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Hassan MA, Zhou W, Ye M, He H, Gao Z. The effectiveness of physical activity interventions on blood pressure in children and adolescents: A systematic review and network meta-analysis. JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:699-708. [PMID: 38244922 PMCID: PMC11282348 DOI: 10.1016/j.jshs.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 10/18/2023] [Accepted: 11/09/2023] [Indexed: 01/22/2024]
Abstract
BACKGROUND High blood pressure (BP) is a major contributor to mortality and cardiovascular diseases. Despite the known benefits of exercise for reducing BP, it is crucial to identify the most effective physical activity (PA) intervention. This systematic review and network meta-analysis (NMA) aimed to evaluate the available evidence on the effectiveness of various PA interventions for reducing BP and to determine their hierarchy based on their impact on BP. METHODS A search of PubMed, SPORTDiscus, PsycINFO, Web of Science, CINAHL, Cochrane, and Eric databases was conducted up to December 2022 for this systematic review and NMA. Randomized controlled trials and quasi-experimental studies targeting healthy children and adolescents aged 6-12 years old were included in this study. Only studies that compared controlled and intervention groups using PA or exercise as the major influence were included. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Three independent investigators performed the literature screening, data extraction, and risk of bias assessment. We used Bayesian arm-based NMA to synthesize the data. The primary outcomes were systolic BP and diastolic BP. We calculated the mean differences (MDs) in systolic BP and diastolic BP before and after treatment. Mean treatment differences were estimated using NMA and random-effect models. RESULTS We synthesized 27 studies involving 15,220 children and adolescents. PA combined with nutrition and behavior change was the most effective intervention for reducing both systolic BP and diastolic BP (MD = -8.64, 95% credible interval (95%CI):-11.44 to -5.84; MD = -6.75, 95%CI: -10.44 to -3.11), followed by interventions with multiple components (MD = -1.39, 95%CI: -1.94 to -0.84; MD = -2.54, 95%CI: -4.89 to -0.29). CONCLUSION Our findings suggest that PA interventions incorporating nutrition and behavior change, followed by interventions with multiple components, are most effective for reducing both systolic BP and diastolic BP in children and adolescents.
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Affiliation(s)
- Mohamed A Hassan
- School of Kinesiology, University of Minnesota-Twin Cities, Minneapolis, MN 55455, USA; Department of Methods and Curriculum, Physical Education College for Men, Helwan University, Cairo 12552, Egypt
| | - Wanjiang Zhou
- School of Kinesiology, University of Minnesota-Twin Cities, Minneapolis, MN 55455, USA
| | - Mingyi Ye
- China Institute of Sport and Health Science, Beijing Sport University, Beijing 100084, China
| | - Hui He
- China Institute of Sport and Health Science, Beijing Sport University, Beijing 100084, China
| | - Zan Gao
- Department of Kinesiology, Recreation, and Sport Studies, University of Tennessee, Knoxville, TN 37996, USA.
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Spiga F, Davies AL, Tomlinson E, Moore TH, Dawson S, Breheny K, Savović J, Gao Y, Phillips SM, Hillier-Brown F, Hodder RK, Wolfenden L, Higgins JP, Summerbell CD. Interventions to prevent obesity in children aged 5 to 11 years old. Cochrane Database Syst Rev 2024; 5:CD015328. [PMID: 38763517 PMCID: PMC11102828 DOI: 10.1002/14651858.cd015328.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/21/2024]
Abstract
BACKGROUND Prevention of obesity in children is an international public health priority given the prevalence of the condition (and its significant impact on health, development and well-being). Interventions that aim to prevent obesity involve behavioural change strategies that promote healthy eating or 'activity' levels (physical activity, sedentary behaviour and/or sleep) or both, and work by reducing energy intake and/or increasing energy expenditure, respectively. There is uncertainty over which approaches are more effective and numerous new studies have been published over the last five years, since the previous version of this Cochrane review. OBJECTIVES To assess the effects of interventions that aim to prevent obesity in children by modifying dietary intake or 'activity' levels, or a combination of both, on changes in BMI, zBMI score and serious adverse events. SEARCH METHODS We used standard, extensive Cochrane search methods. The latest search date was February 2023. SELECTION CRITERIA Randomised controlled trials in children (mean age 5 years and above but less than 12 years), comparing diet or 'activity' interventions (or both) to prevent obesity with no intervention, usual care, or with another eligible intervention, in any setting. Studies had to measure outcomes at a minimum of 12 weeks post baseline. We excluded interventions designed primarily to improve sporting performance. DATA COLLECTION AND ANALYSIS We used standard Cochrane methods. Our outcomes were body mass index (BMI), zBMI score and serious adverse events, assessed at short- (12 weeks to < 9 months from baseline), medium- (9 months to < 15 months) and long-term (≥ 15 months) follow-up. We used GRADE to assess the certainty of the evidence for each outcome. MAIN RESULTS This review includes 172 studies (189,707 participants); 149 studies (160,267 participants) were included in meta-analyses. One hundred forty-six studies were based in high-income countries. The main setting for intervention delivery was schools (111 studies), followed by the community (15 studies), the home (eight studies) and a clinical setting (seven studies); one intervention was conducted by telehealth and 31 studies were conducted in more than one setting. Eighty-six interventions were implemented for less than nine months; the shortest was conducted over one visit and the longest over four years. Non-industry funding was declared by 132 studies; 24 studies were funded in part or wholly by industry. Dietary interventions versus control Dietary interventions, compared with control, may have little to no effect on BMI at short-term follow-up (mean difference (MD) 0, 95% confidence interval (CI) -0.10 to 0.10; 5 studies, 2107 participants; low-certainty evidence) and at medium-term follow-up (MD -0.01, 95% CI -0.15 to 0.12; 9 studies, 6815 participants; low-certainty evidence) or zBMI at long-term follow-up (MD -0.05, 95% CI -0.10 to 0.01; 7 studies, 5285 participants; low-certainty evidence). Dietary interventions, compared with control, probably have little to no effect on BMI at long-term follow-up (MD -0.17, 95% CI -0.48 to 0.13; 2 studies, 945 participants; moderate-certainty evidence) and zBMI at short- or medium-term follow-up (MD -0.06, 95% CI -0.13 to 0.01; 8 studies, 3695 participants; MD -0.04, 95% CI -0.10 to 0.02; 9 studies, 7048 participants; moderate-certainty evidence). Five studies (1913 participants; very low-certainty evidence) reported data on serious adverse events: one reported serious adverse events (e.g. allergy, behavioural problems and abdominal discomfort) that may have occurred as a result of the intervention; four reported no effect. Activity interventions versus control Activity interventions, compared with control, may have little to no effect on BMI and zBMI at short-term or long-term follow-up (BMI short-term: MD -0.02, 95% CI -0.17 to 0.13; 14 studies, 4069 participants; zBMI short-term: MD -0.02, 95% CI -0.07 to 0.02; 6 studies, 3580 participants; low-certainty evidence; BMI long-term: MD -0.07, 95% CI -0.24 to 0.10; 8 studies, 8302 participants; zBMI long-term: MD -0.02, 95% CI -0.09 to 0.04; 6 studies, 6940 participants; low-certainty evidence). Activity interventions likely result in a slight reduction of BMI and zBMI at medium-term follow-up (BMI: MD -0.11, 95% CI -0.18 to -0.05; 16 studies, 21,286 participants; zBMI: MD -0.05, 95% CI -0.09 to -0.02; 13 studies, 20,600 participants; moderate-certainty evidence). Eleven studies (21,278 participants; low-certainty evidence) reported data on serious adverse events; one study reported two minor ankle sprains and one study reported the incident rate of adverse events (e.g. musculoskeletal injuries) that may have occurred as a result of the intervention; nine studies reported no effect. Dietary and activity interventions versus control Dietary and activity interventions, compared with control, may result in a slight reduction in BMI and zBMI at short-term follow-up (BMI: MD -0.11, 95% CI -0.21 to -0.01; 27 studies, 16,066 participants; zBMI: MD -0.03, 95% CI -0.06 to 0.00; 26 studies, 12,784 participants; low-certainty evidence) and likely result in a reduction of BMI and zBMI at medium-term follow-up (BMI: MD -0.11, 95% CI -0.21 to 0.00; 21 studies, 17,547 participants; zBMI: MD -0.05, 95% CI -0.07 to -0.02; 24 studies, 20,998 participants; moderate-certainty evidence). Dietary and activity interventions compared with control may result in little to no difference in BMI and zBMI at long-term follow-up (BMI: MD 0.03, 95% CI -0.11 to 0.16; 16 studies, 22,098 participants; zBMI: MD -0.02, 95% CI -0.06 to 0.01; 22 studies, 23,594 participants; low-certainty evidence). Nineteen studies (27,882 participants; low-certainty evidence) reported data on serious adverse events: four studies reported occurrence of serious adverse events (e.g. injuries, low levels of extreme dieting behaviour); 15 studies reported no effect. Heterogeneity was apparent in the results for all outcomes at the three follow-up times, which could not be explained by the main setting of the interventions (school, home, school and home, other), country income status (high-income versus non-high-income), participants' socioeconomic status (low versus mixed) and duration of the intervention. Most studies excluded children with a mental or physical disability. AUTHORS' CONCLUSIONS The body of evidence in this review demonstrates that a range of school-based 'activity' interventions, alone or in combination with dietary interventions, may have a modest beneficial effect on obesity in childhood at short- and medium-term, but not at long-term follow-up. Dietary interventions alone may result in little to no difference. Limited evidence of low quality was identified on the effect of dietary and/or activity interventions on severe adverse events and health inequalities; exploratory analyses of these data suggest no meaningful impact. We identified a dearth of evidence for home and community-based settings (e.g. delivered through local youth groups), for children living with disabilities and indicators of health inequities.
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Affiliation(s)
- Francesca Spiga
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Annabel L Davies
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Eve Tomlinson
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Theresa Hm Moore
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Sarah Dawson
- NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Katie Breheny
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jelena Savović
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Yang Gao
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon, Hong Kong
| | - Sophie M Phillips
- Department of Sport and Exercise Science, Durham University, Durham, UK
- Fuse - Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
- Child Health and Physical Activity Laboratory, School of Occupational Therapy, Western University, London, Ontario, Canada
| | - Frances Hillier-Brown
- Fuse - Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
- Human Nutrition Research Centre and Population Health Sciences Institute, University of Newcastle, Newcastle, UK
| | - Rebecca K Hodder
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton, Australia
- National Centre of Implementation Science, The University of Newcastle, Callaghan, Australia
| | - Luke Wolfenden
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, Australia
| | - Julian Pt Higgins
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
- NIHR Bristol Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - Carolyn D Summerbell
- Department of Sport and Exercise Science, Durham University, Durham, UK
- Fuse - Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
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van der Wurff I, Kirschner M, Golsteijn R, de Jonge M, Berendsen B, Singh A, Savelberg H, de Groot R. School-based physical activity interventions: which intervention characteristics are associated with participation and retention? A meta-analysis. Prev Med 2024; 182:107925. [PMID: 38437923 DOI: 10.1016/j.ypmed.2024.107925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 02/28/2024] [Accepted: 03/01/2024] [Indexed: 03/06/2024]
Abstract
OBJECTIVE Many school-based intervention studies are conducted to increase students' physical activity (PA). Recruitment and retention problems potentially impact the robustness of RCT findings. We conducted a meta-analysis to summarize recruitment and retention rates in long-term secondary school-based PA intervention studies and examined associated participant and intervention characteristics. METHODS Web of Science, Pubmed, Medline, and PsychInfo were searched until March 20th 2023. We included studies on secondary school-based PA interventions ≥12 weeks, aimed at typically developing adolescents. We abstracted number of schools and students invited, randomized, and participating at follow-up to calculate pooled recruitment and retention rates; participant and intervention characteristics were abstracted to execute subgroup or meta-regression analyses. RESULTS Recruitment rates were 51% for invited schools and 80% for invited students, the retention for schools was almost 100% and for students 91%. Interventions with fixed and flexible components, executed in Asia and South America, and from later publication years had higher student recruitment rates. Students' retention rates were lower for interventions which had flexible components, were theory/model-based, used an accelerometer, had a longer intervention duration, and included more females. CONCLUSION Recruitment and retention rates in school-based PA interventions are high. Some participant and intervention characteristics influence these rates: flexibility of the intervention, theory/model-based intervention, accelerometer use, intervention duration, continent, and number of females. Researchers should consider these characteristics in intervention development to achieve optimal balance between intervention effectiveness, recruitment, and retention.
