|
1
|
Haferanke J, Baumgartner L, Willinger L, Oberhoffer-Fritz R, Schulz T. Molecular Mechanisms of Vascular Tone in Exercising Pediatric Populations: A Comprehensive Overview on Endothelial, Antioxidative, Metabolic and Lipoprotein Signaling Molecules. Int J Mol Sci 2025; 26:1027. [PMID: 39940797 PMCID: PMC11817131 DOI: 10.3390/ijms26031027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2024] [Revised: 01/20/2025] [Accepted: 01/23/2025] [Indexed: 02/16/2025] Open
Abstract
Vasoactive molecules are central regulators of vascular tone, angiogenesis and inflammation. Key molecular agents include nitric oxide (NO), endothelin-1 (ET-1), prostacyclin, free triiodothyronine (fT3), leptin, low-density lipoprotein (LDL), high-density lipoprotein (HDL), superoxide dismutase (SOD), and glutathione peroxidase (GPX). Dysregulation of these compounds can lead to endothelial dysfunction, an early predictor of atherosclerosis and cardiovascular diseases (CVD). Maintaining endothelial health is thus essential for vascular homeostasis and cardiovascular risk prevention. Regular exercise serves as a vital protective measure against CVD and the risk of cardiovascular conditions. However, young athletes often significantly exceed recommended levels of training load, engaging in highly intensive training that leads to substantial physiological adaptations. Despite this, research on the impact of exercise on vasoactive substances in children and adolescents, particularly young athletes, is limited and inconsistent. Most studies focus on those with pre-existing conditions, like obesity or diabetes mellitus. Existing findings suggest exercise may favorably affect vascular biomarkers in youth, but methodological variations hinder consistent conclusions. This literature review examines 68 studies on the effects of exercise on vascular molecules in children and adolescents, young athletes, and children and adolescents with pre-existing conditions, offering deeper insights into how exercise may influence vascular health at the molecular level.
Collapse
Affiliation(s)
- Jonas Haferanke
- Department Health and Sport Sciences, Institute of Preventive Pediatrics, TUM School of Medicine and Health, Technical University of Munich (TUM), 80992 Munich, Germany
| | | | | | | | - Thorsten Schulz
- Department Health and Sport Sciences, Institute of Preventive Pediatrics, TUM School of Medicine and Health, Technical University of Munich (TUM), 80992 Munich, Germany
| |
Collapse
|
|
2
|
Pinho CDF, Bagatini-PhD NC, Lisboa SDC, Mello JB, Cunha GDS. Effects of different supervised and structured physical exercise on the physical fitness trainability of children and adolescents: a meta-analysis and meta-regression : Physical fitness trainability in children and adolescents' health. BMC Pediatr 2024; 24:798. [PMID: 39639233 PMCID: PMC11619429 DOI: 10.1186/s12887-024-04929-2] [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] [Received: 10/26/2023] [Accepted: 07/03/2024] [Indexed: 12/07/2024] Open
Abstract
BACKGROUND Physical fitness has been considered an important health indicator. Several factors can impact the increase in physical fitness in children and adolescents, including chronological age, sex and BMI, in addition to training variables such as weekly frequency, session and intervention duration, and types of exercises performed. To know the importance of variables that can impact physical fitness, it is important for health professionals to identify the most efficient way of prescribing physical exercises for children and adolescents. The aim is review and meta-analyses of the effects of supervised and structured physical exercise on the physical fitness trainability of children and adolescents. METHODS Relevant articles were searched in the PubMed, Cochrane Library, Embase and Scopus platform databases and selected based on the following criteria: children and adolescents aged between 7 and 17 years who performed any type of structured physical exercise compared to a control group without exercise and evaluating physical fitness (strength or muscular power, cardiorespiratory fitness (CRF) or speed. The results are reported in accordance with PRISMA 2020. RESULTS Eighty studies were included with a total of 5769 participants. Strength exercises (ES: 1.073; 95% CI, 0.612-1.533; P < 0.001; I2: 74%), concurrent (ES: 1.054; 95% CI, 0.255-1.853; P < 0.010; I2: 72%) and sports (ES: 0.573; 95% CI, 0.015 to 1.132; P < 0.044; I2: 34%) seem to be the most effective in increasing muscular strength. Aerobic activities (ES: 0.400; 95% CI, 0.258-0.542; P < 0.001; I2: 74%), sports (ES: 0.271; 95% IC, 0.148-0.394; P < 0.001; I2: 15), or HIIT (ES: 0.668; 95% IC, 0.333-1.003; P < 0.001; I2: 29%) resulted in increased CRF (ES: 0.514; 95% IC, 0.220-1.808; P < 0.001; I2: 66%). The practice of physical exercise increased muscular power (ES: 0.241; 95% CI, 0.053-0.429; P = 0.012; I2: 0%). The practice of HIIT impacts MAS gains (ES: 0.048; 95% CI, 0.050 - 0.026; P = 0.029; I2: 44%). CONCLUSION Supervised and structured physical exercise can improve muscular strength (15-35%), CRF (5.4-8.5%), muscular power (5.6-11.8%), and MAS (5.4%) trainability in children and adolescents. Sex, BMI of the subjects and type of exercise performed (aerobic activities, exclusive to strength, HIIT or sports) should be considered when prescribing the exercise.
Collapse
Affiliation(s)
- Carolina Dertzbocher Feil Pinho
- Physiotherapy and Dance, Federal University of Rio Grande do Sul - School of Physical Education, 750, Felizardo Street - Jardim Botânico, Porto Alegre, 90690-200, Brazil.
| | - Natália Carvalho Bagatini-PhD
- Physiotherapy and Dance, Federal University of Rio Grande do Sul - School of Physical Education, 750, Felizardo Street - Jardim Botânico, Porto Alegre, 90690-200, Brazil
| | - Salime Donida Chedid Lisboa
- Physiotherapy and Dance, Federal University of Rio Grande do Sul - School of Physical Education, 750, Felizardo Street - Jardim Botânico, Porto Alegre, 90690-200, Brazil
| | - Júlio Brugnara Mello
- Pontificia Universidad Católica de Valparaíso - Escuela de Educación Física - eFIDac Research Group, Valparaíso, Chile
| | - Giovani Dos Santos Cunha
- Physiotherapy and Dance, Federal University of Rio Grande do Sul - School of Physical Education, 750, Felizardo Street - Jardim Botânico, Porto Alegre, 90690-200, Brazil
| |
Collapse
|
|
3
|
Popescu C, Matei D, Amzolini AM, Trăistaru MR. Inflammation and Physical Performance in Overweight and Obese Schoolchildren. Life (Basel) 2024; 14:1583. [PMID: 39768291 PMCID: PMC11678139 DOI: 10.3390/life14121583] [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: 10/09/2024] [Revised: 11/24/2024] [Accepted: 11/30/2024] [Indexed: 01/11/2025] Open
Abstract
Obesity represents a critical public health concern, often linked to low-grade chronic inflammation starting in childhood. This study aimed to evaluate the impact of a 12-week kinesiotherapy program on physical performance and levels of leptin and C-reactive protein (CRP) in overweight and obese children. METHODS Conducted at the Filantropia Municipal Clinical Hospital, 160 children aged 6 to 15 were randomly assigned to a study group (SG, n = 80) and a control group (CG, n = 80). The SG engaged in a tailored kinesiotherapy program, while the CG maintained their usual activities. All children and their families learned five key principles for preventing and managing obesity. RESULTS Results indicated significant improvements in the SG, with enhancements in the 6 min walking distance, Timed Up and Go test, and walking cadence (all p-values < 0.001). Notably, leptin and CRP levels (23.02 ± 7.17 to 16.62 ± 7.83, 4.13 ± 1.00 to 3.90 ± 0.95 mg/l, respectively) decreased significantly in the SG, contrasting with no significant changes in the CG. Regression analysis revealed a positive correlation between leptin levels and physical activity in the SG (coefficient: 0.5642, R-squared: 0.266). CONCLUSIONS These findings suggest that targeted exercise programs can effectively enhance physical performance and reduce inflammation markers in overweight children, highlighting the importance of tailored interventions in managing obesity.
Collapse
Affiliation(s)
- Cristina Popescu
- Doctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Daniela Matei
- Department of Medical Rehabilitation, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Anca Maria Amzolini
- Department of Medical Semiology, University of Medicine and Pharmacy Craiova, 200349 Craiova, Romania
| | - Magdalena Rodica Trăistaru
- Department of Medical Rehabilitation, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| |
Collapse
|
|
4
|
Calcaterra V, Magenes VC, Bianchi A, Rossi V, Gatti A, Marin L, Vandoni M, Zuccotti G. How Can Promoting Skeletal Muscle Health and Exercise in Children and Adolescents Prevent Insulin Resistance and Type 2 Diabetes? Life (Basel) 2024; 14:1198. [PMID: 39337980 PMCID: PMC11433096 DOI: 10.3390/life14091198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2024] [Revised: 09/16/2024] [Accepted: 09/19/2024] [Indexed: 09/30/2024] Open
Abstract
Skeletal muscle secretome, through its paracrine and endocrine functions, contributes to the maintenance and regulation of overall physiological health. We conducted a narrative review on the role of skeletal muscle and exercise in maintaining glucose homeostasis, driving insulin resistance (IR), and preventing type 2 diabetes in pediatric populations, especially in the context of overweight and obesity. Myokines such as interleukin (IL)-6, IL-8, and IL-15, as well as irisin, myonectin, and myostatin, appear to play a crucial role in IR. Skeletal muscle can also become a target of obesity-induced and IR-induced inflammation. In the correlation between muscle, IR, and inflammation, the role of infiltration of the immune cells and the microvasculature may also be considered. It remains unclear which exercise approach is the best; however, combining aerobic exercise with resistance training seems to be the most effective strategy for managing IR, with high-intensity activities offering superior metabolic benefits and long-term adherence. Encouraging daily participation in enjoyable and engaging exercise is key for long-term commitment and effective glucose metabolism management. Promoting physical activity in children and adolescents must be a top priority for public health, not only in terms of individual quality of life and well-being but also for community health.
Collapse
Affiliation(s)
- Valeria Calcaterra
- Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy; (V.C.M.); (A.B.); (V.R.); (G.Z.)
| | - Vittoria Carlotta Magenes
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy; (V.C.M.); (A.B.); (V.R.); (G.Z.)
| | - Alice Bianchi
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy; (V.C.M.); (A.B.); (V.R.); (G.Z.)
| | - Virginia Rossi
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy; (V.C.M.); (A.B.); (V.R.); (G.Z.)
| | - Alessandro Gatti
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (A.G.); (L.M.); (M.V.)
| | - Luca Marin
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (A.G.); (L.M.); (M.V.)
| | - Matteo Vandoni
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (A.G.); (L.M.); (M.V.)
| | - Gianvincenzo Zuccotti
- Pediatric Department, Buzzi Children’s Hospital, 20154 Milano, Italy; (V.C.M.); (A.B.); (V.R.); (G.Z.)
- Department of Biomedical and Clinical Science, University of Milano, 20157 Milano, Italy
| |
Collapse
|
|
5
|
Li LY, Li SM, Pang BX, Wei JP, Wang QH. Effects of exercise training on glucose metabolism indicators and inflammatory markers in obese children and adolescents: A meta-analysis. World J Diabetes 2024; 15:1353-1366. [PMID: 38983830 PMCID: PMC11229972 DOI: 10.4239/wjd.v15.i6.1353] [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: 12/30/2023] [Revised: 02/07/2024] [Accepted: 03/26/2024] [Indexed: 06/11/2024] Open
Abstract
BACKGROUND Obesity in children and adolescents is a serious problem, and the efficacy of exercise therapy for these patients is controversial. AIM To assess the efficacy of exercise training on overweight and obese children based on glucose metabolism indicators and inflammatory markers. METHODS The PubMed, Web of Science, and Embase databases were searched for randomized controlled trials related to exercise training and obese children until October 2023. The meta-analysis was conducted using RevMan 5.3 software to evaluate the efficacy of exercise therapy on glucose metabolism indicators and inflammatory markers in obese children. RESULTS In total, 1010 patients from 28 studies were included. Exercise therapy reduced the levels of fasting blood glucose (FBG) [standardized mean difference (SMD): -0.78; 95% confidence interval (CI): -1.24 to -0.32, P = 0.0008], fasting insulin (FINS) (SMD: -1.55; 95%CI: -2.12 to -0.98, P < 0.00001), homeostatic model assessment for insulin resistance (HOMA-IR) (SMD: -1.58; 95%CI: -2.20 to -0.97, P < 0.00001), interleukin-6 (IL-6) (SMD: -1.31; 95%CI: -2.07 to -0.55, P = 0.0007), C-reactive protein (CRP) (SMD: -0.64; 95%CI: -1.21 to -0.08, P = 0.03), and leptin (SMD: -3.43; 95%CI: -5.82 to -1.05, P = 0.005) in overweight and obese children. Exercise training increased adiponectin levels (SMD: 1.24; 95%CI: 0.30 to 2.18, P = 0.01) but did not improve tumor necrosis factor-alpha (TNF-α) levels (SMD: -0.80; 95%CI: -1.77 to 0.18, P = 0.11). CONCLUSION In summary, exercise therapy improves glucose metabolism by reducing levels of FBG, FINS, HOMA-IR, as well as improves inflammatory status by reducing levels of IL-6, CRP, leptin, and increasing levels of adiponectin in overweight and obese children. There was no statistically significant effect between exercise training and levels of TNF-α. Additional long-term trials should be conducted to explore this therapeutic perspective and confirm these results.
