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Leonardi-Figueiredo MM, de Queiroz Davoli GB, Avi AE, Crescêncio JC, Moura-Tonello SC, Manso PH, Júnior LG, Martinez EZ, Catai AM, Mattiello-Sverzut AC. Cardiac Autonomic Modulation of Heart Rate Recovery in Children with Spina Bifida. Int J Sports Med 2021; 42:1113-1121. [PMID: 33890263 DOI: 10.1055/a-1393-6472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
We aimed to analyse cardiac autonomic control by assessing the post-exercise heart rate recovery (HRR) and physical fitness in children and adolescents with spina bifida (SB), compared to participants with typical development. A total of 124 participants, 42 with spina bifida (SB group) and 82 typical developmental controls (CO group) performed the arm cranking exercise test with a gas analysis system. HRR was determined at the first (HRR_1) and second (HRR_2) minute at recovery phase. Data are shown as [mean difference (95% CI)]. The SB group showed reduced HR reserve [14.5 (7.1-22.0) bmp, P<0.01], slower HRR_1 [12.4 (7.4-17.5) bpm, P<0.01] and HRR_2 [16.3 (10.6-21.9) bpm; P<0.01], lower VO2peak [VO2peak relative: 7.3 (4.2-10.3) mL·min-1·kg-1, P<0.01; VO2peak absolute: 0.42 (0.30-0.54) L·min-1, P<0.01], and lower O2 pulse [2.5 (1.8-3.2) mL·bpm, P<0.01] and ventilatory responses [13.5 (8.8-18.1) L·min-1, P<0.01] than the CO group. VE/VO2 was not different between groups [-2.82 (-5.77- -0.12); P=0.06], but the VE/VCO2 [-2.59 (-4.40-0.78); P<0.01] and the values of the anaerobic threshold corrected by body mass [-3.2 (-5.8- -0.6) mL·min-1·kg-1, P=0.01] were higher in the SB group than in the CO group. We concluded that children and adolescents with SB have reduced physical fitness and a slower HRR response after maximal effort.
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Affiliation(s)
| | | | - Amanda Evangelista Avi
- Departamento Ciências da Saúde, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Julio Cesar Crescêncio
- Departamento Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
| | | | - Paulo Henrique Manso
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Lourenço Gallo Júnior
- Departamento de Medicina Social, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Edson Zangiacomi Martinez
- Departamento de Medicina Social, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Aparecida Maria Catai
- Departamento de Fisioterapia, Universidade Federal de São Carlos, São Carlos, Brazil
| | - Ana Claudia Mattiello-Sverzut
- Departamento Ciências da Saúde, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
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Changes in adiposity and fat tissue distribution among preschool children from Kraków, Poland, from 2008 to 2018. J Biosoc Sci 2021; 54:333-346. [DOI: 10.1017/s0021932021000018] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Abstract
In the light of changes in the living conditions of populations, excess adiposity is currently a serious public health problem worldwide. The aim of this study was to assess the changes in the body fat ratio among preschool children aged 3–7 years from Kraków, Poland, between 2008 and 2018. The study group consisted of children examined in two cross-sectional studies. Analysed characteristics included triceps, calf, subscapular, abdominal and suprailiac skinfold thicknesses, and adiposity calculated according to Slaughter’s equations. The trunk adiposity index and limbs-to-trunk fat ratio were also calculated. Statistical significance was obtained using two-way ANOVA and Tukey’s tests. Lower-limb adiposity was largest in the 2008 cohort and trunk adiposity was greater in the 2018 cohort. The mean values of the trunk adiposity index and limbs-to-trunk fat ratio were lower in the 2018 cohort than in the 2008 cohort. The 2018 cohort was also characterized by a lower overall adiposity. Regardless of the lower body adiposity percentage, in 2018 there was a tendency towards the central allocation of fat tissue. This is a negative phenomenon because, especially when co-existing with reduced lower-limb adiposity, it is associated with an increased risk of metabolic and cardiovascular diseases, even in young children.
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Stoner L, Pontzer H, Barone Gibbs B, Moore JB, Castro N, Skidmore P, Lark S, Williams MA, Hamlin MJ, Faulkner J. Fitness and Fatness Are Both Associated with Cardiometabolic Risk in Preadolescents. J Pediatr 2020; 217:39-45.e1. [PMID: 31759583 DOI: 10.1016/j.jpeds.2019.09.076] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 08/27/2019] [Accepted: 09/26/2019] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To determine the associations between cardiorespiratory fitness (CRF) and fatness (overweight-obesity) with cardiometabolic disease risk among preadolescent children. STUDY DESIGN This cross-sectional study recruited 392 children (50% female, 8-10 years of age). Overweight-obesity was classified according to 2007 World Health Organization criteria for body mass index. High CRF was categorized as a maximum oxygen uptake, determined using a shuttle run test, exceeding 35 mL·kg-1·minute-1 in girls and 42 mL·kg-1·minute-1 in boys. Eleven traditional and novel cardiometabolic risk factors were measured including lipids, glucose, glycated hemoglobin, peripheral and central blood pressure, and arterial wave reflection. Factor analysis identified underlying cardiometabolic disease risk factors and a cardiometabolic disease risk summary score. Two-way analysis of covariance determined the associations between CRF and fatness with cardiometabolic disease risk factors. RESULTS Factor analysis revealed four underlying factors: blood pressure, cholesterol, vascular health, and carbohydrate-metabolism. Only CRF was significantly (P = .001) associated with the blood pressure factor. Only fatness associated with vascular health (P = .010) and carbohydrate metabolism (P = .005) factors. For the cardiometabolic disease risk summary score, there was an interaction effect. High CRF was associated with decreased cardiometabolic disease risk in overweight-obese but not normal weight children (P = .006). Conversely, high fatness was associated with increased cardiometabolic disease risk in low fit but not high fit children (P < .001). CONCLUSIONS In preadolescent children, CRF and fatness explain different components of cardiometabolic disease risk. However, high CRF may moderate the relationship between fatness and cardiometabolic disease risk. TRIAL REGISTRATION ACTRN 12614000433606.
