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1
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Wilhite DP, Bhammar DM, Balmain BN, Martinez-Fernandez T, Liu Y, Babb TG. Ventilatory response and dyspnea on exertion in children with obesity and respiratory symptoms. Respir Physiol Neurobiol 2025; 335:104437. [PMID: 40274038 DOI: 10.1016/j.resp.2025.104437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2024] [Revised: 04/16/2025] [Accepted: 04/21/2025] [Indexed: 04/26/2025]
Abstract
We investigated whether the exercise ventilatory response is associated with dyspnea on exertion (DOE) in children with (CWO;n = 25) and without (CWOO;n = 49) obesity, and with obesity and respiratory symptoms (CWORS;n = 14). The ventilatory response to exercise (V̇E/V̇CO2 slope) and ratings of perceived breathlessness (RPB, Borg 0-10 scale) were measured during 6-min cycling at 45 % maximal work rate. The V̇E/V̇CO2 slope (CWOO=34 ± 7; CWO=34 ± 5; CWORS=37 ± 6) and RPB (CWORS=4.0 ± 3.4; CWOO=2.5 ± 1.7; CWO=3.2 ± 2.1) were similar among groups (p > 0.05). A significant association between the V̇E/V̇CO2 slope and RPB in CWORS (r2=0.49;p < 0.05) was observed. To investigate this relationship more closely, children with an RPB≤ 2 were classified as having no or mild DOE (-DOE;n = 39;RPB=1.2 ± 0.7), and those with RPB≥ 3 were classified as having moderate to severe DOE (+DOE;n = 49;RPB=4.7 ± 1.9). +DOE had a higher V̇E/V̇CO2 slope (+DOE=36 ± 6;-DOE=33 ± 5;p = 0.02), higher breathing frequency, and higher V̇E (%max;p < 0.05). These findings suggest a heightened sensitivity to ventilatory demand among children, and that +DOE may be driven by factors other than obesity alone, possibly increased ventilatory response to exercise.
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Affiliation(s)
- Daniel P Wilhite
- Department of Veterans Affairs New Jersey Health Care System, Airborne Hazards Center of Excellence - War Related Illness and Injury Study Center, 385 Tremont Ave., East Orange, NJ 07018, United States.
| | - Dharini M Bhammar
- Center for Tobacco Research, Division of Medical Oncology, Department of Internal Medicine, The Ohio State University, 3650 Olentangy River Rd., Ste 420, Columbus, OH 43214, United States.
| | - Bryce N Balmain
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas and UT Southwestern Medical Center, 7232 Greenville Ave., Dallas, TX 75231, United States.
| | - Tanya Martinez-Fernandez
- Department of Pediatrics, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390, United States.
| | - Yulun Liu
- Peter O'Donnel Jr. School of Public Health, UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390, United States.
| | - Tony G Babb
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas and UT Southwestern Medical Center, 7232 Greenville Ave., Dallas, TX 75231, United States.
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2
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Larios G, Uribe S, Trincado C, Arancibia-Galilea F, Valderrama P, Espejo JP, Amezquita MV, Barja S. Myocardial function, mechanics and work by echocardiography in adolescents with severe obesity. Cardiovasc Endocrinol Metab 2024; 13:e0301. [PMID: 38706533 PMCID: PMC11068145 DOI: 10.1097/xce.0000000000000301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 03/18/2024] [Indexed: 05/07/2024]
Abstract
Introduction Obesity and its metabolic complications can impact the heart's structure and function in childhood, although demonstrating this impact has been challenging. New echocardiographic parameters such as left atrial strain (LAε) and left ventricular strain (LVε), as well as myocardial work (MW), could reveal subclinical alterations in cardiac function. Objective The aim is to evaluate the feasibility of these parameters in adolescents with severe obesity and explore their associations with body fat, metabolic comorbidities, and physical capacity. Methods This is a cross-sectional study in adolescents with obesity who underwent echocardiography with analysis of LAε, LVε and MW using speckle tracking. Feasibility and association with anthropometry, body fat percentage, comorbidities and cardiopulmonary test were analyzed. Results Twenty adolescents were recruited, 13 (65%) were males, median age 14.2 (interquartile range: 12.9-14.9) years old. The median Z-score for BMI (zBMI) was +3.03 (2.87-3.14), 14 (70%) had severe obesity (zBMI ≥+3), 12 (60%) body fat ≥95th percentile, 9 (45%) high blood pressure (HBP) and 8 (40%) metabolic syndrome. The analysis of the echocardiographic parameters was feasible in 95% (LAε) and 100% (LVε and MW). LVε was lower in adolescents with vs. without metabolic syndrome: 17.8% (17.5-19.3%) vs. 19.3% (18.3-20.3%), P = 0.046; and with vs. without HBP 17.8% (17.5-18.6%) vs. 19.7% (18.4-20.3%), P = 0.02. Those with body fat ≥95th percentile had lower LAε and MW parameters, without association with cardiopulmonary test. Conclusion Echocardiographic evaluation of LAε, LVε and MW is feasible in adolescents with severe obesity. A higher proportion of body fat and the presence of comorbidities are associated with alterations in these new echocardiographic functional parameters suggesting myocardial impact of higher metabolic compromise.
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Affiliation(s)
- Guillermo Larios
- Division of Pediatrics, Department of Pediatric Cardiology, Pontificia Universidad Católica de Chile
| | - Sergio Uribe
- Department of Medical Imaging and Radiation Sciences, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University
| | - Claudia Trincado
- Division of Pediatrics, Department of Pediatric Cardiology, Pontificia Universidad Católica de Chile
| | | | - Paulo Valderrama
- Division of Pediatrics, Department of Pediatric Cardiology, Pontificia Universidad Católica de Chile
| | - Juan Pablo Espejo
- School of Nutrition and Dietetics, Pontificia Universidad Católica de Chile
| | - María Virginia Amezquita
- Division of Pediatrics, Department of Pediatric Gastroenterology and Nutrition, Pontificia Universidad Católica de Chile
| | - Salesa Barja
- Division of Pediatrics, Department of Pediatric Gastroenterology and Nutrition, Pontificia Universidad Católica de Chile
- Josefina Martinez Hospital, Santiago, Chile
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Chen IY, Radom-Aizik S, Stehli A, Palmer JR, Lui KK, Dave A, Chappel-Farley MG, Vinces KG, Gealer D, Lim A, Mander BA, Benca RM, Neikrug AB. Cardiorespiratory fitness and circadian rhythms in adolescents: a pilot study. J Appl Physiol (1985) 2024; 136:372-384. [PMID: 38126092 PMCID: PMC11213564 DOI: 10.1152/japplphysiol.00291.2023] [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: 05/08/2023] [Revised: 11/07/2023] [Accepted: 11/27/2023] [Indexed: 12/23/2023] Open
Abstract
Although cardiorespiratory fitness (CRF), an important marker of youth health, is associated with earlier sleep/wake schedule, its relationship with circadian rhythms is unclear. This study examined the associations between CRF and rhythm variables in adolescents. Eighteen healthy adolescents (10 females and 8 males; Mage = 14.6 ± 2.3 yr) completed two study visits on weekdays bracketing an ambulatory assessment during summer vacation. Visit 1 included in-laboratory CRF assessment (peak V̇o2) using a ramp-type progressive cycle ergometry protocol and gas exchange measurement, which was followed by 7-14 days of actigraphy to assess sleep/wake patterns and 24-h activity rhythms. During Visit 2, chronotype, social jetlag (i.e., the difference in midsleep time between weekdays and weekends), and phase preference were assessed using a questionnaire, and hourly saliva samples were collected to determine the dim light melatonin onset (DLMO) phase. All analyses were adjusted for sex, pubertal status, and physical activity. Greater peak V̇o2 was associated with earlier sleep/wake times and circadian phase measures, including acrophase, UP time, DOWN time, last activity peak (LAP) time, and chronotype (all P < 0.05). Peak V̇o2 was negatively associated with social jetlag (P = 0.02). In addition, the mixed-model analysis revealed a significant interaction effect between peak V̇o2 and actigraphy-estimated hour-by-hour activity patterns (P < 0.001), with the strongest effects observed at around the time of waking (0600-1000). In healthy adolescents, better CRF was associated with an earlier circadian phase and increased activity levels notably during the morning. Future studies are needed to investigate the longitudinal effects of the interactions between CRF and advanced rhythms on health outcomes.NEW & NOTEWORTHY In healthy adolescents, better cardiorespiratory fitness, as assessed by the gold standard measure [laboratory-based assessment of peak oxygen consumption (V̇o2)], was associated with earlier circadian timing of sleep/wake patterns, rest-activity rhythms and chronotype, and less social jetlag. These findings highlight the close interrelationships between fitness and rhythms and raise the possibility that maintaining higher cardiorespiratory fitness levels alongside earlier sleep/wake schedule and activity rhythms may be important behavioral intervention targets to promote health in adolescents.
