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Haapala EA, Kuronen E, Ihalainen JK, Lintu N, Leppänen MH, Tompuri T, Atalay M, Schwab U, Lakka TA. Cross-sectional associations between physical fitness and biomarkers of inflammation in children-The PANIC study. Scand J Med Sci Sports 2023; 33:1000-1009. [PMID: 36779507 DOI: 10.1111/sms.14337] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 01/25/2023] [Accepted: 02/06/2023] [Indexed: 02/14/2023]
Abstract
BACKGROUND Systemic low-grade inflammation has been proposed as an underlying pathophysiological mechanism for cardiometabolic diseases. We investigated the associations of physical fitness with a systemic low-grade inflammatory state in a population sample of children. METHODS Altogether 391 children aged 6-9 years were examined. Cardiorespiratory fitness (maximal power output, Wmax ) was assessed by a maximal cycle ergometer test and neuromuscular fitness by hand grip strength, sit-up, standing long jump, 50-meter shuttle run, static balance, sit-and-reach, and box and block tests. Body fat percentage (BF%) and lean mass (LM) were assessed by dual-energy X-ray absorptiometry (DXA). High sensitivity C-reactive protein (hs-CRP), leptin, leptin receptor, high molecular weight adiponectin (HMW-adiponectin), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and glycoprotein acetyls (GlycA) were assessed from fasting blood samples. The modified inflammatory score (IS) was calculated using the population-specific z-scores and formula (z hs-CRP + z leptin + z IL-6 + z TNF-α + z GlycA)-z leptin receptor-z HMW-adiponectin. The data were analyzed using linear regression analyses. RESULTS Higher Wmax /kg of body mass (β = -0.416, 95% CI = -0.514 to -0.318), higher number of completed sit-ups (β = -0.147, 95% CI = -0.244 to -0.049), a longer distance jumped in the standing long jump test (β = -0.270, 95% CI = -0.371 to -0.169), and a shorter time in the 50-meter shuttle run test (β = 0.123, 95% CI = 0.022 to 0.223) were associated with lower IS. None of these associations remained statistically significant after adjustment for BF%. CONCLUSIONS Higher physical fitness is associated with a more favorable inflammatory biomarker profile in children. However, the associations were explained by BF%.
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Affiliation(s)
- Eero A Haapala
- Sports & Exercise Medicine, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Emmi Kuronen
- Sports & Exercise Medicine, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Johanna K Ihalainen
- Sports & Exercise Medicine, 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
| | - Marja H Leppänen
- Sports & Exercise Medicine, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Folkhälsan Research Center, Helsinki, Finland
| | - 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
| | - Mustafa Atalay
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Ursula Schwab
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.,Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, 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
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2
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Griffith G, Liem RI, Carr M, Corson T, Ward K. Development of a Pediatric Cardiology Cardiopulmonary Exercise Testing Database. Pediatr Cardiol 2023:10.1007/s00246-023-03112-1. [PMID: 36757429 DOI: 10.1007/s00246-023-03112-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 01/23/2023] [Indexed: 02/10/2023]
Abstract
Cardiopulmonary exercise testing (CPET) provides clinicians with information vital to the management of pediatric cardiology patients. CPET can also be used to measure cardiorespiratory fitness (CRF) in these patients. CRF is a robust marker of overall health in children. However, a complete understanding of CRF in pediatric cardiology patients is limited by lack of large, standardized CPET databases. Our purpose was to develop a standardized CPET database, describe available data at our institution, and discuss challenges and opportunities associated with this project. CPETs performed from 1993 to present in an urban pediatric hospital were collected and compiled into a research database. Historical data included demographic and clinical variables and CPET outcomes, and additional variables were calculated and coded to facilitate analyses in these cohorts. Patient diagnoses were coded to facilitate sub-analyses of specific cohorts. Quality assurance protocols were established to ensure future database contributions and promote inter-institutional collaborations. This database includes 10,319 CPETs (56.1% male), predominantly using the Bruce Protocol. Patients ranging from ages 6 to 18 years comprise 86.8% of available CPETs. Diagnosis classification scheme includes patients with structurally normal hearts (n = 3,454), congenital heart disease (n = 3,614), electrophysiological abnormalities (n = 2,082), heart transplant or cardiomyopathy (n = 833), and other diagnoses (n = 336). Historically, clinicians were provided with suboptimal interpretive resources for CPET, often generalizing inferences from these resources to non-representative clinical populations. This database supports representative CRF comparisons and establishes a framework for future CRF-based registries in pediatric patients referred for CPET, ultimately improving clinical decision-making regarding fitness in these populations.
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Affiliation(s)
- Garett Griffith
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, 645 N. Michigan Ave., Suite 1100, Chicago, IL, 60611, USA.
| | - Robert I Liem
- Division of Hematology, Oncology, and Stem Cell Transplantation, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Michael Carr
- Division of Cardiology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Tyler Corson
- Rush University College of Health Sciences, Chicago, IL, USA
| | - Kendra Ward
- Division of Cardiology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Feinberg School of Medicine, Northwestern University, Chicago, USA
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3
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A Meta-Analysis of Sampled Maximal Aerobic Capacity Data for Boys Aged 11 Years Old or Less Obtained by Cycle Ergometry. Life (Basel) 2023; 13:life13020276. [PMID: 36836634 PMCID: PMC9967809 DOI: 10.3390/life13020276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 12/14/2022] [Accepted: 12/22/2022] [Indexed: 01/20/2023] Open
Abstract
The aim of this study was to develop distributions of VO2max based on measured values that exist in the literature in prepubertal boys using cycle ergometry. PRISMA guidelines were followed in conducting this research. One database was searched for peak and maximal VO2 values in healthy boys with mean age under 11 years old. Data were split into articles reporting absolute and relative VO2max values and analyzed accordingly. Multilevel models grounded in Bayesian principles were used. We investigated associations between VO2max and body mass, year of the study, and country of origin. Differences in "peak" and "maximal" VO2 were assessed. Absolute VO2max (Lmin-1) increases with age (P ~100%) but mean relative VO2max does not change (P ~100%). Absolute VO2max is higher in more recent studies (P = 95.7 ± 0.3%) and mean relative VO2max is lower (P = 99.6 ± 0.1%). Relative VO2max in the USA is lower compared with boys from other countries (P = 98.8 ± 0.2%), but there are no differences in absolute values. Mean aerobic capacity estimates presented as "peak" values are higher than "maximal" values on an absolute basis (P = 97.5 ± 0.3%) but not on a relative basis (P = 99.6 ± 0.1%). Heavier boys have lower cardiorespiratory fitness (P ≈ 100%), and body mass seems to be increasing faster with age in the USA compared with other countries (P = 92.3 ± 0.3%). New reference values for cardiorespiratory fitness are presented for prepubertal boys obtained with cycle ergometry. This is new, as no reference values have been determined so far based on actual measured values in prepubertal boys. Aerobic capacity normalized to body weight does not change with age. Cardiorespiratory fitness in prepubertal boys is declining, which is associated with increasing body mass over the last few decades. Lastly, this study did not find any statistically significant difference in the sample's mean aerobic capacity estimates using the "peak" and "maximum" distinctions identified in the literature.