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Affiliation(s)
- Lee Stoner
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC.
| | - Herman Pontzer
- Department of Evolutionary Anthropology, Duke University, Durham, NC; Duke Global Health Institute, Duke University, Durham, NC
| | - Bethany Barone Gibbs
- Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, PA
| | - Justin B Moore
- Department of Family & Community Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Nicholas Castro
- School of Sport & Exercise, Massey University, Wellington, NZ; School of Kinesiology and Nutrition, University of Southern Mississippi, Hattiesburg, MS
| | - Paula Skidmore
- Department of Medicine, University of Otago, Christhcurch, NZ
| | - Sally Lark
- School of Sport & Exercise, Massey University, Wellington, NZ
| | - Michelle A Williams
- Depepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Michael J Hamlin
- Department of Tourism, Sport and Society, Lincoln University, Christchurch, NZ
| | - James Faulkner
- Sport & Exercise, University of Winchester, Winchester, United Kingdom
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Changes in the prevalence of overweight/obesity and adiposity among pre-school children in Kraków, Poland, from 2008 to 2018. J Biosoc Sci 2020; 52:895-906. [DOI: 10.1017/s0021932019000853] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractSocioeconomic changes occurring over time influence the lifestyle choices of a population, and these can significantly affect children’s body weight and composition. The aim of this study was to assess the changes in prevalence of overweight, obesity and adiposity in pre-school children in Poland between 2008 and 2018. Body height, body weight and subscapular and triceps skinfolds were measured in 2167 children aged 3–7 years from Kraków. Body mass index and adiposity (percentage body fat, %BF) were calculated for the children, who were then categorized as underweight, normal weight, overweight or obese according to Cole’s cut-off points. Adiposity was categorized according to the z-scores for %BF as low (<−1), normal (−1 to 1) or high (>1). Differences between cohorts were analysed using the chi-squared test. Only the decrease in the prevalence of obesity in 5-year-old girls was found to be statistically significant. However, some overall tendencies were noted. Decreases in the prevalence of underweight, overweight and obesity were observed for both sexes, as well as in the incidence of high adiposity in boys and low adiposity in girls. Increases in the prevalence of high adiposity in girls and low adiposity in boys were also noted. There was no significant change in the prevalence of overweight and obesity among pre-school children over the study decade, and the visible tendencies included decreases in the prevalence of excess body weight and adiposity as well as underweight and low body fat. Also, the visible trends in adiposity were mostly negative. Further studies should, however, also consider the levels of physical fitness and activity of children, as these have a crucial influence on the measured characteristics.
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Liu J, Wong MCM, Lo ECM. Validation of the Oral Health Impact on Daily Life Questionnaire (OHIDL) among Hong Kong older adults. Gerodontology 2019; 37:143-152. [PMID: 31347743 DOI: 10.1111/ger.12434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 05/21/2019] [Accepted: 06/27/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND The Oral Health Impact on Daily Life Questionnaire (OHIDL) was developed through a qualitative study to measure oral health-related quality of life, including intensity and bother measurements, among older adults in Hong Kong. The instrument comprises 20 items divided into eight domains. OBJECTIVES This study describes the psychometric properties of the OHIDL and refines the instrument through validity and reliability testing. MATERIALS AND METHODS The OHIDL was administered to older adults who attended dental clinics for general dental treatments. Items with low discriminant ability were to be eliminated. Construct validity was assessed through convergent, divergent and factorial validity. Criterion validity was investigated by assessing the correlation between the measurements and the global questions. Reliability was assessed with Cronbach's alpha. RESULTS In total, 306 participants (mean age: 69.6 years) completed the interviews. Two items for which over 90% of the participants reported no impact and two items with poor discriminant validity were eliminated. Both intensity and bother measurements demonstrated good construct and criterion validity, with the intensity measurement showing better performance being selected for the OHIDL to reduce the respondents' burden. The intensity measurement also showed satisfactory internal consistency. CONCLUSIONS The refined OHIDL with 16 items in seven domains is valid and reliable in measuring the oral health impacts on daily life among Hong Kong older adults.
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Affiliation(s)
- Jian Liu
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology, Beijing, China.,Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - May Chun Mei Wong
- Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Edward Chin Man Lo
- Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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Kryst Ł, Woronkowicz A, Kowal M, Sobiecki J. Intergenerational changes in limb circumferences in children and adolescents aged 3-18 from Kraków (Poland) from 1983 to 2010. Am J Hum Biol 2018; 30:e23165. [DOI: 10.1002/ajhb.23165] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Revised: 05/07/2018] [Accepted: 06/27/2018] [Indexed: 01/13/2023] Open
Affiliation(s)
- Łukasz Kryst
- Department of Anthropology, Faculty of Physical Education; University of Physical Education in Kraków; Poland
| | - Agnieszka Woronkowicz
- Department of Anthropology, Faculty of Physical Education; University of Physical Education in Kraków; Poland
| | - Małgorzata Kowal
- Department of Anthropology, Faculty of Physical Education; University of Physical Education in Kraków; Poland
| | - Jan Sobiecki
- Department of Anthropology, Faculty of Physical Education; University of Physical Education in Kraków; Poland
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Chen Y, Liang X, Zheng S, Wang Y, Lu W. Association of Body Fat Mass and Fat Distribution With the Incidence of Hypertension in a Population-Based Chinese Cohort: A 22-Year Follow-Up. J Am Heart Assoc 2018; 7:e007153. [PMID: 29745366 PMCID: PMC5907541 DOI: 10.1161/jaha.117.007153] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 12/08/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND There have been few studies on the association between the incidence of hypertension and the presence and distribution of body fat. The aim of this article was to evaluate this association. METHODS AND RESULTS Data were obtained from the China Health Nutrition Survey, a 22-year cohort study of 12 907 participants. Body mass index and triceps skinfold thickness were used as markers of body fat, whereas waist circumference (WC) was used as a marker of fat distribution. Cox regression was used to examine the association of body mass index, WC, and skinfold thickness with the incidence of hypertension. The interval between the baseline and hypertension diagnosis was the time variable, and hypertension was the end event. The mean age and proportion of men and women were 38.29 and 38.03 years and 45.63% and 54.37%, respectively. Compared with normal WC, abdominal obesity was associated with hypertension (P<0.001; crude hazard ratio, 2.11; 95% confidence interval, 1.89-2.37). Similarly, overweight (crude hazard ratio, 1.75; 95% confidence interval, 1.64-1.87) and obesity (crude hazard ratio, 3.19; 95% confidence interval, 2.80-3.63) were risk factors for hypertension (all P<0.001). When stratified by sex, the results confirmed that WC and body mass index predicted the development of hypertension in both men and women but not skinfold thickness in women. CONCLUSIONS Body mass index and WC were independent risk factors for hypertension, but skinfold thickness was a poor marker of body fat and could not be used to predict hypertension.