Collapse
Affiliation(s)
- Le-Yang Li
- Department of Endocrinology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
| | - Song-Mei Li
- Department of Endocrinology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
| | - Bo-Xian Pang
- Graduate School, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Jun-Ping Wei
- Department of Endocrinology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
| | - Qiu-Hong Wang
- Department of Endocrinology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
| |
Collapse
|
|
6
|
García-Hermoso A, López-Gil JF, Izquierdo M, Ramírez-Vélez R, Ezzatvar Y. Exercise and Insulin Resistance Markers in Children and Adolescents With Excess Weight: A Systematic Review and Network Meta-Analysis. JAMA Pediatr 2023; 177:1276-1284. [PMID: 37812414 PMCID: PMC10562991 DOI: 10.1001/jamapediatrics.2023.4038] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 08/10/2023] [Indexed: 10/10/2023]
Abstract
IMPORTANCE Although benefits have been reported for most exercise modalities, the most effective exercise approaches for reducing insulin resistance in children and adolescents with excess weight and the optimal exercise dose remain unknown. OBJECTIVE To compare exercise training modalities and their association with changes in insulin resistance markers among children and adolescents with excess weight and to establish the optimal exercise dose. DATA SOURCES For this systematic review and network meta-analysis, 6 electronic databases (PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Scopus, Web of Science, and CINAHL) were searched for studies from inception to April 1, 2023. STUDY SELECTION Randomized clinical trials (ie, randomized controlled trials and randomized trials without a control group) were included if they reported outcomes associated with aerobic training, resistance training, high-intensity interval training (HIIT), or a combination of these interventions. DATA EXTRACTION AND SYNTHESIS Data extraction for this systematic review was conducted following a network meta-analysis extension of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guideline. Effect sizes were calculated as the mean difference (MD) with 95% CI using random-effects inverse-variance models with the Hartung-Knapp-Sidik-Jonkman method. The hierarchy of competing interventions was defined using the surface under the cumulative ranking curve. The Cochrane Risk-of-Bias tool, version 2 (RoB2), was used to independently assess the risk of bias of the included studies. The certainty of evidence in consistent networks was assessed using the Grading of Recommendation, Assessment, Development and Evaluation approach. The study protocol was prospectively registered with PROSPERO. Data analyses were conducted between May and June 2023. MAIN OUTCOMES AND MEASURES The primary outcomes were fasting glucose, insulin, and homeostatic model assessment for insulin resistance (HOMA-IR). RESULTS This analysis included 55 studies with a total of 3051 children and adolescents (mean [SD] age, 13.5 [2.3] years; 1537 girls [50.4%] and 1514 boys [49.6%]). Exercise was associated with reductions in fasting insulin (MD, -4.38 μU/mL [95% CI, -5.94 to -2.82 μU/mL]) and HOMA-IR (MD, -0.87 [95% CI, -1.20 to -0.53]). A nonlinear association in both markers was observed, with a required minimal exercise dosage of approximately 900 to 1200 metabolic equivalent of task minutes per week, especially in children and adolescents with insulin resistance at baseline. Combination HIIT and resistance training and concurrent training were the most effective approaches for reducing insulin resistance markers. On average, the certainty of evidence varied from low to moderate. CONCLUSIONS AND RELEVANCE These findings underscore the role of exercise interventions in enhancing insulin resistance markers among children and adolescents with overweight and obesity. It is advisable to include resistance exercises alongside aerobic and HIIT programs for a minimum of two to three 60-minute sessions per week.
Collapse
Affiliation(s)
- Antonio García-Hermoso
- Navarrabiomed, Instituto de Investigación Sanitaria de Navarra, Hospital Universitario de Navarra, Universidad Pública de Navarra, Pamplona, Spain
| | - José Francisco López-Gil
- Navarrabiomed, Instituto de Investigación Sanitaria de Navarra, Hospital Universitario de Navarra, Universidad Pública de Navarra, Pamplona, Spain
- One Health Research Group, Universidad de Las Américas, Quito, Ecuador
| | - Mikel Izquierdo
- Navarrabiomed, Instituto de Investigación Sanitaria de Navarra, Hospital Universitario de Navarra, Universidad Pública de Navarra, Pamplona, Spain
- Centro de Investigación Biomédica en Red Sobre Fragilidad y Envejecimiento Saludable, Instituto de Salud Carlos III, Madrid, Spain
| | - Robinson Ramírez-Vélez
- Navarrabiomed, Instituto de Investigación Sanitaria de Navarra, Hospital Universitario de Navarra, Universidad Pública de Navarra, Pamplona, Spain
- Centro de Investigación Biomédica en Red Sobre Fragilidad y Envejecimiento Saludable, Instituto de Salud Carlos III, Madrid, Spain
| | - Yasmin Ezzatvar
- Department of Nursing, Universitat de València, Valencia, Spain
| |
Collapse
|
|
7
|
Salama M, Balagopal B, Fennoy I, Kumar S. Childhood Obesity, Diabetes. and Cardiovascular Disease Risk. J Clin Endocrinol Metab 2023; 108:3051-3066. [PMID: 37319430 DOI: 10.1210/clinem/dgad361] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/09/2023] [Accepted: 06/12/2023] [Indexed: 06/17/2023]
Abstract
This mini-review aims to briefly summarize the pathophysiology of childhood obesity, type 2 diabetes mellitus (T2DM), and cardiovascular disease (CVD) risk in children and adolescents. Recent data on efficacy of lifestyle interventions, medications, and metabolic surgery for obesity, T2DM, and CVD risk factors are also reviewed. We conducted a PubMed search of English-language original and review articles relevant to childhood obesity, T2DM, and CVD risk factors, and biomarkers in children with an emphasis on recent publications. Childhood obesity arises from an intricate interaction between genetic, physiologic, environmental, and socioeconomic factors. The rise in the prevalence of childhood obesity is associated with the development of comorbidities including T2DM and CVD at an early age. A multipronged approach is central to the detection, monitoring, and management of childhood obesity and associated adverse metabolic consequences.
Collapse
Affiliation(s)
- Mostafa Salama
- Division of Pediatric Endocrinology and Metabolism, Mayo Clinic, Rochester, MN 55905, USA
- Department of Pediatrics, Mayo Clinic, Rochester, MN 55905, USA
| | - Babu Balagopal
- Department of Pediatrics, Mayo Clinic, Rochester, MN 55905, USA
- Department of Biomedical Research, Nemours Children's Health System, Jacksonville, FL 32207, USA
| | - Ilene Fennoy
- Division of Pediatric Endocrinology, Diabetes and Metabolism, Columbia University, New York, NY 10032, USA
| | - Seema Kumar
- Division of Pediatric Endocrinology and Metabolism, Mayo Clinic, Rochester, MN 55905, USA
- Department of Pediatrics, Mayo Clinic, Rochester, MN 55905, USA
| |
Collapse
|
|
8
|
Climie RE, Alastruey J, Mayer CC, Schwarz A, Laucyte-Cibulskiene A, Voicehovska J, Bianchini E, Bruno RM, Charlton PH, Grillo A, Guala A, Hallab M, Hametner B, Jankowski P, Königstein K, Lebedeva A, Mozos I, Pucci G, Puzantian H, Terentes-Printzios D, Yetik-Anacak G, Park C, Nilsson PM, Weber T. Vascular ageing: moving from bench towards bedside. Eur J Prev Cardiol 2023; 30:1101-1117. [PMID: 36738307 PMCID: PMC7614971 DOI: 10.1093/eurjpc/zwad028] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 12/20/2022] [Accepted: 01/12/2023] [Indexed: 02/05/2023]
Abstract
Prevention of cardiovascular disease (CVD) remains one of the largest public health challenges of our time. Identifying individuals at increased cardiovascular risk at an asymptomatic, sub-clinical stage is of paramount importance for minimizing disease progression as well as the substantial health and economic burden associated with overt CVD. Vascular ageing (VA) involves the deterioration in vascular structure and function over time and ultimately leads to damage in the heart, brain, kidney, and other organs. Vascular ageing encompasses the cumulative effect of all cardiovascular risk factors on the arterial wall over the life course and thus may help identify those at elevated cardiovascular risk, early in disease development. Although the concept of VA is gaining interest clinically, it is seldom measured in routine clinical practice due to lack of consensus on how to characterize VA as physiological vs. pathological and various practical issues. In this state-of-the-art review and as a network of scientists, clinicians, engineers, and industry partners with expertise in VA, we address six questions related to VA in an attempt to increase knowledge among the broader medical community and move the routine measurement of VA a little closer from bench towards bedside.
Collapse
Affiliation(s)
- Rachel E. Climie
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool St, 7000 Hobart, Australia
- Sports Cardiology, Baker Heart and Diabetes Institute, 99 Commercial Rd, Melbourne 3000, Australia
- Integrative Epidemiology of Cardiovascular Disease, Université de Paris, INSERM, U970, Paris Cardiovascular Research Center (PARCC), 56 rue Leblanc, 75015 Paris, France
| | - Jordi Alastruey
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King’s College London, 249 Westminster Bridge Rd, London SE1 7EH, UK
| | - Christopher C. Mayer
- Medical Signal Analysis, Center for Health & Bioresources, AIT Austrian Institute of Technology, Giefinggasse 4, 1210 Vienna, Austria
| | - Achim Schwarz
- ALF Distribution GmbH, Stephanstrasse 19, 52064 Aachen, Germany
| | - Agne Laucyte-Cibulskiene
- Department of Clinical Sciences, Lund University, Skane University Hospital, Sölvegatan 19 - BMC F12, 221 84 Lund, Malmö, Sweden
- Faculty of Medicine, Vilnius University, M. K. C iurlionio g. 21, 03101 Vilnius, Lithuania
| | - Julija Voicehovska
- Department of Internal Diseases, Riga Stradins University, Dzirciema str. 16, Riga, L-1007, Latvia
- Nephrology and Renal Replacement Therapy Clinics, Riga East University Hospital, Hipokrata str. 2, Riga, LV-1079, Latvia
| | - Elisabetta Bianchini
- Institute of Clinical Physiology, Italian National Research Council (CNR), Via Moruzzi, 1, 56124 Pisa (PI), Italy
| | - Rosa-Maria Bruno
- Integrative Epidemiology of Cardiovascular Disease, Université de Paris, INSERM, U970, Paris Cardiovascular Research Center (PARCC), 56 rue Leblanc, 75015 Paris, France
| | - Peter H. Charlton
- Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, 2 Worts Causeway, Cambridge CB1 8RN, UK
| | - Andrea Grillo
- Medicina Clinica, Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy
| | - Andrea Guala
- Vall d’Hebron Institut de Recerca (VHIR), Paseo de la Vall d’Hebron, 129, 08035 Barcelona, Spain
| | - Magid Hallab
- Clinique Bizet, 23 Georges Bizet, 75116 Paris, France
| | - Bernhard Hametner
- Medical Signal Analysis, Center for Health & Bioresources, AIT Austrian Institute of Technology, Giefinggasse 4, 1210 Vienna, Austria
| | - Piotr Jankowski
- Department of Internal Medicine and Geriatric Cardiology, Centre of Postgraduate Medical Education, 231 Czerniakowska St., 00-416 Warsaw, Poland
| | - Karsten Königstein
- Department of Sport, Exercise and Health (DSBG) University of Basel, Grosse Allee 6, 4052 Basel, Switzerland
| | - Anna Lebedeva
- Department of Internal Medicine and Cardiology, Dresden Heart Centre, Dresden University of Technology, Fetscher str. 76, 01307 Dresden, Germany
| | - Ioana Mozos
- Department of Functional Sciences-Pathophysiology, Center for Translational Research and Systems Medicine, ‘Victor Babes’ University of Medicine and Pharmacy, T. Vladimirescu Street 14, 300173 Timisoara, Romania
| | - Giacomo Pucci
- Unit of Internal Medicine, Terni University Hospital - Department of Medicine and Surgery, University of Perugia, Terni, Italy
| | - Houry Puzantian
- Hariri School of Nursing, American University of Beirut, P.O. Box 11-0236, Riad El Solh 1107 2020, Beirut, Lebanon
| | - Dimitrios Terentes-Printzios
- First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, 114 Vasilissis Sofias Avenue, 11527 Athens, Greece
| | - Gunay Yetik-Anacak
- Department of Pharmacology, Faculty of Pharmacy, Acibadem Mehmet Ali Aydinlar University, Kayisdagi Cad. No:32 Atasehir, 34752 Istanbul, Turkey
| | - Chloe Park
- MRC Unit for Lifelong Health and Ageing at UCL, 1-19 Torrington Place, London WC1E 7HB, UK; and
| | - Peter M. Nilsson
- Department of Clinical Sciences, Lund University, Skane University Hospital, Sölvegatan 19 - BMC F12, 221 84 Lund, Malmö, Sweden
| | - Thomas Weber
- Cardiology Department, Klinikum Wels-Grieskirchen, Grieskirchnerstrasse 42, 4600 Wels, Austria
| |
Collapse
|
|
9
|
Kazeminasab F, Sharafifard F, Miraghajani M, Behzadnejad N, Rosenkranz SK. The effects of exercise training on insulin resistance in children and adolescents with overweight or obesity: a systematic review and meta-analysis. Front Endocrinol (Lausanne) 2023; 14:1178376. [PMID: 37635963 PMCID: PMC10450243 DOI: 10.3389/fendo.2023.1178376] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 05/03/2023] [Indexed: 08/29/2023] Open
Abstract
Aim The aim of present meta-analysis was to determine the effects of exercise training (Exe) on insulin resistance (IR) and body weight in children and adolescents with overweight or obesity. Methods PubMed, Web of Science, and Scopus were searched for original articles, published through October 2022 that included exercise versus control interventions on fasting glucose, insulin, HOMA-IR, and body weight outcomes in children and adolescents with overweight or obesity. Standardized mean differences (SMD) for fasting insulin, and weighted mean differences (WMD) for fasting glucose, HOMA-IR, body weight (BW), and 95% confidence intervals were determined using random effects models. Results Thirty-five studies comprising 1,550 children and adolescents with overweight and obesity were included in the present meta-analysis. Exercise training reduced fasting glucose (WMD=-2.52 mg/dL, p=0.001), fasting insulin (SMD=-0.77, p=0.001), HOMA-IR (WMD=-0.82, p=0.001), and BW (WMD=-1.51 kg, p=0.001), as compared to a control. Subgroup analyses showed that biological sex, intervention duration, type of exercise training, BMI percentile, and health status (with or without diagnosed condition), were sources of heterogeneity. Conclusion Exercise training is effective for lowering fasting glucose, fasting insulin, HOMA-IR, and BW in children and adolescents with overweight or obesity and could provide an important strategy for controlling IR and related factors. With clear evidence for the effectiveness of exercise interventions in this vulnerable population, it is important to determine effective approaches for increasing exercise training in children and adolescents with overweight or obesity.