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Affiliation(s)
- I van der Wurff
- Health Psychology, Faculty of Psychology, Open Univerity of the Netherlands, Heerlen 6419 AT, the Netherlands.
| | - M Kirschner
- Conditions for Lifelong Learning, Faculty of Educational Sciences, Open University of the Netherlands, Heerlen 6419 AT, the Netherlands
| | - R Golsteijn
- Health Psychology, Faculty of Psychology, Open Univerity of the Netherlands, Heerlen 6419 AT, the Netherlands
| | - M de Jonge
- (Former Employee of) Mulier Institute, Herculesplein 269, Utrecht 3584 AA, the Netherlands
| | - B Berendsen
- Department of Nutritional and Movement Sciences, NUTRIM, School of Nutrition and Translational Research in Metabolism, Maastricht University, P.O. Box 616, Maastricht 6200 MD, the Netherlands
| | - A Singh
- (Former Employee of) Mulier Institute, Herculesplein 269, Utrecht 3584 AA, the Netherlands; Human Movement. School and Sport, Applied University of Windesheim, Zwolle, the Netherlands
| | - H Savelberg
- Department of Nutritional and Movement Sciences, NUTRIM, School of Nutrition and Translational Research in Metabolism, Maastricht University, P.O. Box 616, Maastricht 6200 MD, the Netherlands; SHE, School of Health Professions Education, Maastricht University, P.O. Box 616, 6200 MD Maastricht, the Netherlands
| | - R de Groot
- Conditions for Lifelong Learning, Faculty of Educational Sciences, Open University of the Netherlands, Heerlen 6419 AT, the Netherlands
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Kemi OJ, Hoydal MA, Haram PM, Smith GL, Ellingsen O, Koch LG, Britton SL, Wisloff U. Inherited physical capacity: Widening divergence from young to adult to old. Ann N Y Acad Sci 2024; 1534:145-155. [PMID: 38520387 DOI: 10.1111/nyas.15130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2024]
Abstract
Cardiorespiratory performance segregates into rat strains of inherited low- and high-capacity runners (LCRs and HCRs); during adulthood, this segregation remains stable, but widens in senescence and is followed by segregated function, health, and mortality. However, this segregation has not been investigated prior to adulthood. We, therefore, assessed cardiorespiratory performance and cardiac cell (cardiomyocyte) structure-function in 1- and 4-month-old LCRs and HCRs. Maximal oxygen uptake was 23% less in LCRs at 1-month compared to HCRs at 1-month, and 72% less at 4 months. Cardiomyocyte contractility was 37-56% decreased, and Ca2+ release was 34-62% decreased, in 1- and 4-month LCRs versus HCRs. This occurred because HCRs had improved contractility and Ca2+ release during maturation, whereas LCRs did not. In quiescent cardiomyocytes, LCRs displayed 180% and 297% more Ca2+ sparks and 91% and 38% more Ca2+ waves at 1 and 4 months versus HCRs. Cell sizes were not different between LCRs and HCRs, but LCRs showed reduced transverse-tubules versus HCRs, though no discrepant transverse-tubule generation occurred during maturation. In conclusion, LCRs show reduced scores for aerobic capacity and cardiomyocyte structure-function compared to HCRs and there is a widening divergence between LCRs and HCRs during juvenile to near-adult maturation.
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Affiliation(s)
- Ole J Kemi
- School of Cardiovascular and Metabolic Health, University of Glasgow College of Medical, Veterinary and Life Sciences, Glasgow, UK
| | - Morten A Hoydal
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Faculty of Medicine and Health Sciences, Trondheim, Norway
| | - Per M Haram
- Department of Cardiothoracic Surgery, St Olav's Hospital, Trondheim, Norway
| | - Godfrey L Smith
- School of Cardiovascular and Metabolic Health, University of Glasgow College of Medical, Veterinary and Life Sciences, Glasgow, UK
| | - Oyvind Ellingsen
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Faculty of Medicine and Health Sciences, Trondheim, Norway
- Department of Cardiology, St Olav's Hospital, Trondheim, Norway
| | - Lauren G Koch
- Department of Physiology and Pharmacology, University of Toledo, Toledo, Ohio, USA
| | - Steven L Britton
- Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, Michigan, USA
- Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Ulrik Wisloff
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Faculty of Medicine and Health Sciences, Trondheim, Norway
- School of Human Movement and Nutrition Science, University of Queensland, Saint Lucia, Queensland, Australia
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Wu J, Yang Y, Yu H, Li L, Chen Y, Sun Y. Comparative effectiveness of school-based exercise interventions on physical fitness in children and adolescents: a systematic review and network meta-analysis. Front Public Health 2023; 11:1194779. [PMID: 37342273 PMCID: PMC10278967 DOI: 10.3389/fpubh.2023.1194779] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 05/18/2023] [Indexed: 06/22/2023] Open
Abstract
Background Schools provide a favorable setting for health education, however, the most effective school-based exercise mode for improving physical fitness remains unclear. This network meta-analysis was designed to assess and rank the comparative efficacy of six exercise modalities on physical fitness indicators in a school-based setting. Methods An online search of the Web of Science, PubMed, SPORTDiscus, and Scopus databases was conducted. Randomized and quasi-randomized controlled trials were considered. Outcomes included measures of anthropometry and body composition, muscular fitness, and cardiorespiratory fitness. Data were pooled with a random effects model using the frequentist framework. Results A total of 66 studies with 8,578 participants (48% girls) were included. High-intensity interval training was the most effective intervention reducing body mass index (mean difference (MD) = -0.60 kg·m-2, 95% confidence interval (95%CI) = -1.04 to -0.15, p = 0.009), elevating VO2max (MD = 3.59 mL·kg-1·min-1, 95% CI = 2.45 to 4.74, p < 0.001), and 20-meter sprint performance (MD = -0.35 s, 95% CI = -0.55 to -0.14, p = 0.001). Aerobic training had the highest probability of reducing waist circumference (standardized mean difference (SMD) = -0.60, 95% CI = -0.88 to -0.32, p < 0.001). Active video games emerged as a promising modality for improving countermovement jump (MD = 2.43 cm, 95% CI = 0.06 to 4.80, p = 0.041) and shuttle running performance (SMD = 0.86, 95% CI = 0.29 to 1.43, p = 0.003). Strength training was the best exercise mode for improving standing long jump performance (SMD = 1.03, 95% CI = 0.07 to 1.98, p = 0.035) while combined training was rated the first for decreasing body fat percent (MD = -2.56%, 95% CI = -4.73 to -0.40, p = 0.022) and increasing push-up repetitions (SMD = 3.59, 95% CI = 0.81 to 6.37, p = 0.012). Conclusion School-based exercise interventions have multiple effects on physical fitness. The findings of this study will help to inform physical education teachers and coaches how best to deliver exercise programs in a school setting. Since the study was limited by the original research, the conclusions will require further verification using high-quality randomized controlled trials. Systematic Review Registration PROSPERO, Identifier: CRD42023401963.
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Affiliation(s)
- Jin Wu
- College of Physical Education and Health, East China Normal University, Shanghai, China
| | - Yuhang Yang
- College of Physical Education and Health, East China Normal University, Shanghai, China
| | - Huasen Yu
- College of Physical Education and Health, East China Normal University, Shanghai, China
| | - Liqiang Li
- College of Physical Education and Health, East China Normal University, Shanghai, China
| | - Yanying Chen
- Business School, NingboTech University, Ningbo, China
| | - Youping Sun
- College of Physical Education and Health, East China Normal University, Shanghai, China
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Does a Physical Activity Intervention on Classroom-Based Ergometers During Teaching Lessons Effect Physical Fitness, Body Composition, and Health-Related Blood Parameters? A Pilot Cluster Randomized Controlled Study. J Phys Act Health 2022; 19:490-499. [PMID: 35894983 DOI: 10.1123/jpah.2021-0790] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 05/20/2022] [Accepted: 05/27/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Time constraints comprise one limiting factor for implementing school-based physical activity programs. The aim of this pilot cluster randomized controlled study was to explore the effects of a cycle ergometer intervention during regular lessons on physical fitness, body composition, and health-related blood parameters. METHODS Participants attended one of 2 classes selected from one school, which were randomly assigned to an intervention group (n = 23, 11.2 [0.5] y) consisting of cycling on classroom-based ergometers during 3 lessons per week at a self-selected intensity and a control group (n = 21, 11.3 [0.5] y) not receiving any treatment. Prior to and after the 5-month intervention period, physical fitness (with ventilatory threshold as primary outcome), body composition, and parameters of glucose and lipid metabolism were assessed. RESULTS A significant time × group interaction was revealed for ventilatory threshold (P = .035), respiratory compensation point (P = .038), gross efficiency (P < .001), maximal aerobic power (P = .024), triglycerides (P = .041), and blood glucose levels (P = .041) with benefits for the intervention group. Peak oxygen uptake and body composition were not affected. CONCLUSIONS Children's aerobic capacity benefited from the low-intensity school-based cycling intervention, while body composition and most blood parameters were not affected. The intervention using cycle ergometers is a feasible and time-saving strategy to elevate submaximal physical fitness.
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Cesa CC, Molino GOG, Lima J, Pereira RB, Eibel B, Barbiero SM, Schaan BD, Pellanda LC. Physical Activity and Cardiovascular Risk Factors in Children: a Meta-Analysis Update. INTERNATIONAL JOURNAL OF CARDIOVASCULAR SCIENCES 2021. [DOI: 10.36660/ijcs.20210137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Garritson JD, Boudina S. The Effects of Exercise on White and Brown Adipose Tissue Cellularity, Metabolic Activity and Remodeling. Front Physiol 2021; 12:772894. [PMID: 34795599 PMCID: PMC8593176 DOI: 10.3389/fphys.2021.772894] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 10/12/2021] [Indexed: 12/15/2022] Open
Abstract
Emerging evidence suggests a significant functional role of adipose tissue in maintaining whole-body metabolic health. It is well established that obesity leads to compositional and morphological changes in adipose tissue that can contribute to the development of cardiometabolic disorders. Thus, the function and size of adipocytes as well as perfusion and inflammation can significantly impact health outcomes independent of body mass index. Lifestyle interventions such as exercise can improve metabolic homeostasis and reduce the risk for developing cardiometabolic disorders. Adipose tissue displays remarkable plasticity in response to external stimuli such as dietary intervention and exercise. Here we review systemic and local effects of exercise that modulate white and brown adipose tissue cellularity, metabolic function and remodeling in humans and animals.
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Affiliation(s)
- Jacob D Garritson
- Department of Nutrition and Integrative Physiology, College of Health, University of Utah, Salt Lake City, UT, United States
| | - Sihem Boudina
- Department of Nutrition and Integrative Physiology, College of Health, University of Utah, Salt Lake City, UT, United States
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Neil-Sztramko SE, Caldwell H, Dobbins M. School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6 to 18. Cochrane Database Syst Rev 2021; 9:CD007651. [PMID: 34555181 PMCID: PMC8459921 DOI: 10.1002/14651858.cd007651.pub3] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Physical activity among children and adolescents is associated with lower adiposity, improved cardio-metabolic health, and improved fitness. Worldwide, fewer than 30% of children and adolescents meet global physical activity recommendations of at least 60 minutes of moderate to vigorous physical activity per day. Schools may be ideal sites for interventions given that children and adolescents in most parts of the world spend a substantial amount of time in transit to and from school or attending school. OBJECTIVES The purpose of this review update is to summarise the evidence on effectiveness of school-based interventions in increasing moderate to vigorous physical activity and improving fitness among children and adolescents 6 to 18 years of age. Specific objectives are: • to evaluate the effects of school-based interventions on increasing physical activity and improving fitness among children and adolescents; • to evaluate the effects of school-based interventions on improving body composition; and • to determine whether certain combinations or components (or both) of school-based interventions are more effective than others in promoting physical activity and fitness in this target population. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, BIOSIS, SPORTDiscus, and Sociological Abstracts to 1 June 2020, without language restrictions. We screened reference lists of included articles and relevant systematic reviews. We contacted primary authors of studies to ask for additional information. SELECTION CRITERIA Eligible interventions were relevant to public health practice (i.e. were not delivered by a clinician), were implemented in the school setting, and aimed to increase physical activity among all school-attending children and adolescents (aged 6 to 18) for at least 12 weeks. The review was limited to randomised controlled trials. For this update, we have added two new criteria: the primary aim of the study was to increase physical activity or fitness, and the study used an objective measure of physical activity or fitness. Primary outcomes included proportion of participants meeting physical activity guidelines and duration of moderate to vigorous physical activity and sedentary time (new to this update). Secondary outcomes included measured body mass index (BMI), physical fitness, health-related quality of life (new to this update), and adverse events (new to this update). Television viewing time, blood cholesterol, and blood pressure have been removed from this update. DATA COLLECTION AND ANALYSIS: Two independent review authors used standardised forms to assess each study for relevance, to extract data, and to assess risk of bias. When discrepancies existed, discussion occurred until consensus was reached. Certainty of evidence was assessed according to GRADE. A random-effects meta-analysis based on the inverse variance method was conducted with participants stratified by age (children versus adolescents) when sufficient data were reported. Subgroup analyses explored effects by intervention type. MAIN RESULTS Based on the three new inclusion criteria, we excluded 16 of the 44 studies included in the previous version of this review. We screened an additional 9968 titles (search October 2011 to June 2020), of which 978 unique studies were potentially relevant and 61 met all criteria for this update. We included a total of 89 studies representing complete data for 66,752 study participants. Most studies included children only (n = 56), followed by adolescents only (n = 22), and both (n = 10); one study did not report student age. Multi-component interventions were most common (n = 40), followed by schooltime physical activity (n = 19), enhanced physical education (n = 15), and before and after school programmes (n = 14); one study explored both enhanced physical education and an after school programme. Lack of blinding of participants, personnel, and outcome assessors and loss to follow-up were the most common sources of bias. Results show that school-based physical activity interventions probably result in little to no increase in time engaged in moderate to vigorous physical activity (mean difference (MD) 0.73 minutes/d, 95% confidence interval (CI) 0.16 to 1.30; 33 studies; moderate-certainty evidence) and may lead to little to no decrease in sedentary time (MD -3.78 minutes/d, 95% CI -7.80 to 0.24; 16 studies; low-certainty evidence). School-based physical activity interventions may improve physical fitness reported as maximal oxygen uptake (VO₂max) (MD 1.19 mL/kg/min, 95% CI 0.57 to 1.82; 13 studies; low-certainty evidence). School-based physical activity interventions may result in a very small decrease in BMI z-scores (MD -0.06, 95% CI -0.09 to -0.02; 21 studies; low-certainty evidence) and may not impact BMI expressed as kg/m² (MD -0.07, 95% CI -0.15 to 0.01; 50 studies; low-certainty evidence). We are very uncertain whether school-based physical activity interventions impact health-related quality of life or adverse events. AUTHORS' CONCLUSIONS Given the variability of results and the overall small effects, school staff and public health professionals must give the matter considerable thought before implementing school-based physical activity interventions. Given the heterogeneity of effects, the risk of bias, and findings that the magnitude of effect is generally small, results should be interpreted cautiously.