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Affiliation(s)
- Yongjie Chen
- Department of Epidemiology and Statistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xuan Liang
- Department of Epidemiology and Statistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Senshuang Zheng
- Department of Epidemiology and Statistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yuan Wang
- Department of Epidemiology and Statistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Wenli Lu
- Department of Epidemiology and Statistics, School of Public Health, Tianjin Medical University, Tianjin, China
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da Silva AC, de Sousa Tavares M, Penido MGMG. Prevalence of risk factors for cardiovascular and kidney disease in Brazilian healthy preschool children. World J Nephrol 2016; 5:507-516. [PMID: 27872832 PMCID: PMC5099596 DOI: 10.5527/wjn.v5.i6.507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 08/31/2016] [Accepted: 09/22/2016] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate the prevalence of nutritional parameters of risk for cardiovascular disease (CVD) and kidney diseases in healthy preschool children.
METHODS This is an observational cross-sectional study with 60 healthy children, of both genders, aged two to six years old and 56 mothers, in Belo Horizonte, Minas Gerais, Brazil. Preschool children and their families with regular activities at public schools were invited to paticipate in the study. The following characteristics were assessed: Socio-demographic condictions, clinical health, anthropometric, biochemical, lifestyle and data on food consumption. The 56 healthy children were divided into two groups, overweight (C1) and non-overweight (C2), as well as their mothers, respectively, in overweight (M1) and non-overweight (M2). Nutritional status was defined according to results obtained through the Anthro® Software for nutritional analysis.
RESULTS Thirty-five children were male, with mean age of 4.44 ± 1.0 years old. Eighty-nine percent of them were eutrophic, 86.7% were sedentary and they had five meals a day. Body mass index (BMI) for age and total cholesterol (TC) was higher on C1 (P = 0.0001) and high density lipoprotein cholesterol (HDL-c) was higher on C2. Mothers were 32.5 ± 7.1 years old, mostly married and employed. Eighty-six percent of them were sedentary and 62.5% were overweight with BMI = 26.38 ± 5.07 kg/m2. Eighteen percent of the overweight mothers had isolated total hypercholesterolemia (TC levels elevated) and 12.5% had low HDL-c levels. The present study showed an association between overweight and obesity during the preschool years and the correspondent mothers’ nutritional status of overweight and obesity (OR = 4.96; 95%CI: 0.558-44.17). There was a positive correlation between the food risk associated with CVD by children and mothers when their consumption was 4 times/wk (P = 0.049; r = 0.516) or daily (P = 0.000008; r = 0.892).
CONCLUSION Analyzed children showed high rates of physical inactivity, high serum cholesterol levels and high consumption of food associated with risk for CVD and renal disease. Changes in habits should be encouraged early in kindergarten.
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Ørntoft C, Fuller CW, Larsen MN, Bangsbo J, Dvorak J, Krustrup P. 'FIFA 11 for Health' for Europe. II: effect on health markers and physical fitness in Danish schoolchildren aged 10-12 years. Br J Sports Med 2016; 50:1394-1399. [PMID: 27130927 PMCID: PMC5136709 DOI: 10.1136/bjsports-2016-096124] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2016] [Indexed: 12/19/2022]
Abstract
Objectives To evaluate whether a modified ‘FIFA 11 for Health’ programme for non-communicable diseases had effects on body composition, blood pressure and physical fitness of Danish schoolchildren aged 10–12 years. Design A cluster-randomised controlled study with 7 intervention and 2 control schools. Participants 546 Danish 5th grade municipal schoolchildren allocated to an intervention group (IG; n=402: 11.1±0.4 (±SD) years, 150.1±7.0 cm, 41.3±8.4 kg) and a control group (CG; n=144: 11.0±0.5 years, 151.2±7.8 cm, 41.3±9.0 kg). Intervention As part of the physical education (PE) curriculum, IG carried out 2 weekly 45 min ‘FIFA 11 for Health’ sessions focusing on health issues, football skills and 3v3 games. CG continued regular school PE activities. Measurements of body composition, blood pressure at rest, Yo-Yo intermittent recovery level 1 children's test (YYIR1C), balance, jump and sprint performance were performed before and after the 11-week study period. Results During the 11-week study period, systolic blood pressure (−3.5 vs 0.9 mm Hg), mean arterial blood pressure (−1.9 vs 0.4 mm Hg), body mass index (−0.02 vs 0.13 kg/m2) and body fat percentage (−0.83% vs −0.04%) decreased more (p<0.05) in IG than in CG. Within-group improvements (p<0.05) were observed in IG for 20 m sprint (4.09±0.29 to 4.06±0.28 s) and YYIR1C performance (852±464 to 896±517 m), but these changes were not significantly different from CG, and balance or jump performance remained unchanged in both groups. Conclusions The modified ‘FIFA 11 for Health’ programme has beneficial effects on body composition and blood pressure for Danish schoolchildren aged 10–12 years, thereby providing evidence that this football-based health education programme can directly impact participants' cardiovascular health profile.