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4
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Edelman Bos AMM, Hjalmarsson E, Dallmeijer AJ, Fernandez-Gonzalo R, Buizer AI, Pingel J, Pontén E, von Walden F, van Schie PEM. Physiological Response to the 6-Minute Frame Running Test in Children and Adults With Cerebral Palsy. Pediatr Phys Ther 2022; 34:529-534. [PMID: 36067377 DOI: 10.1097/pep.0000000000000947] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To determine the physiological response and association to peak oxygen uptake of the 6-minute Frame Running test (6-MFRT) in persons with cerebral palsy (CP). METHODS Twenty-four participants with CP, Gross Motor Function Classification System II/III/IV, performed the 6-MFRT. Distance, peak heart rate (HR peak ), peak respiratory exchange ratio (RER peak ), and peak oxygen uptake ( O 2peak ) were measured. RESULTS HR peak ranged from 146 to 201 beats per minute, RER peak from 0.94 to 1.49, 6-MFRT distance from 179 to 1220 m and O 2peak from 0.62 to 2.18 L/min. HR peak was achieved in 63%, RER peak in 71%. A strong correlation was observed between 6-MFRT and O 2peak . CONCLUSIONS The 6-MFRT represented a (near) maximum effort for 75% of the participants and the 6-MFRT can be used to estimate oxygen consumption on an individual basis.
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Affiliation(s)
- Arnoud M M Edelman Bos
- Department Rehabilitation Medicine (Mr Edelman Bos and Drs Dallmeijer, Buizer, and van Schie), Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Rehabilitation and Development (Mr Edelman Bos and Drs Dallmeijer, Buizer, and van Schie), Amsterdam Movement Sciences, Amsterdam, the Netherlands; Division of Pediatric Neurology, Department of Women's and Children's Health (Ms Hjalmarsson and Drs Pingel, Pontén, and von Walden), Karolinska Institutet, Stockholm, Sweden; Allied Health Professionals Function, Medical Unit Occupational Therapy & Physiotherapy (Ms Hjalmarsson), Karolinska University Hospital, Stockholm, Sweden; Department of Laboratory Medicine (Dr Fernandez-Gonzalo), Division of Clinical Physiology, Karolinska Institutet, and Unit of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden; Emma Children's Hospital (Dr Buizer), Amsterdam UMC, Amsterdam, the Netherlands; Department of Neuroscience (Dr Pingel), Faculty of Health & Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Pediatric Orthopedic Surgery (Dr Pontén), Karolinska University Hospital, Stockholm, Sweden
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A Systematic Review of the Associations of Adiposity and Cardiorespiratory Fitness With Arterial Structure and Function in Nonclinical Children and Adolescents. Pediatr Exerc Sci 2022:1-12. [PMID: 36150705 DOI: 10.1123/pes.2022-0029] [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: 02/16/2022] [Revised: 08/02/2022] [Accepted: 08/07/2022] [Indexed: 11/07/2022]
Abstract
PURPOSE To summarize the evidence on associations of adiposity and cardiorespiratory fitness (CRF) with arterial structure and function in nonclinical children and adolescents. METHODS Two researchers conducted a search in 5 electronic databases in April 2022 to find studies in nonclinical youth (age 5-17.9 y) reporting multivariable associations. Studies were eligible if adiposity and/or CRF were used as the predictor and arterial structure and/or function was the outcome. The Quality Assessment Tool for Quantitative Studies was used to assess methodological quality for experimental studies, and a modified version was used for observational studies. RESULTS Ninety-nine studies (72.7% cross-sectional) were included. Ninety-four assessed associations between adiposity and arterial outcomes, most using overall body proportion (n = 71), abdominal (n = 52), or whole-body adiposity (n = 40). Most evidence was inconsistent or nonsignificant, but 59 studies suggested higher abdominal adiposity and worse body proportion were associated with adverse arterial outcomes. Twenty-one assessed associations between CRF and arterial outcomes, with findings inconsistent. Most evidence was rated weak in quality. CONCLUSION While high adiposity may contribute to poor arterial outcomes, evidence is limited regarding CRF. Future studies should disentangle these associations by studying youth with healthy adiposity but poor CRF, or vice versa, using longitudinal or experimental study designs.
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6
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Haapala EA, Tompuri T, Lintu N, Viitasalo A, Savonen K, Lakka TA, Laukkanen JA. Is low cardiorespiratory fitness a feature of metabolic syndrome in children and adults? J Sci Med Sport 2022; 25:923-929. [DOI: 10.1016/j.jsams.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 05/18/2022] [Accepted: 08/02/2022] [Indexed: 11/29/2022]
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7
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Chandramouli C, Lam CSP. Sex, Fat and the Heart: It's All in the Waist. Eur J Heart Fail 2022; 24:1371-1376. [DOI: 10.1002/ejhf.2615] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 07/07/2022] [Indexed: 11/07/2022] Open
Affiliation(s)
- Chanchal Chandramouli
- National Heart Centre Singapore
- Duke‐National University of Singapore Medical School Singapore
| | - Carolyn SP Lam
- National Heart Centre Singapore
- Duke‐National University of Singapore Medical School Singapore
- University Medical Centre Groningen Groningen the Netherlands
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8
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Association between Cardiopulmonary Capacity and Body Mass Composition in Children and Adolescents with High Body Weight: A Cross-Sectional Study. CHILDREN 2022; 9:children9050647. [PMID: 35626824 PMCID: PMC9140148 DOI: 10.3390/children9050647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/19/2022] [Accepted: 04/28/2022] [Indexed: 12/02/2022]
Abstract
(1) Background: Excessive body weight is a global problem in the 21st century. Children and adolescents, in particular, are at risk. Recently, there has been an increasing interest in the relationship between aerobic capacity and body composition. Therefore, this study aimed to determine the association between the individual parameters of cardiopulmonary capacity obtained in cardiopulmonary exercise testing (CPET) and selected parameters of body mass composition in high-BMI children and children over the 85th percentile according to the WHO growth reference. (2) Materials and Method: The research included 100 children of school-age (7–15 years) with an excessive BMI, i.e., over the 85th percentile as per the WHO Growth Reference (BMI percentile 95.21 ± 4.65; Z-score BMI: 2.07 ± 0.94). The study consisted of three parts: anthropometric measurements, measurement of body mass composition using a body composition analyzer (TANITA MC-780 S MA) using the bioimpedance method, and a cardiopulmonary exercise test on a pediatric cycle ergometer (Corival Pediatric, Lode BV) using the Godfrey protocol; (3) Results: The correlation between BMI and fat mass (FM) was very high (rho = 0.83; p = 0.00) with moderate body fat percentage (BF%) (rho = 0.48; p = 0.00). There was a relevant correlation between the amount of fat-free mass in total body mass and cardiopulmonary capacity expressed as the absolute aerobic capacity (VO2peak) (rho = 0.55; p = 0.00). (4) Conclusions: In the case of children and youth with higher BMI, there was a correlation between the amount of fat-free mass in total body mass and cardiopulmonary capacity in terms of absolute aerobic capacity.
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9
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Korhonen M, Väistö J, Veijalainen A, Leppänen M, Ekelund U, Laukkanen JA, Brage S, Lintu N, Haapala EA, Lakka TA. Longitudinal associations of physical activity, sedentary time, and cardiorespiratory fitness with arterial health in children - the PANIC study. J Sports Sci 2021; 39:1980-1987. [PMID: 33829952 DOI: 10.1080/02640414.2021.1912450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
We investigated the longitudinal associations of physical activity (PA), sedentary time (ST), and cardiorespiratory fitness (CRF) with arterial health among children. In our primary analyses, we investigated 245 children (girls 51.8%) aged 6-9 years participating in the baseline examinations who had data on arterial health at 2-year follow-up. We also utilized a subsample of 90 children who had a complete arterial health data at baseline and 2-year follow-up. ST (≤1.5 METs), light PA (>1.5-4 METs), moderate PA (>4-7 METs), vigorous PA (>7METs), and moderate-to-vigorous PA (MVPA, >4 METs) were assessed by combined movement and heart rate monitoring and CRF by maximal exercise testing on a cycle ergometer at baseline and 2-year follow-up. Stiffness index (SI) as a measure of arterial stiffness and change in reflection index during exercise test (DRI) as a measure of arterial dilation capacity were assessed by pulse contour analysis. Two-year change in vigorous PA was associated with DRI in boys but not in girls (p=0.021 for interaction). In a subsample analyses, 2-year changes in MPA, VPA, and MVPA were inversely associated with 2-year change in SI. In conclusion, promoting PA at higher intensities may confer larger benefits on arterial health than reducing ST and increasing LPA.