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Affiliation(s)
| | - Hilary Caldwell
- Department of Kinesiology, Child Health & Exercise Medicine Program, McMaster University, Hamilton, Canada
| | - Maureen Dobbins
- School of Nursing, McMaster University, Hamilton, Canada
- National Collaborating Centre for Methods and Tools, Hamilton, Canada
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10
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Truong K, Park S, Tsiros MD, Milne N. Physiotherapy and related management for childhood obesity: A systematic scoping review. PLoS One 2021; 16:e0252572. [PMID: 34125850 PMCID: PMC8202913 DOI: 10.1371/journal.pone.0252572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 05/18/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Despite targeted efforts globally to address childhood overweight/obesity, it remains poorly understood and challenging to manage. Physiotherapists have the potential to manage children with obesity as they are experts in movement and physical activity. However, their role remains unclear due to a lack of physiotherapy-specific guidelines. This scoping review aims to explore existing literature, critically appraising and synthesising findings to guide physiotherapists in the evidence-based management of childhood overweight/obesity. METHOD A scoping review was conducted, including literature up to May 2020. A review protocol exists on Open Science Framework at https://osf.io/fap8g/. Four databases were accessed including PubMed, Embase, CINAHL, Medline via OVID, with grey literature searched through google via "file:pdf". A descriptive synthesis was undertaken to explore the impact of existing interventions and their efficacy. RESULTS From the initial capture of 1871 articles, 263 intervention-based articles were included. Interventions included qualitative focused physical activity, quantitative focused physical activity and multicomponent interventions. Various outcome measures were utilised including health-, performance- and behaviour-related outcomes. The general trend for physiotherapy involvement with children who are obese appears to favour: 1) multicomponent interventions, implementing more than one component with environmental modification and parental involvement and 2) quantitative physical activity interventions, focusing on the quantity of bodily movement. These approaches most consistently demonstrated desirable changes across behavioural and health-related outcome measures for multicomponent and quantitative physical activity interventions respectively. CONCLUSION When managing children with obesity, physiotherapists should consider multicomponent approaches and increasing the quantity of physical activity, given consistent improvements in various obesity-related outcomes. Such approaches are well suited to the scope of physiotherapists and their expertise in physical activity prescription for the management of childhood obesity. Future research should examine the effect of motor skill interventions and consider the role of environmental modification/parental involvement as factors contributing to intervention success.
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Affiliation(s)
- Kim Truong
- Faculty of Health Sciences and Medicine, Bond Institute of Health and Sport, Bond University, Gold Coast, Queensland, Australia
| | - Sandra Park
- Faculty of Health Sciences and Medicine, Bond Institute of Health and Sport, Bond University, Gold Coast, Queensland, Australia
| | - Margarita D. Tsiros
- UniSA Allied Health and Human Performance, Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, South Australia, Australia
| | - Nikki Milne
- Faculty of Health Sciences and Medicine, Bond Institute of Health and Sport, Bond University, Gold Coast, Queensland, Australia
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11
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Zhang B, Li D, Liu G, Tan W, Zhang G, Liao J. Impaired activity of circulating EPCs and endothelial function are associated with increased Syntax score in patients with coronary artery disease. Mol Med Rep 2021; 23:321. [PMID: 33760184 PMCID: PMC7974324 DOI: 10.3892/mmr.2021.11960] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 02/10/2021] [Indexed: 12/13/2022] Open
Abstract
It has previously been shown that the number of endothelial progenitor cells (EPCs) is negatively correlated with Syntax score in patients with coronary artery disease (CAD). However, the association between alterations in EPC function and Syntax score is still unknown. The present study evaluated the association between the activity of EPCs as well as endothelial function and Syntax score in patients with CAD and investigated the underlying mechanisms. A total of 60 patients with CAD were enrolled in 3 groups according to Syntax score, and 20 healthy subjects were recruited as the control group. The number and migratory, proliferative and adhesive activities of circulating EPCs were studied. The endothelial function was measured by flow-mediated dilatation (FMD) and the levels of nitric oxide (NO) in plasma or secreted by EPCs were detected. The number and activity of circulating EPCs were lower in patients with a high Syntax score, which was similar to the alteration in FMD. The level of NO in plasma or secreted by EPCs also decreased as Syntax score increased. There was a negative association between FMD or circulating EPCs and Syntax score. A similar association was observed between the levels of NO in plasma or secreted by EPCs and Syntax score. Patients with CAD who had a higher Syntax score exhibited lower EPC numbers or activity and weaker endothelial function, which may be associated with attenuated NO production. These findings provide novel surrogate parameters for evaluation of the severity and complexity of CAD.
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Affiliation(s)
- Bin Zhang
- Department of Cardiovascular Disease, Jiangmen Central Hospital, Affiliated Jiangmen Hospital of Sun Yat‑Sen University, Jiangmen, Guangdong 529030, P.R. China
| | - Dong Li
- Clinical Experimental Center, Jiangmen Central Hospital, Affiliated Jiangmen Hospital of Sun Yat‑Sen University, Jiangmen, Guangdong 529030, P.R. China
| | - Gexiu Liu
- Institute of Hematology, Medical College, Jinan University, Guangzhou, Guangdong 510632, P.R. China
| | - Wenfeng Tan
- Department of Cardiovascular Disease, Jiangmen Central Hospital, Affiliated Jiangmen Hospital of Sun Yat‑Sen University, Jiangmen, Guangdong 529030, P.R. China
| | - Gaoxing Zhang
- Department of Cardiovascular Disease, Jiangmen Central Hospital, Affiliated Jiangmen Hospital of Sun Yat‑Sen University, Jiangmen, Guangdong 529030, P.R. China
| | - Jinli Liao
- Division of Emergency Medicine, Department of General Internal Medicine, Department of Emergency Intensive Care Unit, The First Affiliated Hospital, Sun Yat‑Sen University, Guangzhou, Guangdong 510080, P.R. China
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12
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Dabravolskaj J, Montemurro G, Ekwaru JP, Wu XY, Storey K, Campbell S, Veugelers PJ, Ohinmaa A. Effectiveness of school-based health promotion interventions prioritized by stakeholders from health and education sectors: A systematic review and meta-analysis. Prev Med Rep 2020; 19:101138. [PMID: 32612906 PMCID: PMC7322344 DOI: 10.1016/j.pmedr.2020.101138] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 05/15/2020] [Accepted: 05/23/2020] [Indexed: 01/28/2023] Open
Abstract
Childhood obesity and associated modifiable risk factors exert significant burden on the health care system. The goal of this systematic review and meta-analysis was to examine the effectiveness of school-based intervention types perceived by Canadian stakeholders in health and education as feasible, acceptable and sustainable in terms of improving physical activity (PA), fruit and vegetable intake, and body weight. We searched multiple databases for studies that evaluated school-based interventions to prevent obesity and associated risk factors (i.e., unhealthy diet, physical inactivity, sedentary behaviour) in children aged 4–18 years from January 1, 2012 to January 28, 2020. From 10,871 identified records, we included 83 and 80 studies in our systematic review and meta-analysis, respectively. Comprehensive School Health (CSH) and interventions which focused on modifications to school nutrition policies showed statistically significant positive effects on fruit intake of 0.13 (95% CI: 0.04, 0.23) and 0.30 (95% CI: 0.1, 0.51) servings per day, respectively. No intervention types showed statistically significant effect on vegetable intake. CSH, modifications to physical education (PE) curriculum, and multicomponent interventions showed statistically significant difference in BMI of −0.26 (95% CI: −0.40, −0.12), −0.16 (95% CI: −0.3, −0.02), and −0.18 (95% CI: −0.29, −0.07), respectively. CSH interventions showed positive effect on step-count per day, but no other types of interventions showed significant effect on any of PA outcome measures. Thus, the results of this systematic review and meta-analysis suggest that decision-makers should carefully consider CSH, multicomponent interventions, modifications to PE curricula and school nutrition policies to prevent childhood obesity.
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Key Words
- BMI, body mass index
- CI, confidence interval
- CSH, Comprehensive School Health
- Childhood obesity prevention
- FV, fruit and vegetable
- HSAT, Healthy School Action Tools
- Health promotion
- MVPA, moderate to vigorous physical activity
- Meta-analysis
- PA, physical activity
- PE, physical education
- PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses
- RCT, randomized controlled trial
- SES, socioeconomic status
- School-based interventions
- Systematic review
- UK, United Kingdom
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Affiliation(s)
| | | | - John Paul Ekwaru
- School of Public Health, University of Alberta, Edmonton, Canada
| | - Xiu Yun Wu
- School of Public Health, University of Alberta, Edmonton, Canada
| | - Kate Storey
- School of Public Health, University of Alberta, Edmonton, Canada
| | - Sandra Campbell
- John W. Scott Health Sciences Library, University of Alberta, Edmonton, Canada
| | - Paul J Veugelers
- School of Public Health, University of Alberta, Edmonton, Canada
| | - Arto Ohinmaa
- School of Public Health, University of Alberta, Edmonton, Canada
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13
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Play as a Method to Reduce Overweight and Obesity in Children: An RCT. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17010346. [PMID: 31947884 PMCID: PMC6981949 DOI: 10.3390/ijerph17010346] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 12/24/2019] [Accepted: 12/25/2019] [Indexed: 01/31/2023]
Abstract
Background: Overweight and obesity are the result of a complex interaction between genetic and environmental factors, which begins prenatally. Aim: To analyse an intervention based on play as a means of improving the body composition of children who are overweight or obese. Methods: The Kids-Play study is a randomized clinical trial (RCT) consisting of 49 children aged 8–12 years on a nine-month intervention programme based on physical activity, play and nutritional advice. Controls had another 49 children, who received only nutritional advice. Results: The play-based intervention achieved a moderate-vigorous level of physical activity in the study group of 81.18 min per day, while the corresponding level for the control group was only 37.34 min. At the start of the intervention, the children in the study group had an average body fat content of 41.66%, a level that decreased to 38.85% by the end of the programme. Among the control group, body fat increased from 38.83% to 41.4% during the same period. Conclusions: The intervention programme considered, based on both play and nutritional recommendations, produced a decrease in body fat among children aged 8–12 years. However, the control group, which received only nutritional recommendations, experienced an increase in body weight.
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14
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Henriques M, Fernandes R, Gonçalves AC, Ribeiro IP, Santos R, Fardilha M, Ferreira R, Ribeiro F. High-intensity, high-volume exercise in addition to school exercise classes reduces endothelial progenitor cells, inflammation and catabolism in adolescent boys. Eur J Prev Cardiol 2019; 27:2255-2258. [PMID: 31648554 DOI: 10.1177/2047487319884793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Magda Henriques
- Department of Medical Sciences, University of Aveiro, Portugal.,Institute of Biomedicine - iBiMED, University of Aveiro, Portugal
| | - Raquel Fernandes
- Department of Medical Sciences, University of Aveiro, Portugal.,Institute of Biomedicine - iBiMED, University of Aveiro, Portugal
| | - Ana Cristina Gonçalves
- Cytogenetics and Genomics Laboratory, iCBR-CIMAGO - Center of Investigation on Environment Genetics and Oncobiology - Faculty of Medicine, University of Coimbra, Portugal
| | - Ilda Patrícia Ribeiro
- Cytogenetics and Genomics Laboratory, iCBR-CIMAGO - Center of Investigation on Environment Genetics and Oncobiology - Faculty of Medicine, University of Coimbra, Portugal
| | | | - Margarida Fardilha
- Department of Medical Sciences, University of Aveiro, Portugal.,Institute of Biomedicine - iBiMED, University of Aveiro, Portugal
| | - Rita Ferreira
- QOPNA & LAQV, Department of Chemistry, University of Aveiro, Portugal
| | - Fernando Ribeiro
- Institute of Biomedicine - iBiMED, University of Aveiro, Portugal.,School of Health Sciences, University of Aveiro, Portugal
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15
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Hansen SL, Lorentzen J, Pedersen LT, Hendrich FL, Jorsal M, Pingel J, Nielsen JB, Kiens B. Suboptimal Nutrition and Low Physical Activity Are Observed Together with Reduced Plasma Brain-Derived Neurotrophic Factor (BDNF) Concentration in Children with Severe Cerebral Palsy (CP). Nutrients 2019; 11:E620. [PMID: 30875771 PMCID: PMC6470501 DOI: 10.3390/nu11030620] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 02/28/2019] [Accepted: 03/08/2019] [Indexed: 01/08/2023] Open
Abstract
Brain-derived neurotrophic factor (BDNF) is a mediator of exercise and nutrition-induced neural plasticity. In children with cerebral palsy (CP), neuromuscular deficits and mobility impairment have a negative impact on their physical activity level and nutritional status, but whether these children have reduced BDNF concentrations is unknown. Therefore, the aim of the present study was to investigate the plasma BDNF concentration, nutritional status, and physical activity level in children with mild to severe CP. Blood sampling, dietary registration, and questionnaires were completed for children with mild CP (gross motor function classification system (GMFCS) I⁻II, n = 31, age 10.6 ± 0.6 years), severe CP (GMFCS IV⁻V, n = 14, age 10.9 ± 1.1 years) and typically developed (TD) children (n = 22, age 10.9 ± 0.6 years). Children with severe CP had ~40% lower plasma BDNF concentration than TD children (p < 0.05). Furthermore, children with severe CP had lower daily physical activity level than TD children (p < 0.01), and a daily intake of energy, n-3 fatty acids, and dietary fibers that was only ~50% of TD (p > 0.001). Reduced plasma BDNF concentrations were observed in children with severe CP. This may be of significance for optimal neural growth and plasticity. This was observed together with low physical activity levels and a suboptimal intake of energy, n-3 fatty acids, and dietary fibers.