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Affiliation(s)
- Christina Ørntoft
- Department of Nutrition, Exercise and Sports, Copenhagen Centre for Team Sport and Health, University of Copenhagen, Copenhagen, Denmark
| | | | - Malte Nejst Larsen
- Department of Nutrition, Exercise and Sports, Copenhagen Centre for Team Sport and Health, University of Copenhagen, Copenhagen, Denmark
| | - Jens Bangsbo
- Department of Nutrition, Exercise and Sports, Copenhagen Centre for Team Sport and Health, University of Copenhagen, Copenhagen, Denmark
| | - Jiri Dvorak
- FIFA Medical Assessment and Research Centre, Zurich, Switzerland.,Schulthess Clinic, Zurich, Switzerland
| | - Peter Krustrup
- Department of Nutrition, Exercise and Sports, Copenhagen Centre for Team Sport and Health, University of Copenhagen, Copenhagen, Denmark.,Faculty of Life and Environmental Sciences, Sport and Health Sciences, University of Exeter, Exeter, UK
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Seabra A, Katzmarzyk P, Carvalho MJ, Seabra A, Coelho-E-Silva M, Abreu S, Vale S, Póvoas S, Nascimento H, Belo L, Torres S, Oliveira J, Mota J, Santos-Silva A, Rêgo C, Malina RM. Effects of 6-month soccer and traditional physical activity programmes on body composition, cardiometabolic risk factors, inflammatory, oxidative stress markers and cardiorespiratory fitness in obese boys. J Sports Sci 2016; 34:1822-9. [DOI: 10.1080/02640414.2016.1140219] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Singhammer J, Ried-Larsen M, Møller NC, Lund-Kristensen P, Froberg K, Andersen LB. Single parent status and children's objectively measured level of physical activity. SPORTS MEDICINE - OPEN 2015; 1:10. [PMID: 26284166 PMCID: PMC4532699 DOI: 10.1186/s40798-015-0020-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 05/04/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Single-parent family status has been investigated as a possible psychosocial determinant of children's level of physical activity (PA)-although with mixed and inconclusive results. Prevailing evidence of the importance of two-parent family status as a resource for children's PA is based on a mix of subjective and objective measurements of PA. Objectives: To investigate if the level of PA among children living with a single parent was lower compared to children living with two parents by means of a meta-analysis of published and unpublished studies. We restricted our analysis to studies with objective measurements of PA. METHODS Data sources: The databases, Social Science Citation Index, PsycINFO, PubMed, and EBSCO were searched (1987-2013). Study eligibility criteria: Observational studies comparing objectively measured PA between single-parent children and children from two-parent families. Study appraisal and synthesis methods: We used guidelines from the Cochrane Handbook of Systematic Reviews of Interventions and a modified version of the Newcastle-Ottawa Scale overall to assess the quality of the included studies. We refrained from calculation of summary scores. RESULTS Twelve studies met the following inclusion criteria of which six were unpublished: (a) child age (6-18 years) and (b) objectively measured level of PA. Meta-analysis revealed pooled estimates of -0.01 for boys (95 % CI -0.04-0.03, p = 0.77, I2 = 6.5 %, p = 0.38) and 0.01 for girls (95 % CI -0.03-0.04, p = 0.62, I2 = 21.0 %, p = 0.24), respectively. Estimates show no differences in objectively measured physical activity between children living in single-parent families compared to children living with two parents. Analyses investigating seven potential moderators did not yield any statistical significant effect size estimates. No evidence of heterogeneity between studies was observed. Limitations: Retrieved articles were assessed by several of the authors. Blinding of the authors was not feasible, as most of the authors have been involved in the studies. CONCLUSIONS No evidence was found suggesting that children of single-parent families are in special need of extraordinary measures to facilitate their level of PA.
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Affiliation(s)
- John Singhammer
- Department of Physiotherapy, VIA University College, Hedeager 2, DK8200 Aarhus, Denmark
| | - Mathias Ried-Larsen
- Institute of Sports Science and Clinical Biomechanics, Centre of Research in Childhood Health, University of Southern Denmark, Odense, Denmark
| | - Niels Christian Møller
- Institute of Sports Science and Clinical Biomechanics, Centre of Research in Childhood Health, University of Southern Denmark, Odense, Denmark
| | - Peter Lund-Kristensen
- Institute of Sports Science and Clinical Biomechanics, Centre of Research in Childhood Health, University of Southern Denmark, Odense, Denmark
| | - Karsten Froberg
- Institute of Sports Science and Clinical Biomechanics, Centre of Research in Childhood Health, University of Southern Denmark, Odense, Denmark
| | - Lars Bo Andersen
- Institute of Sports Science and Clinical Biomechanics, Centre of Research in Childhood Health, University of Southern Denmark, Odense, Denmark
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Abstract
BACKGROUND High adiposity is major risk factor for hypertension. Various anthropometric indices are used to assess excess fatness. OBJECTIVES (1) To examine relationship of body mass index (BMI), waist circumference (WC), waist to height ratio (WHtR), triceps skin fold thickness (TSFT) and wrist measurements with blood pressure in children and adolescents 2) to suggest age- and gender-specific cutoffs for these indices in Indian children. METHODS Cross-sectional school-based study on a random sample of 6380 children (6-18 yr old, 3501 boys) from five major cities in India. Height, weight, waist and wrist circumference, TSFT, and blood pressure were recorded. Children with systolic blood pressure (BP) and/or Diastolic BP >95th percentile were classified as hypertensive. RESULTS Prevalence of overweight and obesity was 23.5% and 9.7%, respectively. Hypertension was observed in 5.6%. Multiple logistic regression (adjustments: age, gender) indicated double risk of hypertension for overweight and 7 times higher odds for obese than normal-weight children. Children with TSFT >95th centile for US children showed three times risk and with TSFT from 85th to 95th double risk of hypertension. Higher WC and WHtR exhibited 1.5 times risk and larger Wrist 1.3 times higher risk of hypertension (P<0.001). Receiver operating curve (ROC) analysis provided age-gender specific cut offs for the five indices to detect the risk of high BP. Area under ROC curves (AUC) for five indices were similar and greater in older age groups indicating equal sensitivity and specificity. Conclusion: Using age- and gender-specific cutoffs for BMI, TSFT, WC or WHtR may offer putative markers for early detection of hypertension. CONCLUSION Using age- and gender-specific cutoffs for BMI, TSFT, WC or WHtR may offer putative markers for early detection of hypertension.