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Affiliation(s)
- Marika Korhonen
- Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Juuso Väistö
- School of Medicine, Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
| | - Aapo Veijalainen
- School of Medicine, Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
| | - Marja Leppänen
- Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Folkhälsan Research Center, Helsinki, Finland
| | - Ulf Ekelund
- Norwegian School of Sports Science, Oslo, Norway
| | - Jari A Laukkanen
- Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.,Department of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,Department of Medicine, Central Finland Health Care District Hospital District, Jyväskylä, Finland
| | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Niina Lintu
- School of Medicine, Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
| | - Eero A Haapala
- Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Timo A Lakka
- School of Medicine, Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland.,Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland.,Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
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10
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Afolabi PR, Scorletti E, Calder PC, Byrne CD. Factors independently associated with cardiorespiratory fitness in patients with non-alcoholic fatty liver disease. Liver Int 2020; 40:2998-3007. [PMID: 32706931 DOI: 10.1111/liv.14618] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 07/16/2020] [Accepted: 07/17/2020] [Indexed: 02/13/2023]
Abstract
UNLABELLED Low cardiorespiratory fitness (CRF) is associated with non-alcoholic fatty liver disease (NAFLD) and low CRF is an important risk factor for cardiovascular disease. The factors that influence CRF in NAFLD are poorly understood and it has been suggested that reduced hepatic mitochondrial function (HMF) may be linked to low CRF. Therefore, our aim was to determine the factors associated with CRF in NAFLD. METHODS Ninety-seven patients with NAFLD were studied. CRF was assessed by treadmill testing and expressed as maximal O2 consumption (VO2 peak) per lean body mass. HMF was assessed by the 13 C-ketoisocaproate breath test. Multivariable linear regression modelling was undertaken to test the independence of associations with CRF. RESULTS Mean (SD) age was 51 (13) years and 61% were men. With CRF as the outcome, age (B coefficient -0.3, 95%CI -0.4, -0.2, P < .0001), total body fat mass (B coefficient -0.2, 95%CI -0.3, -0.05, P = .01), type 2 diabetes mellitus (T2DM) (B coefficient -3.6, 95%CI -1.1, -6.1, P = .005), smoking status (B coefficient -5.7, 95%CI -1.9, -9.5, P = .004), serum γ-glutamyl transferase (GGT) (B coefficient -0.04, 95%CI -0.05, -0.02, P < .0001), HMF (B coefficient -0.5, 95%CI -0.8, -0.1, P = .01) and diastolic function (B coefficient 0.1, 95%CI 0.05, 0.13, P < .0001) were independently associated with CRF. This model explained 60% of the total variance in CRF (R2 = 0.6, P < .0001); and this model with GGT alone explained 24% of the variance in CRF. CONCLUSIONS In patients with NAFLD, HMF is independently associated with CRF and a model with GGT alone explained most of the variance in CRF.
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Affiliation(s)
- Paul R Afolabi
- National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.,School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Eleonora Scorletti
- National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.,School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK.,Department of Gastroenterology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
| | - Philip C Calder
- National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.,School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Christopher D Byrne
- National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.,School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
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11
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Haapala EA, Gao Y, Lintu N, Väistö J, Vanhala A, Tompuri T, Lakka TA, Finni T. Associations between cardiorespiratory fitness, motor competence, and adiposity in children. TRANSLATIONAL SPORTS MEDICINE 2020. [DOI: 10.1002/tsm2.198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Eero A. Haapala
- Faculty of Sport and Health Sciences University of Jyväskylä Jyväskylä Finland
- Institute of Biomedicine School of Medicine University of Eastern Finland Kuopio Finland
| | - Ying Gao
- Faculty of Sport and Health Sciences University of Jyväskylä Jyväskylä Finland
- Department of Sports Science College of Education Zhejiang University Hangzhou China
| | - Niina Lintu
- Institute of Biomedicine School of Medicine University of Eastern Finland Kuopio Finland
| | - Juuso Väistö
- Institute of Biomedicine School of Medicine University of Eastern Finland Kuopio Finland
| | - Anssi Vanhala
- Faculty of Sport and Health Sciences University of Jyväskylä Jyväskylä Finland
- Department of Education Faculty of Educational Sciences University of Helsinki Helsinki Finland
| | - 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
| | - Timo A. Lakka
- Institute of Biomedicine School of Medicine University of Eastern Finland Kuopio Finland
- Department of Clinical Physiology and Nuclear Medicine Kuopio University Hospital Kuopio Finland
- Kuopio Research Institute of Exercise Medicine Kuopio Finland
| | - Taija Finni
- Faculty of Sport and Health Sciences University of Jyväskylä Jyväskylä Finland
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12
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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: 5] [Impact Index Per Article: 1.3] [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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13
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Haapala EA, Wiklund P, Lintu N, Tompuri T, Väistö J, Finni T, Tarkka IM, Kemppainen T, Barker AR, Ekelund U, Brage S, Lakka TA. Cardiorespiratory Fitness, Physical Activity, and Insulin Resistance in Children. Med Sci Sports Exerc 2020; 52:1144-1152. [PMID: 31764464 PMCID: PMC7358077 DOI: 10.1249/mss.0000000000002216] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
PURPOSE Few studies have investigated the independent and joint associations of cardiorespiratory fitness (CRF) and body fat percentage (BF%) with insulin resistance in children. We investigated the independent and combined associations of CRF and BF% with fasting glycemia and insulin resistance and their interactions with physical activity (PA) and sedentary time among 452 children age 6 to 8 yr. METHODS We assessed CRF with a maximal cycle ergometer exercise test and used allometrically scaled maximal power output (Wmax) for lean body mass (LM) and body mass (BM) as measures of CRF. The BF% and LM were measured by dual-energy X-ray absorptiometry, fasting glycemia by fasting plasma glucose, and insulin resistance by fasting serum insulin and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR). The PA energy expenditure, moderate-to-vigorous PA (MVPA), and sedentary time were assessed by combined movement and heart rate sensor. RESULTS Wmax/LM was not associated with glucose (β = 0.065, 95% confidence interval [CI] = -0.031 to 0.161), insulin (β = -0.079, 95% CI = -0.172 to 0.015), or HOMA-IR (β = -0.065, 95% CI = -0.161 to 0.030). Wmax/BM was inversely associated with insulin (β = -0.289, 95% CI = -0.377 to -0.200) and HOMA-IR (β = -0.269, 95% CI = -0.359 to -0.180). The BF% was directly associated with insulin (β = 0.409, 95% CI = 0.325 to 0.494) and HOMA-IR (β = 0.390, 95% CI = 0.304 to 0.475). Higher Wmax/BM, but not Wmax/LM, was associated with lower insulin and HOMA-IR in children with higher BF%. Children with higher BF% and who had lower levels of MVPA or higher levels of sedentary time had the highest insulin and HOMA-IR. CONCLUSIONS Children with higher BF% together with less MVPA or higher levels of sedentary time had the highest insulin and HOMA-IR. Cardiorespiratory fitness appropriately controlled for body size and composition using LM was not related to insulin resistance among children.