Collapse
Affiliation(s)
- Fatemeh Kazeminasab
- Department of Physical Education and Sport Sciences, Faculty of Humanities, University of Kashan, Kashan, Iran
| | - Fatemeh Sharafifard
- Department of Physical Education and Sport Sciences, Faculty of Humanities, University of Kashan, Kashan, Iran
| | - Maryam Miraghajani
- Department of Cancer Research Center, Shahid Beheshti of Medical Sciences, Tehran, Iran
| | - Nasim Behzadnejad
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, University of Isfahan, Isfahan, Iran
| | - Sara K. Rosenkranz
- Department of Kinesiology and Nutrition Sciences, University of Nevada Las Vegas, Las Vegas, NV, United States
| |
Collapse
|
|
10
|
Edwards S, Foster M, Ahmed SF, Lucas-Herald AK. Preventative interventions that target cardiovascular dysfunction in children and young people: a systematic review of their effectiveness and an investigation of sexual dimorphism. J Hum Hypertens 2023; 37:726-734. [PMID: 36463360 PMCID: PMC10403341 DOI: 10.1038/s41371-022-00780-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 11/07/2022] [Accepted: 11/11/2022] [Indexed: 12/07/2022]
Abstract
Given that cardiovascular diseases remain a primary cause of mortality and morbidity, there is a need to consider preventative strategies to improve vascular function from early in life. The aims of this study were therefore to investigate which interventions may improve endothelial function, intima media thickness and arterial stiffness in children and young people and to assess whether these interventions differ in boys and girls. A systematic literature search of Science Direct, Pubmed, Google Scholar and the Cochrane Library by two independent reviewers was performed to source articles. Inclusion criteria were any studies including any child ≤18 years of age receiving an intervention, which measured vascular function other than blood pressure. Exclusion criteria were studies assessing children with chronic medical conditions. A total of 72 studies were identified, which met the inclusion criteria. A measurable change in outcome was more likely to be reported in studies investigating endothelial function (p = 0.03). Interventions which improved vascular function included physical activity and dietary programmes. Under 10% of studies considered sex differences. In conclusion, school-based physical activity interventions are most likely to result in improvements in vascular function. Endothelial function may be the first variable of vascular function to change secondary to an intervention. Standardisation of reporting of differences between the sexes is essential to be able to ensure interventions are equally effective for boys and girls.
Collapse
Affiliation(s)
- Sophie Edwards
- Developmental Endocrinology Research Group, University of Glasgow, Royal Hospital for Children, Glasgow, UK
| | - Murray Foster
- Developmental Endocrinology Research Group, University of Glasgow, Royal Hospital for Children, Glasgow, UK
| | - S Faisal Ahmed
- Developmental Endocrinology Research Group, University of Glasgow, Royal Hospital for Children, Glasgow, UK
| | - Angela K Lucas-Herald
- Developmental Endocrinology Research Group, University of Glasgow, Royal Hospital for Children, Glasgow, UK.
| |
Collapse
|
|
11
|
Kwon JA, Kim B, Kim E, Kwon K. Interaction between blood cadmium and lead concentration and physical activity on hypertension from the Korean national health and nutrition examination survey in 2008-2013. BMC Public Health 2023; 23:703. [PMID: 37069558 PMCID: PMC10111815 DOI: 10.1186/s12889-023-15614-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 04/05/2023] [Indexed: 04/19/2023] Open
Abstract
BACKGROUND Previous studies have suggested that blood Cd, Pb exposure, and physical activity levels may influence the development of hypertension. This study aimed to investigate the relationship between blood Cd, Pb levels, and hypertension by the level of physical activity in Korean adults using The Korea National Health and Nutrition Examination Survey (KNHANES). METHODS We used data from the KNHANES (2008-2013), a nationally representative, cross-sectional, population-based study. We included 8,510 participants who had records of blood Cd, Pb and, blood pressure measurements. Multiple logistic regression was used to examine the association between blood Cd and Pb exposure and the development of hypertension, as well as the modifying effects of physical activity levels. Additive interaction was estimated using relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP) and synergy index (S). RESULTS Following covariates adjustments, we found significant associations of blood Cd and Pb with higher hypertension prevalence. This association was more apparent in low physical activity while blood Cd and Pb concentrations were not significantly associated with hypertension in participants with more activity. Additionally, there was a significant interaction between blood Cd and physical activity on hypertension risk (RERI = 0.17, 95% CI: -0.36-0.7; AP = 0.12, 95% CI: -0.28-0.52; S = 1.75, 95% CI:1.36-2.14). CONCLUSIONS Our results suggest that low physical activity may substantially amplify the adverse effects of blood Pb and Cd exposure on hypertension risk. However, interactions were only found for Cd. Further studies are needed to confirm these findings.
Collapse
Affiliation(s)
- Jeoung A Kwon
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
| | - Byungmi Kim
- National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
- National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Republic of Korea
| | - Eunji Kim
- Department of Environmental Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Kisung Kwon
- Department of Sport Science, College of Art, Cultural & Engineering, Kangwon National University, Chuncheon, Republic of Korea.
| |
Collapse
|
|
12
|
Tao X, Chen Y, Zhen K, Ren S, Lv Y, Yu L. Effect of continuous aerobic exercise on endothelial function: A systematic review and meta-analysis of randomized controlled trials. Front Physiol 2023; 14:1043108. [PMID: 36846339 PMCID: PMC9950521 DOI: 10.3389/fphys.2023.1043108] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 02/01/2023] [Indexed: 02/12/2023] Open
Abstract
Background: Current research suggests that continuous aerobic exercise can be effective in improving vascular endothelial function, while the effect between different intensities and durations of exercise is unclear. The aim of this study was to explore the effect of different durations and intensities of aerobic exercise on vascular endothelial function in different populations. Methods: Searches were performed in PubMed, Web of Science, and EBSCO databases. We included studies that satisfied the following criteria: 1) randomized controlled trials (RCTs); 2) including both an intervention and control group; 3) using flow-mediated dilation (FMD) as the outcome measure; and 4) testing FMD on the brachial artery. Results: From 3,368 search records initially identified, 41 studies were eligible for meta-analysis. There was a significant effect of continuous aerobic exercise on improving flow-mediated dilation (FMD) [weighted mean difference (WMD), 2.55, (95% CI, 1.93-3.16), p < 0.001]. Specifically, moderate-intensity [2.92 (2.02-3.825), p < 0.001] and vigorous-intensity exercise [2.58 (1.64-3.53), p < 0.001] significantly increased FMD. In addition, a longer duration [<12 weeks, 2.25 (1.54-2.95), p < 0.001; ≥12 weeks, 2.74 (1.95-3.54), p < 0.001], an older age [age <45, 2.09 (0.78-3.40), p = 0.002; 45 ≤ age <60, 2.25 (1.49-3.01), p < 0.001; age ≥60, 2.62 (1.31-3.94), p < 0.001], a larger basal body mass index (BMI) [20 < BMI < 25, 1.43 (0.98-1.88), p < 0.001; 25 ≤ BMI < 30, 2.49 (1.07-3.90), p < 0.001; BMI ≥ 30, 3.05 (1.69-4.42), p < 0.001], and a worse basal FMD [FMD < 4, 2.71 (0.92-4.49), p = 0.003; 4 ≤ FMD < 7, 2.63 (2.03-3.23), p < 0.001] were associated with larger improvements in FMD. Conclusion: Continuous aerobic exercise, especially moderate-intensity and vigorous-intensity aerobic exercise, contributed to improving FMD. The effect of continuous aerobic exercise on improving FMD was associated with duration and participant's characteristics. Specifically, a longer duration, an older age, a larger basal BMI, and a worse basal FMD contributed to more significant improvements in FMD. Systematic Review Registration: [https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=341442], identifier [CRD42022341442].
Collapse
Affiliation(s)
- Xifeng Tao
- Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing, China
- Department of Sports Performance, Beijing Sport University, Beijing, China
| | - Yiyan Chen
- Department of Sports Performance, Beijing Sport University, Beijing, China
| | - Kai Zhen
- Department of Sports Performance, Beijing Sport University, Beijing, China
| | - Shiqi Ren
- China Institute of Sport and Health Science, Beijing Sport University, Beijing, China
| | - Yuanyuan Lv
- Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing, China
- China Institute of Sport and Health Science, Beijing Sport University, Beijing, China
| | - Laikang Yu
- Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing, China
- Department of Sports Performance, Beijing Sport University, Beijing, China
| |
Collapse
|
|
13
|
Peng S, Fang Y, Othman AT, Liang J. Meta-analysis and systematic review of physical activity on neurodevelopment disorders, depression, and obesity among children and adolescents. Front Psychol 2022; 13:940977. [PMID: 36533019 PMCID: PMC9747947 DOI: 10.3389/fpsyg.2022.940977] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 11/02/2022] [Indexed: 08/22/2023] Open
Abstract
Background No consensus on whether physical activity (PA) is related to physical and mental health among pediatric population remains has been reached to date. To further explore their association, our study assessed the effect of PA on physical and mental health of children and adolescents through a systematic review and meta-analysis of randomized controlled studies (RCTs). Methods Several databases(Web of science, PubMed, Embase, Cochrane Central register of controlled trials, CINAHL) were searched from inception to 1st, December 2020 without language restrictions. Results 38,236 records were identified primitively and 31 included studies with 1,255 participants eventually met our inclusion criteria, all of which exhibited a relatively low-moderate risk of bias of overall quality. In regard to mental health, the administration of PA, compared with the control group, led to moderate improvements in Autism Spectrum Disorder(ASD)[Standard mean difference (SMD) = -0.50, Confidence interval(CI): -0.87, -0.14)] and depression(SMD = -0.68, CI: -0.98, -0.38) among children and adolescents. Similarly, significant result was observed in obesity (SMD = -0.58, CI: -0.80, -0.36). No significant differences were observed in Attention deficit hyperactivity disorder (ADHD) (SMD = -0.29, CI: -0.59, 0.01). Conclusion Altogether, PA may have a beneficial effect on children and adolescents with ASD, depression and obesity; nevertheless, there is insufficient evidence to confirm its efficacy in ADHD. More large-scale population based randomized controlled trials are needed to explore more reliable evidence between them.
Collapse
Affiliation(s)
- Sanying Peng
- Department of Physical Education, Hohai University, Nanjing, China
- School of Educational Studies, Universiti Sains Malaysia, Penang, Malaysia
| | - Yuan Fang
- College of International Languages and Cultures of Hohai University, Nanjing, China
| | | | - Jinghong Liang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
|
14
|
Alvarez-Pitti J, Herceg-Čavrak V, Wójcik M, Radovanović D, Brzeziński M, Grabitz C, Wühl E, Drożdż D, Melk A. Blood pressure response to exercise in children and adolescents. Front Cardiovasc Med 2022; 9:1004508. [PMID: 36247478 PMCID: PMC9561233 DOI: 10.3389/fcvm.2022.1004508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 09/08/2022] [Indexed: 11/27/2022] Open
Abstract
Blood pressure changes during exercise are part of the physiological response to physical activity. Exercise stress testing can detect an exaggerated blood pressure response in children and adolescent. It is applied for certain clinical conditions, but is also commonly used as part of the assessment of athletes. The interpretation of blood pressure values in response to exercise during childhood and adolescence requires appropriate reference data. We discuss the available reference values and their limitations with regard to device, exercise protocol and normalization. While the link between an exaggerated blood pressure response and cardiovascular events and mortality has been demonstrated for adults, the situation is less clear for children and adolescents. We discuss the existing evidence and propose that under certain circumstances it might be reasonable to have children and adolescents undergo exercise stress testing as a rather non-invasive procedure to add additional information with regard to their cardiovascular risk profile. Based on the existing data future studies are needed to extend our current knowledge on possible links between the presence of certain clinical conditions, the detectability of an exaggerated blood pressure response during childhood and adolescence and the risk of developing cardiovascular morbidity and mortality in later life.
Collapse
Affiliation(s)
- Julio Alvarez-Pitti
- Pediatric Department, Consorcio Hospital General, University of Valencia, Valencia, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- INCLIVA Biomedical Research Institute, Hospital Clínico, University of Valencia, Valencia, Spain
| | - Vesna Herceg-Čavrak
- Faculty of Health Science, Libertas International University, Zagreb, Croatia
| | - Małgorzata Wójcik
- Department of Pediatric and Adolescent Endocrinology, Chair of Pediatrics, Pediatric Institute, Jagiellonian University Medical College, Kraków, Poland
| | - Dragan Radovanović
- Department of Medical Sciences, Faculty of Sport and Physical Education, University of Niš, Niš, Serbia
| | - Michał Brzeziński
- Department of Pediatrics, Gastroenterology, Allergology and Pediatric Nutrition, Medical University of Gdansk, Gdańsk, Poland
| | - Carl Grabitz
- Children’s Hospital, Hannover Medical School, Hanover, Germany
| | - Elke Wühl
- Division of Pediatric Nephrology, Center for Pediatrics and Adolescent Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Dorota Drożdż
- Department of Pediatric Nephrology and Hypertension, Pediatric Institute, Jagiellonian University Medical College, Kraków, Poland
- Dorota Drożdż,
| | - Anette Melk
- Children’s Hospital, Hannover Medical School, Hanover, Germany
- *Correspondence: Anette Melk,
| |
Collapse
|
|
15
|
Xu R, Huang QT, Chen YT, Wang PY. Effects and dose-response relationships of exercise intervention on weight loss in overweight and obese children: a meta-regression and system review. J Pediatr Endocrinol Metab 2022; 35:1117-1131. [PMID: 35933324 DOI: 10.1515/jpem-2022-0209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 07/11/2022] [Indexed: 11/15/2022]
Abstract
The aim of this study was to determine the effect of different exercise doses on weight loss in obese/overweight children. PubMed, Embase, SPORTDiscus, and the Cochrane library were searched from inception to November 2020 for randomized controlled trials. Fourty six trials involving 2,599 obese/overweight children were finally included. Different exercise dose interventions had different impacts. Exercise intervention reduce body weight (BW) by 1.46 kg (95% CI, -2.35 to -0.56, p=0.001), body fat percentage (BF%) by 2.24 (95% CI, -2.63 to -1.84, p<0.001) and body mass index (BMI) by 1.09 kg/m2 (95% CI, -1.45 to -0.73, p<0.001). Each MET-h/week was association with 0.147 kg (95% CI, -0.287 to -0.007, p=0.039) decrease in BW, 0.060 (95% CI, -0.118 to -0.002, p=0.042) decrease in BF%, and 0.069 kg/m2 (95% CI, -0.125 to -0.014, p=0.015) decrease in BMI. The findings suggest that there is a positive liner between exercise dose and weight loss, each MET-h/week associated with 0.147 kg, 0.060 and 0.069 kg/m2 decrease in body weight, BF%, BMI, respectively.