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Affiliation(s)
- Solvejg L Hansen
- Molecular Physiology Section, Department of Nutrition, Exercise and Sports, University of Copenhagen, 2100 Copenhagen Ø, Denmark.
- Department of Neuroscience, University of Copenhagen, 2200 Copenhagen N, Denmark.
| | - Jakob Lorentzen
- Department of Neuroscience, University of Copenhagen, 2200 Copenhagen N, Denmark.
- Elsass Institute, 2920 Charlottenlund, Denmark.
| | - Lin T Pedersen
- Molecular Physiology Section, Department of Nutrition, Exercise and Sports, University of Copenhagen, 2100 Copenhagen Ø, Denmark.
| | - Frederikke L Hendrich
- Molecular Physiology Section, Department of Nutrition, Exercise and Sports, University of Copenhagen, 2100 Copenhagen Ø, Denmark.
| | - Martin Jorsal
- Geelsgårdskolen, Region Hovedstaden, 2830 Virum, Denmark.
| | - Jessica Pingel
- Department of Neuroscience, University of Copenhagen, 2200 Copenhagen N, Denmark.
| | - Jens B Nielsen
- Department of Neuroscience, University of Copenhagen, 2200 Copenhagen N, Denmark.
- Elsass Institute, 2920 Charlottenlund, Denmark.
| | - Bente Kiens
- Molecular Physiology Section, Department of Nutrition, Exercise and Sports, University of Copenhagen, 2100 Copenhagen Ø, Denmark.
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16
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Głąbska D, Guzek D, Mellová B, Zadka K, Żywczyk K, Gutkowska K. The National After-School Athletics Program Participation as a Tool to Reduce the Risk of Obesity in Adolescents after One Year of Intervention: A Nationwide Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16030405. [PMID: 30708984 PMCID: PMC6388155 DOI: 10.3390/ijerph16030405] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 01/23/2019] [Accepted: 01/29/2019] [Indexed: 12/15/2022]
Abstract
Regular exercise during school hours is encouraged; however many children and adolescents fail to meet the recommendations during this time. Extracurricular activities may be a more appealing way for youth to achieve guidelines, and it is recommended that they attend two sessions each week. The aim of the study was to assess the influence of participation in a national physical activity program accompanied by nutritional education for trainers on the risk of obesity and body composition in a nationwide sample of boys and girls, after one year of intervention. The #goathletics Study was conducted in a group of 1014 adolescents aged 12⁻13: 507 individuals for the Athletics for All program (210 boys, 297 girls) and 507 pair-matched individuals not participating in any physical activity program (matching including: gender, age, city of residence). The body mass (kg), Body Mass Index (BMI) (kg/m²), waist circumference (WC) (cm), waist-to-height ratio (WHtR) (-) and body composition (%) (measured using bioelectrical impedance method) were compared in a gender-related sub-groups using t-Student test (for parametric distributions) or Mann-Whitney U test (for nonparametric distributions) and chi² test (for the share of sub-groups). After one year of intervention, lower body mass percentile, BMI percentile, WC, WHtR and fat mass share, higher muscle mass share, as well as lower frequency of overweight/obesity and abdominal fat distribution were observed both for boys and girls participating in the physical activity intervention compared to the pair-matched controls. The after-school physical activity program accompanied by nutritional education for trainers may be a highly effective method for reducing the risk of obesity both for boys and girls, as regular participation is ensured.
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Affiliation(s)
- Dominika Głąbska
- Department of Dietetics, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences (SGGW-WULS), 159C Nowoursynowska Street, 02-776 Warsaw, Poland.
| | - Dominika Guzek
- Department of Organization and Consumption Economics, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences (SGGW-WULS), 159C Nowoursynowska Street, 02-776 Warsaw, Poland.
| | - Blanka Mellová
- Nutrition, Health and Wellness Unit, Nestlé Polska S.A., 32 Domaniewska Street, 02-672 Warsaw, Poland.
| | - Katarzyna Zadka
- Department of Dietetics, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences (SGGW-WULS), 159C Nowoursynowska Street, 02-776 Warsaw, Poland.
| | - Katarzyna Żywczyk
- Nutrition, Health and Wellness Unit, Nestlé Polska S.A., 32 Domaniewska Street, 02-672 Warsaw, Poland.
| | - Krystyna Gutkowska
- Department of Organization and Consumption Economics, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences (SGGW-WULS), 159C Nowoursynowska Street, 02-776 Warsaw, Poland.
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17
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Werner CM, Hecksteden A, Morsch A, Zundler J, Wegmann M, Kratzsch J, Thiery J, Hohl M, Bittenbring JT, Neumann F, Böhm M, Meyer T, Laufs U. Differential effects of endurance, interval, and resistance training on telomerase activity and telomere length in a randomized, controlled study. Eur Heart J 2019; 40:34-46. [PMID: 30496493 PMCID: PMC6312574 DOI: 10.1093/eurheartj/ehy585] [Citation(s) in RCA: 118] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2017] [Revised: 02/26/2018] [Accepted: 09/21/2018] [Indexed: 02/07/2023] Open
Abstract
Aims It is unknown whether different training modalities exert differential cellular effects. Telomeres and telomere-associated proteins play a major role in cellular aging with implications for global health. This prospective training study examines the effects of endurance training, interval training (IT), and resistance training (RT) on telomerase activity and telomere length (TL). Methods and results One hundred and twenty-four healthy previously inactive individuals completed the 6 months study. Participants were randomized to three different interventions or the control condition (no change in lifestyle): aerobic endurance training (AET, continuous running), high-intensive IT (4 × 4 method), or RT (circle training on 8 devices), each intervention consisting of three 45 min training sessions per week. Maximum oxygen uptake (VO2max) was increased by all three training modalities. Telomerase activity in blood mononuclear cells was up-regulated by two- to three-fold in both endurance exercise groups (AET, IT), but not with RT. In parallel, lymphocyte, granulocyte, and leucocyte TL increased in the endurance-trained groups but not in the RT group. Magnet-activated cell sorting with telomerase repeat-ampliflication protocol (MACS-TRAP) assays revealed that a single bout of endurance training-but not RT-acutely increased telomerase activity in CD14+ and in CD34+ leucocytes. Conclusion This randomized controlled trial shows that endurance training, IT, and RT protocols induce specific cellular pathways in circulating leucocytes. Endurance training and IT, but not RT, increased telomerase activity and TL which are important for cellular senescence, regenerative capacity, and thus, healthy aging.
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Affiliation(s)
- Christian M Werner
- Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universität und Universitätsklinikum des Saarlandes, Geb. 41.1/IMED, Homburg/Saar, Germany
| | - Anne Hecksteden
- Institut für Sport und Präventivmedizin, Universität des Saarlandes, Campus, B8 2, Saarbrücken, Germany
| | - Arne Morsch
- Deutsche Hochschule für Prävention und Gesundheitsmanagement, Hermann-Neuberger-Sportschule 3, Saarbrücken, Germany
| | - Joachim Zundler
- Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universität und Universitätsklinikum des Saarlandes, Geb. 41.1/IMED, Homburg/Saar, Germany
| | - Melissa Wegmann
- Institut für Sport und Präventivmedizin, Universität des Saarlandes, Campus, B8 2, Saarbrücken, Germany
| | - Jürgen Kratzsch
- Institut für Labormedizin, Klinische Chemie und Molekulare Diagnostik, Universitätsklinikum, Liebigstr. 20, Leipzig, Germany
| | - Joachim Thiery
- Institut für Labormedizin, Klinische Chemie und Molekulare Diagnostik, Universitätsklinikum, Liebigstr. 20, Leipzig, Germany
| | - Mathias Hohl
- Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universität und Universitätsklinikum des Saarlandes, Geb. 41.1/IMED, Homburg/Saar, Germany
| | - Jörg Thomas Bittenbring
- Klinik für Innere Medizin I, Onkologie, Hämatologie, Klinische Immunologie und Rheumatologie, Universitätsklinikum des Saarlandes, Geb. 41.1/IMED, Homburg/Saar, Germany
| | - Frank Neumann
- Klinik für Innere Medizin I, Onkologie, Hämatologie, Klinische Immunologie und Rheumatologie, Universitätsklinikum des Saarlandes, Geb. 41.1/IMED, Homburg/Saar, Germany
| | - Michael Böhm
- Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universität und Universitätsklinikum des Saarlandes, Geb. 41.1/IMED, Homburg/Saar, Germany
| | - Tim Meyer
- Institut für Sport und Präventivmedizin, Universität des Saarlandes, Campus, B8 2, Saarbrücken, Germany
| | - Ulrich Laufs
- Klinik und Poliklinik für Kardiologie, Universitätsklinikum Leipzig, Liebigstr. 20, Leipzig, Germany
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18
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Pozuelo-Carrascosa DP, Cavero-Redondo I, Herráiz-Adillo Á, Díez-Fernández A, Sánchez-López M, Martínez-Vizcaíno V. School-Based Exercise Programs and Cardiometabolic Risk Factors: A Meta-analysis. Pediatrics 2018; 142:peds.2018-1033. [PMID: 30337478 DOI: 10.1542/peds.2018-1033] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/30/2018] [Indexed: 11/24/2022] Open
Abstract
CONTEXT The effects of school-based physical activity (PA) programs on different cardiometabolic risk factors and the most appropriate features of PA programs to achieve maximum effectiveness are unclear. OBJECTIVE To provide a comprehensive synthesis of the effectiveness of school-based PA interventions on cardiometabolic risk factors in children. DATA SOURCES We identified studies from database inception to February 22, 2018. STUDY SELECTION We selected studies that were focused on examining the effect of school-based PA interventions on cardiometabolic risk factors in children. DATA EXTRACTION Random-effects models were used to calculate the pooled effect size (ES) for the included cardiometabolic risk factors (waist circumference [WC], triglycerides, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, systolic blood pressure and diastolic blood pressure (DBP), and fasting insulin and glucose). RESULTS Nineteen randomized controlled trials (which included 11 988 children aged 3-12 years) were included in the meta-analysis. School-based PA programs were associated with a significant small improvement in WC (ES = -0.14; 95% confidence interval [CI]: -0.22 to -0.07; P < .001), DBP (ES = -0.21; 95% CI: -0.42 to -0.01; P = .040), and fasting insulin (ES = -0.12; 95% CI: -0.20 to -0.04; P = .003). LIMITATIONS Authors of few studies described the implementation conditions of their interventions in detail, and compliance rates were lacking in most studies. In addition, results by sex were provided in a small number of studies. CONCLUSIONS School-based PA interventions improve some cardiometabolic risk factors in children, such as WC, DBP, and fasting insulin.