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Affiliation(s)
| | | | - Niina Lintu
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, FINLAND
| | | | - Juuso Väistö
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, FINLAND
| | - Taija Finni
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, FINLAND
| | - Ina M Tarkka
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, FINLAND
| | - Titta Kemppainen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, FINLAND
| | - Alan R Barker
- Children's Health and Exercise Research Centre, University of Exeter, Exeter, UNITED KINGDOM
| | - Ulf Ekelund
- Norwegian School of Sports Science, Oslo, NORWAY
| | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UNITED KINGDOM
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14
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Leppänen MH, Haapala EA, Veijalainen A, Seppälä S, Oliveira RS, Lintu N, Laitinen T, Tarvainen MP, Lakka TA. Associations of cardiometabolic risk factors with heart rate variability in 6- to 8-year-old children: The PANIC Study. Pediatr Diabetes 2020; 21:251-258. [PMID: 31855297 DOI: 10.1111/pedi.12967] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 11/15/2019] [Accepted: 12/16/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Associations of cardiometabolic risk factors with heart rate variability (HRV) in children are unclear. We examined associations of cardiometabolic risk score (CRS) and individual cardiometabolic risk factors with HRV variables in 6- to 8-year-olds. METHODS The participants were a population-based sample of 443 children participating in baseline measurements of the Physical Activity and Nutrition in Children trial. Cardiometabolic risk factors included waist circumference (WC), insulin, glucose, triglycerides, HDL cholesterol, systolic blood pressure (SBP), and diastolic blood pressure (DBP). CRS was calculated as WC + insulin + glucose + triglycerides - HDL cholesterol + the mean of SBP and DBP. HRV variables (SDNN, RMSSD, HF, LF, LF/HF, Mean RR) were measured using 5-minute electrocardiography at rest and analyzed using the Kubios HRV software. In this cross-sectional study, associations of CRS and individual cardiometabolic risk factors with HRV were investigated using linear regression analyses adjusted for sex and peak height velocity. RESULTS CRS was negatively associated with RMSSD, HF, Mean RR (P value < .05) and positively with LF/HF (P value = .005). Insulin was negatively associated with SDNN, RMSSD, HF, LF, and Mean RR (P value < .05) and positively with LF/HF (P value = .008). SBP was negatively associated with SDNN, RMSSD, HF, LF, and Mean RR (P value < .05). DBP was negatively associated with SDNN, RMSSD, and Mean RR (P value < .05). WC, glucose, triglycerides, or HDL cholesterol were not associated with HRV variables. CONCLUSIONS Higher CRS, insulin, and blood pressure were associated with smaller HRV, mainly indicating lower parasympathetic activity, in young children. This knowledge may help improving the clinical management of metabolic syndrome and cardiovascular diseases since childhood.
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Affiliation(s)
- Marja H Leppänen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Folkhälsan Research Center, Helsinki, Finland
| | - Eero A Haapala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Aapo Veijalainen
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Santeri Seppälä
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Ricardo S Oliveira
- Departamento de Educação Física, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - Niina Lintu
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Tomi Laitinen
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Mika P Tarvainen
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland.,Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Timo A Lakka
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland.,Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland.,Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
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15
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Shang X, Li Y, Xu H, Zhang Q, Hu X, Liu A, Du S, Li T, Guo H, Li Y, Xu G, Liu W, Ma J, Ma G. Independent and Interactive Associations of Fitness and Fatness With Changes in Cardiometabolic Risk in Children: A Longitudinal Analysis. Front Endocrinol (Lausanne) 2020; 11:342. [PMID: 32595599 PMCID: PMC7304437 DOI: 10.3389/fendo.2020.00342] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 04/30/2020] [Indexed: 12/12/2022] Open
Abstract
Background: Findings for associations between cardiorespiratory fitness (CRF) and cardiometabolic risk (CMR) factors are inconsistent, and the interactive association between CRF and fatness with CMR factors is unclear in children. Our study aimed to examine whether CRF and fatness are independently and interactively associated with CMR factors. Methods: We included 5,869 children aged 6-13 years in the analysis. Physical examinations, blood tests, and CRF were measured at baseline and 1 year later. Cardiometabolic risk score (CMRS) was computed by summing Z scores of waist circumference (WC), averaged systolic and diastolic blood pressure, glucose, high-density lipoprotein cholesterol (HDL-C, multiplied by -1), and triglycerides. Results: There was a high correlation between fatness and CRF in both boys and girls. High baseline CRF was independently associated with favorable changes in CMRS, BMI, WC, percent body fat (PBF), total cholesterol, LDL-C, and HDL-C (all P < 0.025). Improved CRF was independently associated with favorable changes in CMRS, BMI, WC, PBF, total cholesterol, LDL-C, HDL-C, triglycerides, and fasting glucose (all P < 0.0321). Baseline BMI was positively associated with changes in CMRS, WC, blood pressure, triglycerides, insulin, and HOMA-IR (all P < 0.0462). Low PBF at baseline was associated with favorable changes in CMRS, BMI, WC, blood pressure, HDL-C, triglycerides, insulin, and HOMA-IR (all P < 0.0423). The percentage of the total effect of baseline CRF on changes in CMRS, triglycerides, HDL-C, PBF, and WC mediated by baseline BMI was 66.0, 61.6, 40.3, 20.7, and 9.2%, respectively. Baseline CRF was a significant mediator for the association between baseline BMI and changes in CMRS (mediated by 4.3%), triglycerides (5.1%), and HDL-C (12.0%). An inverse association was found between baseline CRF and CMRS in children with high baseline BMI/PBF only. Improved CRF was associated with decreased BMI and WC in children with low baseline CRF. Conclusions: Fatness and CRF are each independently associated with changes in CMR factors. Fatness is a major mediator for the association between CRF and CMR factors, whereas the association between fatness and CMR factors is also mediated by CRF. The beneficial effect of high CRF on CMR factors was more evident in obese or unfit children.
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Affiliation(s)
- Xianwen Shang
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing, China
- School of Behavioural and Health Sciences, Australian Catholic University, Fitzroy, VIC, Australia
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Yanping Li
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing, China
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Haiquan Xu
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing, China
- Institute of Food and Nutrition Development, Ministry of Agriculture and Rural Affairs, Beijing, China
| | - Qian Zhang
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing, China
| | - Xiaoqi Hu
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing, China
| | - Ailing Liu
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing, China
| | - Songming Du
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing, China
| | - Tingyu Li
- Department of Pediatrics, Chongqing Children's Hospital, Chongqing, China
| | - Hongwei Guo
- School of Public Health, Fudan University, Shanghai, China
| | - Ying Li
- Department of Nutrition and Food Hygiene, Public Health College, Harbin Medical University, Harbin, China
| | - Guifa Xu
- Department of Public Health, Shandong University, Jinan, China
| | - Weijia Liu
- School Health Department, Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Jun Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Guansheng Ma
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University, Beijing, China
- *Correspondence: Guansheng Ma
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Vinciguerra F, Tumminia A, Roppolo F, Romeo LC, La Spina N, Baratta R, Parrino C, Sciacca L, Vigneri R, Frittitta L. Impact of unhealthy childhood and unfavorable parents' characteristics on adiposity in schoolchildren. Diabetes Metab Res Rev 2019; 35:e3199. [PMID: 31257680 DOI: 10.1002/dmrr.3199] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 06/06/2019] [Accepted: 06/20/2019] [Indexed: 11/06/2022]
Abstract
BACKGROUND Childhood obesity is encouraged by low physical activity (PA), time spent using screens (screen time, ST), and by sugar-sweetened beverage consumption (SSBc). It is also influenced by unfavorable parents' characteristics, such as a high body mass index (BMI) and low education level (EL). Our aim was to evaluate the overall and specific influence of these factors on childhood adiposity. MATERIAL AND METHODS Anthropometric parameters including BMI z-score, waist circumference (WC), waist to height ratio (WtHR), and fat mass were measured in a cohort of 1702 schoolchildren (6.0-14.5 years, mean 10.7 ± 1.8) and questionnaires concerning children's PA, ST, and SSBc, and parent's BMI and EL were administered to parents. RESULTS Overweight/obesity prevalence was higher (P < .0001) in males (57%) than in females (43%). Less physically active children (28.9%) had a higher prevalence of overweight/obesity and higher BMI z-score, WC, WtHR, and fat mass relative to more physically active children (P < .05). PA was negatively associated with the BMI z-score (r = 0.18, P < .0001) and fat mass percentage (r = 0.18, P < .0001). Children with more ST had higher WC and WtHR than non-ST viewers (P < .05) but not BMI. Moreover, SSBc did not influence the anthropometric parameters. At multivariate analysis, male gender, less PA, and parental risk factors (parent's overweight/obesity and low/medium EL) were independently associated with overweight and obesity among childhood with a progressively increasing odds ratio (1.65, 1.40, and 1.80, respectively). CONCLUSIONS Male gender, behavioral risk factors (particularly low PA), and parent's characteristics are important correlates of obesity in children.