Collapse
Affiliation(s)
- Rui Xu
- School of Sports and Health, Nanjing Sport Institute, Nanjing, P.R. China.,Laboratory of Kinesiology, Nanjing Sport Institute, Nanjing, P.R. China
| | - Qiao-Ting Huang
- College of Physical Education, Chengdu University, Chengdu, P.R. China
| | - Yu-Ting Chen
- School of Sports and Health, Nanjing Sport Institute, Nanjing, P.R. China
| | - Peng-Yin Wang
- School of Sports and Health, Nanjing Sport Institute, Nanjing, P.R. China
| |
Collapse
|
|
16
|
Estébanez B, Huang CJ, Rivera-Viloria M, González-Gallego J, Cuevas MJ. Exercise Outcomes in Childhood Obesity-Related Inflammation and Oxidative Status. Front Nutr 2022; 9:886291. [PMID: 35859754 PMCID: PMC9289530 DOI: 10.3389/fnut.2022.886291] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 06/08/2022] [Indexed: 12/14/2022] Open
Abstract
Childhood obesity is identified as one of the major public health issues to increase the risk for cardiometabolic diseases and related complications in adulthood. The literature has supported inflammation and oxidative stress as the primary underlying mechanisms involved in the pathogenesis of obesity-related diseases. Epidemiological evidence consistently shows the benefits of physical activity in the improvement of obesity-mediated inflammation and oxidative stress status. In this narrative mini-review, the available scientific evidence on the potential effects of exercise in alleviating these susceptibilities in childhood obesity will be assessed.
Collapse
Affiliation(s)
- Brisamar Estébanez
- Institute of Biomedicine (IBIOMED), University of León, León, Spain
- *Correspondence: Brisamar Estébanez,
| | - Chun-Jung Huang
- Exercise Biochemistry Laboratory, Department of Exercise Science and Health Promotion, Florida Atlantic University, Boca Raton, FL, United States
| | | | - Javier González-Gallego
- Institute of Biomedicine (IBIOMED), University of León, León, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | - María J. Cuevas
- Institute of Biomedicine (IBIOMED), University of León, León, Spain
| |
Collapse
|
|
17
|
Wang S, Zhou H, Zhao C, He H. Effect of Exercise Training on Body Composition and Inflammatory Cytokine Levels in Overweight and Obese Individuals: A Systematic Review and Network Meta-Analysis. Front Immunol 2022; 13:921085. [PMID: 35812437 PMCID: PMC9260601 DOI: 10.3389/fimmu.2022.921085] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 05/25/2022] [Indexed: 12/13/2022] Open
Abstract
ObjectiveThis study aimed to compare and rank the effectiveness of aerobic exercise (AE), resistance training (RT), combined aerobic and resistance training (CT), and high-intensity interval training (HIIT) on body composition and inflammatory cytokine levels in overweight and obese individuals by using network meta-analysis (NMA).MethodsWe searched the PubMed, Cochrane, Embase, Web of Science, and EBSCO databases to identify randomized controlled trials investigating the effects of exercise training on inflammatory cytokines in overweight and obese patients. The retrieval period was from inception to November 2021. Two reviewers independently screened the retrieved articles, extracted the pertinent data, and assessed the risk of bias of the included studies; then, they used Stata 16.0 and Review Manager 5.3 to perform an NMA.ResultsA total of 38 studies involving 1317 patients were included in this study. The results of the NMA indicated that AE had the greatest effect on weight loss (SUCRA=78.3; SMD=−0.51, 95% CI: −0.70, −0.33); CT had the greatest effect on reducing body mass index (SUCRA=70.7; SMD=−0.46, 95% CI: −0.81, −0.10), waist circumference (SUCRA=93.4; SMD=−1.86, 95% CI: −2.80, −0.93), percentage body fat (SUCRA=79.6; SMD=−1.38, 95% CI: −2.29, −0.48), interleukin-6 level (SUCRA=86.4; SMD=−1.98, 95% CI: −3.87, −0.09), and tumor necrosis factor-α level (SUCRA=79.4; SMD=−2.08, 95% CI: −3.75, −0.42); AE (SMD=0.51, 95% CI: −1.68, 2.69), RT (SMD=0.15, 95% CI: −3.01, 3.32), CT (SMD=1.78, 95% CI: −1.35, 4.92), and HIIT (SMD=2.29, 95% CI: −1.27, 5.86) did not significantly increase the adiponectin level.ConclusionThe current results suggest that CT is the best exercise modality for improving body composition and inflammatory status in overweight and obese individuals. More rigorous randomized control trials are needed for further validation.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42022303165.
Collapse
Affiliation(s)
- Shengya Wang
- Department of Exercise Physiology, Beijing Sport University, Beijing, China
| | - Huayi Zhou
- Department of Exercise Physiology, Beijing Sport University, Beijing, China
| | - Changtao Zhao
- Department of Physical Health and Arts Education, Ministry of Education, Beijing, China
| | - Hui He
- China Institute of Sport and Health Science, Beijing Sport University, Beijing, China
- *Correspondence: Hui He,
| |
Collapse
|
|
18
|
Leister KR, Cilhoroz BT, Rosenberg J, Brown EC, Kim JY. Metabolic syndrome: Operational definitions and aerobic and resistance training benefits on physical and metabolic health in children and adolescents. Diabetes Metab Syndr 2022; 16:102530. [PMID: 35709585 DOI: 10.1016/j.dsx.2022.102530] [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] [Received: 02/13/2022] [Revised: 05/25/2022] [Accepted: 05/27/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND The variation in parameters for childhood metabolic syndrome (MetS) has hindered the development of a consensus for the diagnostic criteria in this group. Despite these inconsistencies, it is accepted that exercise can ameliorate the deleterious effects of MetS. However, direct comparison between aerobic versus resistance exercise on MetS symptomology in adolescents is lacking. AIM Aim of this review was to discuss controversies associated with current MetS operation definitions in adolescents and present a review summarizing longitudinal studies relevant to the influence of aerobic and resistance training on children with MetS. METHODS Reviews of PubMed and Web of Science were conducted to identify literature focusing on the influence of aerobic and resistance training on children with MetS. Selected manuscripts featured longitudinal research only. RESULTS A universally accepted definition of MetS for the pediatric population has yet to be established. As such, consensus regarding diagnostic criteria for MetS among children is lacking despite the presence of various descriptions in the literature. Though studies support the importance of aerobic and resistance exercise to combat comorbidities associated with MetS, longitudinal studies investigating the benefits of each exercise type among adolescents are limited and inconsistent. CONCLUSION An improved understanding of the impact of aerobic and resistance training on children with MetS is clinically relevant because it may facilitate more appropriate exercise recommendations for children with MetS. Additional large cohort studies are warranted to determine optimal exercise type.
Collapse
Affiliation(s)
- Kyle R Leister
- Department of Exercise Science, David B. Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, USA
| | - Burak T Cilhoroz
- Department of Exercise Science, David B. Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, USA
| | - Jared Rosenberg
- Department of Exercise Science, David B. Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, USA
| | | | - Joon Young Kim
- Department of Exercise Science, David B. Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, USA.
| |
Collapse
|
|
19
|
Hertiš Petek T, Petek T, Močnik M, Marčun Varda N. Systemic Inflammation, Oxidative Stress and Cardiovascular Health in Children and Adolescents: A Systematic Review. Antioxidants (Basel) 2022; 11:894. [PMID: 35624760 PMCID: PMC9137597 DOI: 10.3390/antiox11050894] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/16/2022] [Accepted: 04/24/2022] [Indexed: 12/02/2022] Open
Abstract
Recent studies indicate that cerebrovascular diseases and processes of atherosclerosis originate in the childhood era and are largely influenced by chronic inflammation. Some features of vascular dysfunction in adulthood may even be programmed prenatally via genetic influences and an unfavorable intrauterine milieu. Oxidative stress, defined by an imbalance between the production and generation of reactive oxygen species (ROS) in cells and tissues and the capability of an organism to scavenge these molecules via antioxidant mechanisms, has been linked to adverse cardiovascular health in adults, yet has not been systematically reviewed in the pediatric population. We performed a systematic search as per the PRISMA guidelines in PubMed/Medline and Cochrane Reviews and detected, in total, 1228 potentially eligible pediatric articles on systemic inflammation, oxidative stress, antioxidant use, cardiovascular disease and endothelial dysfunction. The abstracts and full-text manuscripts of these were screened for inclusion and exclusion criteria, and a total of 160 articles were included. The results indicate that systemic inflammation and oxidative stress influence cardiovascular health in many chronic pediatric conditions, including hypertension, obesity, diabetes mellitus types 1 and 2, chronic kidney disease, hyperlipidemia and obstructive sleep apnea. Exercise and diet may diminish ROS formation and enhance the total serum antioxidant capacity. Antioxidant supplementation may, in selected conditions, contribute to the diminution of the oxidative state and improve endothelial function; yet, in many areas, studies provide unsatisfactory results.
Collapse
Affiliation(s)
- Tjaša Hertiš Petek
- Department of Paediatrics, University Medical Centre Maribor, Ljubljanska 5, 2000 Maribor, Slovenia; (T.H.P.); (M.M.); (N.M.V.)
- Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia
| | - Tadej Petek
- Department of Paediatrics, University Medical Centre Maribor, Ljubljanska 5, 2000 Maribor, Slovenia; (T.H.P.); (M.M.); (N.M.V.)
- Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia
| | - Mirjam Močnik
- Department of Paediatrics, University Medical Centre Maribor, Ljubljanska 5, 2000 Maribor, Slovenia; (T.H.P.); (M.M.); (N.M.V.)
- Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia
| | - Nataša Marčun Varda
- Department of Paediatrics, University Medical Centre Maribor, Ljubljanska 5, 2000 Maribor, Slovenia; (T.H.P.); (M.M.); (N.M.V.)
- Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia
| |
Collapse
|
|
20
|
Gong L, Liu Y. Effect of Exercise Training on Arterial Stiffness in Overweight or Obese Populations. Int J Sports Med 2022; 43:996-1012. [PMID: 35468651 PMCID: PMC9622304 DOI: 10.1055/a-1795-2940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The purpose was to analyze the effects of exercise training (ET) on arterial
stiffness in all-age overweight or obese individuals. Sixty-one trials were
included with ET improving flow-mediated dilation (FMD), pulse wave velocity
(PWV), and intima-media thickness (IMT). In the subgroup analysis: (i) ET
improved FMD in overweight or obese children and adolescents with a large effect
size (SMD=0.83, 95% CI 0.42–1.25). PWV was decreased
after ET regardless of age. IMT was decreased by ET in participants younger than
60, (ii) ET improved FMD, PWV, and IMT in participants whose BMI were smaller
than 30 kg/m
2
, but ET only improved PWV of
participants whose BMI were larger than 30 kg/m
2
.
(iii) AE improved FMD, PWV, and IMT. High-intensity interval training (HIIT)
decreased IMT. (iv) The increase of FMD only happened when training duration was
longer than eight weeks. However, ET decreased PWV when the training duration
was no longer than 12 weeks. IMT was decreased when the training duration was
longer than eight weeks. ET instigated an improvement in endothelial function
and arterial stiffness in overweight or obese populations, but depending on the
different characteristics of exercise intervention and participants’
demographics.
Collapse
Affiliation(s)
- Lijing Gong
- Key Laboratory of Exercise and Physical Fitness, Ministry of Education, Beijing Sport University, Beijing, China
| | - Yujia Liu
- Physical education, Jiangsu Normal University, Xuzhou, China
| |
Collapse
|
|
21
|
Drenowatz C, Chen ST, Cocca A, Ferrari G, Ruedl G, Greier K. Association of Body Weight and Physical Fitness during the Elementary School Years. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3441. [PMID: 35329129 PMCID: PMC8951208 DOI: 10.3390/ijerph19063441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/10/2022] [Accepted: 03/11/2022] [Indexed: 12/04/2022]
Abstract
Physical fitness and body weight are key correlates of health. Nevertheless, an increasing number of children display poor physical fitness and high body weight. The aim of this study was to examine the prospective association of physical fitness with body weight throughout the elementary school years with a special emphasis on children with high body weight or poor physical fitness at baseline. A total of 303 Austrian children (55.1% male) completed the German motor test up to eight times over a 4-year time span (between the ages 6 and 10 years). Physical fitness did not differ across quartiles of body weight at baseline. A more pronounced weight gain, however, was associated with an impaired development of physical fitness and this association was more pronounced in children with higher baseline body weight. In addition, the detrimental effects of an impaired development of physical fitness on subsequent body weight were more pronounced in children with higher baseline body weight. No differences in the longitudinal association between body weight and physical fitness, on the other hand, were observed across quartiles of baseline fitness. These results emphasize the importance of the promotion of physical fitness, particularly in children with increased body weight, to ensure future health.
Collapse
Affiliation(s)
- Clemens Drenowatz
- Division of Sport, Physical Activity and Health, University of Education Upper Austria, 4020 Linz, Austria
| | - Si-Tong Chen
- Institute for Health and Sport, Victoria University, Melbourne 8001, Australia;
| | - Armando Cocca
- Department of Sport Science, University of Innsbruck, 6020 Innbruck, Austria; (A.C.); (G.R.); (K.G.)
| | - Gerson Ferrari
- Escuela de Ciencias de la Actividad Física, El Deporte y la Salud, Universidad de Santiago de Chile (USACH), Santiago 7500618, Chile;
| | - Gerhard Ruedl
- Department of Sport Science, University of Innsbruck, 6020 Innbruck, Austria; (A.C.); (G.R.); (K.G.)
| | - Klaus Greier
- Department of Sport Science, University of Innsbruck, 6020 Innbruck, Austria; (A.C.); (G.R.); (K.G.)