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Dalla Pozza R. Kardiovaskuläre Risikofaktoren im Kindes- und Jugendalter. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2013; 56:487-91. [DOI: 10.1007/s00103-012-1633-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Dobbins M, Husson H, DeCorby K, LaRocca RL. School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6 to 18. Cochrane Database Syst Rev 2013; 2013:CD007651. [PMID: 23450577 PMCID: PMC7197501 DOI: 10.1002/14651858.cd007651.pub2] [Citation(s) in RCA: 438] [Impact Index Per Article: 36.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND The World Health Organization (WHO) estimates that 1.9 million deaths worldwide are attributable to physical inactivity and at least 2.6 million deaths are a result of being overweight or obese. In addition, WHO estimates that physical inactivity causes 10% to 16% of cases each of breast cancer, colon, and rectal cancers as well as type 2 diabetes, and 22% of coronary heart disease and the burden of these and other chronic diseases has rapidly increased in recent decades. OBJECTIVES The purpose of this systematic review was to summarize the evidence of the effectiveness of school-based interventions in promoting physical activity and fitness in children and adolescents. SEARCH METHODS The search strategy included searching several databases to October 2011. In addition, reference lists of included articles and background papers were reviewed for potentially relevant studies, as well as references from relevant Cochrane reviews. Primary authors of included studies were contacted as needed for additional information. SELECTION CRITERIA To be included, the intervention had to be relevant to public health practice (focused on health promotion activities), not conducted by physicians, implemented, facilitated, or promoted by staff in local public health units, implemented in a school setting and aimed at increasing physical activity, included all school-attending children, and be implemented for a minimum of 12 weeks. In addition, the review was limited to randomized controlled trials and those that reported on outcomes for children and adolescents (aged 6 to 18 years). Primary outcomes included: rates of moderate to vigorous physical activity during the school day, time engaged in moderate to vigorous physical activity during the school day, and time spent watching television. Secondary outcomes related to physical health status measures including: systolic and diastolic blood pressure, blood cholesterol, body mass index (BMI), maximal oxygen uptake (VO2max), and pulse rate. DATA COLLECTION AND ANALYSIS Standardized tools were used by two independent reviewers to assess each study for relevance and for data extraction. In addition, each study was assessed for risk of bias as specified in the Cochrane Handbook for Systematic Reviews of Interventions. Where discrepancies existed, discussion occurred until consensus was reached. The results were summarized narratively due to wide variations in the populations, interventions evaluated, and outcomes measured. MAIN RESULTS In the original review, 13,841 records were identified and screened, 302 studies were assessed for eligibility, and 26 studies were included in the review. There was some evidence that school-based physical activity interventions had a positive impact on four of the nine outcome measures. Specifically positive effects were observed for duration of physical activity, television viewing, VO2 max, and blood cholesterol. Generally, school-based interventions had little effect on physical activity rates, systolic and diastolic blood pressure, BMI, and pulse rate. At a minimum, a combination of printed educational materials and changes to the school curriculum that promote physical activity resulted in positive effects.In this update, given the addition of three new inclusion criteria (randomized design, all school-attending children invited to participate, minimum 12-week intervention) 12 of the original 26 studies were excluded. In addition, studies published between July 2007 and October 2011 evaluating the effectiveness of school-based physical interventions were identified and if relevant included. In total an additional 2378 titles were screened of which 285 unique studies were deemed potentially relevant. Of those 30 met all relevance criteria and have been included in this update. This update includes 44 studies and represents complete data for 36,593 study participants. Duration of interventions ranged from 12 weeks to six years.Generally, the majority of studies included in this update, despite being randomized controlled trials, are, at a minimum, at moderate risk of bias. The results therefore must be interpreted with caution. Few changes in outcomes were observed in this update with the exception of blood cholesterol and physical activity rates. For example blood cholesterol was no longer positively impacted upon by school-based physical activity interventions. However, there was some evidence to suggest that school-based physical activity interventions led to an improvement in the proportion of children who engaged in moderate to vigorous physical activity during school hours (odds ratio (OR) 2.74, 95% confidence interval (CI), 2.01 to 3.75). Improvements in physical activity rates were not observed in the original review. Children and adolescents exposed to the intervention also spent more time engaged in moderate to vigorous physical activity (with results across studies ranging from five to 45 min more), spent less time watching television (results range from five to 60 min less per day), and had improved VO2max (results across studies ranged from 1.6 to 3.7 mL/kg per min). However, the overall conclusions of this update do not differ significantly from those reported in the original review. AUTHORS' CONCLUSIONS The evidence suggests the ongoing implementation of school-based physical activity interventions at this time, given the positive effects on behavior and one physical health status measure. However, given these studies are at a minimum of moderate risk of bias, and the magnitude of effect is generally small, these results should be interpreted cautiously. Additional research on the long-term impact of these interventions is needed.