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Affiliation(s)
- Federica Vinciguerra
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Andrea Tumminia
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Francesca Roppolo
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Luana Catena Romeo
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Nadia La Spina
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | | | - Cristina Parrino
- Endocrinology and Diabetology Unit, I.R.C.C.S, Policlinico San Donato University Hospital, Milan, Italy
| | - Laura Sciacca
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
- Unit of Endocrinology, Garibaldi Hospital, Catania, Italy
| | | | - Lucia Frittitta
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
- Unit of Endocrinology, Garibaldi Hospital, Catania, Italy
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17
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Associations of physical activity, sedentary time, and cardiorespiratory fitness with heart rate variability in 6- to 9-year-old children: the PANIC study. Eur J Appl Physiol 2019; 119:2487-2498. [PMID: 31535217 PMCID: PMC6858383 DOI: 10.1007/s00421-019-04231-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 09/10/2019] [Indexed: 12/16/2022]
Abstract
Purpose To study the associations of physical activity (PA), sedentary time (ST), and cardiorespiratory fitness (CRF) with heart rate variability (HRV) in children. Methods The participants were a population sample of 377 children aged 6–9 years (49% boys). ST, light PA (LPA), moderate PA (MPA), vigorous PA (VPA), and moderate-to-vigorous PA (MVPA), and PA energy expenditure (PAEE) were assessed using a combined heart rate and movement sensor, maximal power output per kilograms of lean body mass as a measure of CRF by maximal cycle ergometer exercise test, and HRV variables (SDNN, RMSSD, LF, and HF) using 5 min resting electrocardiography. Data were analysed by linear regression adjusted for years from peak height velocity. Results In boys, ST was inversely associated (β = − 0.185 to − 0.146, p ≤ 0.049) and MVPA, VPA, PAEE, and CRF were directly associated (β = 0.147 to 0.320, p ≤ 0.048) with HRV variables. CRF was directly associated with all HRV variables and PAEE was directly associated with RMSSD after mutual adjustment for ST, PAEE, and CRF (β = 0.169 to 0.270, p ≤ 0.046). In girls, ST was inversely associated (β = − 0.382 to − 0.294, p < 0.001) and LPA, MPA, VPA, MVPA, and PAEE were directly associated with HRV variables (β = 0.144 to 0.348, p ≤ 0.049). After mutual adjustment for ST, PAEE, and CRF, only the inverse associations of ST with HRV variables remained statistically significant. Conclusions Higher ST and lower PA and CRF were associated with poorer cardiac autonomic nervous system function in children. Lower CRF in boys and higher ST in girls were the strongest correlates of poorer cardiac autonomic function. Electronic supplementary material The online version of this article (10.1007/s00421-019-04231-5) contains supplementary material, which is available to authorized users.
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18
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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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Taylor MK, Hernández LM, Schoenherr MR, Stump J. Genetic, Physiologic, and Behavioral Predictors of Cardiorespiratory Fitness in Specialized Military Men. Mil Med 2019; 184:e474-e481. [DOI: 10.1093/milmed/usz033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 12/18/2018] [Accepted: 02/07/2019] [Indexed: 12/15/2022] Open
Abstract
AbstractIntroductionCardiorespiratory fitness (CRF) is a crucial performance requirement of specialized military occupations. Age and physical activity are established predictors of CRF, but it is not clear how these predictors combine with each other and/or with genetic predisposition. The goal of this study was to derive inclusive explanatory models of CRF in US Navy Explosive Ordnance Disposal (EOD) operators, synthesizing conventional (e.g., age, body composition, and physical activity) and novel influences (e.g., genetic variance).Materials and MethodsIn this cross-sectional study, 40 male, active duty EOD operators completed a graded exercise test to assess maximal oxygen consumption and ventilatory threshold (VT) using the Bruce protocol. Aerobic performance was further quantified via time of test termination and time at which VT was achieved. Body composition was determined via dual x-ray absorptiometry, and physical activity was assessed by self-report. Genetic variants underlying human stress systems (5HTTLPR, BclI, −2 C/G, and COMT) were assayed. Descriptive analyses were conducted to summarize subject characteristics. Hypotheses were tested with linear regression models. Specifically, separate univariate regression models first determined associations between each of the independent and dependent variables. This protocol was approved by the Naval Health Research Center Institutional Review Board (NHRC.2015.0013).ResultsIn univariate regression models, age, body composition, physical activity, and 5HTTLPR consistently predicted CRF and/or aerobic performance (R2 range 0.07–0.55). Multivariate regression models routinely outperformed the univariate models, explaining 36–62% of variance.ConclusionThis study signifies a shift toward inclusive explanatory models of CRF and aerobic performance, accounting for combined roles of genetic, physiologic, and behavioral influences. Although we were able to quantify combined effects, we were unable to evaluate interaction effects (e.g., gene–gene, gene–behavior) due to limited statistical power. Other limitations are that this specialized military population may not readily generalize to broader populations, and the current sample was all male. Considering these limitations, we aim to replicate this study in various populations, both male and female. Despite its limitations, this study reflects a shift toward more comprehensive predictive models of CRF, explaining the unique and shared contributions of genetic predisposition, physiology, and behavior. These findings have implications for assessment, selection, and training of specialized military members, and may also impact mission success and survivability. Future studies are needed to better characterize additive, interactive, and mediated effects.