- Division of Physical Education and Sports, University of Education Stams—KPH-ES, 6422 Stams, Austria
| |
Collapse
|
|
22
|
Pfeifer CE, Sacko RS, Ortaglia A, Monsma EV, Beattie PF, Goins J, Stodden DF. Fit to Play? Health-Related Fitness Levels of Youth Athletes: A Pilot Study. J Strength Cond Res 2022; 36:245-251. [PMID: 31809462 DOI: 10.1519/jsc.0000000000003430] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Pfeifer, CE, Sacko, RS, Ortaglia, A, Monsma, EV, Beattie, PF, Goins, J, and Stodden, DF. Fit to play? Health-related fitness levels of youth athletes: A pilot study. J Strength Cond Res 36(1): 245-251, 2022-A recent National Strength and Conditioning Association position statement suggests that many youth are not prepared for the physical demands of sport. The purpose of this study was to compare health-related fitness (HRF) of youth athletes with normative findings from the general population. We recruited 136 athletes (63 male and 73 female athletes) aged 11-19 (16.01 ± 1.35) years and collected HRF (body composition, cardiorespiratory endurance, musculoskeletal strength and endurance). Results were categorized based on FITNESSGRAM® standards and compared with Canadian youth general population normative data. Most male athletes were classified as "needs improvement" for cardiorespiratory and muscular endurance, and body mass index (BMI). Conversely, most female athletes were at or above the "healthy fitness zone" for all measures. Male athletes at both age groups (11-14, 15-19; p < 0.001) and female athletes aged 11-14 (p < 0.05) demonstrated lower cardiorespiratory endurance compared with Canadian general population. Female athletes (both age groups) demonstrated greater muscular strength, and male athletes (age, 15-19 years) demonstrated lower BMI than the Canadian general population. The results are concerning as male athletes demonstrated poorer HRF compared with the general population. Although most female athletes were within healthy ranges, a portion of them were still at risk. Considering the demands sport places on the body, evaluating HRF is paramount for performance and injury prevention but more importantly for overall health. Youth sport and strength coaches should evaluate and aim to enhance HRF, as participation in sport does not guarantee adequate HRF. Promoting long-term athletic development and life-long health should be a priority in youth.
Collapse
Affiliation(s)
- Craig E Pfeifer
- Applied Sport and Exercise Sciences, University of Gloucestershire, Gloucester, United Kingdom
| | - Ryan S Sacko
- Department of Health and Human Performance, The Citadel, Charleston, South Carolina
| | | | - Eva V Monsma
- Department of Physical Education, University of South Carolina, Columbia, South Carolina
| | | | | | - David F Stodden
- Department of Physical Education, University of South Carolina, Columbia, South Carolina
| |
Collapse
|
|
23
|
Climie RE, Park C, Avolio A, Mynard JP, Kruger R, Bruno RM. Vascular Ageing in Youth: A Call to Action. Heart Lung Circ 2021; 30:1613-1626. [PMID: 34275753 DOI: 10.1016/j.hlc.2021.06.516] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 05/31/2021] [Accepted: 06/06/2021] [Indexed: 12/18/2022]
Abstract
Extensive evidence shows that risk factors for cardiovascular disease (CVD) begin to develop early in life. Childhood obesity and elevated blood pressure (BP) have become overwhelmingly challenging, with 57% of today's children predicted to be obese by the age of 35 years, and global rates of hypertension in children and adolescents increasing by 75% from 2000 to 2015. Thus, there is an urgent need for tools that can assess early CVD risk in youth, which may lead to better risk stratification, preventative intervention, and personalised medicine. Vascular ageing (the deterioration in vascular structure and function) is a pivotal progenitor of health degeneration associated with elevated BP. Exposure to adverse environmental and genetic factors from fetal life promotes the development and accumulation of subclinical vascular changes that direct an individual towards a trajectory of early vascular ageing (EVA)-an independent predictor of target organ damage in the heart, brain, and kidneys. Therefore, characterising vascular ageing from youth may provide a window into cardiovascular risk later in life. However, vascular ageing measurements only have value when techniques are accurate/validated and when reliable thresholds are available for defining normal ranges and ranges that signal increased risk of disease. The aim of this paper is to summarise current evidence on the importance of vascular ageing assessment in youth and the impact of interventions to prevent or delay EVA, to highlight the need for standardisation and validation of measurement techniques in children and adolescents, and the importance of establishing reference values for vascular ageing measures in this population.
Collapse
Affiliation(s)
- R E Climie
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tas, Australia; Baker Heart and Diabetes Institute, Melbourne, Vic, Australia; Université de Paris, INSERM, U970, Paris Cardiovascular Research Center (PARCC), Paris, France.
| | - C Park
- MRC Unit for Lifelong Health and Ageing at UCL, Institute of Cardiovascular Science, UCL, London, UK
| | - A Avolio
- Department of Biomedical Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - J P Mynard
- Heart Research, Murdoch Children's Research Institute, Melbourne, Vic, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Vic, Australia; Department of Biomedical Engineering, University of Melbourne, Melbourne, Vic, Australia; Department of Cardiology, Royal Children's Hospital, Melbourne, Vic, Australia
| | - R Kruger
- Hypertension in Africa Research Team (HART); North-West University, Potchefstroom, South Africa; MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - R-M Bruno
- Université de Paris, INSERM, U970, Paris Cardiovascular Research Center (PARCC), Paris, France. https://twitter.com/rosam_bruno
| |
Collapse
|
|
24
|
Soltero EG, Solovey AN, Hebbel RP, Palzer EF, Ryder JR, Shaibi GQ, Olson M, Fox CK, Rudser KD, Dengel DR, Evanoff NG, Kelly AS. Relationship of Circulating Endothelial Cells With Obesity and Cardiometabolic Risk Factors in Children and Adolescents. J Am Heart Assoc 2021; 10:e018092. [PMID: 33372524 PMCID: PMC7955458 DOI: 10.1161/jaha.120.018092] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 10/22/2020] [Indexed: 12/14/2022]
Abstract
Background Circulating endothelial cells (CECs) reflect early changes in endothelial health; however, the degree to which CEC number and activation is related to adiposity and cardiovascular risk factors in youth is not well described. Methods and Results Youth in this study (N=271; aged 8-20 years) were classified into normal weight (body mass index [BMI] percentage <85th; n=114), obesity (BMI percentage ≥95th to <120% of the 95th; n=63), and severe obesity (BMI percentage ≥120% of the 95th; n=94) catagories. CEC enumeration was determined using immunohistochemical examination of buffy coat smears and activated CEC (percentage of vascular cell adhesion molecule-1 expression) was assessed using immunofluorescent staining. Cardiovascular risk factors included measures of body composition, blood pressure, glucose, insulin, lipid profile, C-reactive protein, leptin, adiponectin, oxidized low-density lipoprotein cholesterol, carotid artery intima-media thickness, and pulse wave velocity. Linear regression models examined associations between CEC number and activation with BMI and cardiovascular risk factors. CEC number did not differ among BMI classes (P>0.05). Youth with severe obesity had a higher degree of CEC activation compared with normal weight youth (8.3%; 95% CI, 1.1-15.6 [P=0.024]). Higher CEC number was associated with greater body fat percentage (0.02 per percentage; 95% CI, 0.00-0.03 [P=0.020]) and systolic blood pressure percentile (0.01 per percentage; 95% CI, 0.00-0.01 [P=0.035]). Higher degree of CEC activation was associated with greater visceral adipose tissue (5.7% per kg; 95% CI, 0.4-10.9 [P=0.034]) and non-high-density lipoprotein cholesterol (0.11% per mg/dL; 95% CI, 0.01-0.21 [P=0.039]). Conclusions Methods of CEC quantification are associated with adiposity and cardiometabolic risk factors and may potentially reflect accelerated atherosclerosis as early as childhood.
Collapse
Affiliation(s)
- Erica G. Soltero
- Department of PediatricsChildren’s Nutrition Research CenterBaylor College of MedicineHoustonTX
| | - Anna N. Solovey
- Vascular Biology CenterDivision of HematologyOncology & TransplantationUniversity of Minnesota Medical SchoolMinneapolisMN
| | - Robert P. Hebbel
- Vascular Biology CenterDivision of HematologyOncology & TransplantationUniversity of Minnesota Medical SchoolMinneapolisMN
- Department of MedicineUniversity of Minnesota Medical SchoolMinneapolisMN
| | - Elise F. Palzer
- Division of BiostatisticsSchool of Public HealthUniversity of MinnesotaMinneapolisMN
| | - Justin R. Ryder
- Center for Pediatric Obesity MedicineUniversity of Minnesota Medical SchoolMinneapolisMN
- Department of PediatricsUniversity of Minnesota Medical SchoolMinneapolisMN
| | - Gabriel Q. Shaibi
- Center for Health Promotion and Disease PreventionArizona State UniversityPhoenixAZ
- Department of Pediatric Endocrinology and DiabetesPhoenix Children’s HospitalPhoenixAZ
| | - Micah Olson
- Center for Health Promotion and Disease PreventionArizona State UniversityPhoenixAZ
- Department of Pediatric Endocrinology and DiabetesPhoenix Children’s HospitalPhoenixAZ
| | - Claudia K. Fox
- Center for Pediatric Obesity MedicineUniversity of Minnesota Medical SchoolMinneapolisMN
- Department of PediatricsUniversity of Minnesota Medical SchoolMinneapolisMN
| | - Kyle D. Rudser
- Division of BiostatisticsSchool of Public HealthUniversity of MinnesotaMinneapolisMN
- Center for Pediatric Obesity MedicineUniversity of Minnesota Medical SchoolMinneapolisMN
| | - Donald R. Dengel
- Center for Pediatric Obesity MedicineUniversity of Minnesota Medical SchoolMinneapolisMN
- Department of PediatricsUniversity of Minnesota Medical SchoolMinneapolisMN
- School of KinesiologyUniversity of MinnesotaMinneapolisMN
| | - Nicholas G. Evanoff
- Center for Pediatric Obesity MedicineUniversity of Minnesota Medical SchoolMinneapolisMN
- School of KinesiologyUniversity of MinnesotaMinneapolisMN
| | - Aaron S. Kelly
- Center for Pediatric Obesity MedicineUniversity of Minnesota Medical SchoolMinneapolisMN
- Department of PediatricsUniversity of Minnesota Medical SchoolMinneapolisMN
| |
Collapse
|
|
25
|
Kelley GA, Kelley KS, Pate RR. Inter-individual differences in body mass index were not observed as a result of aerobic exercise in children and adolescents with overweight and obesity. Pediatr Obes 2021; 16:e12692. [PMID: 32657544 DOI: 10.1111/ijpo.12692] [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: 11/27/2019] [Accepted: 04/09/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Exercise has been recommended as an important intervention for reducing adiposity in children and adolescents with overweight and obesity. OBJECTIVE Determine whether inter-individual differences exist in relation to exercise-induced changes in adiposity among children and adolescents with overweight and obesity. METHODS Meta-analysis of randomized controlled aerobic exercise trials and body mass index (BMI) in kg · m-2 . Change outcome standard deviations were pooled using the inverse-variance heterogeneity model. RESULTS Twenty-eight studies (1185 participants) were included. Inter-individual differences in BMI were -0.1 (95% compatibility interval, -0.7 to 0.7). The 95% prediction interval for inter-individual responses in a future study was -2.9 to 2.9. The probability of a clinically meaningful difference in variability was 29% (possibly clinically important) in favour of controls vs exercisers. CONCLUSIONS Inter-individual differences for BMI in kg · m-2 were not observed as a result of aerobic exercise in children and adolescents with overweight and obesity.
Collapse
Affiliation(s)
- George A Kelley
- School of Public Health, Department of Biostatistics, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, West Virginia, USA
| | - Kristi S Kelley
- School of Public Health, Department of Biostatistics, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, West Virginia, USA
| | - Russell R Pate
- Children's Physical Activity Research Group, Department of Exercise Science, University of South Carolina, Columbia, South Carolina, USA
| |
Collapse
|
|
26
|
Kim JY, Jeon JY. Role of exercise on insulin sensitivity and beta-cell function: is exercise sufficient for the prevention of youth-onset type 2 diabetes? Ann Pediatr Endocrinol Metab 2020; 25:208-216. [PMID: 33401879 PMCID: PMC7788350 DOI: 10.6065/apem.2040140.070] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 08/19/2020] [Indexed: 12/16/2022] Open
Abstract
Parallel with the current pediatric obesity epidemic, the escalating rates of youthonset type 2 diabetes mellitus (T2DM) have become a major public health burden. Although lifestyle modification can be the first-line prevention for T2DM in youths, there is a lack of evidence to establish optimal specific exercise strategies for obese youths at high risk for T2DM. The purpose of this narrative review is to summarize the potential impact of exercise on 2 key pathophysiological risk factors for T2DM, insulin sensitivity and β-cell function, among obese youths. The studies cited are grouped by use of metabolic tests, i.e., direct and indirect measures of insulin sensitivity and β-cell function. In general, there are an increasing number of studies that demonstrate positive effects of aerobic exercise, resistance exercise, and the 2 combined on insulin sensitivity. However, a lack of evidence exists for the effect of any exercise modality on β-cell functional improvement. We also suggest a future direction for research into exercise medical prevention of youth-onset T2DM. These suggestions focus on the effects of exercise modalities on emerging biomarkers of T2DM risk.