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Affiliation(s)
| | | | - Ángel Herráiz-Adillo
- Social and Health Care Research Center and.,Department of Primary Care, Health Service of Castilla-La Mancha, Tragacete, Cuenca, Spain
| | - Ana Díez-Fernández
- Social and Health Care Research Center and.,Faculty of Nursing, Universidad de Castilla-La Mancha, Cuenca, Spain
| | - Mairena Sánchez-López
- Social and Health Care Research Center and.,Faculty of Education, Universidad de Castilla-La Mancha, Ciudad Real, Spain; and
| | - Vicente Martínez-Vizcaíno
- Social and Health Care Research Center and.,Faculty of Health Science, Universidad Autónoma de Chile, Talca, Chile
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19
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Fulghum K, Hill BG. Metabolic Mechanisms of Exercise-Induced Cardiac Remodeling. Front Cardiovasc Med 2018; 5:127. [PMID: 30255026 PMCID: PMC6141631 DOI: 10.3389/fcvm.2018.00127] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 08/23/2018] [Indexed: 12/13/2022] Open
Abstract
Exercise has a myriad of physiological benefits that derive in part from its ability to improve cardiometabolic health. The periodic metabolic stress imposed by regular exercise appears fundamental in driving cardiovascular tissue adaptation. However, different types, intensities, or durations of exercise elicit different levels of metabolic stress and may promote distinct types of tissue remodeling. In this review, we discuss how exercise affects cardiac structure and function and how exercise-induced changes in metabolism regulate cardiac adaptation. Current evidence suggests that exercise typically elicits an adaptive, beneficial form of cardiac remodeling that involves cardiomyocyte growth and proliferation; however, chronic levels of extreme exercise may increase the risk for pathological cardiac remodeling or sudden cardiac death. An emerging theme underpinning acute as well as chronic cardiac adaptations to exercise is metabolic periodicity, which appears important for regulating mitochondrial quality and function, for stimulating metabolism-mediated exercise gene programs and hypertrophic kinase activity, and for coordinating biosynthetic pathway activity. In addition, circulating metabolites liberated during exercise trigger physiological cardiac growth. Further understanding of how exercise-mediated changes in metabolism orchestrate cell signaling and gene expression could facilitate therapeutic strategies to maximize the benefits of exercise and improve cardiac health.
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Affiliation(s)
- Kyle Fulghum
- Department of Medicine, Envirome Institute, Institute of Molecular Cardiology, Diabetes and Obesity Center, Louisville, KY, United States
- Department of Physiology, University of Louisville, Louisville, KY, United States
| | - Bradford G. Hill
- Department of Medicine, Envirome Institute, Institute of Molecular Cardiology, Diabetes and Obesity Center, Louisville, KY, United States
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20
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Silveira DS, Lemos LFGBF, Tassitano RM, Cattuzzo MT, Feitoza AHP, Aires LMSMC, Silva Mota JAP, Martins CMDL. Effect of a pilot multi-component intervention on motor performance and metabolic risks in overweight/obese youth. J Sports Sci 2018; 36:2317-2326. [PMID: 29558321 DOI: 10.1080/02640414.2018.1452142] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
This study evaluated the effect of a multi-component intervention on motor performance (MP) and metabolic risk markers (MRM) in overweight/obese youth. A secondary aim was to examine whether changes in MP are associated to changes in MRM. A 3-month multi-component intervention was performed, consisting of physical exercise sessions (twice/week;1h), nutritional education sessions (once/month), and parental support (twice/week). The sample included 35 volunteers (7-13 y.o), allocated to intervention (INT, n = 17) and control (CONT, n = 18) group. Variables were measured pre (T0) and post intervention (T1). Fasting blood samples were analyzed for MRM. MP tests included the measurement of health related physical fitness components and motor coordination performance (KTK battery). To assess food intake, a 24-hour recall diary was used. GLM-ANCOVA was performed. Standardized scores were calculated for the outcome variables, and multilinear regressions were applied to analyze associations between the key variables. INT group showed improvements in MP, glycolytic and hepatic profiles. After adjustments for MVPA, SB, total intake and maturational stage, negative associations between %ΔMP and %Δglycolytic (β = -.424; 95%CI:-0.343:-0.022), and %Δhepatic scores (β = -.382 95%CI:-0.001:-0.009) were observed. The intervention produced a moderate-to-high effect on the MP and some MRM. Changes in MP were inversely associated with changes in glycolytic and hepatic markers.
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21
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Affiliation(s)
- Ephraim Bernhard Winzer
- Department of Internal Medicine/Cardiology, Helios Stiftungsprofessur, Heart Center Leipzig-University Hospital, Leipzig, Germany
| | - Felix Woitek
- Department of Internal Medicine/Cardiology, Helios Stiftungsprofessur, Heart Center Leipzig-University Hospital, Leipzig, Germany
| | - Axel Linke
- Department of Internal Medicine and Cardiology, Technische Universität Dresden Heart Center Dresden-University Hospital, Dresden, Germany
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22
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Kelley GA, Kelley KS, Pate RR. Exercise and adiposity in overweight and obese children and adolescents: protocol for a systematic review and network meta-analysis of randomised trials. BMJ Open 2017; 7:e019512. [PMID: 29288191 PMCID: PMC5770943 DOI: 10.1136/bmjopen-2017-019512] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 11/17/2017] [Accepted: 11/20/2017] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Overweight and obesity is a worldwide public health problem among children and adolescents. However, the magnitude of effect, as well as hierarchy of exercise interventions (aerobic, strength training or both), on selected measures of adiposity is not well established despite numerous trials on this issue. The primary purposes of this study are to use the network meta-analytical approach to determine the effects and hierarchy of exercise interventions on selected measures of adiposity in overweight and obese children and adolescents. METHODS AND ANALYSIS Randomised exercise intervention trials >4 weeks, available in any language up to 31 August 2017 and which include direct and/or indirect evidence, will be included. Studies will be located by searching seven electronic databases, cross-referencing and expert review. Dual selection and abstraction of data will occur. The primary outcomes will be changes in body mass index (in kg/m2), fat mass and percent body fat. Risk of bias will be assessed using the Cochrane Risk of Bias assessment instrument while confidence in the cumulative evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation instrument for network meta-analysis. Network meta-analysis will be performed using multivariate random-effects meta-regression models. The surface under the cumulative ranking curve will be used to provide a hierarchy of exercise treatments (aerobic, strength or both). ETHICS AND DISSEMINATION This study does not require ethics approval. Findings will be presented at a professional conference and published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD 42017073103 .
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Affiliation(s)
- George A Kelley
- Department of Biostatistics, School of Public Health, West Virginia University, Morgantown, West Virginia, USA
| | - Kristi S Kelley
- Department of Biostatistics, School of Public Health, West Virginia University, Morgantown, West Virginia, USA
| | - Russell R Pate
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina, USA
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23
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Pozuelo-Carrascosa DP, García-Hermoso A, Álvarez-Bueno C, Sánchez-López M, Martinez-Vizcaino V. Effectiveness of school-based physical activity programmes on cardiorespiratory fitness in children: a meta-analysis of randomised controlled trials. Br J Sports Med 2017; 52:1234-1240. [DOI: 10.1136/bjsports-2017-097600] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2017] [Indexed: 11/03/2022]
Abstract
ObjectiveTo conduct a meta-analysis of randomised controlled trials aimed at testing whether school-based physical activity programmes improve cardiorespiratory fitness (CRF) in children.DesignSystematic review with meta-analysis.Data sourcesUsing keywords, we performed a computerised search in five databases: MEDLINE, EMBASE, CINAHL, Web of Science and SportDiscus.Eligibility criteria for selecting studiesStudies that assessed the effectiveness of school-based physical activity programmes on improving CRF in children (3–12 years old). We selected interventions that included an additional physical activity programme and not only a physical activity educational component. The reference lists of selected full-text articles and systematic reviews were also searched for relevant studies. Pooled effect size (Hedges′ g) was calculated assuming a random-effects model.ResultsTwenty trials with 7287 healthy children aged 3–12 years were included in the meta-analysis. School-based physical activity interventions with aerobic games and activities were associated with a significant small increase in CRF (Hedges′ g=0.22; 95% CI 0.14 to 0.30; p<0.001). Based on subgroup analysis, the increase in CRF was significant in girls (Hedges′ g=0.25; 95% CI 0.13 to 0.37; p<0.001), but not in boys (Hedges′ g=0.02; 95% CI −0.10 to 0.14; p=0.731).SummaryModerate quality evidence supports the effectiveness of school-based physical activity interventions on improving CRF in children.Trial registration numberProtocol PROSPERO registration number CRD42016050173.
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24
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Mueller UM, Walther C, Adam J, Fikenzer K, Erbs S, Mende M, Adams V, Linke A, Schuler G. Endothelial Function in Children and Adolescents Is Mainly Influenced by Age, Sex and Physical Activity - An Analysis of Reactive Hyperemic Peripheral Artery Tonometry. Circ J 2017; 81:717-725. [PMID: 28190797 DOI: 10.1253/circj.cj-16-0994] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND As adolescents rarely experience cardiovascular events, surrogate markers of atherosclerosis are useful to justify and monitor effects of primary prevention and therapy of risk factors. Endothelial function assessed by reactive hyperemic peripheral arterial tonometry (RH-PAT) resulting in a reactive hyperemic index (RHI) is a noninvasive method with limited data for use in children and adolescents. METHODS AND RESULTS We performed a total of 931 RHI measurements in 445 high-school students, aged 10-17 years, over a time period of 5 years. Students were randomized by class to 60 min physical exercise (PE) at school daily (intervention group), or 2 units of 45-min PE weekly (control group). To characterize the factors influencing the RHI, anthropometry, cardiopulmonary exercise testing, blood cholesterol and quality of life were assessed and used to build mixed linear models. Main influential factors were age, with an increase of RHI from 1.53±0.42 in the youngest to 1.96±0.59 in the oldest students, sex, with higher values in girls, and physical activity. This increase adjusted by age and sex was estimated as 0.11 [0.08, 0.14] per year. RHI was higher in the intervention group by 0.09 [-0.05, 0.23] in comparison with the control group. CONCLUSIONS If RH-PAT is used in research or as a clinical tool in adolescents, the shown age- and sex-dependence of RHI have to be taken in account.
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Affiliation(s)
- Ulrike M Mueller
- Department of Internal Medicine/Cardiology, University Leipzig - Heart Center
| | - Claudia Walther
- Department of Internal Medicine/Cardiology, University Leipzig - Heart Center
- Department of Cardiology, Kerckhoff Heart Center
| | - Jennifer Adam
- Department of Internal Medicine/Cardiology, University Leipzig - Heart Center
| | - Kati Fikenzer
- Department of Internal Medicine/Cardiology, University Leipzig - Heart Center
| | - Sandra Erbs
- Department of Internal Medicine/Cardiology, University Leipzig - Heart Center
| | | | - Volker Adams
- Department of Internal Medicine/Cardiology, University Leipzig - Heart Center
| | - Axel Linke
- Department of Internal Medicine/Cardiology, University Leipzig - Heart Center
| | - Gerhard Schuler
- Department of Internal Medicine/Cardiology, University Leipzig - Heart Center
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25
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Minatto G, Barbosa Filho VC, Berria J, Petroski EL. School-Based Interventions to Improve Cardiorespiratory Fitness in Adolescents: Systematic Review with Meta-analysis. Sports Med 2017; 46:1273-92. [PMID: 26846429 DOI: 10.1007/s40279-016-0480-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND School-based intervention can contribute to the promotion of cardiorespiratory fitness (CRF) in adolescents. However, it is neces sary to systematize how intervention strategies and the methodological characteristics of studies influence the effects of CRF interventions. OBJECTIVE A meta-analysis review of school-based intervention studies aimed at increasing CRF in adolescents (10-19 years of age) was conducted. METHODS A search for studies was conducted using the Medline, Web of Science, LILACS, PsycINFO, Embase, Scopus, SPORTDiscus and Cochrane databases and the reference lists of the selected studies. The peer selection process included consideration of school-based randomized or non-randomized controlled trials with a duration ≥12 weeks published in English, Portuguese or Spanish, and with some CRF measures. The methodological quality of the studies was also assessed. The standardized mean differences (SMDs) and 95 % confidence intervals (95 % CIs) were calculated as an effect measure. RESULTS Forty publications of 30 interventions were included in the review, and 25 of these were meta-analysed. The effects of CRF interventions were moderate and significant (SMD = 0.68, 95 % CI 0.45-0.90), with high heterogeneity (I (2) = 97 %). The effect size varied significantly according to the age group, sample size, intervention environment, strategies in experimental groups, CRF priority in the study, CRF test and indicator, session length, weekly frequency, intervention duration and presentation of results by sex. CONCLUSION Interventions in the school environment seem to have a positive effect on CRF among adolescents, but there is high heterogeneity between studies. Some intervention characteristics can explain better effects on CRF (e.g. exercise sessions in addition to physical education classes; primary focus on this outcome; combination of aerobic and resistance exercises; classes lasting ≥60 min; frequency of three times weekly; and intensity control).
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Affiliation(s)
- Giseli Minatto
- Research Centre for Kinanthropometry and Human Performance, Sports Centre, Campus Universitário, Federal University of Santa Catarina, Trindade, Caixa Postal 476, Florianópolis, SC, CEP 88040-900, Brazil.
| | - Valter Cordeiro Barbosa Filho
- Research Centre for Physical Activity and Health, Sports Centre, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Juliane Berria
- Research Centre for Kinanthropometry and Human Performance, Sports Centre, Campus Universitário, Federal University of Santa Catarina, Trindade, Caixa Postal 476, Florianópolis, SC, CEP 88040-900, Brazil
| | - Edio Luiz Petroski
- Research Centre for Kinanthropometry and Human Performance, Sports Centre, Campus Universitário, Federal University of Santa Catarina, Trindade, Caixa Postal 476, Florianópolis, SC, CEP 88040-900, Brazil
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26
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Affiliation(s)
- Scott Kinlay
- From Veterans Affairs Boston Healthcare System, MA (S.K.); and Brigham and Women's Hospital and Harvard Medical School, Boston, MA (S.K., T.M., J.A.L.)
| | - Thomas Michel
- From Veterans Affairs Boston Healthcare System, MA (S.K.); and Brigham and Women's Hospital and Harvard Medical School, Boston, MA (S.K., T.M., J.A.L.)
| | - Jane A Leopold
- From Veterans Affairs Boston Healthcare System, MA (S.K.); and Brigham and Women's Hospital and Harvard Medical School, Boston, MA (S.K., T.M., J.A.L.).