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Affiliation(s)
- Marcus K Taylor
- Naval Health Research Center, 140 Sylvester Road, San Diego, CA
| | - Lisa M Hernández
- Naval Health Research Center, 140 Sylvester Road, San Diego, CA
- Leidos, Inc., 140 Sylvester Road, San Diego, CA
| | - Matthew R Schoenherr
- Naval Health Research Center, 140 Sylvester Road, San Diego, CA
- Leidos, Inc., 140 Sylvester Road, San Diego, CA
| | - Jeremiah Stump
- Explosive Ordnance Disposal Training and Evaluation Unit One, NAS North Island, San Diego, CA
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Haapala EA, Laukkanen JA, Takken T, Kujala UM, Finni T. Peak oxygen uptake, ventilatory threshold, and arterial stiffness in adolescents. Eur J Appl Physiol 2018; 118:2367-2376. [DOI: 10.1007/s00421-018-3963-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 08/05/2018] [Indexed: 02/04/2023]
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Werneck AO, Silva DR, Agostinete RR, Fernandes RA, Ronque ERV, Cyrino ES. Social, behavioral and biological correlates of cardiorespiratory fitness according to sex, nutritional status and maturity status among adolescents. A cross-sectional study. SAO PAULO MED J 2018; 136:237-244. [PMID: 29947698 PMCID: PMC9907740 DOI: 10.1590/1516-3180.2017.0405190218] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Accepted: 02/19/2018] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Our aim was to analyze multilevel correlates of cardiorespiratory fitness (CRF) according to sex, nutritional status and maturity status among adolescents. DESIGN AND SETTING Cross-sectional study conducted in public schools. METHODS This was a cross-sectional study on 1,209 adolescents aged between 10 and 17 years. CRF was estimated from the 20-meter shuttle run test. Anthropometric data on body mass index and waist circumference were obtained. Somatic maturation was assessed from the peak height velocity. Questionnaires were used to evaluate socioeconomic variables (family income, parents' education level and number of siblings) and behavioral variables (physical activity, screen time and alcohol and tobacco consumption) among the parents and adolescents. RESULTS Boys, adolescents with normal weight and on-time maturers presented greater CRF (P < 0.05). Concerning socioeconomic correlates, girls (tobacco smoking, alcohol consumption, physical activity and screen time), adolescents with normal weight (alcohol consumption, physical activity and screen time), and on-time maturers (alcohol consumption, physical activity during childhood and habitual physical activity) demonstrated higher numbers of behavioral correlates with CRF. Normal-weight adolescents presented a higher number of biological correlates (chronological age, age at peak height velocity and waist circumference). CONCLUSIONS Different correlates were observed according to sex, nutritional status and somatic maturation status. However, habitual physical activity, waist circumference and chronological age seemed to be the strongest factors associated with cardiorespiratory fitness among adolescents.
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Affiliation(s)
- André Oliveira Werneck
- Undergraduate Student, Centro de Educação Física e Esporte (CEFE), Universidade Estadual de Londrina (UEL), Londrina (PR), Brazil
| | - Danilo Rodrigues Silva
- PhD. Professor, Department of Physical Education, Universidade Federal de Sergipe (UFS), São Cristóvão (SE), Brazil
| | - Ricardo Ribeiro Agostinete
- Doctoral Student, Department of Physical Education, Universidade Estadual Paulista Julio de Mesquita Filho, São Paulo (SP), Brazil
| | - Rômulo Araújo Fernandes
- PhD. Professor, Department of Physical Education, Universidade Estadual Paulista Julio de Mesquita Filho, São Paulo (SP), Brazil
| | - Enio Ricardo Vaz Ronque
- PhD. Professor, Centro de Ciências da Saude (CCS), Universidade Estadual de Londrina (UEL), Londrina (PR), Brazil
| | - Edilson Serpeloni Cyrino
- PhD. Professor, Centro de Ciências da Saude (CCS), Universidade Estadual de Londrina (UEL), Londrina (PR), Brazil
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Köhler A, King R, Bahls M, Groß S, Steveling A, Gärtner S, Schipf S, Gläser S, Völzke H, Felix SB, Markus MRP, Dörr M. Cardiopulmonary fitness is strongly associated with body cell mass and fat-free mass: The Study of Health in Pomerania (SHIP). Scand J Med Sci Sports 2018; 28:1628-1635. [PMID: 29345858 DOI: 10.1111/sms.13057] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2018] [Indexed: 01/02/2023]
Abstract
Peak oxygen uptake (VO2peak) is commonly indexed by total body weight (TBW) to determine cardiopulmonary fitness (CPF). This approach may lead to misinterpretation, particularly in obese subjects. We investigated the normalization of VO2peak by different body composition markers. We analyzed combined data of 3848 subjects (1914 women; 49.7%), aged 20-90, from two independent cohorts of the population-based Study of Health in Pomerania (SHIP-2 and SHIP-TREND). VO2peak was assessed by cardiopulmonary exercise testing. Body cell mass (BCM), fat-free mass (FFM), and fat mass (FM) were determined by bioelectrical impedance analysis. The suitability of the different markers as a normalization variable was evaluated by taking into account correlation coefficients (r) and intercept (α-coefficient) values from linear regression models. A combination of high r and low α values was considered as preferable for normalization purposes. BCM was the best normalization variable for VO2peak (r = .72; P ≤ .001; α-coefficient = 63.3 mL/min; 95% confidence interval [CI]: 3.48-123) followed by FFM (r = .63; P ≤ .001; α-coefficient = 19.6 mL/min; 95% CI: -57.9-97.0). On the other hand, a much weaker correlation and a markedly higher intercept were found for TBW (r = .42; P ≤ .001; α-coefficient = 579 mL/min; 95% CI: 483 to 675). Likewise, FM was also identified as a poor normalization variable (r = .10; P ≤ .001; α-coefficient = 2133; 95% CI: 2074-2191). Sex-stratified analyses confirmed the above order for the different normalization variables. Our results suggest that BCM, followed by FFM, might be the most appropriate marker for the normalization of VO2peak when comparing CPF between subjects with different body shape.
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Affiliation(s)
- A Köhler
- University Sports, University of Greifswald, Greifswald, Germany.,DZHK (German Centre for Cardiovascular Research), Greifswald, Germany
| | - R King
- DZHK (German Centre for Cardiovascular Research), Greifswald, Germany.,Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - M Bahls
- DZHK (German Centre for Cardiovascular Research), Greifswald, Germany.,Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - S Groß
- DZHK (German Centre for Cardiovascular Research), Greifswald, Germany.,Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - A Steveling
- Department of Internal Medicine A, University Medicine Greifswald, Greifswald, Germany
| | - S Gärtner
- Department of Internal Medicine A, University Medicine Greifswald, Greifswald, Germany
| | - S Schipf
- Department of Study of Health in Pomerania/Clinical-Epidemiological Research, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.,DZD (German Center for Diabetes Research), Greifswald, Germany
| | - S Gläser
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany.,Department of Internal Medicine and Pulmonary Diseases, Vivantes Klinikum Spandau, Berlin, Germany
| | - H Völzke
- DZHK (German Centre for Cardiovascular Research), Greifswald, Germany.,Department of Study of Health in Pomerania/Clinical-Epidemiological Research, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - S B Felix
- DZHK (German Centre for Cardiovascular Research), Greifswald, Germany.,Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
| | - M R P Markus
- DZHK (German Centre for Cardiovascular Research), Greifswald, Germany.,Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany.,Department of Study of Health in Pomerania/Clinical-Epidemiological Research, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.,DZD (German Center for Diabetes Research), Greifswald, Germany
| | - M Dörr
- DZHK (German Centre for Cardiovascular Research), Greifswald, Germany.,Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
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23
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Talukdar T, Nikolaidis A, Zwilling CE, Paul EJ, Hillman CH, Cohen NJ, Kramer AF, Barbey AK. Aerobic Fitness Explains Individual Differences in the Functional Brain Connectome of Healthy Young Adults. Cereb Cortex 2017; 28:3600-3609. [DOI: 10.1093/cercor/bhx232] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 08/24/2017] [Indexed: 02/06/2023] Open