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Affiliation(s)
- Ivy Y Chen
- Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, California, United States
| | - Shlomit Radom-Aizik
- Pediatric Exercise and Genomics Research Center, University of California, Irvine, Irvine, California, United States
| | - Annamarie Stehli
- Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, California, United States
- Pediatric Exercise and Genomics Research Center, University of California, Irvine, Irvine, California, United States
| | - Jake R Palmer
- School of Psychology, Faculty of Science, University of Sydney, Sydney, New South Wales, Australia
- Brain and Mind Centre and Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Kitty K Lui
- Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, California, United States
| | - Abhishek Dave
- Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, California, United States
| | - Miranda G Chappel-Farley
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, Irvine, California, United States
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, California, United States
| | - Karla G Vinces
- Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, California, United States
| | - Daniel Gealer
- Pediatric Exercise and Genomics Research Center, University of California, Irvine, Irvine, California, United States
| | - Alexandra Lim
- Pediatric Exercise and Genomics Research Center, University of California, Irvine, Irvine, California, United States
| | - Bryce A Mander
- Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, California, United States
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, Irvine, California, United States
| | - Ruth M Benca
- Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, California, United States
| | - Ariel B Neikrug
- Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, California, United States
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Keramat SA, Alam K, Basri R, Siddika F, Siddiqui ZH, Okyere J, Seidu AA, Ahinkorah BO. Sleep duration, sleep quality and the risk of being obese: Evidence from the Australian panel survey. Sleep Med 2023; 109:56-64. [PMID: 37418828 DOI: 10.1016/j.sleep.2023.06.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 05/27/2023] [Accepted: 06/11/2023] [Indexed: 07/09/2023]
Abstract
BACKGROUND Sleep difficulty is an unmet public health concern affecting a vast proportion of the world's population. Poor sleep duration (short or long sleep length) and quality affect more than half of older people. Sleep difficulty is associated with negative health outcomes such as obesity and reduced longevity. We aimed to assess whether poor sleep duration and quality are significant risk factors for obesity in adults aged 15 and over in Australia by examining a nationally representative panel data. METHODS We used three waves (waves 13, 17, and 21) of the nationally representative Household, Income and Labour Dynamics in Australia (HILDA) survey data. The study applied generalized estimating equations (GEE) logistic regression model to assess the relationship between sleep duration and quality with obesity. RESULTS The study found that the odds of being obese was significantly higher amongst the study participants with poor sleep duration (adjusted odds ratio [aOR]: 1.24, 95% confidence interval [CI]: 1.16-1.32) and poor sleep quality (aOR: 1.29, 95% CI: 1.02-1.38) compared with their counterparts who had good sleep duration and quality, respectively. CONCLUSION Having short or long sleep at night and poor sleep quality are associated with an increased risk of obesity. Obesity poses a significant threat to the health of Australian adults. Enacting policies that raise public awareness of the significance of good sleep hygiene and encouraging healthy sleeping habits should be considered to address the alarming rise in the obesity rate.
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Affiliation(s)
- Syed Afroz Keramat
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Australia; School of Business, and Centre for Health Research, The University of Southern Queensland, Australia.
| | - Khorshed Alam
- School of Business, and Centre for Health Research, The University of Southern Queensland, Australia
| | - Rabeya Basri
- Department of Economics, Rajshahi University, Bangladesh
| | - Farzana Siddika
- Department of Mathematics and Natural Sciences, BRAC University, Dhaka, Bangladesh
| | - Zubayer Hassan Siddiqui
- Department of Business Administration, Bangladesh University of Professionals, Dhaka, Bangladesh
| | - Joshua Okyere
- Department of Population and Health, University of Cape Coast, Ghana
| | - Abdul-Aziz Seidu
- REMS Consult Limited, Sekondi-Takoradi, Western Region, Ghana; College of Public Health, Medical and Veterinary Sciences, James Cook University, Australia
| | - Bright Opoku Ahinkorah
- REMS Consult Limited, Sekondi-Takoradi, Western Region, Ghana; School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
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La Grasta Sabolic L, Pozgaj Sepec M, Valent Moric B, Cigrovski Berkovic M. Association between cardiorespiratory fitness level and insulin resistance in adolescents with various obesity categories. World J Diabetes 2023; 14:1126-1136. [PMID: 37547583 PMCID: PMC10401457 DOI: 10.4239/wjd.v14.i7.1126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/22/2023] [Accepted: 06/02/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND An association between cardiorespiratory fitness (CRF) and insulin resistance in obese adolescents, especially in those with various obesity categories, has not been systematically studied. There is a lack of knowledge about the effects of CRF on insulin resistance in severely obese adolescents, despite their continuous rise. AIM To investigate the association between CRF and insulin resistance in obese adolescents, with special emphasis on severely obese adolescents. METHODS We performed a prospective, cross-sectional study that included 200 pubertal adolescents, 10 years to 18 years of age, who were referred to a tertiary care center due to obesity. According to body mass index (BMI), adolescents were classified as mildly obese (BMI 100% to 120% of the 95th percentile for age and sex) or severely obese (BMI ≥ 120% of the 95th percentile for age and sex or ≥ 35 kg/m2, whichever was lower). Participant body composition was assessed by bioelectrical impedance analysis. A homeostatic model assessment of insulin resistance (HOMA-IR) was calculated. Maximal oxygen uptake (VO2max) was determined from submaximal treadmill exercise test. CRF was expressed as VO2max scaled by total body weight (TBW) (mL/min/kg TBW) or by fat free mass (FFM) (mL/min/kg FFM), and then categorized as poor, intermediate, or good, according to VO2max terciles. Data were analyzed by statistical software package SPSS (IBM SPSS Statistics for Windows, Version 24.0). P < 0.05 was considered statistically significant. RESULTS A weak negative correlation between CRF and HOMA-IR was found [Spearman's rank correlation coefficient (rs) = -0.28, P < 0.01 for CRFTBW; (rs) = -0.21, P < 0.01 for CRFFFM]. One-way analysis of variance (ANOVA) revealed a significant main effect of CRF on HOMA-IR [F(2200) = 6.840, P = 0.001 for CRFTBW; F(2200) = 3.883, P = 0.022 for CRFFFM]. Subsequent analyses showed that obese adolescents with poor CRF had higher HOMA-IR than obese adolescents with good CRF (P = 0.001 for CRFTBW; P = 0.018 for CRFFFM). Two-way ANOVA with Bonferroni correction confirmed significant effect of interaction of CRF level and obesity category on HOMA-IR [F(2200) = 3.292, P = 0.039 for CRFTBW]. Severely obese adolescents had higher HOMA-IR than those who were mildly obese, with either good or poor CRF. However, HOMA-IR did not differ between severely obese adolescents with good and mildly obese adolescents with poor CRF. CONCLUSION CRF is an important determinant of insulin resistance in obese adolescents, regardless of obesity category. Therefore, CRF assessment should be a part of diagnostic procedure, and its improvement should be a therapeutic goal.
