic risk factors included waist circumference (WC), insulin, glucose, triglycerides, HDL cholesterol, systolic blood pressure (SBP), and diastolic blood pressure (DBP). CRS was calculated as WC + insulin + glucose + triglycerides - HDL cholesterol + the mean of SBP and DBP. HRV variables (SDNN, RMSSD, HF, LF, LF/HF, Mean RR) were measured using 5-minute electrocardiography at rest and analyzed using the Kubios HRV software. In this cross-sectional study, associations of CRS and individual cardiometabolic risk factors with HRV were investigated using linear regression analyses adjusted for sex and peak height velocity. RESULTS CRS was negatively associated with RMSSD, HF, Mean RR (P value < .05) and positively with LF/HF (P value = .005). Insulin was negatively associated with SDNN, RMSSD, HF, LF, and Mean RR (P value < .05) and positively with LF/HF (P value = .008). SBP was negatively associated with SDNN, RMSSD, HF, LF, and Mean RR (P value < .05). DBP was negatively associated with SDNN, RMSSD, and Mean RR (P value < .05). WC, glucose, triglycerides, or HDL cholesterol were not associated with HRV variables. CONCLUSIONS Higher CRS, insulin, and blood pressure were associated with smaller HRV, mainly indicating lower parasympathetic activity, in young children. This knowledge may help improving the clinical management of metabolic syndrome and cardiovascular diseases since childhood.
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Affiliation(s)
- Marja H Leppänen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Folkhälsan Research Center, Helsinki, Finland
| | - Eero A Haapala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Aapo Veijalainen
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Santeri Seppälä
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Ricardo S Oliveira
- Departamento de Educação Física, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - Niina Lintu
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Tomi Laitinen
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Mika P Tarvainen
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland.,Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Timo A Lakka
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland.,Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland.,Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
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16
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Associations of Cardiorespiratory Fitness and Adiposity With Arterial Stiffness and Arterial Dilatation Capacity in Response to a Bout of Exercise in Children. Pediatr Exerc Sci 2019; 31:238-247. [PMID: 30626267 DOI: 10.1123/pes.2018-0145] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Purpose: To investigate the associations of directly measured peak oxygen uptake ( V˙O2peak ) and body fat percentage (BF%) with arterial stiffness and arterial dilatation capacity in children. Methods: Findings are based on 329 children (177 boys and 152 girls) aged 8-11 years. V˙O2peak was assessed by a maximal cardiopulmonary exercise test on a cycle ergometer and scaled by lean body mass (LM). BF% and LM were measured by bioelectrical impedance. Stiffness index (measure of arterial stiffness) and change in reflection index (ΔRI, measure of arterial dilatation capacity) were assessed by pulse contour analysis. Data were analyzed by linear regression models. Results:V˙O2peak/LM was positively associated with ΔRI in boys adjusted for age and BF% (β = 0.169, P = .03). Further adjustments for systolic blood pressure, heart rate, and the study group had no effect on this association, but additional adjustment for clinical puberty attenuated it (β = 0.171, P = .07). BF% was inversely related to ΔRI in boys adjusted for age and V˙O2peak/LM (β = -0.171, P = .03). V˙O2peak or BF% was not associated with ΔRI in girls or with stiffness index in either boys or girls. Conclusion: Increasing cardiorespiratory fitness and decreasing adiposity may improve arterial health in childhood, especially among boys.
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Armstrong N, Welsman J. Development of peak oxygen uptake from 11-16 years determined using both treadmill and cycle ergometry. Eur J Appl Physiol 2019; 119:801-812. [PMID: 30627827 PMCID: PMC6394694 DOI: 10.1007/s00421-019-04071-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 01/03/2019] [Indexed: 11/12/2022]
Abstract
PURPOSES To investigate the development of peak oxygen uptake ([Formula: see text]) assessed on both a treadmill and a cycle ergometer in relation with sex and concurrent changes in age, body mass, fat-free mass (FFM), and maturity status and to evaluate currently proposed 'clinical red flags' or health-related cut-points for peak [Formula: see text]. METHODS Multiplicative multilevel modelling, which enables the effects of variables to be partitioned concurrently within an allometric framework, was used to analyze the peak [Formula: see text]s of 138 (72 boys) students initially aged 11-14 years and tested on three annual occasions. Models were founded on 640 (340 from boys) determinations of peak [Formula: see text], supported by anthropometric measures and maturity status. RESULTS Mean peak [Formula: see text]s were 11-14% higher on a treadmill. The data did not meet the statistical assumptions underpinning ratio scaling of peak [Formula: see text] with body mass. With body mass appropriately controlled for boys' peak [Formula: see text]s were higher than girls' values and the difference increased with age. The development of peak [Formula: see text] was sex-specific, but within sex models were similar on both ergometers with FFM the dominant anthropometric factor. CONCLUSIONS Data should not be pooled for analysis but data from either ergometer can be used independently to interpret the development of peak [Formula: see text] in youth. On both ergometers and in both sexes, FFM is the most powerful morphological influence on the development of peak [Formula: see text]. 'Clinical red flags' or health-related cut-points proposed without consideration of exercise mode and founded on peak [Formula: see text] in ratio with body mass are fallacious.
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Affiliation(s)
- Neil Armstrong
- Children’s Health and Exercise Research Centre, University of Exeter, St Lukes Campus, Heavitree Road, Exeter, EX1 2LU UK
| | - Jo Welsman
- Children’s Health and Exercise Research Centre, University of Exeter, St Lukes Campus, Heavitree Road, Exeter, EX1 2LU UK
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18
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Abstract
This commentary highlights 23 noteworthy publications from 2018, selected by leading scientists in pediatric exercise science. These publications have been deemed as significant or exciting in the field as they (a) reveal a new mechanism, (b) highlight a new measurement tool, (c) discuss a new concept or interpretation/application of an existing concept, or (d) describe a new therapeutic approach or clinical tool in youth. In some cases, findings in adults are highlighted, as they may have important implications in youth. The selected publications span the field of pediatric exercise science, specifically focusing on: aerobic exercise and training; neuromuscular physiology, exercise, and training; endocrinology and exercise; resistance training; physical activity and bone strength; growth, maturation, and exercise; physical activity and cognition; childhood obesity, physical activity, and exercise; pulmonary physiology or diseases, exercise, and training; immunology and exercise; cardiovascular physiology and disease; and physical activity, inactivity, and health.
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