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Friedemann C, Heneghan C, Mahtani K, Thompson M, Perera R, Ward AM. Cardiovascular disease risk in healthy children and its association with body mass index: systematic review and meta-analysis. BMJ 2012; 345:e4759. [PMID: 23015032 PMCID: PMC3458230 DOI: 10.1136/bmj.e4759] [Citation(s) in RCA: 427] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/22/2012] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To describe the association and its magnitude between body mass index category, sex, and cardiovascular disease risk parameters in school aged children in highly developed countries. DESIGN Systematic review and meta-analysis. Quality of included studies assessed by an adapted version of the Cochrane Collaboration's risk of bias assessment tool. Results of included studies in meta-analysis were pooled and analysed by Review Manager version 5.1. DATA SOURCES Embase, PubMed, EBSCOHost's cumulative index to nursing and allied health literature, and the Web of Science databases for papers published between January 2000 and December 2011. REVIEW METHODS Healthy children aged 5 to 15 in highly developed countries enrolled in studies done after 1990 and using prospective or retrospective cohort, cross sectional, case-control, or randomised clinical trial designs in school, outpatient, or community settings. Included studies had to report an objective measure of weight and at least one prespecified risk parameter for cardiovascular disease. RESULTS We included 63 studies of 49 220 children. Studies reported a worsening of risk parameters for cardiovascular disease in overweight and obese participants. Compared with normal weight children, systolic blood pressure was higher by 4.54 mm Hg (99% confidence interval 2.44 to 6.64; n=12 169, eight studies) in overweight children, and by 7.49 mm Hg (3.36 to 11.62; n=8074, 15 studies) in obese children. We found similar associations between groups in diastolic and 24 h ambulatory systolic blood pressure. Obesity adversely affected concentrations of all blood lipids; total cholesterol and triglycerides were 0.15 mmol/L (0.04 to 0.25, n=5072) and 0.26 mmol/L (0.13 to 0.39, n=5138) higher in obese children, respectively. Fasting insulin and insulin resistance were significantly higher in obese participants but not in overweight participants. Obese children had a significant increase in left ventricular mass of 19.12 g (12.66 to 25.59, n=223), compared with normal weight children. CONCLUSION Having a body mass index outside the normal range significantly worsens risk parameters for cardiovascular disease in school aged children. This effect, already substantial in overweight children, increases in obesity and could be larger than previously thought. There is a need to establish whether acceptable parameter cut-off levels not considering weight are a valid measure of risk in modern children and whether methods used in their study and reporting should be standardised.
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Affiliation(s)
- Claire Friedemann
- University of Oxford, Department of Primary Care Health Sciences, New Radcliffe House, Radcliffe Observatory Quarter, Oxford OX2 6GG, UK.
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Andersen LB, Bugge A, Dencker M, Eiberg S, El-Naaman B. The association between physical activity, physical fitness and development of metabolic disorders. ACTA ACUST UNITED AC 2011; 6 Suppl 1:29-34. [DOI: 10.3109/17477166.2011.606816] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Dencker M, Bugge A, Hermansen B, Froberg K, Andersen LB. Aerobic fitness in prepubertal children according to level of body fat. Acta Paediatr 2010; 99:1854-60. [PMID: 20670311 DOI: 10.1111/j.1651-2227.2010.01952.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM The purpose of this study was to investigate the relationship between maximum oxygen uptake (VO(2PEAK) ) and body fat in young children on a population-based level. METHODS Participants were 586 children (311 boys and 275 girls) aged 6.8±0.4 years, recruited from a population-based cohort. VO(2PEAK) was measured by indirect calorimetry during a maximal exercise test. Percent body fat (BF%) was estimated from skinfold measurements. RESULTS Significant relationships existed between BF% and absolute values of VO(2PEAK) (mL/min), VO(2PEAK) scaled by body weight (mL/min/kg) and VO(2PEAK) by allometric scaling (mL/min/kg(0.71) ), whereas no relationships were detected for VO(2PEAK) scaled to fat-free mass (FFM) (mL/min/FFM). Person correlation coefficients for boys were 0.26, -0.38, -0.19 and -0.01 NS and for girls 0.33, -0.42, -0.21 and -0.03 NS, respectively. Significant differences in VO(2PEAK) existed between different quartiles of BF%, with the exception when VO(2PEAK) was scaled to FFM. CONCLUSION Our findings document the coexistence of two known risk factors for disease at a young age on a population-base and confirms that VO(2PEAK) was scaled to FFM represents a body fat independent way of expressing fitness.
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Affiliation(s)
- Magnus Dencker
- Department of Clinical Physiology, Skåne University Hospital, Malmö, Sweden.
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Dencker M, Bugge A, Hermansen B, Andersen LB. Objectively measured daily physical activity related to aerobic fitness in young children. J Sports Sci 2009; 28:139-45. [DOI: 10.1080/02640410903460726] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Magnus Dencker
- a Department of Clinical Physiology , Malmö University Hospital , Malmö, Sweden
- b Institute of Sport Science and Clinical Biomechanics, University of Southern Denmark , Odense, Denmark
| | - Anna Bugge
- b Institute of Sport Science and Clinical Biomechanics, University of Southern Denmark , Odense, Denmark
| | - Bianca Hermansen
- b Institute of Sport Science and Clinical Biomechanics, University of Southern Denmark , Odense, Denmark
| | - Lars B. Andersen
- b Institute of Sport Science and Clinical Biomechanics, University of Southern Denmark , Odense, Denmark
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Dobbins M, DeCorby K, Robeson P, Husson H, Tirilis D. Cochrane review: School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6-18. ACTA ACUST UNITED AC 2009. [DOI: 10.1002/ebch.461] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Discigil G, Tekin N, Soylemez A. Obesity in Turkish children and adolescents: prevalence and non-nutritional correlates in an urban sample. Child Care Health Dev 2009; 35:153-8. [PMID: 19228152 DOI: 10.1111/j.1365-2214.2008.00919.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The aim of the present study was to identify the prevalence and non-nutritional correlates of childhood obesity in primary school children and adolescents living in a representative sample of an urban area in western Anatolia. METHODS The study was designed as a cross-sectional, population-based study. A representative sample of primary school children in Aydin was randomly selected according to age, gender and socio-economic status. Body mass index (BMI) was calculated after weight and height measurement. Centres for Disease Control 2000 growth charts for children and adolescents were used to identify BMI percentiles. Weight and height percentiles were obtained from charts of growth curves for Turkish children. RESULTS The age range of children was 6-16 years. A total of 924 children and 424 adolescents were screened for obesity. Overweight and obesity prevalence in primary school children living in Aydin was 12.2% and 3.7%, respectively. High socio-economic status was found to be associated with childhood obesity. There was no association between obesity and gender, adolescence, educational status of parents and occupation of father. CONCLUSION In the present study, we focused on some of the non-nutritional correlates of obesity in a representative population of an urban area in a developing country. Obesity prevalence rate in Turkish children living in Aydin was higher in children from a higher socio-economic group in contrast to reports from many developed countries.