Collapse
Affiliation(s)
- Joon Young Kim
- Department of Exercise Science, David B. Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, USA
| | - Justin Y. Jeon
- Department of Sport Industry Studies, Exercise Medicine Center for Diabetes and Cancer Patients, ICONS Yonsei University, Seoul, Korea,Address for correspondence: Justin Y. Jeon, PhD Department of Sport Industry Studies, Exercise Medicine Center for Diabetes and Cancer Patients, ICONS Yonsei University, 50 Yonseiro, Seodaemun-gu, Seoul 03722, Korea Tel: +82-2-2123-6197 E-mail:
| |
Collapse
|
|
27
|
Raine LB, Kao SC, Drollette ES, Pontifex MB, Pindus D, Hunt J, Kramer AF, Hillman CH. The role of BMI on cognition following acute physical activity in preadolescent children. Trends Neurosci Educ 2020; 21:100143. [PMID: 33303110 PMCID: PMC8683838 DOI: 10.1016/j.tine.2020.100143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 10/19/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND There is an increasing prevalence of physical inactivity during childhood, concurrent with a rise in obesity rates, which is associated with a variety of health problems. However, the extent to which increased body mass index (BMI) influences acute physical activity (PA) benefits on cognition in childhood remains unknown. The aim of this study was to examine whether BMI influences the effects of acute PA on inhibitory control task performance. METHODS In a sample of 116 children pooled from four prior studies (ages 8-11; 51 females), demographic measures of age, sex, IQ, socioeconomic status, and aerobic fitness were considered along with BMI. Children participated in a counterbalanced, randomized crossover study, whereby they completed two different interventions; 20 minutes of treadmill walking (60-70% heart rate max) and restful reading (non-exercise control). Following each intervention, children performed a modified flanker task that manipulates inhibitory control demands. Correlations were conducted to determine the influence of demographic variables, fitness, and BMI on inhibitory control following each intervention. Subsequent hierarchical regression analyses were performed with significant demographic factors in the first step, aerobic fitness in the second step when significant, and BMI in the final step. RESULTS Analyses indicated that children exhibited improved task performance (p's ≤ 0.001) and decreased interference (p = 0.04) following the walking intervention compared to the restful reading control condition, indicating greater benefits following acute PA across task condition, with selectively greater benefits for the task condition requiring greater inhibitory control. Regression analyses revealed that greater BMI was related to decreased performance following acute PA (p = 0.001); an association not observed following restful reading (p's ≥ 0.11). These results suggest that BMI negatively influences the effect of acute exercise on performance. CONCLUSION Confirming previous studies, these findings indicate beneficial effects of acute PA on a flanker task that modulates inhibitory control requirements, but the effects are significantly greater for task conditions requiring greater amounts of inhibitory control. Further, these beneficial effects of PA appear to be blunted in children with higher BMI. These findings suggest that the acute benefits of PA on cognition may not be fully realized in children with higher BMI.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Arthur F Kramer
- Northeastern University; Univeristy of Illinois at Urbana-Champaign
| | | |
Collapse
|
|
28
|
Costa R, Barroso B, Reichert T, Vieira A, Kruel L. Effects of supervised exercise training on lipid profile of children and adolescents: Systematic review, meta-analysis and meta-regression. Sci Sports 2020. [DOI: 10.1016/j.scispo.2020.02.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
|
29
|
García-Hermoso A, Izquierdo M, Alonso-Martínez AM, Faigenbaum A, Olloquequi J, Ramírez-Vélez R. Association between Exercise-Induced Changes in Cardiorespiratory Fitness and Adiposity among Overweight and Obese Youth: A Meta-Analysis and Meta-Regression Analysis. CHILDREN-BASEL 2020; 7:children7090147. [PMID: 32967205 PMCID: PMC7552631 DOI: 10.3390/children7090147] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 09/14/2020] [Accepted: 09/18/2020] [Indexed: 11/16/2022]
Abstract
The aim of this study was to determine the minimum change in cardiorespiratory fitness (CRF) required to reduce adiposity (percent body fat) in exercise programs for overweight and obese youth. Studies were identified through a systematic search of five databases. Studies were limited to randomized controlled trials (RCTs) of exercise training (e.g., aerobic, strength, concurrent) that assessed percent body fat and CRF for both exercise and control groups in overweight and obese children and adolescents. A series of meta-regressions were conducted to explore links between change in CRF (maximum oxygen consumption, ml/kg/min) and change in percent body fat. Twenty-three RCTs were included (n = 1790, 59% females). Meta-regression analysis suggested that increases of at least 0.38 mL/kg/min in CRF (p < 0.001) were considered to be a clinically important reduction of percent body fat (−2.30%, 95% confidence interval −3.02 to −1.58; p < 0.001; I2 = 92.2%). Subgroup analysis showed that increases of at least 0.17 mL/kg/min in CRF favored a reduction of percent body fat of −1.62% (95% confidence interval −2.04 to −1.20; p < 0.001; I2 = 69.9%). In conclusion, this change in CRF could be considered by pediatric researchers, youth fitness specialists, and health care providers to determine the effectiveness in body fat reductions through exercise.
Collapse
Affiliation(s)
- Antonio García-Hermoso
- Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), IdiSNA, 31008 Pamplona, Navarra, Spain; (M.I.); (R.R.-V.)
- Facultad de Ciencias Médicas, Laboratorio de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile, USACH, Santiago 71783-5, Chile
- Correspondence:
| | - Mikel Izquierdo
- Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), IdiSNA, 31008 Pamplona, Navarra, Spain; (M.I.); (R.R.-V.)
- Department of Health Sciences, Public University of Navarra, 31006 Pamplona, Navarra, Spain;
- CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, 28001 Madrid, Spain
| | | | - Avery Faigenbaum
- Department of Health and Exercise Science, The College of New Jersey, Ewing, NJ 08628, USA;
| | - Jordi Olloquequi
- Instituto de Ciencias Biomédicas, Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca 3460000, Chile;
| | - Robinson Ramírez-Vélez
- Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), IdiSNA, 31008 Pamplona, Navarra, Spain; (M.I.); (R.R.-V.)
- Department of Health Sciences, Public University of Navarra, 31006 Pamplona, Navarra, Spain;
- CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, 28001 Madrid, Spain
| |
Collapse
|
|
30
|
Patel SS, Daniels SR. Beginning With the End in Mind: The Case for Primordial and Primary Cardiovascular Prevention in Youth. Can J Cardiol 2020; 36:1344-1351. [DOI: 10.1016/j.cjca.2020.07.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 07/07/2020] [Accepted: 07/08/2020] [Indexed: 11/29/2022] Open
|
|
31
|
Rajakumar K, Moore CG, Khalid AT, Vallejo AN, Virji MA, Holick MF, Greenspan SL, Arslanian S, Reis SE. Effect of vitamin D3 supplementation on vascular and metabolic health of vitamin D-deficient overweight and obese children: a randomized clinical trial. Am J Clin Nutr 2020; 111:757-768. [PMID: 31950134 PMCID: PMC7138671 DOI: 10.1093/ajcn/nqz340] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 12/19/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Obese children are vulnerable to vitamin D deficiency and impaired cardiovascular health; vitamin D replenishment might improve their cardiovascular health. OBJECTIVES The aims were to determine, in vitamin D-deficient overweight and obese children, whether supplementation with vitamin D3 1000 or 2000 IU/d is more effective than 600 IU/d in improving arterial endothelial function, arterial stiffness, central and systemic blood pressure (BP), insulin sensitivity (1/fasting insulin concentration), fasting glucose concentration, and lipid profile and to explore whether downregulation of adipocytokines and markers of systemic inflammation underlies vitamin D effects. METHODS We conducted a randomized, double-masked, controlled clinical trial in 225 10- to 18-y-old eligible children. Change in endothelial function at 6 mo was the primary outcome. RESULTS Dose-response increases in serum 25-hydroxyvitamin D concentrations were significant and tolerated without developing hypercalcemia. Changes at 3 and 6 mo in endothelial function, arterial stiffness, systemic-systolic BP, lipids, and inflammatory markers did not differ between children receiving 1000 or 2000 IU vitamin D and children receiving 600 IU. Some secondary outcomes differed between groups. Compared with the 600-IU group, central-systolic, central-diastolic, and systemic-diastolic BP was lower at 6 mo in the 1000-IU group [-2.66 (95% CI: -5.27, -0.046), -3.57 (-5.97, -1.17), and -3.28 (-5.55, -1.00) mm Hg, respectively]; insulin sensitivity increased at 3 and 6 mo and fasting glucose concentration declined at 6 mo (-2.67; 95% CI: -4.88, -0.46 mg/dL) in the 2000-IU group. CONCLUSIONS Correction of vitamin D deficiency in overweight and obese children by vitamin D3 supplementation with 1000 or 2000 IU/d versus 600 IU/d did not affect measures of arterial endothelial function or stiffness, systemic inflammation, or lipid profile, but resulted in reductions in BP and fasting glucose concentration and in improvements in insulin sensitivity. Optimization of children's vitamin D status may improve their cardiovascular health. This trial was registered at clinicaltrials.gov as NCT01797302.
Collapse
Affiliation(s)
- Kumaravel Rajakumar
- Department of Pediatrics, University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, Pittsburgh, PA, USA,Address correspondence to KR (e-mail: )
| | - Charity G Moore
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA, USA
| | - Arshad T Khalid
- Department of Pediatrics, University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Abbe N Vallejo
- Department of Pediatrics, University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Mohamed A Virji
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Michael F Holick
- Department of Medicine, Boston University Medical Center, Boston, MA, USA
| | - Susan L Greenspan
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Silva Arslanian
- Department of Pediatrics, University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Steven E Reis
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| |
Collapse
|
|
32
|
Kelley GA, Kelley KS, Pate RR. Exercise and adiposity in overweight and obese children and adolescents: a systematic review with network meta-analysis of randomised trials. BMJ Open 2019; 9:e031220. [PMID: 31719081 PMCID: PMC6858189 DOI: 10.1136/bmjopen-2019-031220] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 09/13/2019] [Accepted: 10/02/2019] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES Determine both the effects and hierarchy of effectiveness for exercise interventions (aerobic, strength training or both) on selected measures of adiposity (body mass index (BMI) in kg/m2, fat mass and per cent body fat) in overweight and obese children and adolescents. DESIGN Network meta-analysis of randomised exercise intervention trials. SETTING Any setting where a randomised trial could be conducted. PARTICIPANTS Overweight and obese male and/or female children and adolescents 2-18 years of age. INTERVENTIONS Randomised exercise intervention trials>4 weeks, published between 1 January 1973 and 22 August 2018, and which included direct and/or indirect evidence for aerobic, strength training or combined aerobic and strength training. PRIMARY OUTCOMES Changes in BMI in kg/m2, fat mass and per cent body fat. RESULTS Fifty-seven studies representing 127 groups (73 exercise, 54 control) and 2792 participants (1667 exercise, 1125 control) met the criteria for inclusion. Length of training ([Formula: see text] ± SD) averaged 14.1±6.2 weeks, frequency, 3.3±1.1 days per week and duration 42.0±21.0 min per session. Significant and clinically important reductions in BMI, fat mass and per cent body fat were observed in aerobic versus control comparisons (BMI, mean, 95% CI -1.0, 1.4 to -0.6; fat mass -2.1, -3.3 to -1.0 kg; per cent fat -1.5, -2.2 to -0.9%) and combined aerobic and strength versus control comparisons (BMI -0.7, -1.4 to -0.1; fat mass -2.5, -4.1 to -1.0 kg; per cent fat, -2.2, -3.2 to -1.2%). A significant reduction in per cent fat was also found for strength vs control comparisons (-1.3,-2.5 to -0.1%). Combined aerobic and strength training was ranked first for improving both fat mass (kg) and per cent body fat while aerobic exercise was ranked first for improving BMI. CONCLUSIONS Aerobic and combined aerobic and strength training are associated with improvements in adiposity outcomes in overweight and obese children and adolescents. PROSPERO REGISTRATION NUMBER CRD42017073103.
Collapse
Affiliation(s)
- George A Kelley
- Biostatistics, West Virginia University, Morgantown, West Virginia, USA
| | - Kristi S Kelley
- Biostatistics, West Virginia University, Morgantown, West Virginia, USA
| | - Russell R Pate
- Exercise Science, University of South Carolina, Columbia, South Carolina, USA
| |
Collapse
|
|
33
|
Rahimlou M, Jahromi NB, Hasanyani N, Ahmadi AR. Effects of Flaxseed Interventions on Circulating Inflammatory Biomarkers: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Adv Nutr 2019; 10:1108-1119. [PMID: 31115436 PMCID: PMC6855939 DOI: 10.1093/advances/nmz048] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 12/27/2018] [Accepted: 04/10/2019] [Indexed: 01/22/2023] Open
Abstract
There have been various clinical studies on the effect of flaxseed-derived products on circulating inflammatory biomarkers, but the findings from these are contradictory. The aim of the present study was to clarify any association. A comprehensive literature search was conducted from inception to May 2018. From the eligible trials, 32 articles describing studies conducted on adults aged 18-70 y were selected for the meta-analysis. Meta-analyses using the random-effects model were performed to investigate the data and results showed significant effects of flaxseed intake on circulating high-sensitivity CRP (hs-CRP) [weighted mean difference (WMD) = -0.75; 95% CI: -1.19, -0.30; P < 0.001] and TNFα (WMD = -0.38; 95% CI: -0.75,-0.01; P = 0.04). However, no significant changes were found in IL6 concentration (WMD = -0.24; 95% CI: -0.70, 0.21; P = 0.28) and C-reactive protein (CRP) (WMD = -0.34; 95% CI:-0.89, 0.20; P = 0.22). Moreover, by eliminating 1 of the studies from the sensitivity analysis, changes in IL6 concentration were significant (WMD = -0.44; 95% CI: -0.81, -0.08). The changes in inflammatory biomarkers were dependent on study design (parallel or crossover), supplement type (flaxseed, flaxseed oil, or lignan), study quality (high or low), and participants' age and BMI. According to this meta-analysis, flaxseed significantly reduced circulating concentrations of hs-CRP and TNFα, but did not affect IL6 and CRP. Further research is needed to examine the effect of different doses and long-term benefits of flaxseed and its derivatives on inflammatory factors.
Collapse
Affiliation(s)
- Mehran Rahimlou
- Department of Nutrition, School of Para-Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nasrin Banaie Jahromi
- Department of Nutrition, School of Para-Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nazila Hasanyani
- Emam Reza Hospital affiliated with Social Security Organization, Urmia, Iran
| | - Amirhossein Ramezani Ahmadi
- Department of Nutrition, School of Para-Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| |
Collapse
|
|
34
|
Freemark M. Endothelial dysfunction and cardiovascular disease in childhood obesity. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2019. [DOI: 10.1016/j.jpedp.2018.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
|
|
35
|
Affiliation(s)
- Michael Freemark
- Duke University Medical Center, Pediatric Endocrinology and Diabetes, Durham, United States.
| |
Collapse
|
|
36
|
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: 0.7] [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.
Collapse
|
|
37
|
Han Y, Liu Y, Zhao Z, Zhen S, Chen J, Ding N, Ma Y, Wen D. Does Physical Activity-Based Intervention Improve Systemic Proinflammatory Cytokine Levels in Overweight or Obese Children and Adolescents? Insights from a Meta-Analysis of Randomized Control Trials. Obes Facts 2019; 12:653-668. [PMID: 31645033 PMCID: PMC6940473 DOI: 10.1159/000501970] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Accepted: 07/08/2019] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES The purpose of this research was to conduct a meta-analysis of the role that physical activity (PA) plays in influencing the critical proinflammatory cytokine levels associated with overweight/obese children and adolescents to explore the effectiveness of exercise intervention within this population. METHODS With searches of the PubMed, EMBASE, and CENTRAL databases, we updated our meta-analysis up to November 2018. The randomized controlled trials (RCT) evaluated the ability of exercise training to increase the following factors in children and/or adolescents classified as obese or overweight: tumor necrosis factor (TNF)-α, interleukin (IL)-6, and C-reactive protein (CRP). RESULTS Eleven RCT comprising 623 children and/or adolescents who were obese or overweight (i.e., 393 with PA and 230 controls) were suitable for use in this study. The meta-analysis showed that PA in general was associated with a significant reduction of CRP levels (mean difference = -0.45 mg/L, p = 0.02) in overweight/obese children and adolescents. Based on 115 overweight and obese youths, this study suggests that PA does not significantly mitigate IL-6 levels (mean difference = -0.39 pg/mL, p = 0.08), although there was a trend towards a reduction. Additionally, no close connection was observed between PA and TNF-α levels at 0.04 pg/mL (p = 0.78). Moreover, meta-regression analysis revealed a statistical association between CPR levels and changes in BMI or changes in adiponectin; likewise, IL-6 levels dramatically impacted the effect of exercise on changes in adiponectin. CONCLUSIONS PA was associated with significantly reduced CRP levels, whereas there was no significant association with IL-6 or TNF-α in overweight/obese children or adolescents; however, there was a trend towards a reduction of IL-6.