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Affiliation(s)
- Lavinia La Grasta Sabolic
- Department of Pediatric Endocrinology and Diabetology, University Hospital Centre Sestre milosrdnice, Zagreb 10000, Croatia
- School of Medicine, Catholic University, Zagreb 10000, Croatia
| | - Marija Pozgaj Sepec
- Department of Pediatric Endocrinology and Diabetology, University Hospital Centre Sestre milosrdnice, Zagreb 10000, Croatia
| | - Bernardica Valent Moric
- Department of Pediatric Endocrinology and Diabetology, University Hospital Centre Sestre milosrdnice, Zagreb 10000, Croatia
| | - Maja Cigrovski Berkovic
- Department for Sport and Exercise Medicine, Faculty of Kinesiology University of Zagreb, Zagreb 10000, Croatia
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Grace B, Taylor Lucas C, Shetgiri R, Cardenas K, Perez de la Garza G, Pak Y, Yee JK. Physical Activity Counseling and Documentation by Pediatric Residents in Primary Care: Before and After Introduction of the FITT Principle. Clin Pediatr (Phila) 2023; 62:449-455. [PMID: 35978477 PMCID: PMC9935740 DOI: 10.1177/00099228221115989] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Physician training on physical activity (PA) counseling in patient care is highly variable. The objective of this study was to improve PA counseling by pediatric residents through introduction of the four components of PA, called the FITT principle (frequency, intensity, time, type). Pediatric residents (n=30) received lectures, curriculum content, and an electronic smart-phrase addressing PA in obesity, including the FITT principle. Surveys assessed resident attitudes, and chart reviews (n = 423 over 16 months) identified evidence of PA counseling including FITT principle components preintervention and postintervention. Survey results showed positive attitudes and confidence regarding primary care provider roles in counseling on PA, with no differences postintervention. Chart reviews demonstrated increased documentation on PA frequency postintervention (pre 31.9% vs post 50.9%, P=.00006), but no significant changes in intensity, time or type. In conclusion, a focused PA curriculum promoted PA counseling by pediatric residents, with increased documentation of one component of the FITT principle.
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Affiliation(s)
- Benjamin Grace
- Department of Pediatrics, Division of Endocrinology, The Lundquist Institute of Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Candice Taylor Lucas
- Department of Pediatrics, University of California, Irvine, School of Medicine, Orange, CA, USA
| | - Rashmi Shetgiri
- Office of Health Assessment and Epidemiology, Los Angeles County Department of Public Health, Los Angeles, CA, USA
| | - Krystal Cardenas
- Department of Pediatrics, Division of Endocrinology, The Lundquist Institute of Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Giselle Perez de la Garza
- Department of Pediatrics, Division of Endocrinology, The Lundquist Institute of Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Youngju Pak
- Department of Internal Medicine, Division of Endocrinology, The Lundquist Institute of Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Jennifer K. Yee
- Department of Pediatrics, Division of Endocrinology, The Lundquist Institute of Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
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Evaluation of Muscle Oxygen Dynamics in Children's Gait and Its Relationship with the Physiological Cost Index. Healthcare (Basel) 2023; 11:healthcare11020221. [PMID: 36673589 PMCID: PMC9858938 DOI: 10.3390/healthcare11020221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/02/2023] [Accepted: 01/10/2023] [Indexed: 01/13/2023] Open
Abstract
The response of muscle oxygen saturation, which is an index for the energy metabolism of muscles during walking in children, and its relationship to the physiological cost index, which indicates walking efficiency, are unknown. This study aimed to evaluate muscle oxygen saturation in lower extremity muscles during walking in children, its changes with age, and the relationship between the physiological cost index. The oxygen saturation was measured by the amount of change during a two-minute walk, and the physiological cost index was calculated from the change in heart rate before and after exercise and walking speed. Results were compared for each muscle, and the correlation between the two was examined. Changes in muscle oxygen saturation were greater in the lower leg muscles, significantly greater in the tibialis anterior at six to seven years, and in the gastrocnemius medial head at eight to ten years. The physiological cost index was significantly correlated with changes in muscle oxygen saturation in the tibialis anterior (r = 0.44, p < 0.001). The lower leg muscles were metabolically active in children’s gait, and their response varied with age. Moreover, the muscle oxygenation dynamics of the tibialis anterior may influence walking efficiency.
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Galan-Lopez P, Gísladóttir T, Pihu M, Sánchez-Oliver AJ, Ries F, Domínguez R. Health-Related Physical Fitness in Adolescents from Spain, Estonia and Iceland: A Cross-Sectional, Quantitative Study. Sports (Basel) 2022; 10:188. [PMID: 36548485 PMCID: PMC9788329 DOI: 10.3390/sports10120188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/11/2022] [Accepted: 11/21/2022] [Indexed: 11/24/2022] Open
Abstract
The benefits of physical fitness (PF) for health are well-known. Low PF significantly contributes to the prevalence of obesity in adolescents, with an increased risk of developing chronic diseases. The objectives of the present study were to explore the health-related PF components and body composition levels in adolescents in three European cities, and their differences. The present study is a cross-sectional, descriptive, and quantitative research effort with 1717 participants aged between 13−16 years (48% girls), enrolled in public and private secondary schools in Seville (Spain), Reykjavik (Iceland) and Tartu (Estonia). The ALPHA fitness battery test was used with the following tests: handgrip strength, standing broad jump, 4 × 10 m speed-agility, 20 m shuttle run, and anthropometric variables. Regarding body composition, differences were detected for city and gender in height (p < 0.001), weight (p < 0.001), body fat percentage (p < 0.001), and waist circumference (p < 0.001); but no differences were reported for BMI for both city (p = 0.150) and gender (p = 0.738). Similarly, concerning PF, it was detected statistically significant differences between cities and gender in handgrip strength (p < 0.001), jump test (p < 0.001), speed-agility test (p < 0.001), and cardiovascular endurance in both variables (p < 0.001). In total, 26.8% of the boys and 27.3% of the girls were categorized as overweight; 18.1% of the boys and 31.2% of the girls had an excessive percentage of fat mass; and 22.7% of the boys and 22.2% of the girls showed an excessive waist circumference. The participants from Seville presented the lowest results in PF tests. In contrast, Reykjavik, with the highest results in the endurance and speed-agility tests, and Tartu, with higher results in the manual grip strength and long jump tests, shared the highest results.
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Affiliation(s)
- Pablo Galan-Lopez
- Department of Communication and Education, Universidad Loyola Andalucía, 41704 Dos Hermanas, Sevilla, Spain
| | - Thordis Gísladóttir
- Research Center for Sport and Health Sciences, School of Education, University of Iceland, 105 Reykjavík, Iceland
| | - Maret Pihu
- Institute of Sport Sciences and Physiotherapy, Faculty of Medicine, University of Tartu, 51005 Tartu, Estonia
| | - Antonio J. Sánchez-Oliver
- Departamento de Motricidad Humana y Rendimiento Deportivo, Universidad de Sevilla, 41013 Sevilla, Sevilla, Spain
| | - Francis Ries
- Physical Education and Sports, Faculty of Educational Sciences, University of Seville, 41013 Sevilla, Sevilla, Spain
| | - Raúl Domínguez
- Departamento de Motricidad Humana y Rendimiento Deportivo, Universidad de Sevilla, 41013 Sevilla, Sevilla, Spain
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9
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Powell AW, Siegel Z, Kist C, Mays WA, Kharofa R, Siegel R. Pediatric youth who have obesity have high rates of adult criminal behavior and low rates of homeownership. SAGE Open Med 2022; 10:20503121221127884. [PMID: 36312326 PMCID: PMC9608036 DOI: 10.1177/20503121221127884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 09/02/2022] [Indexed: 11/06/2022] Open
Abstract
Objectives: The social outcomes in adulthood for pediatric patients with obesity are not well-described. This study investigated lifetime criminal behavior and homeownership in youth with obesity. Methods: Retrospective data on all children enrolled in the weight management program from 1999 to 2009 and who completed exercise testing were collected. Demographic and public record collection included body habitus, death records, real estate transactions, and criminal conviction history with comparisons made to published normative data. Results: In the children with obesity studied (N = 716; 12.0 ± 3.1 years old), the now-adult patients (28.5 ± 3.7 years) had a 1.5% mortality rate (11/716). Overall, 9.6% of these adults were convicted of a felony compared to ~7% lifetime prevalence in Ohio (p = 0.03). Also, 14.7% of study patients purchased a home compared to 38.3% of Midwest adults <30 years old (p < 0.0001). Mortality, history of a criminal conviction, or homeownership was associated with any exercise or study parameter. Conclusion: Children with obesity appear to have greater social risk than their peers in adulthood with higher rates of criminal behavior and lower rates of homeownership. This appears to highlight the need for treatment in this vulnerable group of children and young adults.