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Affiliation(s)
- G Discigil
- Department of Family Medicine, Medical Faculty, Adnan Menderes University, Aydin, Turkey.
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Dobbins M, De Corby K, Robeson P, Husson H, Tirilis D. School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6-18. Cochrane Database Syst Rev 2009:CD007651. [PMID: 19160341 DOI: 10.1002/14651858.cd007651] [Citation(s) in RCA: 213] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The World Health Organization estimates that 1.9 million deaths worldwide are attributable to physical inactivity. Chronic diseases associated with physical inactivity include cancer, diabetes and coronary heart disease. OBJECTIVES The purpose of this systematic review is to summarize the evidence of the effectiveness of school-based interventions in promoting physical activity and fitness in children and adolescents. SEARCH STRATEGY The search strategy included searching several databases. In addition, reference lists of included articles and background papers were reviewed for potentially relevant studies, as well as references from relevant Cochrane reviews. Primary authors of included studies were contacted as needed for additional information. SELECTION CRITERIA To be included, the intervention had to be relevant to public health practice, implemented, facilitated, or promoted by staff in local public health units, implemented in a school setting and aimed at increasing physical activity, report on outcomes for children and adolescents (aged 6 to 18 years), and use a prospective design with a control group. DATA COLLECTION AND ANALYSIS Standardized tools were used by two independent reviewers to rate each study's methodological quality and for data extraction. Where discrepancies existed discussion occurred until consensus was reached. The results were summarized narratively due to wide variations in the populations, interventions evaluated and outcomes measured. MAIN RESULTS 13,841 titles were identified and screened and 482 articles were retrieved. Multiple publications on the same project were combined and counted as one project, resulting in 395 distinct project accounts (studies). Of the 395 studies 104 were deemed relevant and of those, four were assessed as having strong methodological quality, 22 were of moderate quality and 78 were considered weak. In total 26 studies were included in the review. There is good evidence that school-based physical activity interventions have a positive impact on four of the nine outcome measures. Specifically positive effects were observed for duration of physical activity, television viewing, VO2 max, and blood cholesterol. Generally school-based interventions had no effect on leisure time physical activity rates, systolic and diastolic blood pressure, body mass index, and pulse rate. At a minimum, a combination of printed educational materials and changes to the school curriculum that promote physical activity result in positive effects. AUTHORS' CONCLUSIONS Given that there are no harmful effects and that there is some evidence of positive effects on lifestyle behaviours and physical health status measures, ongoing physical activity promotion in schools is recommended at this time.
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Affiliation(s)
- Maureen Dobbins
- School of Nursing, McMaster University, Rm 3N25G, 1200 Main Street West, Hamilton, Ontario, Canada, L8N 3Z5.
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Abstract
AIM Since the mortality rate due to cardiovascular disease continues to increase, research into dyslipidemia has been emphasized in not only adults but also paediatric populations. We aimed to study the risk factors of dyslipidemia in Chinese children. METHODS Nine hundred and sixty-two children, aged 6-18 years, in Beijing were enrolled. For each child, data were collected on body height (cm), body weight (kg), sitting height (cm), waist circumference, upper arm circumference, serum lipid levels, as well as familial history of dyslipidemia and early onset cardiovascular disease. Subgroups were determined on the basis of age and sex. RESULTS The prevalence rate of dyslipidemia was 11.1% (107/962). Children with dyslipidemia differed significantly from those without, in sitting height, upper arm circumference, body mass index (BMI), waist-to-height ratio (WHR) and diastolic and systolic blood pressure (p < 0.05). Logistic regression analysis suggested that WHR, diastolic blood pressure and positive familial history were risk factors for dyslipidemia in children. CONCLUSION Sitting height, upper arm circumference, BMI, WHR, diastolic pressure and systolic pressure were significantly higher in dyslipidemic children than in normal subjects in China. BMI, WHR, diastolic pressure and familial history of dyslipidemia and early-onset cardiovascular disease were risk factors for dyslipidemia in Chinese children.
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Affiliation(s)
- Ying Liao
- Department of Pediatrics, Peking University First Hospital, Beijing 100034, People' Republic of China
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Lawlor DA, Cooper AR, Bain C, Davey Smith G, Irwin A, Riddoch C, Ness A. Associations of birth size and duration of breast feeding with cardiorespiratory fitness in childhood: findings from the Avon Longitudinal Study of Parents and Children (ALSPAC). Eur J Epidemiol 2008; 23:411-22. [PMID: 18470625 DOI: 10.1007/s10654-008-9259-x] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2007] [Accepted: 04/17/2008] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To explore the developmental origins of cardiorespiratory fitness. METHODS We examined the associations of birth size and duration of breast feeding with cardiorespiratory fitness assessed at the 9 year follow-up examination in 3612 participants of the Avon Longitudinal Study of Parents and Children (ALSPAC). We used physical work capacity at a heart rate of 170 beats per minute (PWC(170)) as our assessment of cardiorespiratory fitness. This was estimated using standard regression methods from parameters measured using an electronically braked cycle ergometer. RESULTS Birth weight, length and ponderal index were all positively associated with cardiorespiratory fitness in both sexes, with no strong evidence of a difference in effect between girls and boys. Work capacity increased by 1.12 W (95% CI: 0.83, 1.40) on average per 1 standard deviation (SD) greater birth weight. This association was not affected by adjustment for socioeconomic position and maternal smoking during pregnancy; there was some attenuation with adjustment for both maternal and paternal height and body mass index and more marked attenuation with adjustment for the child's height and body mass index. In the fully adjusted model work capacity increased by 0.51 W (95% CI: 0.21, 0.81) per SD birth weight. Whether an individual had been breastfed and duration of breastfeeding were not associated with cardiorespiratory fitness in any models. CONCLUSION Our results provide some support for a role of intrauterine factors in determining cardiorespiratory fitness in childhood.