Collapse
Affiliation(s)
- Yanshuo Han
- Institute of Health Science, China Medical University, Shenyang, China
- Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yang Liu
- Institute of Health Science, China Medical University, Shenyang, China
| | - Zhongyi Zhao
- Institute of Health Science, China Medical University, Shenyang, China
| | - Shihan Zhen
- Institute of Health Science, China Medical University, Shenyang, China
| | - Jianhua Chen
- Institute of Health Science, China Medical University, Shenyang, China
- No. 2 Orthopedic Department, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ning Ding
- Research Center of Medical Education, China Medical University, Shenyang, China
| | - Yanan Ma
- Institute of Health Science, China Medical University, Shenyang, China
- School of Public Health, China Medical University, Shenyang, China
| | - Deliang Wen
- Institute of Health Science, China Medical University, Shenyang, China,
- Research Center of Medical Education, China Medical University, Shenyang, China,
| |
Collapse
|
|
38
|
Agbaje AO, Haapala EA, Lintu N, Viitasalo A, Barker AR, Takken T, Tompuri T, Lindi V, Lakka TA. Peak oxygen uptake cut-points to identify children at increased cardiometabolic risk - The PANIC Study. Scand J Med Sci Sports 2018; 29:16-24. [PMID: 30230064 DOI: 10.1111/sms.13307] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 08/20/2018] [Accepted: 09/13/2018] [Indexed: 11/27/2022]
Abstract
We aimed to develop cut-points for directly measured peak oxygen uptake ( V ˙ O 2 peak ) to identify boys and girls at increased cardiometabolic risk using different scaling methods to control for body size and composition. Altogether 352 children (186 boys, 166 girls) aged 9-11 years were included in the analyses. We measured V̇O2peak directly during a maximal cycle ergometer exercise test and lean body mass (LM) by bioelectrical impedance. We computed a sex- and age-specific cardiometabolic risk score (CRS) by summing important cardiometabolic risk factors and defined increased cardiometabolic risk as >1 standard deviation above the mean of CRS. Receiver operating characteristics curves were used to detect V̇O2peak cut-points for increased cardiometabolic risk. Boys with V̇O2peak <45.8 mL kg body mass (BM)-1 min-1 (95% confidence interval [CI] = 45.1 to 54.6, area under the curve [AUC] = 0.86, P < 0.001) and <63.2 mL kg LM-1 min-1 (95% CI =52.4 to 67.5, AUC = 0.65, P = 0.006) had an increased CRS. Girls with V̇O2peak <44.1 mL kg BM-1 min-1 (95% CI = 44.0 to 58.6, AUC = 0.67, P = 0.013) had an increased CRS. V̇O2peak scaled by BM-0.49 and LM-0.77 derived from log-linear allometric modeling poorly predicted increased cardiometabolic risk in boys and girls. In conclusion, directly measured V ˙ O 2 peak <45.8 mL kg BM-1 min-1 among boys and <44.1 mL kg BM-1 min-1 among girls were cut-points to identify those at increased cardiometabolic risk. Appropriately controlling for body size and composition reduced the ability of cardiorespiratory fitness to identify children at increased cardiometabolic risk.
Collapse
Affiliation(s)
- Andrew O Agbaje
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Eero A Haapala
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland.,Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Niina Lintu
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Anna Viitasalo
- Institute of Biomedicine, 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, UK
| | - Tim Takken
- Child Development and Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Tuomo Tompuri
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland.,Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Virpi Lindi
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland.,University of Eastern Finland Library Kuopio, 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.,Foundation for Research in Health Exercise and Nutrition, Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
| |
Collapse
|
|
39
|
Bruñó A, Escobar P, Cebolla A, Álvarez-Pitti J, Guixeres J, Lurbe E, Baños R, Lisón JF. Home-exercise Childhood Obesity Intervention: A Randomized Clinical Trial Comparing Print Versus Web-based (Move It) Platforms. J Pediatr Nurs 2018; 42:e79-e84. [PMID: 29747957 DOI: 10.1016/j.pedn.2018.04.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 04/16/2018] [Accepted: 04/19/2018] [Indexed: 12/18/2022]
Abstract
PURPOSE To compare the impact of adhering to a Mediterranean diet plus mixed physical exercise program (Move-It) implemented by means of printed instructions or via a web-platform (with or without e-mail support) on body composition, physical fitness, and blood pressure. DESIGN AND METHODS Randomized clinical trial. Fifty-two overweight or obese Spanish children and adolescents were randomly assigned to the print-based (n = 18), Move-It (n = 18), or Move-It plus support (n = 16) intervention groups. Two-way mixed ANOVA tests were used to compare any changes between the groups in terms of percentage body fat, physical fitness (VO2peak), handgrip strength, and systolic and diastolic blood pressure. The measurements were taken before and after a three-month mixed-exercise (aerobic and resistance) and Mediterranean-diet program which was either implemented by means of printed instructions or via a web-platform (with or without e-mail support). RESULTS No statistical differences were found between groups. However, the results highlighted significant improvements in body fat percentage metrics over time for all three groups (print-based: -1.8%, 95%CI -3.3% to -0.3%; Move-It: -1.8%, 95%CI -3.3% to -0.3%; Move-It plus support: -2.0%, 95%CI -3.7% to -0.4%, P < 0.05). We also observed a tendency towards improvement in the VO2peak, handgrip strength, and blood pressure variable values 10 min after the exercise-stress test in these three groups. CONCLUSIONS The program improved the body composition, regardless of the way it is implemented. PRACTICE IMPLICATIONS A mixed physical exercise program lasting for three months, combined with a Mediterranean diet, improves the body composition of children and adolescents with overweight/obesity.
Collapse
Affiliation(s)
- Alejandro Bruñó
- Department of Medicine, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | - Patricia Escobar
- Department of Personality, Evaluation and Psychological Treatment, University of Valencia, Spain
| | - Ausias Cebolla
- Department of Personality, Evaluation and Psychological Treatment, University of Valencia, Spain; CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Spain(3)
| | - Julio Álvarez-Pitti
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Spain(3); Obesity and Cardiovascular Risk Unit, Pediatric Department, Consorcio Hospital General Universitario, University of Valencia, Spain
| | - Jaime Guixeres
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Spain(3); I3BH Innovation & Research Institute on Bioengineering for Humans, Universidad Politécnica de Valencia, Spain
| | - Empar Lurbe
- CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Spain(3); Obesity and Cardiovascular Risk Unit, Pediatric Department, Consorcio Hospital General Universitario, University of Valencia, Spain
| | - Rosa Baños
- Department of Personality, Evaluation and Psychological Treatment, University of Valencia, Spain; CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Spain(3)
| | - Juan F Lisón
- Department of Medicine, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain.
| |
Collapse
|
|
40
|
Madani A, Alack K, Richter MJ, Krüger K. Immune-regulating effects of exercise on cigarette smoke-induced inflammation. J Inflamm Res 2018; 11:155-167. [PMID: 29731655 PMCID: PMC5923223 DOI: 10.2147/jir.s141149] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Long-term cigarette smoking (LTCS) represents an important risk factor for cardiac infarction and stroke and the central risk factor for the development of a bronchial carcinoma, smoking-associated interstitial lung fibrosis, and chronic obstructive pulmonary disease. The pathophysiologic development of these diseases is suggested to be promoted by chronic and progressive inflammation. Cigarette smoking induces repetitive inflammatory insults followed by a chronic and progressive activation of the immune system. In the pulmonary system of cigarette smokers, oxidative stress, cellular damage, and a chronic activation of pattern recognition receptors are described which are followed by the translocation of the NF-kB, the release of pro-inflammatory cytokines, chemokines, matrix metalloproteases, and damage-associated molecular patterns. In parallel, smoke pollutants cross directly through the alveolus-capillary interface and spread through the systemic bloodstream targeting different organs. Consequently, LTCS induces a systemic low-grade inflammation and increased oxidative stress in the vascular system. In blood, these processes promote an increased coagulation and endothelial dysfunction. In muscle tissue, inflammatory processes activate catabolic signaling pathways followed by muscle wasting and sarcopenia. In brain, several characteristics of neuroinflammation were described. Regular exercise training has been shown to be an effective nonpharmacological treatment strategy in smoke-induced pulmonary diseases. It is well established that exercise training exerts immune-regulating effects by activating anti-inflammatory signaling pathways. In this regard, the release of myokines from contracting skeletal muscle, the elevations of cortisol and adrenalin, the reduced expression of Toll-like receptors, and the increased mobilization of immune-regulating leukocyte subtypes might be of vital importance. Exercise training also increases the local and systemic antioxidative capacity and several compensatory mechanisms in tissues such as an increased anabolic signaling in muscle or an increased compliance of the vascular system. Accordingly, regular exercise training seems to protect long-term smokers against some important negative local and systemic consequences of smoking. Data suggest that it seems to be important to start exercise training as early as possible.
Collapse
Affiliation(s)
- Ashkan Madani
- Department of Exercise and Health, Institute of Sports Science, Leibniz University Hannover, Germany
| | - Katharina Alack
- Department of Sports Medicine, University of Giessen, Germany
| | - Manuel Jonas Richter
- Department of Internal Medicine, Justus Liebig University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Germany
- German Center for Lung Research (DZL), Giessen, Germany
| | - Karsten Krüger
- Department of Exercise and Health, Institute of Sports Science, Leibniz University Hannover, Germany
| |
Collapse
|
|
41
|
Abstract
Atherosclerotic cardiovascular disease is a leading cause of death and disability worldwide, and the atherosclerotic process begins in childhood. Prevention or containment of risk factors that accelerate atherosclerosis can delay the development of atherosclerotic cardiovascular disease. Although current recommendations are to periodically screen for commonly prevailing risk factors for atherosclerosis in children, a single test that could quantify the cumulative effect of all risk factors on the vasculature, thus assessing arterial health, would be helpful in further stratifying risk. Measurement of pulse wave velocity and assessment of augmentation index - measures of arterial stiffness - are easy-to-use, non-invasive methods of examining arterial health. Various studies have assessed pulse wave velocity and augmentation index in children with commonly occurring conditions including obesity, hypertension, insulin resistance, diabetes mellitus, dyslipidaemia, physical inactivity, chronic kidney disease, CHD and acquired heart diseases, and in children who were born premature or small for gestational age. This article summarises pulse wave velocity and augmentation index assessments and the effects of commonly prevailing chronic conditions on arterial health in children. In addition, currently available reference values for pulse wave velocity and augmentation index in healthy children are included. Further research to establish widely applicable normative values and the effect of lifestyle and pharmacological interventions on arterial health in children is needed.
Collapse
|
|
42
|
Kelley GA, Kelley KS, Pate RR. Exercise and adiposity in overweight and obese children and adolescents: protocol for a systematic review and network meta-analysis of randomised trials. BMJ Open 2017; 7:e019512. [PMID: 29288191 PMCID: PMC5770943 DOI: 10.1136/bmjopen-2017-019512] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 11/17/2017] [Accepted: 11/20/2017] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Overweight and obesity is a worldwide public health problem among children and adolescents. However, the magnitude of effect, as well as hierarchy of exercise interventions (aerobic, strength training or both), on selected measures of adiposity is not well established despite numerous trials on this issue. The primary purposes of this study are to use the network meta-analytical approach to determine the effects and hierarchy of exercise interventions on selected measures of adiposity in overweight and obese children and adolescents. METHODS AND ANALYSIS Randomised exercise intervention trials >4 weeks, available in any language up to 31 August 2017 and which include direct and/or indirect evidence, will be included. Studies will be located by searching seven electronic databases, cross-referencing and expert review. Dual selection and abstraction of data will occur. The primary outcomes will be changes in body mass index (in kg/m2), fat mass and percent body fat. Risk of bias will be assessed using the Cochrane Risk of Bias assessment instrument while confidence in the cumulative evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation instrument for network meta-analysis. Network meta-analysis will be performed using multivariate random-effects meta-regression models. The surface under the cumulative ranking curve will be used to provide a hierarchy of exercise treatments (aerobic, strength or both). ETHICS AND DISSEMINATION This study does not require ethics approval. Findings will be presented at a professional conference and published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD 42017073103 .
Collapse
Affiliation(s)
- George A Kelley
- Department of Biostatistics, School of Public Health, West Virginia University, Morgantown, West Virginia, USA
| | - Kristi S Kelley
- Department of Biostatistics, School of Public Health, West Virginia University, Morgantown, West Virginia, USA
| | - Russell R Pate
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina, USA
| |
Collapse
|
|
43
|
Zhang H, Jiang L, Yang YJ, Ge RK, Zhou M, Hu H, Liu H, Cui J, Li LL, Dong YF, Cheng XS, Chen R, Li P. Aerobic exercise improves endothelial function and serum adropin levels in obese adolescents independent of body weight loss. Sci Rep 2017; 7:17717. [PMID: 29255252 PMCID: PMC5735148 DOI: 10.1038/s41598-017-18086-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 12/01/2017] [Indexed: 01/18/2023] Open
Abstract
Adropin is a secreted protein that regulates endothelial function. However, adropin levels in obese adolescent patients are currently uncertain. Therefore, we evaluated the association between plasma adropin levels and vascular endothelial function and investigated the effect of aerobic exercise in obese adolescents. A total of 45 obese adolescents and 20 controls (age 16-19 years) were included in our study. The obese adolescents received 12 weeks of aerobic exercise training. Serum adropin was detected using enzyme-linked immunosorbent assay. Vascular reactive hyperemia indexes (RHIs) were obtained using Endo-PAT2000. Adropin levels and RHI were significantly lower in obese adolescents than in normal-weight adolescents. Adropin levels and RHI increased significantly independently of changes in body weight after an exercise intervention (P < 0.01). Pearson correlation analysis revealed that adropin levels positively correlated with HDL-C levels (r = 0.389, P < 0.01) and RHI (r = 0.32, P < 0.01). Multiple linear stepwise regression analysis showed that the insulin resistance index (t = -3.301, P < 0.01) and HDL-C level (t = 2.620, P = 0.011) were independent risk factors of adropin levels. In addition, Δadropin (t = 3.261, P < 0.01) was an independent influencing factor of ΔRHI. Our findings suggest that adropin plays an important role in vascular endothelial function in obese adolescents.