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Affiliation(s)
- Adam W Powell
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA,The Heart Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA,Adam W Powell, Department of Pediatrics, University of Cincinnati College of Medicine, 3333 Burnett Avenue, MLC 2003, Cincinnati, OH 45229, USA.
| | | | - Christopher Kist
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA,The Heart Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Wayne A Mays
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA,The Heart Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Roohi Kharofa
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA,The Heart Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Robert Siegel
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA,The Heart Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
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Bar‐Yoseph R, Radom‐Aizik S, Coronato N, Moradinasab N, Barstow TJ, Stehli A, Brown D, Cooper DM. Heart rate and gas exchange dynamic responses to multiple brief exercise bouts (MBEB) in early- and late-pubertal boys and girls. Physiol Rep 2022; 10:e15397. [PMID: 35923083 PMCID: PMC9349595 DOI: 10.14814/phy2.15397] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/24/2022] [Accepted: 07/02/2022] [Indexed: 04/28/2023] Open
Abstract
Natural patterns of physical activity in youth are characterized by brief periods of exercise of varying intensity interspersed with rest. To better understand systemic physiologic response mechanisms in children and adolescents, we examined five responses [heart rate (HR), respiratory rate (RR), oxygen uptake (V̇O2 ), carbon dioxide production (V̇CO2 ), and minute ventilation (V̇E), measured breath-by-breath] to multiple brief exercise bouts (MBEB). Two groups of healthy participants (early pubertal: 17 female, 20 male; late-pubertal: 23 female, 21 male) performed five consecutive 2-min bouts of constant work rate cycle-ergometer exercise interspersed with 1-min of rest during separate sessions of low- or high-intensity (~40% or 80% peak work, respectively). For each 2-min on-transient and 1-min off-transient we calculated the average value of each cardiopulmonary exercise testing (CPET) variable (Y̅). There were significant MBEB changes in 67 of 80 on- and off-transients. Y̅ increased bout-to-bout for all CPET variables, and the magnitude of increase was greater in the high-intensity exercise. We measured the metabolic cost of MBEB, scaled to work performed, for the entire 15 min and found significantly higher V̇O2 , V̇CO2 , and V̇E costs in the early-pubertal participants for both low- and high-intensity MBEB. To reduce breath-by-breath variability in estimation of CPET variable kinetics, we time-interpolated (second-by-second), superimposed, and averaged responses. Reasonable estimates of τ (<20% coefficient of variation) were found only for on-transients of HR and V̇O2 . There was a remarkable reduction in τHR following the first exercise bout in all groups. Natural patterns of physical activity shape cardiorespiratory responses in healthy children and adolescents. Protocols that measure the effect of a previous bout on the kinetics of subsequent bouts may aid in the clinical utility of CPET.
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Affiliation(s)
- Ronen Bar‐Yoseph
- Pediatric Exercise and Genomics Research CenterUniversity of California at IrvineIrvineCaliforniaUSA
- Pediatric Pulmonary DivisionRuth Children's Hospital, Rambam Health Care CenterHaifaIsrael
| | - Shlomit Radom‐Aizik
- Pediatric Exercise and Genomics Research CenterUniversity of California at IrvineIrvineCaliforniaUSA
| | - Nicholas Coronato
- University of VirginiaCharlottesvilleVirginiaUSA
- United States Military AcademyWest PointNew YorkUSA
| | | | | | - Annamarie Stehli
- Pediatric Exercise and Genomics Research CenterUniversity of California at IrvineIrvineCaliforniaUSA
| | - Don Brown
- University of VirginiaCharlottesvilleVirginiaUSA
| | - Dan M. Cooper
- Pediatric Exercise and Genomics Research CenterUniversity of California at IrvineIrvineCaliforniaUSA
- Department of Pediatrics, Institute for Clinical and Translational Science, and Pediatric Exercise and Genomics Research CenterUniversity of CaliforniaIrvineCaliforniaUSA
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11
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Kernizan D, Glass A, D'Aloisio G, Hossain J, Tsuda T. A Combined Analysis of Peak and Submaximal Exercise Parameters in Delineating Underlying Mechanisms of Sex Differences in Healthy Adolescents. Pediatr Cardiol 2022; 43:1122-1130. [PMID: 35107629 DOI: 10.1007/s00246-022-02832-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/18/2022] [Indexed: 11/24/2022]
Abstract
Peak exercise parameters are considered the gold standard to quantify cardiac reserve in cardiopulmonary exercise testing (CPET). We studied whether submaximal parameters would add additional values in analyzing sex differences in CPET. We reviewed CPET of age-matched healthy male and female adolescents by cycle ergometer. Besides peak parameters, submaximal CPET parameters, including ventilatory anaerobic threshold (VAT), oxygen uptake efficiency slope (OUES), and submaximal slopes of Δoxygen consumption (ΔVO2)/Δwork rate (ΔWR), Δheart rate (ΔHR)/ΔWR, ΔVO2/ΔHR, and Δminute ventilation (ΔVE)/ΔCO2 production (ΔVCO2), were obtained. We studied 35 male and 40 female healthy adolescents. Peak VO2 (pVO2), peak oxygen pulse (pOP), and VAT were significantly lower in females than males (1.9 ± 0.4 vs. 2.5 ± 0.6 L/min; 10 ± 2.0 vs. 13.2 ± 3.5 ml/beat; 1.23 ± 0.3 vs. 1.52 ± 0.5 L/min, respectively, all p < 0.005). Females showed significantly lower pVO2, VAT, and OUES with the same body weight than males, implying higher skeletal muscle mass in males. When simultaneously examining ΔHR/ΔWR and pOP, females showed higher dependency on increases in HR than in stroke volume. Females demonstrated significantly lower pOP with the same levels of ΔVO2/ΔHR, suggesting more limited exercise persistence than males under an anaerobic condition at peak exercise. Oxygen uptake efficiency in relation to peak VE was significantly higher in males. There was no sex difference in either ΔVO2/ΔWR or ΔVE/ΔVCO2. Combinational assessment of peak and submaximal CPET parameters delineates the multiple mechanisms that contribute to the sex differences in exercise performance.
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Affiliation(s)
- Daphney Kernizan
- Nemours Cardiac Center, Nemours Children's Hospital, Delaware, 1600 Rockland Road, Wilmington, DE, 19803, USA
| | - Austin Glass
- Nemours Cardiac Center, Nemours Children's Hospital, Delaware, 1600 Rockland Road, Wilmington, DE, 19803, USA.,Department of Biomedical Engineering, Saint Louis University, St. Louis, MO, 63103, USA
| | - Gina D'Aloisio
- Nemours Cardiac Center, Nemours Children's Hospital, Delaware, 1600 Rockland Road, Wilmington, DE, 19803, USA
| | - Jobayer Hossain
- Department of Biostatistics, Nemours Children's Hospital, Delaware, Wilmington, DE, 19803, USA
| | - Takeshi Tsuda
- Nemours Cardiac Center, Nemours Children's Hospital, Delaware, 1600 Rockland Road, Wilmington, DE, 19803, USA. .,Department of Pediatrics, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, 19107, USA.
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12
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Wang S, Liu Y, Lam J, Kwan MP. The effects of the built environment on the general health, physical activity and obesity of adults in Queensland, Australia. Spat Spatiotemporal Epidemiol 2021; 39:100456. [PMID: 34774262 DOI: 10.1016/j.sste.2021.100456] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 06/30/2021] [Accepted: 08/25/2021] [Indexed: 01/04/2023]
Abstract
The built environment has been identified as a key factor for health intervention and obesity prevention. However, it is still unclear to what extent the built environment is associated with obesity and general health and to what extent such an association is mediated through variation in physical activity. This study aims to examine the associations between individual characteristics, the built environment, physical activity, general health and body mass index to reveal the pathways through which the built environment is associated with the prevalence of obesity. Using data from 1,788 adults aged 18 to 65 in Queensland from Wave 16 of the Household, Income, and Labour Dynamics in Australia survey, we use geographic information system-based methods to quantify built environment factors in 5D dimensions: Density, Diversity, Design, Distance and Destination accessibility. We then employ multi-level mixed-effect models to test the hypothesised relationships between individual characteristics, the built environment, physical activity, general health and body mass index. The results indicate that physical activity is positively associated with general health and negatively associated with the prevalence of obesity. Adjusting for individual characteristics, we find that built-environment factors have direct effects on physical activity but indirect effects on general health and obesity. Among these factors, greater green space exposure plays a key role in enhancing general health and reducing obesity. Low-density and car-dependent neighbourhoods can be activity-friendly and mitigate obesity if these neighbourhoods are also equipped with easy access to green space.