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Affiliation(s)
- Debbie A Lawlor
- Department of Social Medicine, University of Bristol, Canynge Hall, Whiteladies Rd, Bristol, BS8 2PR, UK.
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Dencker M, Andersen LB. Health-related aspects of objectively measured daily physical activity in children. Clin Physiol Funct Imaging 2008; 28:133-44. [DOI: 10.1111/j.1475-097x.2008.00788.x] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Obesity markers and blood pressure in a sample of Portuguese children and adolescents. ACTA ACUST UNITED AC 2008; 15:73-7. [DOI: 10.1097/hjr.0b013e3282f0e344] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Wittmeier K, Mulder K. Enhancing lifestyle for individuals with haemophilia through physical activity and exercise: the role of physiotherapy. Haemophilia 2007; 13 Suppl 2:31-7. [PMID: 17685922 DOI: 10.1111/j.1365-2516.2007.01504.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
For individuals with haemophilia, the benefits of many forms of physical activity outweigh their risks. Although activities with significant trauma risk should be avoided, persons who have haemophilia can participate in, enjoy and even excel in a variety of physical activities and sports. Both the National Hemophilia Foundation and the World Foundation of Hemophilia have produced documents to guide individuals with haemophilia and their healthcare professionals, coaches and parents in developing physical activity programmes and participation in sports. Physical activity guidelines for promoting health benefits exist worldwide and can be incorporated into individualized exercise programmes to ensure that a person with haemophilia is not only choosing appropriate activities, but also improving overall health and preparing the body to manage haemophilia better. Physiotherapy treatment is paramount in helping individuals prevent, manage and optimally recover from bleeds. Furthermore, the physical therapist, along with the haemophilia care team, can assist in preparing an individual to begin or progress to a physical activity programme that enhances fitness level, body composition and overall well-being. This article presents the unique role of the physiotherapist in facilitating safe participation in quality physical activity in the context of risks, benefits and activity recommendations. Participation in physical activity from an early age is ideal to facilitate the development of body awareness and capability and to foster the adoption of a physically active lifestyle; however, it is never too late to start. Consistent participation in quality physical activity beginning at any age is central to managing haemophilia and, equally important, to achieving overall health and well-being.
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Affiliation(s)
- K Wittmeier
- Department of Physiology, University of Manitoba, Winnipeg, Canada.
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Ondrak KS, McMurray RG, Bangdiwala SI, Harrell JS. Influence of aerobic power and percent body fat on cardiovascular disease risk in youth. J Adolesc Health 2007; 41:146-52. [PMID: 17659218 DOI: 10.1016/j.jadohealth.2007.03.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2006] [Revised: 02/19/2007] [Accepted: 03/23/2007] [Indexed: 11/16/2022]
Abstract
PURPOSE To describe how the relationships between aerobic power or percent body fat and cardiovascular disease (CVD) risk differ by age. METHODS A sample of 1,824 young persons was divided into age groups (8-10, 11-13, and 14-16 years). Aerobic power (VO(2)max) was predicted using a submaximal cycle ergometer test, whereas percent body fat was assessed using the sum of skinfolds. Six CVD risk factors were measured: high-density lipoprotein cholesterol, total cholesterol, triglycerides, systolic and diastolic blood pressures, and fasting insulin. These risk factors were classified into risk categories (none, borderline, or at risk) and summed to determine a total CVD risk score. RESULTS The percentages of participants with elevated risk scores was low, despite the high mean percent body fat and low mean aerobic power. Correlations among the six risk variables and either body fat or aerobic power were strongest in the youngest participants. In the multiple regression models adjusted for gender and SES, percent body fat was a stronger predictor of CVD risk score than aerobic power. The variance in risk score attributed to fatness was greatest in the youngest participants and declined in older age groups. CONCLUSIONS Percent body fat had a greater influence on CVD risk than aerobic power. The relationship between body fat and total risk score was strongest in the youngest participants. Thus, interventions to improve CVD risk in youth should target body fat reduction beginning at an early age.
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Affiliation(s)
- Kristin S Ondrak
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina 27599-8700, USA
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Hussey J, Bell C, Bennett K, O'Dwyer J, Gormley J. Relationship between the intensity of physical activity, inactivity, cardiorespiratory fitness and body composition in 7-10-year-old Dublin children. Br J Sports Med 2007; 41:311-6. [PMID: 17395610 PMCID: PMC2659066 DOI: 10.1136/bjsm.2006.032045] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To investigate the relationships between the time spent in specific intensities of activity and inactivity, cardiorespiratory fitness and body composition in children. METHODS A cross-sectional study was conducted in a random sample of schools. Height, weight and waist circumference were measured in 224 children aged 7-10 years. Cardiorespiratory fitness was estimated by the 20 m multistage running test, and physical activity was measured over 4 days by the RT3 (a triaxial accelerometer). Time each day spent in moderate and vigorous intensities of activity was calculated. RESULTS Twelve schools agreed to participate in the study. Body composition and fitness data were obtained for 224 children and activity data for 152 children. Boys were found to take part in about twice as much vigorous and hard activity as girls (mean (95% confidence interval) 64.3 (53.2 to 75.4) min in boys compared with 37 (33.1 to 40.9) min in girls; p<0.001). In boys there was significant difference between those defined as normal, overweight and obese in the time spent in vigorous activity (p<0.05), but no such difference was found in girls. A significant negative correlation between waist circumference and time spent in vigorous activity (r = -0.31, p<0.05) was found in boys but not in girls. Time spent sedentary was positively correlated with waist circumference in boys (r = 0.33, p<0.01) but not in girls. In both boys and girls there were significant negative correlations between fitness and both body mass index (r = -0.274, p<0.001) and waist circumference (boys: r = -0.503, p<0.01; girls: r = -0.286, p<0.01). CONCLUSION In boys, body composition was inversely related to fitness and to vigorous activity and was positively related to inactivity. In girls, body composition was related to fitness but not to specific components of physical activity.
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Affiliation(s)
- J Hussey
- Trinity College, Dublin, Ireland.
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