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27
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Oosterhoff M, Joore M, Ferreira I. The effects of school-based lifestyle interventions on body mass index and blood pressure: a multivariate multilevel meta-analysis of randomized controlled trials. Obes Rev 2016; 17:1131-1153. [PMID: 27432468 DOI: 10.1111/obr.12446] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 04/13/2016] [Accepted: 05/24/2016] [Indexed: 11/30/2022]
Abstract
Primary prevention of childhood obesity and related hypertension is warrant given that both risk factors are intertwined and track into adulthood. This systematic review and meta-analysis assess the impact of school-based lifestyle interventions on children's body mass index (BMI) and blood pressure. We searched databases and prior reviews. Eligibility criteria were the following: randomized controlled trial design, evaluation of a school-based intervention, targeting children aged 4-12 years, reporting on BMI and/or related cardiovascular risk factors, reporting data on at least one follow-up moment. The effects on BMI, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were evaluated by means of univariate and multivariate three-level random effects models. A total of 85 RCTs (91 papers) were included in the meta-analyses. In univariate models, the pooled effects were -0.072 (95%CI: -0.106; -0.038) for BMI, -0.183 (95%CI: -0.288; -0.078) for SBP and -0.071 (95%CI: -0.185; 0.044) for DBP. In multivariate analyses, the pooled effects of interventions were -0.054 (95%CI: -0.131; 0.022) for BMI, -0.182 (95%CI: -0.266; -0.098) for SBP and -0.144 (95%CI: -0.230; -0.057) for DBP. Parental involvement accentuated the beneficial effects of interventions. School-based lifestyle prevention interventions result in beneficial changes in children's BMI and blood pressure, and the effects on the latter may be stronger than and accrue independently from those in the former.
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Affiliation(s)
- M Oosterhoff
- Department of Clinical Epidemiology and Medical Technology Assessment, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre+, Maastricht, The Netherlands.
| | - M Joore
- Department of Clinical Epidemiology and Medical Technology Assessment, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - I Ferreira
- Department of Clinical Epidemiology and Medical Technology Assessment, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre+, Maastricht, The Netherlands.,Division of Epidemiology & Biostatistics, School of Public Health, University of Queensland, Brisbane, Australia
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28
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Onoyama S, Qiu L, Low HP, Chang CI, Strohsnitter WC, Norwitz ER, Lopresti M, Edmiston K, Lee IM, Trichopoulos D, Lagiou P, Hsieh CC. Prenatal Maternal Physical Activity and Stem Cells in Umbilical Cord Blood. Med Sci Sports Exerc 2016. [PMID: 26197028 DOI: 10.1249/mss.0000000000000731] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE Early life processes, through influence on fetal stem cells, affect postnatal and adult health outcomes. This study examines the effects of physical activity before and during pregnancy on stem cell counts in umbilical cord blood. METHODS We isolated mononuclear cells from umbilical cord blood samples from 373 singleton full-term pregnancies and quantified hematopoietic (CD34(+), CD34(+)CD38(-), and CD34(+) c-kit(+)), endothelial (CD34(+)CD133(+), CD34(+)CD133(+)VEGFR2(+), CD34(+)VEGFR2(+), and CD133(+)VEGFR2(+)), and putative breast (EpCAM(+), EpCAM(+)CD49f(+), EpCAM(+)CD49f(+)CD117(+), CD49f(+)CD24(+), CD24(+)CD29(+), and CD24(+)CD29(+)CD49f(+)) stem/progenitor cell subpopulations by flow cytometry. Information on physical activities before and during pregnancy was obtained from questionnaires. Weekly energy expenditure was estimated based on metabolic equivalent task values. RESULTS Prepregnancy vigorous exercise was associated positively with levels of endothelial CD34(+)CD133(+), CD34(+)CD133(+)VEGFR2(+), CD34(+)VEGFR2(+), and CD133(+)VEGFR2(+ )progenitor cell populations (P = 0.02, P = 0.01, P = 0.001, and P = 0.003, respectively); positive associations were observed in samples from the first births and those from the second or later births. Prepregnancy moderate and light exercises and light exercise during the first trimester were not significantly associated with any stem/progenitor cell population. Light exercise during the second trimester was positively associated with CD34(+)VEGFR2(+) endothelial progenitor cells (P = 0.03). In addition, levels of EpCAM(+)CD49f(+) and CD49f(+)CD24(+) breast stem cells were significantly lower among pregnant women who engaged in vigorous/moderate exercise during pregnancy (P = 0.05 and P = 0.02, respectively). CONCLUSIONS Vigorous exercise before pregnancy increases the number of endothelial progenitor cells in umbilical cord blood and thus could potentially enhance endothelial function and improve cardiovascular fitness in the offspring. Findings of lower levels of putative breast stem cell subpopulations could have implications on exercise and breast cancer prevention. Prenatal effects of exercise on fetal stem cells warrant further studies.
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Affiliation(s)
- Sagano Onoyama
- 1Department of Molecular, Cell and Cancer Biology, University of Massachusetts Medical School, Worcester, MA; 2Department of Obstetrics and Gynecology, Tufts Medical Center, Boston, MA; 3Division of Hematology/Oncology, Department of Medicine, University of Massachusetts Medical School and UMass Memorial Health Care, Worcester, MA; 4Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; 5Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA; and 6Department of Hygiene, Epidemiology, and Medical Statistics, University of Athens, Athens, GREECE
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29
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Gallotta MC, Emerenziani GP, Iazzoni S, Iasevoli L, Guidetti L, Baldari C. Effects of different physical education programmes on children's skill- and health-related outcomes: a pilot randomised controlled trial. J Sports Sci 2016; 35:1547-1555. [PMID: 27593901 DOI: 10.1080/02640414.2016.1225969] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Aim of this study was to evaluate the effectiveness of two different 5-month physical education (PE) interventions conducted by a specialist PE teacher on primary school children's skill- and health-related outcomes. About 230 children were randomly assigned to one of three intervention groups: experimental_1 group, experimental_2 group or control group (school curriculum given by the generalist teacher). Pre- and post-intervention tests assessed pupils' fitness (pacer, curl-up, push-up, trunk lift, sit and reach tests) and gross motor coordination (shifting platforms, balance beam, jumping laterally, hopping on one leg over an obstacle tests). Both experimental groups significantly improved some fitness and coordinative tests after the intervention period when compared with control group. However, no differential changes on coordinative development were observed between the 2 experimental groups. Results of this study demonstrated that children benefitted from a well-structured PE intervention conducted and supervised by a specialist PE teacher improving their motor skills and fitness.
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Affiliation(s)
- Maria Chiara Gallotta
- a Department of Movement, Human and Health Sciences , University of Rome "Foro Italico" , Rome , Italy
| | - Gian Pietro Emerenziani
- a Department of Movement, Human and Health Sciences , University of Rome "Foro Italico" , Rome , Italy
| | - Sara Iazzoni
- a Department of Movement, Human and Health Sciences , University of Rome "Foro Italico" , Rome , Italy
| | - Luigi Iasevoli
- a Department of Movement, Human and Health Sciences , University of Rome "Foro Italico" , Rome , Italy
| | - Laura Guidetti
- a Department of Movement, Human and Health Sciences , University of Rome "Foro Italico" , Rome , Italy
| | - Carlo Baldari
- a Department of Movement, Human and Health Sciences , University of Rome "Foro Italico" , Rome , Italy
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30
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Müller UM, Walther C, Adams V, Mende M, Adam J, Fikenzer K, Machalica KC, Erbs S, Linke A, Schuler G. Long term impact of one daily unit of physical exercise at school on cardiovascular risk factors in school children. Eur J Prev Cardiol 2016; 23:1444-52. [DOI: 10.1177/2047487316632966] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 01/27/2016] [Indexed: 11/17/2022]
Affiliation(s)
- Ulrike M Müller
- Department of Internal Medicine/Cardiology, Heart Centre Leipzig, University of Leipzig, Germany
| | - Claudia Walther
- Department of Internal Medicine/Cardiology, Heart Centre Leipzig, University of Leipzig, Germany
- Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany
| | - Volker Adams
- Department of Internal Medicine/Cardiology, Heart Centre Leipzig, University of Leipzig, Germany
| | | | - Jennifer Adam
- Department of Internal Medicine/Cardiology, Heart Centre Leipzig, University of Leipzig, Germany
| | - Kati Fikenzer
- Department of Internal Medicine/Cardiology, Heart Centre Leipzig, University of Leipzig, Germany
| | - Katharina C Machalica
- Department of Internal Medicine/Cardiology, Heart Centre Leipzig, University of Leipzig, Germany
| | - Sandra Erbs
- Department of Internal Medicine/Cardiology, Heart Centre Leipzig, University of Leipzig, Germany
| | - Axel Linke
- Department of Internal Medicine/Cardiology, Heart Centre Leipzig, University of Leipzig, Germany
| | - Gerhard Schuler
- Department of Internal Medicine/Cardiology, Heart Centre Leipzig, University of Leipzig, Germany
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31
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Berghs M, Atkin K, Graham H, Hatton C, Thomas C. Implications for public health research of models and theories of disability: a scoping study and evidence synthesis. PUBLIC HEALTH RESEARCH 2016. [DOI: 10.3310/phr04080] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BackgroundPublic health interventions that are effective in the general population are often assumed to apply to people with impairments. However, the evidence to support this is limited and hence there is a need for public health research to take a more explicit account of disability and the perspectives of people with impairments.Objectives(1) To examine the literature on theories and models of disability; (2) to assess whether or not, and how, intervention studies of effectiveness could incorporate more inclusive approaches that are consistent with these theories and models; and (3) to use the findings to draw out implications for improving evaluative study designs and evidence-based practice.Review methodsThe project is a scoping review of the literature. The first stage examines theories and models of disability and reflects on possible connections between theories of disability and public health paradigms. This discussion is used to develop an ethical–empirical decision aid/checklist, informed by a human rights approach to disability and ecological approaches to public health. We apply this decision aid in the second stage of the review to evaluate the extent to which the 30 generic public health reviews of interventions and the 30 disability-specific public health interventions include the diverse experiences of disability. Five deliberation panels were also organised to further refine the decision aid: one with health-care professionals and four with politically and socially active disabled people.ResultsThe evidence from the review indicated that there has been limited public health engagement with theories and models of disability. Outcome measures were often insensitive to the experiences of disability. Even when disabled people were included, studies rarely engaged with their experiences in any meaningful way. More inclusive research should reflect how people live and ‘flourish’ with disability.LimitationsThe scoping review provides a broad appraisal of a particular field. It generates ideas for future practice rather than a definite framework for action.ConclusionsOur ethical–empirical decision aid offers a critical framework with which to evaluate current research practice. It also offers a resource for promoting more ethical and evidence-based public health research that is methodologically robust while being sensitive to the experiences of disability.Future workDeveloping more inclusive research and interventions that avoid conceptualising disability as either a ‘burden’ or ‘problem’ is an important starting point. This includes exploring ways of refining and validating current common outcome measures to ensure that they capture a diverse range of disabling experiences, as well as generating evidence on meaningful ways of engaging a broad range of disabled children and adults in the research process.FundingThe National Institute for Health Research Public Health Research programme.
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Affiliation(s)
- Maria Berghs
- Department of Health Sciences, University of York, York, UK
| | - Karl Atkin
- Department of Health Sciences, University of York, York, UK
| | - Hilary Graham
- Department of Health Sciences, University of York, York, UK
| | - Chris Hatton
- Faculty of Health and Medicine, Furness College, Lancaster University, Lancaster, UK
| | - Carol Thomas
- Faculty of Health and Medicine, Furness College, Lancaster University, Lancaster, UK
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32
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Childhood obesity-related endothelial dysfunction: an update on pathophysiological mechanisms and diagnostic advancements. Pediatr Res 2016; 79:831-7. [PMID: 26866906 DOI: 10.1038/pr.2016.22] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 11/22/2015] [Indexed: 12/20/2022]
Abstract
Childhood obesity jeopardizes a healthy future for our society's children as it is associated with increased cardiovascular morbidity and mortality later on in life. Endothelial dysfunction, the first step in the development of atherosclerosis, is already present in obese children and may well represent a targetable risk factor. Technological advancements in recent years have facilitated noninvasive measurements of endothelial homeostasis in children. Thereby this topic ultimately starts to get the attention it deserves. In this paper, we aim to summarize the latest insights on endothelial dysfunction in childhood obesity. We discuss methodological advancements in peripheral endothelial function measurement and newly identified diagnostic markers of vascular homeostasis. Finally, future challenges and perspectives are set forth on how to efficiently tackle the catastrophic rise in cardiovascular morbidity and mortality that will be inflicted on obese children if they are not treated optimally.