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Affiliation(s)
- Siqin Wang
- School of Earth and Environmental Sciences, University of Queensland, Room 537, Chamberlain Building, St Lucia, Queensland, 4076, Australia.
| | - Yan Liu
- School of Earth and Environmental Sciences, University of Queensland, Room 514, Chamberlain Building, St Lucia, Queensland, 4076, Australia
| | - Jack Lam
- Institute for Social Science Research, University of Queensland Long Pocket Precinct, Room 123, Building D (Dianella 1021), 80 Meiers Road, Indooroopilly, Queensland, 4068, Australia
| | - Mei-Po Kwan
- Department of Geography and Resource Management and Institute of Space and Earth Information Science, The Chinese University of Hong Kong, Shatin, Hong Kong, China; Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Vening Meineszgebouw A, Room 6.82, Princetonlaan 8a, Utrecht, 3584 CB, The Netherlands
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13
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Lai N, Fiutem JJ, Pfaff N, Salvadego D, Strainic J. Relating cardiorespiratory responses to work rate during incremental ramp exercise on treadmill in children and adolescents: sex and age differences. Eur J Appl Physiol 2021; 121:2731-2741. [PMID: 34143305 PMCID: PMC8416851 DOI: 10.1007/s00421-021-04741-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 06/08/2021] [Indexed: 11/12/2022]
Abstract
PURPOSE Evaluation of cardiopulmonary exercise testing (CPET) slopes such as [Formula: see text] (cardiac/skeletal muscle function) and [Formula: see text] (O2 delivery/utilization), using treadmill protocols is limited because the difficulties in measuring the total work rate ([Formula: see text]). To overcome this limitation, we proposed a new method in quantifying [Formula: see text] to determine CPET slopes. METHODS CPET's were performed by healthy patients, (n = 674, 9-18 year) 300 female (F) and 374 male (M), using an incremental ramp protocol on a treadmill. For this protocol, a quantitative relationship based on biomechanical principles of human locomotion, was used to quantify the [Formula: see text] of the subject. CPET slopes were determined by linear regression of the data recorded until the gas exchange threshold occurred. RESULTS The method to estimate [Formula: see text] was substantiated by verifying that: [Formula: see text] for treadmill exercise corresponded to an efficiency of muscular work similar to that of cycle ergometer; [Formula: see text] (mL min-1 W-1) was invariant with age and greater in M than F older than 12 years old (13-14 years: 9.6 ± 1.5(F) vs. 10.5 ± 1.8(M); 15-16 years: 9.7 ± 1.7(F) vs. 10.6 ± 2.2(M); 17-18 years: 9.6 ± 1.7(F) vs. 11.0 ± 2.3(M), p < 0.05); similar to cycle ergometer exercise, [Formula: see text] was inversely related to body weight (BW) (r = 0.71) or [Formula: see text] (r = 0.66) and [Formula: see text] was not related to BW (r = - 0.01), but had a weak relationship with [Formula: see text] (r = 0.28). CONCLUSION The proposed approach can be used to estimate [Formula: see text] and quantify CPET slopes derived from incremental ramp protocols at submaximal exercise intensities using the treadmill, like the cycle ergometer, to infer cardiovascular and metabolic function in both healthy and diseased states.
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Affiliation(s)
- Nicola Lai
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari, Italy.
- Departments of Pediatrics, Case Western Reserve University, Cleveland, OH, USA.
- Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA.
| | - Justin J Fiutem
- Departments of Pediatrics, Case Western Reserve University, Cleveland, OH, USA
- Rainbow Babies and Children's Hospital, Cleveland, OH, USA
| | - Nora Pfaff
- Department of Pediatrics, University of California, San Francisco, CA, USA
| | - Desy Salvadego
- Department of Automation, Biocybernetics and Robotics, Jožef Stefan Institute, Ljubljana, Slovenia
| | - James Strainic
- Departments of Pediatrics, Case Western Reserve University, Cleveland, OH, USA
- Rainbow Babies and Children's Hospital, Cleveland, OH, USA
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14
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Grzyb A, Domagalska-Szopa M, Siwiec A, Kwiecień-Czerwieniec I, Szopa A. Cardiopulmonary Capacity in Overweight and Obese Children and Adolescents: A Cross-Sectional Study. Front Physiol 2021; 12:671827. [PMID: 34054581 PMCID: PMC8155533 DOI: 10.3389/fphys.2021.671827] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 04/19/2021] [Indexed: 01/07/2023] Open
Abstract
Background: One of the objective methods of assessing the level of cardiopulmonary capacity in overweight and obese children and adolescents is cardiopulmonary exercise testing (CPET). Aims: The purpose of present study is an evaluation of aerobic capacity in high body mass index (BMI) children and adolescents by comparing them with a normal weight control group by CPET. Methods and Procedures: The subjects were recruited from participants of the Program of Treatment for Overweight and Obese Children organized by a local pediatric rehabilitation center in Poland. Based on BMI for age and gender, two validation groups were selected: (1) a group of overweight children (n = 49) and (2) a group of obese children (n = 48). The study included also 53 normal weight participants as a reference group (REF). The study consisted of two parts: anthropometric measurements and CPET. The Godfrey protocol for CPET was applied. Outcomes and Results: In this study, obese children and adolescents showed similar absolute VO2peak values in liters per minute (1.64 L/min) compared to overweight children (1.48 L/min), but significantly higher than children with normal body weight (1.39 L/min). The obese children and adolescents presented lower VO2peak in relation to body weight (25.44 ml/kg/min) compared to their peers with normal body weight (36.5 ml/kg/min), and overweight children (29.18 ml/kg/min). Conclusion and Implications: The main finding of our study was recognition of significant differences between cardiopulmonary capacity parameters in obese children in comparison not only to normal weight peers, but to overweight, too.
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Affiliation(s)
- Agata Grzyb
- Department of Medical Rehabilitation, Medical University of Silesia in Katowice, Katowice, Poland
| | | | - Andrzej Siwiec
- John Paul II Pediatric Center in Sosnowiec, Sosnowiec, Poland
| | | | - Andrzej Szopa
- Department of Physiotherapy, Medical University of Silesia in Katowice, Katowice, Poland
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15
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WITTEKIND SAMUELG, POWELL ADAMW, OPOTOWSKY ALEXANDERR, MAYS WAYNEW, KNECHT SANDRAK, RIVIN GREGORY, CHIN CLIFFORD. Skeletal Muscle Mass Is Linked to Cardiorespiratory Fitness in Youth. Med Sci Sports Exerc 2020; 52:2574-2580. [DOI: 10.1249/mss.0000000000002424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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16
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Evolution of the Habits of Physical Activity and Television Viewing in Spanish Children and Pre-Adolescents between 1997 and 2017. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186836. [PMID: 32962116 PMCID: PMC7558877 DOI: 10.3390/ijerph17186836] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 09/15/2020] [Accepted: 09/16/2020] [Indexed: 01/23/2023]
Abstract
Background: Promoting healthy lifestyles in children, has become a priority for public health institutions. However, electronic devices with screens encourage sedentary behaviors. The aim of this study was to analyze the evolution of the habits of physical activity practice and television watching in a cohort of 20 years of research in Spanish children. Methods: A cross-sectional, observational study was based on data from the Spain National Health Surveys between 1997 and 2017 (N = 11,444). The dependent variables considered were the frequency with which the minor practiced physical activity (PA) in his/her spare time, the daily TV viewing habit, and the daily hours of TV viewing. Results: The children who practiced physical activity daily has decreased 7.3% throughout the study period. The proportion of children who watched the television daily for more hours increased significantly (6.3%). Such increase was constant throughout the years, and the analysis by sex showed that the proportion of boys who watched television for more than three hours per day increased three percent, and that of girls increased fourfold. Conclusions: The habits of physical activity practice and television viewing have changed towards sedentary lifestyle. Particularly, the girls and the children between 12 and 14 years showed the most sedentary behavior. Public health policies must consider the differences between sexes in order for such interventions to be effective in the population of pre-adolescents, in general, and girls, in particular.