Collapse
Affiliation(s)
- Hao Zhang
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi Province, China
- Department of Cardiovascular Medicine, Xiangdong Hospital Affiliated to Hunan Normal University, Liling, 412200, Hunan Province, China
| | - Long Jiang
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi Province, China
| | - Yu-Jing Yang
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi Province, China
| | - Ren-Kai Ge
- School of Physical Education, East China Jiaotong University, Sports Fitness Research Center, Nanchang, 330013, Jiangxi Province, China
| | - Ming Zhou
- School of Physical Education, East China Jiaotong University, Sports Fitness Research Center, Nanchang, 330013, Jiangxi Province, China
| | - Huan Hu
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi Province, China
| | - Hui Liu
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi Province, China
| | - Jie Cui
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi Province, China
| | - Le-Liang Li
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi Province, China
| | - Yi-Fei Dong
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi Province, China
| | - Xiao-Shu Cheng
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi Province, China
| | - Rong Chen
- School of Physical Education, East China Jiaotong University, Sports Fitness Research Center, Nanchang, 330013, Jiangxi Province, China.
| | - Ping Li
- Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi Province, China.
| |
Collapse
|
|
44
|
Abstract
PURPOSE Flow-mediated dilation, a barometer of cardiovascular (CV) health, is reported to increase with exercise training (ET); however, the potential moderating factors of ET are not clear to date. The purpose of this study was to determine the effect of ET assessed by brachial artery flow-mediated dilation (BAFMD). METHODS Authors searched PubMed between January 1999 and December 2013, bibliographies, and reviews to identify studies examining ET and BAFMD. Two independent reviewers extracted quality, descriptive, exercise, and outcome data of eligible studies. Data were presented as weighted effect sizes (ESs) and 95% confidence limits. RESULTS Analysis included 66 studies reporting BAFMD data (1865 ET and 635 control subjects). Overall, ET had significant improvements in BAFMD compared with controls (P < .0001). Exercise training at higher ET intensities resulted in a greater increase in BAFMD (9.29; 95% CI, 5.09-13.47) than lower ET intensities (3.63; 95% CI, -0.56 to 7.83) or control (-0.42; 95% CI, -2.06 to 1.21). Subjects whose ET duration was ≥150 min/wk (11.33; 95% CI, 7.15-15.51) had a significant improvement in BAFMD compared with those with <150 min/wk (4.79; 95% CI, 3.08-6.51) or control (-0.30; 95% CI, -1.99 to 1.39). Age (P = .11) and baseline artery diameter (P = .31) did not modify the BAFMD response to ET. CONCLUSION Exercise training contributes to a significant increase in BAFMD. These results provide indirect evidence that ET alters a well-known factor associated with the primary and secondary prevention of CV diseases. Exercise training interventions, including greater intensity and duration, may optimize the increase in BAFMD.
Collapse
|
|
45
|
Mendizábal B, Urbina EM. Subclinical Atherosclerosis in Youth: Relation to Obesity, Insulin Resistance, and Polycystic Ovary Syndrome. J Pediatr 2017; 190:14-20. [PMID: 28712518 DOI: 10.1016/j.jpeds.2017.06.043] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 05/08/2017] [Accepted: 06/19/2017] [Indexed: 12/25/2022]
Affiliation(s)
- Brenda Mendizábal
- The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Department of Pediatrics, University of Cincinnati, Cincinnati, OH
| | - Elaine M Urbina
- The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Department of Pediatrics, University of Cincinnati, Cincinnati, OH.
| |
Collapse
|
|
46
|
Braaksma P, Stuive I, Garst RME, Wesselink CF, van der Sluis CK, Dekker R, Schoemaker MM. Characteristics of physical activity interventions and effects on cardiorespiratory fitness in children aged 6-12 years-A systematic review. J Sci Med Sport 2017; 21:296-306. [PMID: 28899655 DOI: 10.1016/j.jsams.2017.07.015] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 07/07/2017] [Accepted: 07/13/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To examine the characteristics of physical activity (PA) interventions and the effects on cardiorespiratory fitness (CRF) in healthy children based on treatment theory. DESIGN Systematic review. METHODS PubMed and Embase were searched for studies published between 2003 and 2016. Inclusion criteria were: Participants: healthy children aged 6-12. INTERVENTIONS interventions with activities to increase PA behaviour or physical fitness (PF) regardless of setting. CONTROL no or alternative intervention. OUTCOME exercise-based CRF measure with appropriate analysis of CRF effects. STUDY DESIGN randomized controlled trial. Effect size was calculated using dppc2 and the methodological quality of the studies was assessed using the PEDro scale. RESULTS Of 1002 studies screened, 23 met the inclusion criteria. Thirteen of the 23 studies found statistically significant improvements in CRF and eight studies showed medium to high effect sizes. Interventions with medium to high effect sizes focused more often on PF than PA behaviour, had slightly higher frequencies of activities and had a shorter duration than the less effective interventions. CONCLUSIONS The fact that thirteen studies demonstrated statistically significant improvements in CRF is promising but also emphasizes the need to keep improving research methods and the development and execution of interventions. Interventions with larger effect sizes appear to be more controlled, as they usually relied on smaller sample sizes and the components of these interventions encompassed protocolled training sessions which defined and monitored the relative training intensity intended. A duration of at least six weeks and a frequency of three to four times a week is recommended.
Collapse
Affiliation(s)
- Petra Braaksma
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, The Netherlands.
| | - Ilse Stuive
- University of Groningen, University Medical Center Groningen, Center for Rehabilitation, The Netherlands
| | - Rianne M E Garst
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, The Netherlands
| | - Carlijn F Wesselink
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, The Netherlands
| | - Corry K van der Sluis
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, The Netherlands
| | - Rienk Dekker
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, The Netherlands
| | - Marina M Schoemaker
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, The Netherlands
| |
Collapse
|
|
47
|
Kelley GA, Kelley KS, Pate RR. Exercise and BMI z-score in Overweight and Obese Children and Adolescents: A Systematic Review and Network Meta-Analysis of Randomized Trials. J Evid Based Med 2017; 10:108-128. [PMID: 27792271 PMCID: PMC5553313 DOI: 10.1111/jebm.12228] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Accepted: 07/10/2016] [Indexed: 01/29/2023]
Abstract
AIM Examine the effects of selected types of exercise (aerobic, strength training, both) on BMI z-score in overweight and obese children and adolescents. METHODS Randomized exercise intervention trials ≥ 4 weeks were included. Studies were retrieved by searching six electronic databases, cross-referencing and expert review. Dual selection and abstraction occurred. Risk of bias and confidence in cumulative evidence were assessed. Network meta-analysis was performed using multivariate random-effects meta-regression models while surface under the cumulative ranking curves were used to calculate a hierarchy of exercise treatments. The number needed to treat (NNT) and percentile improvement (U3 ) were also calculated. RESULTS Thirty-four studies representing 2,239 participants were included. Median exercise occurred 3 times per week, 50 minutes per session over a 12-week period. Statistically significant reductions in BMI z-score were found for aerobic exercise and combined aerobic and strength exercise, but not strength training alone (M±SD, 95% CI: aerobic, -0.10, -0.15 to -0.05; aerobic and strength, -0.11, -0.19 to -0.03; strength, 0.04, -0.07 to 0.15). Combined aerobic and strength training was ranked best, followed by aerobic exercise and strength training. The NNT was 2 for both aerobic exercise and combined aerobic exercise and strength training. Percentile improvements were 28.8% for aerobic exercise and 31.5% for combined aerobic exercise and strength training. Confidence in effect estimates was ranked as low for aerobic exercise and very low for combined aerobic and strength training as well as strength training. CONCLUSIONS Aerobic exercise and combined aerobic exercise and strength training are associated with reductions in BMI z-score.
Collapse
Affiliation(s)
- George A Kelley
- Department of Biostatistics, West Virginia University, Morgantown, West Virginia, United States
| | - Kristi S Kelley
- Department of Biostatistics, West Virginia University, Morgantown, West Virginia, United States
| | - Russell R Pate
- Exercise Science, Department of Exercise Science, University of South Carolina, Columbia, South Carolina, United States
| |
Collapse
|
|
48
|
Stodden D, Sacko R, Nesbitt D. A Review of the Promotion of Fitness Measures and Health Outcomes in Youth. Am J Lifestyle Med 2017; 11:232-242. [PMID: 30202338 PMCID: PMC6125085 DOI: 10.1177/1559827615619577] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 10/23/2015] [Accepted: 11/06/2015] [Indexed: 11/16/2022] Open
Abstract
The relationship between physical fitness and health in adults is well established, yet until recently, empirical support for the impact of physical fitness levels on health markers in children has not been thoroughly documented. The aim of this review was to provide a summary of current literature that has examined the linkage between measures of health-related physical fitness (ie, cardiorespiratory fitness, musculoskeletal fitness, flexibility, and body composition) and health markers in youth. Specifically, this review focused on the findings from the recent 2012 Institutes of Medicine report on Fitness Measures in Youth as well as other subsequent review articles related to the topic. In addition, recommendations for health-related fitness assessments in youth populations are presented.
Collapse
Affiliation(s)
| | | | - Danielle Nesbitt
- Department of Physical Education and Athletic Training, University of South Carolina, Columbia, South Carolina
| |
Collapse
|
|
49
|
Marson EC, Delevatti RS, Prado AKG, Netto N, Kruel LFM. Effects of aerobic, resistance, and combined exercise training on insulin resistance markers in overweight or obese children and adolescents: A systematic review and meta-analysis. Prev Med 2016; 93:211-218. [PMID: 27773709 DOI: 10.1016/j.ypmed.2016.10.020] [Citation(s) in RCA: 94] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 10/18/2016] [Accepted: 10/19/2016] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To assess the associations of aerobic, resistance, and combined exercise with changes in insulin resistance, fasting glucose, and fasting insulin in children and adolescents who are overweight or obese. DATA SEARCHES MEDLINE via Pubmed, Cochrane-CENTRAL, SPORTDiscus, and LILACS. STUDY SELECTION Randomized clinical trials of at least six weeks of duration that evaluated the ability of exercise training to lower at least one of the following outcomes: insulin resistance-HOMA, fasting glucose, and fasting insulin in children and/or adolescents classified as obese or overweight. DATA EXTRACTION AND ANALYSIS Two independent reviewers extracted data and assessed the quality of the included studies. Differences (exercise training group minus control group) in the outcomes evaluated were analyzed using a random effects model. RESULTS Of 1853 articles retrieved, 17 studies were included. The meta-analysis showed that physical training in general was not associated with a reduction in fasting glucose levels compared to the control, but it was associated with reductions in fasting insulin levels (-3.37μU/ml; CI 95%, -5.16μU/ml to -1.57μU/ml; I2, 54%, p=0.003) and HOMA (-0.61; CI 95%, -1.19 to -0.02; I2, 49%, p=0.040). In addition, each modality (aerobic, resistance, and combined) was compared to the control group. Aerobic exercise was associated with declines in fasting insulin levels (-4.52μU/ml; CI 95%, -7.40 to -1.65; I2, 65%, p=0.002) and in HOMA (-1.33; 95% confidence interval, -2.47 to -0.18; I2, 73%, p=0.005). CONCLUSIONS Exercise training, especially aerobic training, is associated with the reduction of fasting insulin levels and HOMA in children and adolescents with obesity and overweight, and may prevent metabolic syndrome and type 2 diabetes.
Collapse
Affiliation(s)
- Elisa Corrêa Marson
- Universidade Federal do Rio Grande do Sul, Exercise Research Laboratory, Department of Physical Education, Felizardo Street, 750, Jardim Botânico, Physical Education School/Swimming Center, Room 18, 90690-200 Porto Alegre, RS, Brazil.
| | - Rodrigo Sudatti Delevatti
- Universidade Federal do Rio Grande do Sul, Exercise Research Laboratory, Department of Physical Education, Felizardo Street, 750, Jardim Botânico, Physical Education School/Swimming Center, Room 18, 90690-200 Porto Alegre, RS, Brazil; Faculdade Sogipa de Educação Física, Benjamin Constant Avenue, 80, São João, 90550-003 Porto Alegre, RS, Brazil.
| | - Alexandre Konig Garcia Prado
- Universidade Federal do Rio Grande do Sul, Exercise Research Laboratory, Department of Physical Education, Felizardo Street, 750, Jardim Botânico, Physical Education School/Swimming Center, Room 18, 90690-200 Porto Alegre, RS, Brazil; Faculdade Cenecista de Osório. Jorge Dariva Avenue, 1042, Centro, 95520-000, Osório, RS, Brazil.
| | - Nathalie Netto
- Universidade Federal do Rio Grande do Sul, Exercise Research Laboratory, Department of Physical Education, Felizardo Street, 750, Jardim Botânico, Physical Education School/Swimming Center, Room 18, 90690-200 Porto Alegre, RS, Brazil.
| | - Luiz Fernando Martins Kruel
- Universidade Federal do Rio Grande do Sul, Exercise Research Laboratory, Department of Physical Education, Felizardo Street, 750, Jardim Botânico, Physical Education School/Swimming Center, Room 18, 90690-200 Porto Alegre, RS, Brazil.
| |
Collapse
|
|
50
|
Gidding SS. Special Article: Physical Activity, Physical Fitness, and Cardiovascular Risk Factors in Childhood. Am J Lifestyle Med 2016. [DOI: 10.1177/1559827607306432] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
In adults, physical activity and exercise training are associated with reduced cardiovascular morbidity and mortality, a reduced likelihood of developing adverse cardiovascular risk factors, and improved insulin sensitivity. In childhood, participation in appropriate physical activity may prevent the development of cardiovascular risk factors in the future and complement treatment of existing cardiovascular risk factors, including hypertension, dyslipidemia, and overweight. Exercise in children can also significantly improve insulin sensitivity independent of weight loss. These e fects are mediated in overweight children by increases in lean body mass relative to fat mass and associated improvements in inflammatory mediators, endothelial function, and the associated adverse hormonal milieu.
Collapse
Affiliation(s)
- Samuel S. Gidding
- Jefferson Medical College and Nemours Cardiac Center, A. I. duPont Hospital for Children, Wilmington, Delaware,
| |
Collapse
|