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Altabas V, Altabas K, Kirigin L. Endothelial progenitor cells (EPCs) in ageing and age-related diseases: How currently available treatment modalities affect EPC biology, atherosclerosis, and cardiovascular outcomes. Mech Ageing Dev 2016; 159:49-62. [PMID: 26919825 DOI: 10.1016/j.mad.2016.02.009] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 01/25/2016] [Accepted: 02/22/2016] [Indexed: 12/15/2022]
Abstract
Endothelial progenitor cells (EPCs) are mononuclear cells that circulate in the blood and are derived from different tissues, expressing cell surface markers that are similar to mature endothelial cells. The discovery of EPCs has lead to new insights in vascular repair and atherosclerosis and also a new theory for ageing. EPCs from the bone marrow and some other organs aid in vascular repair by migrating to distant vessels where they differentiate into mature endothelial cells and replace old and injured endothelial cells. The ability of EPCs to repair vascular damage depends on their number and functionality. Currently marketed drugs used in a variety of diseases can modulate these characteristics. In this review, the effect of currently available treatment options for cardiovascular and metabolic disorders on EPC biology will be discussed. The various EPC-based therapies that will be discussed include lipid-lowering agents, antihypertensive agents, antidiabetic drugs, phosphodiesteraze inhibitors, hormones, as well as EPC capturing stents.
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Affiliation(s)
- Velimir Altabas
- Department of Internal Medicine, University Clinical Hospital "Sestre milosrdnice", Zagreb, Croatia.
| | - Karmela Altabas
- Department of Internal Medicine, University Clinical Hospital "Sestre milosrdnice", Zagreb, Croatia.
| | - Lora Kirigin
- Department of Internal Medicine, University Clinical Hospital "Sestre milosrdnice", Zagreb, Croatia.
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Kort EJ, Croskey L, Scibienski T, Rajasekaran S, Jovinge S. Circulating Progenitor Cells and Childhood Cardiovascular Disease. Pediatr Cardiol 2016; 37:225-31. [PMID: 26554720 DOI: 10.1007/s00246-015-1300-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 10/20/2015] [Indexed: 12/18/2022]
Abstract
Circulating progenitor cells have been extensively studied in the context of heart disease in adults. In these patients, they have been demonstrated to be markers of myocardial injury and recovery as well as potential therapeutic agents. However, studies in children are much more limited. Here we review current knowledge pertaining to circulating progenitor cells in the context of childhood cardiovascular disease. Priorities for further research are also highlighted.
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Affiliation(s)
- Eric J Kort
- DeVos Cardiovascular Research Program of Spectrum Health and Van Andel Research Institute, 100 Michigan Street NE, Grand Rapids, MI, 49503, USA.
- Michigan State University, College of Human Medicine, 15 Michigan Street NE, Grand Rapids, MI, USA.
- Helen DeVos Children's Hospital, 100 Michigan Street NE, Grand Rapids, MI, USA.
| | - Lacey Croskey
- Michigan State University, College of Human Medicine, 15 Michigan Street NE, Grand Rapids, MI, USA
| | - Taryn Scibienski
- Michigan State University, College of Human Medicine, 15 Michigan Street NE, Grand Rapids, MI, USA
| | - Surender Rajasekaran
- Michigan State University, College of Human Medicine, 15 Michigan Street NE, Grand Rapids, MI, USA
- Helen DeVos Children's Hospital, 100 Michigan Street NE, Grand Rapids, MI, USA
| | - Stefan Jovinge
- DeVos Cardiovascular Research Program of Spectrum Health and Van Andel Research Institute, 100 Michigan Street NE, Grand Rapids, MI, 49503, USA
- Michigan State University, College of Human Medicine, 15 Michigan Street NE, Grand Rapids, MI, USA
- Cardiovascular Institute, Stanford University, Palo Alto, CA, USA
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Rexen CT, Ersbøll AK, Wedderkopp N, Andersen LB. Longitudinal influence of musculo-skeletal injuries and extra physical education on physical fitness in schoolchildren. Scand J Med Sci Sports 2015; 26:1470-1479. [PMID: 26620453 DOI: 10.1111/sms.12618] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2015] [Indexed: 11/26/2022]
Abstract
The aims of this study were to investigate if (A) injuries and (B) increased physical education (PE) influenced the development of physical fitness in schoolchildren. Simultaneously, to investigate if a possible PE effect was modified by sport participation outside school hours. This was a longitudinal controlled school-based study. Six schools with 270 min of PE (extra PE) and four schools with 90 min of PE were followed up for 2.5 years. In total, 1054 children were included for analysis (normal PE = 443, extra PE = 611). Development in fitness was analyzed using composite z-scores from six fitness tests measured four times. Information of injury and sport was derived from weekly automated mobile phone text messages surveying the presence of musculo-skeletal pain and organized sport participation. Injury and extra PE both influenced the development of physical fitness. Injury decreased development of physical fitness with -1.01 composite z-score units (95% CI: -1.57; -0.45). Extra PE increased physical fitness development with 0.80 (95% CI: 0.49; 1.10) composite z-score units. The influence of injury was not dependent on extra PE. No modifying effect was found by mean weekly sport participation outside school hours. In conclusion, extra PE had a positive effect, whereas injuries had a negative effect on physical fitness development in schoolchildren.
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Affiliation(s)
- C T Rexen
- Centre of Research in Childhood Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - A K Ersbøll
- National Institute of Public Health, University of Southern Denmark, København, Denmark
| | - N Wedderkopp
- Centre of Research in Childhood Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Institute of Regional Health Services Research, University of Southern Denmark, Odense, Denmark.,Sport Medicine Clinic, Orthopaedic Department, Hospital of Lillebaelt, Middelfart, Denmark.,Department of Psychology and Exercise Science, Murdoch University, Perth, Australia
| | - L B Andersen
- Centre of Research in Childhood Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Department of Sports Medicine, The Norwegian School of Sport Sciences, Oslo, Norway
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36
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McNarry MA, Lambrick D, Westrupp N, Faulkner J. The influence of a six-week, high-intensity games intervention on the pulmonary oxygen uptake kinetics in prepubertal obese and normal-weight children. Appl Physiol Nutr Metab 2015; 40:1012-8. [DOI: 10.1139/apnm-2015-0051] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The pulmonary oxygen uptake response is deleteriously influenced by obesity in prepubertal children, as evidenced by a slower phase II response. To date, no studies have investigated the ability of an exercise intervention to ameliorate this. The objective of the study was to investigate the influence of a 6-week, high-intensity, games-orientated intervention on the oxygen uptake kinetic response of prepubertal obese and normal-weight children during heavy-intensity exercise. Thirteen normal-weight and 15 obese children participated in a twice-weekly exercise intervention involving repeated bouts of 6-min high-intensity, games-orientated exercises followed by 2 min of recovery. Sixteen normal-weight and 11 obese children served as a control group. At baseline and post-intervention, each participant completed a graded-exercise test to volitional exhaustion and constant work-rate, heavy-intensity exercise. Post-intervention, obese children demonstrated a reduced phase II τ (pre-intervention: 30 ± 8 cf. post-intervention: 24 ± 7 s), mean response time (pre-intervention: 50 ± 10 cf. post-intervention: 38 ± 9 s) and phase II amplitude (pre-intervention: 1.51 ± 0.30 cf. post-intervention: 1.34 ± 0.27 L·min−1). No changes were evident in the normal-weight children. In conclusion, the present findings demonstrate that a 6-week, high-intensity intervention can have a significant positive impact on the dynamic oxygen uptake response of obese prepubertal children.
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Affiliation(s)
- Melitta A. McNarry
- Applied Sports, Technology, Exercise and Medicine Research Centre, College of Engineering, Swansea University, Swansea SA2 8PP, UK
| | - Danielle Lambrick
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Nicole Westrupp
- Respiratory Unit, Starship Hospital, Auckland, 1142, New Zealand
| | - James Faulkner
- Department of Sport and Exercise, University of Winchester, Winchester, UK
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37
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Boppart MD, De Lisio M, Witkowski S. Exercise and Stem Cells. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2015; 135:423-56. [PMID: 26477925 DOI: 10.1016/bs.pmbts.2015.07.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Stem cells are traditionally studied in the context of embryonic development, yet studies confirm that a fraction remains in the adult organism for the purpose of daily remodeling and rejuvenation of multiple tissues following injury. Adult stem cells (ASCs) are found in close proximity to vessels and respond to tissue-specific cues in the microenvironment that dictate their fate and function. Exercise can dramatically alter strain sensing, extracellular matrix composition, and inflammation, and such changes in the niche likely alter ASC quantity and function postexercise. The field of stem cell biology is still in its infancy and identification and terminology of ASCs continues to evolve; thus, current information regarding exercise and stem cells is lacking. This chapter summarizes the literature that reports on the ASC response to acute exercise and exercise training, with particular emphasis on hematopoietic stem cells, endothelial progenitor cells, and mesenchymal stem cells.
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Affiliation(s)
- Marni D Boppart
- Department of Kinesiology and Community Health, University of Illinois, Urbana, Illinois, USA; Beckman Institute for Advanced Science and Technology, University of Illinois, Urbana, Illinois, USA.
| | - Michael De Lisio
- Department of Kinesiology and Community Health, University of Illinois, Urbana, Illinois, USA
| | - Sarah Witkowski
- Department of Kinesiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, Massachusetts, USA
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Wang Y, Cai L, Wu Y, Wilson RF, Weston C, Fawole O, Bleich SN, Cheskin LJ, Showell NN, Lau BD, Chiu DT, Zhang A, Segal J. What childhood obesity prevention programmes work? A systematic review and meta-analysis. Obes Rev 2015; 16:547-65. [PMID: 25893796 PMCID: PMC4561621 DOI: 10.1111/obr.12277] [Citation(s) in RCA: 388] [Impact Index Per Article: 38.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Revised: 02/11/2015] [Accepted: 02/13/2015] [Indexed: 01/28/2023]
Abstract
Previous reviews of childhood obesity prevention have focused largely on schools and findings have been inconsistent. Funded by the US Agency for Healthcare Research and Quality (AHRQ) and the National Institutes of Health, we systematically evaluated the effectiveness of childhood obesity prevention programmes conducted in high-income countries and implemented in various settings. We searched MEDLINE®, Embase, PsycINFO, CINAHL®, ClinicalTrials.gov and the Cochrane Library from inception through 22 April 2013 for relevant studies, including randomized controlled trials, quasi-experimental studies and natural experiments, targeting diet, physical activity or both, and conducted in children aged 2-18 in high-income countries. Two reviewers independently abstracted the data. The strength of evidence (SOE) supporting interventions was graded for each study setting (e.g. home, school). Meta-analyses were performed on studies judged sufficiently similar and appropriate to pool using random effect models. This paper reported our findings on various adiposity-related outcomes. We identified 147 articles (139 intervention studies) of which 115 studies were primarily school based, although other settings could have been involved. Most were conducted in the United States and within the past decade. SOE was high for physical activity-only interventions delivered in schools with home involvement or combined diet-physical activity interventions delivered in schools with both home and community components. SOE was moderate for school-based interventions targeting either diet or physical activity, combined interventions delivered in schools with home or community components or combined interventions delivered in the community with a school component. SOE was low for combined interventions in childcare or home settings. Evidence was insufficient for other interventions. In conclusion, at least moderately strong evidence supports the effectiveness of school-based interventions for preventing childhood obesity. More research is needed to evaluate programmes in other settings or of other design types, especially environmental, policy and consumer health informatics-oriented interventions.
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Affiliation(s)
- Y Wang
- Department of Epidemiology and Environmental Health (formerly the Department of Social and Preventive Medicine), School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, NY, USA
- Johns Hopkins Global Center on Childhood Obesity, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - L Cai
- Johns Hopkins Global Center on Childhood Obesity, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Y Wu
- Johns Hopkins Global Center on Childhood Obesity, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - R F Wilson
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - C Weston
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - O Fawole
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - S N Bleich
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - L J Cheskin
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - N N Showell
- Division of General Pediatrics and Adolescent Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - B D Lau
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - D T Chiu
- Johns Hopkins Global Center on Childhood Obesity, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - A Zhang
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - J Segal
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
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Jarani J, Grøntved A, Muca F, Spahi A, Qefalia D, Ushtelenca K, Kasa A, Caporossi D, Gallotta MC. Effects of two physical education programmes on health- and skill-related physical fitness of Albanian children. J Sports Sci 2015; 34:35-46. [PMID: 25854535 DOI: 10.1080/02640414.2015.1031161] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study aims to evaluate the effectiveness of two school-based physical education (PE) programmes (exercise-based and games-based) compared with traditional PE, on health- and skill-related physical fitness components in children in Tirana, Albania. Participants were 378 first-grade (6.8 years) and 389 fourth-grade (9.8 years) children attending four randomly selected schools in Tirana. Twenty-four school classes within these schools were randomly selected (stratified by school and school grade) to participate as exercise group (EG), games group (GG) and control group (CG). Both EG and GG intervention programmes were taught by professional PE teachers using station/circuit teaching framework while CG referred to traditional PE school lessons by a general teacher. All programmes ran in parallel and lasted 5 months, having the same frequency (twice weekly) and duration (45 min). Heart rate (HR) monitoring showed that intensity during PE lessons was significantly higher in the intervention groups compared with control (P < 0.001). Both PE exercise- and games programmes significantly improved several health- and skill-related fitness indicators compared with traditional PE lessons (e.g. gross motor skill summary score: 9.4 (95% CI 7.9; 10.9) for exercise vs. control and 6.5 (95% CI 5.1; 8.1) for games vs. control, cardiorespiratory fitness: 2.0 ml O2 · min(-1) · kg(-1) (95% CI 1.5; 2.4) for exercise vs. control and 1.4 ml O2 · min(-1) · kg(-1) (95% CI 1.0; 1.8) for games vs. control). Furthermore, compared to games-based PE, exercise-based PE showed more positive changes in some gross motor coordination skills outcomes, coordination skills outcomes and cardiorespiratory fitness. The results from this study show that exercise- and games-based PE represents a useful strategy for improving health- and skill-related physical fitness in Albanian elementary school children. In addition, the study shows that exercise-based PE was more effective than games-based PE in improving gross motor function and cardiorespiratory fitness.