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17
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Fearnbach SN, Martin CK, Heymsfield SB, Staiano AE, Newton RL, Garn AC, Johannsen NM, Hsia DS, Carmichael OT, Ramakrishnapillai S, Murray KB, Blundell JE, Finlayson G. Validation of the Activity Preference Assessment: a tool for quantifying children's implicit preferences for sedentary and physical activities. Int J Behav Nutr Phys Act 2020; 17:108. [PMID: 32831103 PMCID: PMC7444062 DOI: 10.1186/s12966-020-01014-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 08/13/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND High levels of sedentary behavior and low physical activity are associated with poor health, and the cognitive determinants of these behaviors in children and adolescents are not well understood. To address this gap, we developed a novel, non-verbal, computer-based assessment to quantify the degree to which youth prefer to be sedentary relative to physically active in their leisure time. METHODS The Activity Preference Assessment (APA) uses a forced-choice paradigm to understand implicit decision-making processes when presented with common sedentary and physical activities. The APA bias score ranges from - 100 to + 100, with positive scores indicating a relative preference for sedentary activities, and negative scores representing a preference for physical activities. In 60 children ages 8-17 years, we assessed the validity of this behavioral task against a free-choice play observation, accelerometry-measured activity, anthropometrics and body composition, and cardiorespiratory fitness. We explored neighborhood, family, and individual-level factors that may influence implicit activity preferences. Test-retest reliability was assessed over one week. RESULTS The majority of children (67%) preferred sedentary relative to physical activities. APA bias scores were positively associated with sedentary time during free-choice play. In girls, bias scores were negatively associated with average daily MVPA. APA bias scores were positively associated with body fat and negatively associated with cardiorespiratory fitness. These findings were independent of age, sex, and race/ethnicity. Neighborhood access to physical activity spaces, the number of people in the home, perceived physical self-competence (e.g., coordination, strength), and self-reported depressive symptoms were associated with activity preferences. The intra-class correlation for test-retest reliability was r = 0.59. CONCLUSIONS The APA shows promise as a novel tool for quantifying children's relative preference for sedentary versus physical activities. Implicit bias scores from the APA are clinically meaningful, as shown by significant associations with adiposity and cardiorespiratory fitness. Future longitudinal studies should examine the directionality of the association between preferences and health markers, and the degree to which implicit activity preferences are modifiable. Importantly, the task only takes an average of 10 min to complete, highlighting a potential role as an efficient screening tool for the propensity to be sedentary versus physically active. TRIAL REGISTRATION ClinicalTrials.gov NCT03624582 .
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Affiliation(s)
- S Nicole Fearnbach
- Clinical Sciences Division, Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA.
| | - Corby K Martin
- Clinical Sciences Division, Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Steven B Heymsfield
- Clinical Sciences Division, Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Amanda E Staiano
- Population and Public Health Sciences Division, Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Robert L Newton
- Population and Public Health Sciences Division, Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Alex C Garn
- Louisiana State University, Baton Rouge, Louisiana, USA
| | - Neil M Johannsen
- Clinical Sciences Division, Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
- Louisiana State University, Baton Rouge, Louisiana, USA
| | - Daniel S Hsia
- Clinical Sciences Division, Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Owen T Carmichael
- Clinical Sciences Division, Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | | | - Kori B Murray
- Clinical Sciences Division, Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
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18
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Bar-Yoseph R, Porszasz J, Radom-Aizik S, Stehli A, Law P, Cooper DM. The effect of test modality on dynamic exercise biomarkers in children, adolescents, and young adults. Physiol Rep 2020; 7:e14178. [PMID: 31353834 PMCID: PMC6796805 DOI: 10.14814/phy2.14178] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 06/23/2019] [Accepted: 06/24/2019] [Indexed: 01/05/2023] Open
Abstract
Cardiopulmonary exercise testing (CPET) modalities, treadmill (TM), and cycle ergometer (CE), influence maximal gas exchange and heart rate (HR) responses. Little is known regarding CPET modality effect on submaximal biomarkers during childhood and adolescence. Ninety‐four healthy participants (7–34 y.o., 53% female) performed TM and CE CPET to address two major gaps: (1) the effect of modality on submaximal CPET biomarkers, and (2) estimation of work rate in TM CPET. Breath‐by‐breath gas exchange enabled calculation of linear regression slopes such as V˙O2/ΔHR and ΔV˙E/ΔV˙CO2. Lean body mass (LBM) was measured with dual X‐ray absorptiometry. We tested a novel TM CPET estimate of work rate based on TM velocity2, incline, and body mass (VIM). Like the linear relationship between V˙O2 and work rate in CE CPET, V˙O2 increased linearly with TM VIM. TM ΔV˙O2/ΔHR was highly correlated with CE (r = 0.92), and each increased substantially with LBM (P < 0.0001 for TM and CE). ΔV˙O2/ΔHR was to a small (~8.7%) but significant extent larger in TM (1.6 mL/min/beat, P = 0.04). In contrast, TM and CE ΔV˙E/ΔV˙CO2 decreased significantly with LBM, supporting earlier observations from CE CPET. For both CE and TM, males had significantly higher ΔV˙O2/ΔHR but lower ΔV˙E/ΔV˙CO2 than females. Novel TM CPET biomarkers such as ΔVIM/ΔHR and ∆V˙O2/ΔVIM paralleled effects of LBM observed in CE CPET. TM and CE CPET submaximal biomarkers are not interchangeable, but similarly reflect maturation during critical periods. CPET analysis that utilizes data actually measured (rather than estimated) may improve the clinical value of TM and CE CPET.
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Affiliation(s)
- Ronen Bar-Yoseph
- Pediatric Exercise and Genomics Research Center (PERC), Department of Pediatrics, University of California Irvine, Irvine, California
| | - Janos Porszasz
- Rehabilitation Clinical Trials Center, Division of Respiratory and Critical Care Physiology and Medicine, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California
| | - Shlomit Radom-Aizik
- Pediatric Exercise and Genomics Research Center (PERC), Department of Pediatrics, University of California Irvine, Irvine, California
| | - Annamarie Stehli
- Pediatric Exercise and Genomics Research Center (PERC), Department of Pediatrics, University of California Irvine, Irvine, California
| | - Pearl Law
- Pediatric Exercise and Genomics Research Center (PERC), Department of Pediatrics, University of California Irvine, Irvine, California
| | - Dan M Cooper
- Pediatric Exercise and Genomics Research Center (PERC), Department of Pediatrics, University of California Irvine, Irvine, California.,University of California Irvine Institute for Clinical and Translational Science, Irvine, California
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19
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Balmain BN, Wilhite DP, Bhammar DM, Babb TG. External dead space explains sex-differences in the ventilatory response to submaximal exercise in children with and without obesity. Respir Physiol Neurobiol 2020; 279:103472. [PMID: 32512232 DOI: 10.1016/j.resp.2020.103472] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 05/21/2020] [Accepted: 05/21/2020] [Indexed: 12/14/2022]
Abstract
We compared the exercise ventilatory response (slope of the ventilation, V̇E and carbon dioxide production, V̇CO2 relationship) in boys and girls with and without obesity. 46 children with obesity (BMI percentile: 97.7 ± 1.4) and 27 children without obesity (BMI percentile: 55.1 ± 22.2) were included and divided into groups by sex (with obesity: 17 girls and 29 boys; without obesity: 13 girls and 14 boys). A 6 min constant load cycling test at 45 % of peak work rate was performed. The V̇E/V̇CO2 slope was similar (p = 0.67) between children with (32.7 ± 4.3) and without (32.2 ± 6.1) obesity; however, it was higher (p = 0.02) in girls (35.4 ± 5.6) than boys (32.6 ± 4.9). We also examined a corrected V̇E/V̇CO2 slope for the effects of mechanical dead space (VDM), by subtracting V̇DM from V̇E (V̇Ecorr/V̇CO2 slope). The V̇Ecorr/V̇CO2 slope remained similar (p = 0.37) between children with (26.8 ± 3.2) and without obesity (26.1 ± 3.1); however, no sex differences were observed (p = 0.13). Therefore, VDM should be accounted for before evaluating the V̇E/V̇CO2 slope, particularly when making between-sex comparisons.
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Affiliation(s)
- Bryce N Balmain
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, UT Southwestern Medical Center. Dallas, TX, USA
| | - Daniel P Wilhite
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, UT Southwestern Medical Center. Dallas, TX, USA
| | - Dharini M Bhammar
- Department of Kinesiology and Nutrition Sciences, University of Nevada Las Vegas, Las Vegas, NV, USA
| | - Tony G Babb
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, UT Southwestern Medical Center. Dallas, TX, USA.