Affiliation(s)
- Tanveer Talukdar
- Decision Neuroscience Laboratory, University of Illinois, Urbana, IL, USA
- Beckman Institute for Advanced Science and Technology, University of Illinois, Urbana, IL, USA
| | - Aki Nikolaidis
- Center for the Developing Brain, The Child Mind Institute, New York, NY, USA
| | - Chris E Zwilling
- Decision Neuroscience Laboratory, University of Illinois, Urbana, IL, USA
- Beckman Institute for Advanced Science and Technology, University of Illinois, Urbana, IL, USA
| | - Erick J Paul
- Decision Neuroscience Laboratory, University of Illinois, Urbana, IL, USA
- Beckman Institute for Advanced Science and Technology, University of Illinois, Urbana, IL, USA
| | - Charles H Hillman
- Department of Psychology, Northeastern University, Boston, MA, USA
- Department of Health Sciences, Northeastern University, Boston, MA, USA
| | - Neal J Cohen
- Beckman Institute for Advanced Science and Technology, University of Illinois, Urbana, IL, USA
- Department of Psychology, University of Illinois, Urbana, IL, USA
- Neuroscience Program, University of Illinois, Champaign, IL, USA
| | - Arthur F Kramer
- Beckman Institute for Advanced Science and Technology, University of Illinois, Urbana, IL, USA
- Department of Psychology, Northeastern University, Boston, MA, USA
- Office of the Provost, Northeastern University, Boston, MA, USA
- Department of Mechanical and Industrial Engineering, Northeastern University, Boston, MA, USA
| | - Aron K Barbey
- Decision Neuroscience Laboratory, University of Illinois, Urbana, IL, USA
- Beckman Institute for Advanced Science and Technology, University of Illinois, Urbana, IL, USA
- Department of Psychology, University of Illinois, Urbana, IL, USA
- Neuroscience Program, University of Illinois, Champaign, IL, USA
- Department of Internal Medicine, University of Illinois, Champaign, IL, USA
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24
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Tompuri T, Lintu N, Laitinen T, Lakka TA. Relation of oxygen uptake to work rate in prepubertal healthy children - reference for VO 2 /W-slope and effect on cardiorespiratory fitness assessment. Clin Physiol Funct Imaging 2017; 38:645-651. [PMID: 28795487 DOI: 10.1111/cpf.12461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 06/29/2017] [Indexed: 11/29/2022]
Abstract
PURPOSE Exercise testing by cycle ergometer allows to observe the interaction between oxygen uptake (VO2 ) and workload (W), and VO2 /W-slope can be used as a diagnostic tool. Respectively, peak oxygen uptake (VO2PEAK ) can be estimated by maximal workload. We aim to determine reference for VO2 /W-slope among prepubertal children and define agreement between estimated and measured VO2PEAK . METHODS A total of 38 prepubertal children (20 girls) performed a maximal cycle ergometer test with respiratory gas analysis. VO2 /W-slopes were computed using linear regression. Agreement analysis by Bland and Altman for estimated and measured VO2PEAK was carried out including limits of agreement (LA). Determinants for VO2 /W-slopes and estimation bias were defined. RESULTS VO2/W-slope was in both girls and boys ≥9·4 and did not change with exercise level, but the oxygen cost of exercise was higher among physically more active children. Estimated VO2PEAK had 6·4% coefficient of variation, and LA varied from 13% underestimation to 13% overestimation. Bias had a trend towards underestimation along lean mass proportional VO2PEAK . The primary determinant for estimation bias was VO2/W-slope (β = -0·65; P<0·001). CONCLUSION The reference values for VO2 /W-slope among healthy prepubertal children were similar to those published for adults and among adolescents. Estimated and measured VO2PEAK should not be considered to be interchangeable because of the variation in the relationship between VO2 and W. On other hand, variation in the relationship between VO2 and W enables that VO2 /W-slope can be used as a diagnostic tool.
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Affiliation(s)
- Tuomo Tompuri
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland.,Department of Physiology, School of Medicine, Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
| | - Niina Lintu
- Department of Physiology, School of Medicine, Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
| | - Tomi Laitinen
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Timo A Lakka
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland.,Department of Physiology, School of Medicine, Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland.,Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
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25
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MALCHAIRE J, ALFANO FRD, PALELLA BI. Evaluation of the metabolic rate based on the recording of the heart rate. INDUSTRIAL HEALTH 2017; 55:219-232. [PMID: 28250334 PMCID: PMC5462638 DOI: 10.2486/indhealth.2016-0177] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 02/22/2017] [Indexed: 05/20/2023]
Abstract
The assessment of harsh working conditions requires a correct evaluation of the metabolic rate. This paper revises the basis described in the ISO 8996 standard for the evaluation of the metabolic rate at a work station from the recording of the heart rate of a worker during a representative period of time. From a review of the literature, formulas different from those given in the standard are proposed to estimate the maximum working capacity, the maximum heart rate, the heart rate and the metabolic rate at rest and the relation (HR vs. M) at the basis of the estimation of the equivalent metabolic rate, as a function of the age, height and weight of the person. A Monte Carlo simulation is used to determine, from the approximations of these parameters and formulas, the imprecision of the estimated equivalent metabolic rate. The results show that the standard deviation of this estimate varies from 10 to 15%.
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Affiliation(s)
- Jacques MALCHAIRE
- Unité Hygiène et Physiologie du Travail–Université Catholique de Louvain, Belgium
| | | | - Boris Igor PALELLA
- Dipartimento di Ingegneria Industriale–Università degli Studi di Napoli Federico II, Italy
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26
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Haapala EA, Lankhorst K, de Groot J, Zwinkels M, Verschuren O, Wittink H, Backx FJ, Visser-Meily A, Takken T. The associations of cardiorespiratory fitness, adiposity and sports participation with arterial stiffness in youth with chronic diseases or physical disabilities. Eur J Prev Cardiol 2017; 24:1102-1111. [PMID: 28374647 PMCID: PMC5495431 DOI: 10.1177/2047487317702792] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background The evidence on the associations of cardiorespiratory fitness, body adiposity and sports participation with arterial stiffness in children and adolescents with chronic diseases or physical disabilities is limited. Methods Altogether 140 children and adolescents with chronic diseases or physical disabilities participated in this cross-sectional study. Cardiorespiratory fitness was assessed using maximal exercise test with respiratory gas analyses either using shuttle run, shuttle ride, or cycle ergometer test. Cardiorespiratory fitness was defined as peak oxygen uptake by body weight or fat-free mass. Body adiposity was assessed using waist circumference, body mass index standard deviation score and body fat percentage. Sports participation was assessed by a questionnaire. Aortic pulse wave velocity and augmentation index were assessed by a non-invasive oscillometric tonometry device. Results Peak oxygen uptake/body weight (standardised regression coefficient β −0.222, 95% confidence interval (CI) −0.386 to −0.059, P = 0.002) and peak oxygen uptake/fat-free mass (β −0.173, 95% CI −0.329 to −0.017, P = 0.030) were inversely and waist circumference directly (β 0.245, 95% CI 0.093 to 0.414, P = 0.002) associated with aortic pulse wave velocity. However, the associations of the measures of cardiorespiratory fitness with aortic pulse wave velocity were attenuated after further adjustment for waist circumference. A higher waist circumference (β −0.215, 95% CI −0.381 to −0.049, P = 0.012) and a higher body mass index standard deviation score (β 0.218, 95% CI −0.382 to −0.054, P = 0.010) were related to lower augmentation index. Conclusions Poor cardiorespiratory fitness and higher waist circumference were associated with increased arterial stiffness in children and adolescents with chronic diseases and physical disabilities. The association between cardiorespiratory fitness and arterial stiffness was partly explained by waist circumference.