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20
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Bhammar DM, Adams-Huet B, Babb TG. Quantification of Cardiorespiratory Fitness in Children with Obesity. Med Sci Sports Exerc 2020; 51:2243-2250. [PMID: 31634291 DOI: 10.1249/mss.0000000000002061] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
PURPOSE Without consideration for the effects of fat mass, there could be an underestimation of cardiorespiratory fitness in children with obesity leading to a clinical diagnosis of deconditioning and resulting in unrealistic training goals and limitation of physical activities. The purpose of this study was to identify methods of quantifying cardiorespiratory fitness that were less influenced by fat mass. METHODS Fifty-three children, 27 with obesity (10.9 ± 1.0 yr) and 26 without obesity (11.0 ± 1.0 yr), volunteered for this study. Maximal oxygen uptake, an indicator of cardiorespiratory fitness, was referenced to lean body mass, body mass, and predicted body mass at the 50th and 85th body mass index percentiles. RESULTS Children with obesity carried 18 kg more fat mass and 7 kg more lean body mass compared with children without obesity. Cardiorespiratory fitness based on lean body mass, body mass, and predicted body mass at the 85th percentile was lower in children with obesity compared with children without obesity (P < 0.001). Differences in cardiorespiratory fitness based on predicted body mass at the 50th percentile between children with and without obesity did not reach statistical significance (P = 0.84). Fat mass influenced cardiorespiratory fitness least when referenced to lean body mass or predicted body mass at the 50th percentile (R < 0.26) in contrast to when it was referenced to body mass or predicted body mass at the 85th percentile (R > 0.37). CONCLUSION Quantifying cardiorespiratory fitness based on lean body mass or predicted body mass at the 50th percentile could be useful for estimating fitness levels in children with obesity.
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Affiliation(s)
- Dharini M Bhammar
- Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada, Las Vegas, Las Vegas, NV.,Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas and UT Southwestern Medical Center, Dallas, TX
| | - Beverley Adams-Huet
- Department of Population Health and Data Sciences, Internal Medicine, UT Southwestern Medical Center, Dallas, TX
| | - Tony G Babb
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas and UT Southwestern Medical Center, Dallas, TX
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A Pilot Study of Cardiorespiratory Fitness, Adiposity, and Cardiometabolic Health in Youth With Overweight and Obesity. Pediatr Exerc Sci 2020; 32:124-131. [PMID: 32335525 PMCID: PMC7606316 DOI: 10.1123/pes.2019-0192] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 02/07/2020] [Accepted: 03/08/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To conduct a preliminary assessment of the relationships between cardiorespiratory fitness, adiposity, and cardiometabolic health using gold standard measures in diverse youth ranging from overweight to severe obesity. METHODS Twenty of 30 participants (mean [SD]; age 13.2 [1.8] y, 55% female, 45% African American) met the criteria for VO2peak during a graded cycle ergometer test to volitional fatigue. The body composition was measured by dual-energy X-ray absorptiometry (percentage of body fat, fat mass index, and fat-free mass) and magnetic resonance imaging (abdominal visceral and subcutaneous [SAT] adipose tissue). The VO2peak was expressed relative to fat-free mass. Fasting lipid levels, glycemic biomarkers, and vital signs were examined individually and used in a composite cardiometabolic risk score. Accelerometer-measured physical activity and sedentary time were included as covariates. RESULTS VO2peak was negatively associated with abdominal SAT (r = -.49, P < .05), but not visceral adipose tissue or markers of cardiometabolic health. The association between SAT and VO2peak was partly explained by habitual sedentary time. CONCLUSIONS We demonstrated a significant negative association between cardiorespiratory fitness and SAT in a diverse group of high-risk youth. The inclusion of rigorous, laboratory-based measures and youth with severe obesity extends the previous work in pediatric populations.
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Cooper DM, Radom-Aizik S. Exercise-associated prevention of adult cardiovascular disease in children and adolescents: monocytes, molecular mechanisms, and a call for discovery. Pediatr Res 2020; 87:309-318. [PMID: 31649340 PMCID: PMC11177628 DOI: 10.1038/s41390-019-0581-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 08/07/2019] [Accepted: 08/15/2019] [Indexed: 12/28/2022]
Abstract
Atherosclerosis originates in childhood and adolescence. The goal of this review is to highlight how exercise and physical activity during childhood and adolescence, critical periods of growth and development, can prevent adult cardiovascular disease (CVD), particularly through molecular mechanisms of monocytes, a key cell of the innate immune system. Monocytes are heterogeneous and pluripotential cells that can, paradoxically, play a role in both the instigation and prevention of atherosclerosis. Recent discoveries in young adults reveal that brief exercise affects monocyte gene pathways promoting a cell phenotype that patrols the vascular system and repairs injuries. Concurrently, exercise inhibits pro-inflammatory monocytes, cells that contribute to vascular damage and plaque formation. Because CVD is typically asymptomatic in youth, minimally invasive techniques must be honed to study the subtle anatomic and physiologic evidence of vascular dysfunction. Exercise gas exchange and heart rate measures can be combined with ultrasound assessments of vascular anatomy and reactivity, and near-infrared spectroscopy to quantify impaired O2 transport that is often hidden at rest. Combined with functional, transcriptomic, and epigenetic monocyte expression and measures of monocyte-endothelium interaction, molecular mechanisms of early CVD can be formulated, and then translated into effective physical activity-based strategies in youth to prevent adult-onset CVD.
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Affiliation(s)
- Dan M Cooper
- Pediatric Exercise and Genomics Research Center, University of California Irvine School of Medicine, Pediatrics, Irvine, CA, USA.
| | - Shlomit Radom-Aizik
- Pediatric Exercise and Genomics Research Center, University of California Irvine School of Medicine, Pediatrics, Irvine, CA, USA
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23
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Kampouras A, Hatziagorou E, Avramidou V, Georgopoulou V, Kirvassilis F, Hebestreit H, Tsanakas J. Ventilation efficiency to exercise in patients with cystic fibrosis. Pediatr Pulmonol 2019; 54:1584-1590. [PMID: 31276310 DOI: 10.1002/ppul.24438] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 06/17/2019] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Exercise ventilation efficiency index in cardiopulmonary exercise testing (CPET) is elevated in patients with heart failure providing useful information on disease progression and prognosis. Few data, however, exist for ventilation efficiency index among cystic fibrosis (CF) patients. AIMS To assess ventilation efficiency index (ΔVE/ΔVCO2 or V'E/V'CO2 slope) and intercept of ventilation (VE-intercept) in CF patients with mild, moderate, and severe cystic fibrosis (CF) lung disease. To assess possible correlations with ventilation inhomogeneity and structural damages as seen on high resolution computed tomography (HRCT). METHODS CF patients with mild (FEV1 > 80%, n = 47), moderate (60% < FEV1 < 80%, n = 21), and severe (FEV1 < 60%, n = 9) lung disease, mean age 14.9 years participated. Peak oxygen uptake (VO2 peak), pulmonary ventilation at peak exercise (VE), respiratory equivalent ratios for oxygen and carbon dioxide at peak exercise (VE/VO2 , VE/VCO2 ), end-tidal CO2 (PetCO2 ), and ΔVE/ΔVCO2 , ΔVE/ΔVO2 in a maximal CPET along with spirometry and multiple breath washout indices were examined. HRCT scans were performed and scored using Bhalla score. RESULTS Mean ΔVE/ΔVCO2 showed no significant differences among the three groups (P = .503). Mean VEint discriminated significantly among the different groups (p 2 < 0.001). Ventilation efficiency index did not correlate either with LCI or Bhalla score. However, VE together with ΔVE/ΔVCO2 slope could predict Bhalla score (r 2 = 0.869, P = .006). CONCLUSION No significant differences were found regarding ΔVE/ΔVCO2 slope levels between the three groups. Ventilation intercept (VEint ) was elevated significantly as disease progresses reflecting increased dead space ventilation. CF patients retain their ventilation efficiency to exercise even as lung function deteriorates by adopting a higher respiratory rate along with increased dead space ventilation.
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Affiliation(s)
- Asterios Kampouras
- Pediatric Pulmonology and Cystic Fibrosis Unit, Aristotle University of Thessaloniki School of Health Sciences, Hippokration Hospital of Thessaloniki, Thessaloniki, Greece
| | - Elpis Hatziagorou
- Pediatric Pulmonology and Cystic Fibrosis Unit, Aristotle University of Thessaloniki School of Health Sciences, Hippokration Hospital of Thessaloniki, Thessaloniki, Greece
| | - Vasiliki Avramidou
- Pediatric Pulmonology and Cystic Fibrosis Unit, Aristotle University of Thessaloniki School of Health Sciences, Hippokration Hospital of Thessaloniki, Thessaloniki, Greece
| | - Vasiliki Georgopoulou
- Radiology Department, Hippokration General Hospital of Thessaloniki, Thessaloniki, Greece
| | - Fotis Kirvassilis
- Pediatric Pulmonology and Cystic Fibrosis Unit, Aristotle University of Thessaloniki School of Health Sciences, Hippokration Hospital of Thessaloniki, Thessaloniki, Greece
| | | | - John Tsanakas
- Pediatric Pulmonology and Cystic Fibrosis Unit, Aristotle University of Thessaloniki School of Health Sciences, Hippokration Hospital of Thessaloniki, Thessaloniki, Greece
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Lu KD, Bar-Yoseph R, Radom-Aizik S, Cooper DM. A new approach to estimate aerobic fitness using the NHANES dataset. Scand J Med Sci Sports 2019; 29:1392-1401. [PMID: 31063607 PMCID: PMC6860366 DOI: 10.1111/sms.13461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 04/18/2019] [Accepted: 04/30/2019] [Indexed: 02/01/2023]
Abstract
INTRODUCTION Physical activity and fitness are essential for healthy growth in children. The National Health and Nutrition Examination Survey (NHANES) evaluated fitness by estimating V̇O2 max from submaximal measurements of heart rate (HR) during graded treadmill exercise. Our aims were (a) to examine how well NHANES methodology used to estimate V̇O2 max correlated with actual VO2 max and (b) to evaluate a novel fitness metric using actual data collected during exercise and its relationship to physical activity and sedentary time, lipid profiles, and body composition. METHODS Fifty-three adolescents completed NHANES submaximal exercise protocol and maximal graded cardiopulmonary exercise testing. We used a novel approach to quantifying fitness (Δvelocity × incline × body mass (VIM)/ΔHR slopes) and evaluated its relationship to physical activity and sedentary time using NHANES data (n = 4498). In a subset (n = 740), we compared ΔVIM/ΔHR slopes to NHANES estimated V̇O2 max and examined their relationship to cardiovascular risk factors (BMI percentiles and lipid levels). RESULTS Measured V̇O2 peak was moderately correlated with NHANES estimated V̇O2 max (r = 0.53, P < 0.01). Significantly higher ΔVIM/ΔHR slopes were associated with increased physical activity and decreased sedentary time. ΔVIM/ΔHR slopes were negatively associated with LDL, triglycerides, and BMI percentiles (P < 0.01). In general, the two fitness models were similar; however, ΔVIM/ΔHR was more discriminating than NHANES in quantifying the relationship between fitness and LDL levels. CONCLUSION We found that the NHANES estimated V̇O2 max accounted for approximately 28% of the variability in the measured V̇O2 peak. Our approach to estimating fitness (ΔVIM/ΔHR slopes) using actual data provided similar relationships to lipid levels. We suggest that fitness measurements based on actually measured data may produce more accurate assessments of fitness and, ultimately, better approaches linking exercise to health in children.
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Affiliation(s)
- Kim D Lu
- Department of Pediatrics, Pediatric Exercise and Genomics Research Center (PERC), University of California, Irvine School of Medicine, Irvine, California
| | - Ronen Bar-Yoseph
- Department of Pediatrics, Pediatric Exercise and Genomics Research Center (PERC), University of California, Irvine School of Medicine, Irvine, California
| | - Shlomit Radom-Aizik
- Department of Pediatrics, Pediatric Exercise and Genomics Research Center (PERC), University of California, Irvine School of Medicine, Irvine, California
| | - Dan M Cooper
- Department of Pediatrics, Pediatric Exercise and Genomics Research Center (PERC), University of California, Irvine School of Medicine, Irvine, California
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Martins PC, de Lima LRA, Silva AM, Petroski EL, Moreno YMF, Silva DAS. Phase angle is associated with the physical fitness of HIV-infected children and adolescents. Scand J Med Sci Sports 2019; 29:1006-1012. [PMID: 30892730 DOI: 10.1111/sms.13419] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 02/06/2019] [Accepted: 03/12/2019] [Indexed: 12/28/2022]
Abstract
The objective of this study was to identify the association of phase angle with physical fitness in children and adolescents infected with HIV. Sixty-four children and adolescents infected with HIV (8-15 years old) were tested for vertical transmission. The electrical bioimpedance was used to obtain the phase angle. Body fat (BF) and lean soft tissue mass (LSTM) were measured by x-ray absorptiometry, and the manual grip strength was evaluated by dynamometry. The peak oxygen consumption (VO2 peak) was measured by respiratory change in a submaximal incremental test. Moderate-vigorous physical activity (MVP) and sedentary behavior were measured using accelerometers and were used as covariates. Multiple linear regression was used. The linear correlation analyses demonstrated that the phase angle was inversely proportional to relative BF (r = -0.26), but was not associated with absolute body fat (r = -0.02). The phase angle was directly associated with LSTM (r = 0.57), handgrip strength, and (r = 0.43) peak VO2 (r = 0.55). The phase angle was not associated with absolute BF (β = -0.017, P = 0.413) and relative (β = -0.014, P = 0.175). The phase angle presented a direct association with LSTM (β = 0.041, P = 0.019) and peak VO2 (β = 0.005; P = 0.019), regardless of age, sex, sexual maturation, MVPA, sedentary behavior, antiretroviral drugs, and viral load. No association was found between phase angle and handgrip strength (β = 0.153; P = 0.199). It was concluded that phase angle was associated with LSTM and the aerobic fitness in HIV-infected children and adolescents.
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Affiliation(s)
- Priscila Custódio Martins
- Sports Center, Research Center in Kinanthropometry and Human Performance, Federal University of Santa Catarina, Florianopolis, Brazil
| | - Luiz Rodrigo Augustemak de Lima
- Sports Center, Research Center in Kinanthropometry and Human Performance, Federal University of Santa Catarina, Florianopolis, Brazil
| | | | - Edio Luiz Petroski
- Sports Center, Research Center in Kinanthropometry and Human Performance, Federal University of Santa Catarina, Florianopolis, Brazil
| | - Yara Maria Franco Moreno
- Heath Science Center, Graduate Program of Nutrition, Federal University of Santa Catarina, Florianopolis, Brazil
| | - Diego Augusto Santos Silva
- Sports Center, Research Center in Kinanthropometry and Human Performance, Federal University of Santa Catarina, Florianopolis, Brazil
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Bhammar DM, Stickford JL, Bernhardt V, Babb TG. Verification of Maximal Oxygen Uptake in Obese and Nonobese Children. Med Sci Sports Exerc 2017; 49:702-710. [PMID: 27875494 DOI: 10.1249/mss.0000000000001170] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
PURPOSE The purpose of this study was to examine whether a supramaximal constant-load verification test at 105% of the highest work rate would yield a higher V˙O2max when compared with an incremental test in 10- to 12-yr-old nonobese and obese children. METHODS Nine nonobese (body mass index percentile = 57.5 ± 23.2) and nine obese (body mass index percentile = 97.9 ± 1.4) children completed a two-test protocol that included an incremental test followed 15 min later by a supramaximal constant-load verification test. RESULTS The V˙O2max achieved in verification testing (nonobese = 1.71 ± 0.31 L·min and obese = 1.94 ± 0.47 L·min) was significantly higher than that achieved during the incremental test (nonobese = 1.57 ± 0.27 L·min and obese = 1.84 ± 0.48 L·min; P < 0.001). There was no significant group (i.e., nonobese vs obese)-test (i.e., incremental vs verification) interaction, suggesting that there was no effect of obesity on the difference between verification and incremental V˙O2max (P = 0.747). CONCLUSION A verification test yielded significantly higher values of V˙O2max when compared with the incremental test in obese children. Similar results were observed in nonobese children. Supramaximal constant-load verification is a time-efficient and well-tolerated method for identifying the highest V˙O2 in nonobese and obese children.
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Affiliation(s)
- Dharini M Bhammar
- 1Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, TX; 2UT Southwestern Medical Center, Dallas, TX; 3Exercise Physiology Program, College of Nursing and Health Sciences, Valdosta State University, Valdosta, GA; 4Health and Exercise Science, Appalachian State University, Boone, NC; and 5Exercise Science, Department of Health and Human Performance, Texas A&M University-Commerce, Commerce, TX
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