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Affiliation(s)
- Eero A Haapala
- 1 Faculty of Sport and Health Sciences, University of Jyväskylä, Finland.,2 Institute of Biomedicine, University of Eastern Finland, Finland.,3 Child Development and Exercise Center, Wilhelmina Children's Hospital, the Netherlands
| | - Kristel Lankhorst
- 4 Research Group Lifestyle and Health, University of Applied Sciences, the Netherlands.,5 Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Lab, the Netherlands
| | - Janke de Groot
- 3 Child Development and Exercise Center, Wilhelmina Children's Hospital, the Netherlands.,4 Research Group Lifestyle and Health, University of Applied Sciences, the Netherlands.,5 Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Lab, the Netherlands
| | - Maremka Zwinkels
- 5 Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Lab, the Netherlands.,6 Center of Excellence in Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, the Netherlands
| | - Olaf Verschuren
- 5 Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Lab, the Netherlands.,6 Center of Excellence in Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, the Netherlands
| | - Harriet Wittink
- 4 Research Group Lifestyle and Health, University of Applied Sciences, the Netherlands
| | - Frank Jg Backx
- 7 Department of Rehabilitation, University Medical Center Utrecht, the Netherlands
| | - Anne Visser-Meily
- 6 Center of Excellence in Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, the Netherlands.,7 Department of Rehabilitation, University Medical Center Utrecht, the Netherlands
| | - Tim Takken
- 3 Child Development and Exercise Center, Wilhelmina Children's Hospital, the Netherlands.,5 Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Lab, the Netherlands
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27
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Lu KD, Billimek J, Bar-Yoseph R, Radom-Aizik S, Cooper DM, Anton-Culver H. Sex Differences in the Relationship between Fitness and Obesity on Risk for Asthma in Adolescents. J Pediatr 2016; 176:36-42. [PMID: 27318375 PMCID: PMC5003726 DOI: 10.1016/j.jpeds.2016.05.050] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 04/04/2016] [Accepted: 05/12/2016] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To evaluate the relationship of fitness and obesity on asthma risk in adolescent girls and boys. STUDY DESIGN A cross-sectional assessment of participants 12-19 years of age was conducted by the use of data from the 1999-2004 National Health and Nutrition Examination Survey. Participants completed cardiorespiratory fitness testing, body composition measurements, and respiratory questionnaires. RESULTS A total of 4828 participants were included. Overweight/obesity was associated with increased odds of history of asthma (aOR 1.63, 95% CI 1.16-2.30), current asthma (aOR 1.73, 95% CI 1.13, 2.64), and wheezing (aOR 1.40, 95% CI 1.03-1.91) in girls. Overweight/obesity also was associated with increased odds of asthma attacks (aOR 2.67, 95% CI 1.56-4.65) and wheezing related to exercise (aOR 1.60, 95% CI 1.07-2.38) in girls. High fitness was associated with lower odds of asthma-related visits to the emergency department (aOR 0.24, 95% CI 0.07-0.89), wheezing-related medical visits (aOR 0.31, 95% CI 0.13-0.75), wheezing-related missed days (aOR 0.14, 95% CI 0.06-0.33), and wheezing related to exercise (aOR 0.43, 95% CI 0.24-0.76) in boys. CONCLUSION Overweight/obesity is associated with increased asthma prevalence and morbidity in girls but not in boys, independent of fitness. High fitness is associated with decreased rates of asthma morbidity in boys but not in girls, independent of weight status. Obesity and fitness may each influence asthma onset and severity in different ways for girls compared with boys.
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Affiliation(s)
- Kim D Lu
- Department of Pediatrics and Pediatric Exercise and Genomics Research Center, University of California, Irvine, CA.
| | - John Billimek
- Health Policy Research Institute and Division of General Internal Medicine, School of Medicine, University of California, Irvine, CA
| | - Ronen Bar-Yoseph
- Department of Pediatrics and Pediatric Exercise and Genomics Research Center, University of California, Irvine, CA
| | - Shlomit Radom-Aizik
- Department of Pediatrics and Pediatric Exercise and Genomics Research Center, University of California, Irvine, CA
| | - Dan M Cooper
- Department of Pediatrics and Pediatric Exercise and Genomics Research Center, University of California, Irvine, CA
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28
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Tompuri TT, Lintu N, Soininen S, Laitinen T, Lakka TA. Comparison between parameters from maximal cycle ergometer test first without respiratory gas analysis and thereafter with respiratory gas analysis among healthy prepubertal children. Appl Physiol Nutr Metab 2016; 41:624-30. [PMID: 27163556 DOI: 10.1139/apnm-2015-0355] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
It is important to distinguish true and clinically relevant changes and methodological noise from measure to measure. In the clinical practice, maximal cycle ergometer tests are typically performed first without respiratory gas analysis and thereafter, if needed, with respiratory gas analysis. Therefore, we report a comparison of parameters from maximal cycle ergometer exercise tests that were done first without respiratory gas analysis and thereafter with it in 38 prepubertal and healthy children (20 girls, 18 boys). The Bland-Altman method was used to assess agreement in maximal workload (WMAX), heart rate (HR), and systolic blood pressure (SBP) between rest and maximum. Girls achieved higher WMAX in the exercise tests with respiratory gas analysis compared with exercise tests without respiratory gas analysis (p = 0.016), whereas WMAX was similar in the tests among boys. Maximal HR (proportional offset, -1%; coefficients of variation, 3.3%) and highest SBP (proportional offset, 3%; coefficients of variation, 10.6%) were similar in the tests among children. Precision and agreement for HR improved and precision for SBP worsened with increasing exercise intensity. Heteroscedasticity was not observed for WMAX, HR, or SBP. We conclude that maximal cycle ergometer tests without and with respiratory gas analysis can be used consecutively because measurement of respiratory gases did not impair performance or have a significant effect on the maximality of the exercise tests. Our results suggest that similar references can be used for children who accept or refuse using a mask during a maximal exercise test.
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Affiliation(s)
- Tuomo T Tompuri
- a Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, P.O. Box 100, FIN-70029, Kuopio, Finland
| | - Niina Lintu
- b Institute of Biomedicine (Physiology), University of Eastern Finland, P.O. Box 1627, FIN-70211, Kuopio, Finland
| | - Sonja Soininen
- b Institute of Biomedicine (Physiology), University of Eastern Finland, P.O. Box 1627, FIN-70211, Kuopio, Finland
| | - Tomi Laitinen
- a Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, P.O. Box 100, FIN-70029, Kuopio, Finland
| | - Timo Antero Lakka
- b Institute of Biomedicine (Physiology), University of Eastern Finland, P.O. Box 1627, FIN-70211, Kuopio, Finland
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29
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Tompuri TT. Metabolic equivalents of task are confounded by adiposity, which disturbs objective measurement of physical activity. Front Physiol 2015; 6:226. [PMID: 26321958 PMCID: PMC4531232 DOI: 10.3389/fphys.2015.00226] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 07/27/2015] [Indexed: 11/13/2022] Open
Abstract
Physical activity refers any bodily movements produced by skeletal muscles that expends energy. Hence the amount and the intensity of physical activity can be assessed by energy expenditure. Metabolic equivalents of task (MET) are multiplies of the resting metabolism reflecting metabolic rate during exercise. The standard MET is defined as 3.5 ml/min/kg. However, the expression of energy expenditure by body weight to normalize the size differences between subjects causes analytical hazards: scaling by body weight does not have a physiological, mathematical, or physical rationale. This review demonstrates by examples that false methodology may cause paradoxical observations if physical activity would be assessed by body weight scaled values such as standard METs. While standard METs are confounded by adiposity, lean mass proportional measures of energy expenditure would enable a more truthful choice to assess physical activity. While physical activity as a behavior and cardiorespiratory fitness or adiposity as a state represents major determinants of public health, specific measurements of health determinants must be understood to enable a truthful evaluation of the interactions and their independent role as a health predictor.
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Affiliation(s)
- Tuomo T. Tompuri
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University HospitalKuopio, Finland
- Institute of Biomedicine/Physiology, School of Medicine, University of Eastern FinlandKuopio, Finland
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