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Affiliation(s)
- J Jarani
- a Sports University of Tirana , Tirana , Albania
| | - A Grøntved
- b Department of Sports Science and Clinical Biomechanics , Research Center of Childhood Health, University of Southern Denmark , Odense , Denmark
| | - F Muca
- c Tirana International School , Tirana , Albania
| | - A Spahi
- d Department of Movement and Health, Faculty of Physical Activity and Recreation , Sports University of Tirana , Tirana , Albania
| | - D Qefalia
- e Sport Centre for Children , Tirana , Albania
| | - K Ushtelenca
- f Department of Social Sciences and Education, Faculty of Movement Sciences , Sports University of Tirana , Tirana , Albania
| | - A Kasa
- g Department of Physical Activity, Recreation and Tourism, Faculty of Physical Activity and Recreation , Sports University of Tirana , Tirana , Albania
| | - D Caporossi
- h Department of Movement , Human and Health Sciences, University of Rome "Foro Italico" , Rome , Italy
| | - M C Gallotta
- h Department of Movement , Human and Health Sciences, University of Rome "Foro Italico" , Rome , Italy
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40
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Bruyndonckx L, Hoymans VY, De Guchtenaere A, Van Helvoirt M, Van Craenenbroeck EM, Frederix G, Lemmens K, Vissers DK, Vrints CJ, Ramet J, Conraads VM. Diet, exercise, and endothelial function in obese adolescents. Pediatrics 2015; 135:e653-61. [PMID: 25667241 DOI: 10.1542/peds.2014-1577] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Endothelial dysfunction is the first, although reversible, sign of atherosclerosis and is present in obese adolescents. The primary end point of this study was to investigate the influence of a multicomponent treatment on microvascular function. Additional objectives and end points were a reduced BMI SD score, improvements in body composition, exercise capacity, and cardiovascular risk factors, an increase in endothelial progenitor cells (EPCs), and a decrease in endothelial microparticles (EMPs). METHODS We used a quasi-randomized study with 2 cohorts of obese adolescents: an intervention group (n = 33; 15.4 ± 1.5 years, 24 girls and 9 boys) treated residentially with supervised diet and exercise and a usual care group (n = 28; 15.1 ± 1.2 years, 22 girls and 6 boys), treated ambulantly. Changes in body mass, body composition, cardiorespiratory fitness, microvascular endothelial function, and circulating EPCs and EMPs were evaluated after 5 months and at the end of the 10-month program. RESULTS Residential intervention decreased BMI and body fat percentage, whereas it increased exercise capacity (P < .001 after 5 and 10 months). Microvascular endothelial function also improved in the intervention group (P = .04 at 10 months; + 0.59 ± 0.20 compared with + 0.01 ± 0.12 arbitrary units). Furthermore, intervention produced a significant reduction in traditional cardiovascular risk factors, including high-sensitivity C-reactive protein (P = .012 at 10 months). EPCs were increased after 5 months (P = .01), and EMPs decreased after 10 months (P = .004). CONCLUSIONS A treatment regimen consisting of supervised diet and exercise training was effective in improving multiple adolescent obesity-related end points.
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Affiliation(s)
- Luc Bruyndonckx
- Laboratory of Cellular and Molecular Cardiology and Departments of Pediatrics and Cardiovascular Diseases and Laboratory of Experimental Medicine and Pediatrics, and
| | - Vicky Y Hoymans
- Laboratory of Cellular and Molecular Cardiology and Cardiovascular Diseases and
| | | | | | - Emeline M Van Craenenbroeck
- Laboratory of Cellular and Molecular Cardiology and Cardiovascular Diseases and Cardiology, University Hospital Antwerp, Antwerp, Belgium
| | | | - Katrien Lemmens
- Pharmacology Research Groups, Department of Translational Pathophysiological Research
| | - Dirk K Vissers
- Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Antwerp, Belgium; and
| | - Christiaan J Vrints
- Laboratory of Cellular and Molecular Cardiology and Cardiovascular Diseases and Cardiology, University Hospital Antwerp, Antwerp, Belgium
| | - José Ramet
- Departments of Pediatrics and Laboratory of Experimental Medicine and Pediatrics, and
| | - Viviane M Conraads
- Laboratory of Cellular and Molecular Cardiology and Cardiovascular Diseases and Cardiology, University Hospital Antwerp, Antwerp, Belgium
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Mura G, Rocha NBF, Helmich I, Budde H, Machado S, Wegner M, Nardi AE, Arias-Carrión O, Vellante M, Baum A, Guicciardi M, Patten SB, Carta MG. Physical activity interventions in schools for improving lifestyle in European countries. Clin Pract Epidemiol Ment Health 2015; 11:77-101. [PMID: 25834629 PMCID: PMC4378026 DOI: 10.2174/1745017901511010077] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 10/07/2014] [Accepted: 10/25/2014] [Indexed: 12/15/2022]
Abstract
Background : In the last decades, children’s and adolescents’ obesity and overweight have increased in European Countries. Unhealthy eating habits and sedentary lifestyle have been recognized to determine such an epidemic. Schools represent an ideal setting to modify harmful behaviors, and physical activity could be regarded as a potential way to avoid the metabolic risks related to obesity. Methods : A systematic review of the literature was carried out to summarize the evidence of school-based interventions aimed to promote, enhance and implement physical activity in European schools. Only randomized controlled trials were included, carried out in Europe from January 2000 to April 2014, universally delivered and targeting pupils aged between 3 and 18 years old. Results : Forty-seven studies were retrieved based either on multicomponent interventions or solely physical activity programs. Most aimed to prevent obesity and cardiovascular risks among youths. While few studies showed a decrease in BMI, positive results were achieved on other outcomes, such as metabolic parameters and physical fitness. Conclusion : Physical activity in schools should be regarded as a simple, non-expensive and enjoyable way to reach all the children and adolescents with adequate doses of moderate to vigorous physical activity.
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Affiliation(s)
- Gioia Mura
- Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Italy
| | - Nuno B F Rocha
- Polytechnic Institute of Porto, School of Allied Health Sciences, Porto, Portugal
| | - Ingo Helmich
- Department of Neurology, Psychosomatic Medicine, and Psychiatry, Institute of Health Promotion and Clinical Movement Science, German Sports University, Cologne, Germany
| | - Henning Budde
- Medical School Hamburg, Faculty of Human Sciences, Department of Pedagogy, Reykjavik University, School of Sport Sciences, Reykjavik, Iceland
| | - Sergio Machado
- Laboratory of Panic and Respiration, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Mirko Wegner
- Institute of Sport Science, University of Bern, Switzerland
| | - Antonio Egidio Nardi
- Laboratory of Panic and Respiration, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Oscar Arias-Carrión
- Unidad de Trastornos del Movimiento y Sueño (TMS), Hospital General Dr. Manuel Gea Gonzalez, Secretaria de Salud, México, DF, Mexico
| | - Marcello Vellante
- Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Italy
| | - Antonia Baum
- Walter Reed National Military Medical Center and Major League Baseball
| | - Marco Guicciardi
- Department of Pedagogy, Psychology, Philosophy, University of Cagliari, Italy
| | - Scott B Patten
- Department of Community Health Sciences, University of Calgary, Canada
| | - Mauro Giovanni Carta
- Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Italy
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Cai L, Wu Y, Cheskin LJ, Wilson RF, Wang Y. Effect of childhood obesity prevention programmes on blood lipids: a systematic review and meta-analysis. Obes Rev 2014; 15:933-44. [PMID: 25263653 PMCID: PMC4341953 DOI: 10.1111/obr.12227] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Revised: 08/07/2014] [Accepted: 08/26/2014] [Indexed: 12/16/2022]
Abstract
We aimed to assess the effects of childhood obesity prevention programmes on blood lipids in high-income countries. We searched MEDLINE®, Embase, PsychInfo, CINAHL®, clinicaltrials.gov, and the Cochrane Library up to 22 April 2013 for relevant randomized controlled trials, quasi-experimental studies and natural experiments published in English. Studies were included if they implemented diet and/or physical activity intervention(s) with ≥1 year follow-up (or ≥6 months for school-based intervention studies) in 2-18-year-olds, and were excluded if they targeted only overweight/obese children, or those with a pre-existing medical condition. Seventeen studies were finally included. For total cholesterol, the pooled intervention effect was -0.97 mg dL(-1) [95% confidence interval (CI): -3.26, 1.32; P = 0.408]; for low-density lipoprotein cholesterol (LDL-C), -6.06 mg dL(-1) (95% CI: -11.09, -1.02; P = 0.018); for high-density lipoprotein cholesterol (HDL-C), 1.87 mg dL(-1) (95% CI: 0.39, 3.34; P = 0.013); and for triglycerides, -1.95 mg dL(-1) (95% CI: -4.94, 1.04; P = 0.202). Most interventions (70%) showed similar significant or no effects on adiposity- and lipids outcomes: 15% interventions improved both adiposity- and lipids outcomes; 55% had no significant effects on either. Childhood obesity prevention programmes had a significant desirable effect on LDL-C and HDL-C. Two-thirds of interventions showed similar significant or no effects in adiposity- and lipids outcomes. Assessing lipids outcomes provide additional useful information on obesity prevention programme benefits.
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Affiliation(s)
- L Cai
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China; Johns Hopkins Global Center on Childhood Obesity, Department of International Health, Bloomberg School of Public Health, Baltimore, MD, USA
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Cesa CC, Sbruzzi G, Ribeiro RA, Barbiero SM, de Oliveira Petkowicz R, Eibel B, Machado NB, Marques RDV, Tortato G, dos Santos TJ, Leiria C, Schaan BD, Pellanda LC. Physical activity and cardiovascular risk factors in children: meta-analysis of randomized clinical trials. Prev Med 2014; 69:54-62. [PMID: 25175591 DOI: 10.1016/j.ypmed.2014.08.014] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2013] [Revised: 08/07/2014] [Accepted: 08/08/2014] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To assess the effects of physical activity interventions in preventing cardiovascular risk factors in childhood through a systematic review and meta-analysis of randomized clinical trials (RCTs). METHODS A search of online databases (PubMed, EMBASE and Cochrane CENTRAL) was conducted from inception until June 2013. RCTs enrolling children 6-12years old conducted physical activity interventions longer than 6months, assessing their effect on body mass index (BMI), systolic (SBP) and diastolic blood pressure (DBP), total cholesterol (TC) and triglycerides (TG) were included. Data analysis was performed using a random-effects model. RESULTS Of 23.091 articles retrieved, 11 RCTs (10.748 subjects) were included. Physical activity interventions were not associated with reductions of BMI [-0.03kg/m(2) (95%CI -0.16, 0.13) I(2) 0%]. However, there was an association between the interventions and reduction of SBP [-1.25mmHg (95%CI -2.47, -0.02) I(2) 0%], DBP [-1.34mmHg (95%CI -2.57, -0.11) I(2) 43%] and TG [-0.09mmol/L (95%CI -0.14, -0.04) I(2) 0%], and increase of TC [0.14mmol/L (95%CI 0.01, 0.27) I(2) 0%]. CONCLUSION As physical activity intervention programs lasting longer than 6months are associated with reductions in blood pressure levels and triglycerides, they should be considered to be included in prevention programs for cardiovascular diseases in schoolchildren.
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Affiliation(s)
- Claudia Ciceri Cesa
- Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia, Avenida Princesa Isabel, 370/3 andar. Porto Alegre, Rio Grande do Sul 90620-000, Brazil.
| | - Graciele Sbruzzi
- Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia, Avenida Princesa Isabel, 370/3 andar. Porto Alegre, Rio Grande do Sul 90620-000, Brazil; Universidade Federal do Rio Grande do Sul, School of Physical Education, Rua Felizardo Furtado, 750. Porto Alegre, Rio Grande do Sul90670-090, Brazil.
| | - Rodrigo Antonini Ribeiro
- Hospital Moinhos de Vento, Institute of Education and Research, Rua Ramiro Barcelos, 910. Porto Alegre, Rio Grande do Sul 90035-001, Brazil.
| | - Sandra Mari Barbiero
- Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia, Avenida Princesa Isabel, 370/3 andar. Porto Alegre, Rio Grande do Sul 90620-000, Brazil.
| | - Rosemary de Oliveira Petkowicz
- Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia, Avenida Princesa Isabel, 370/3 andar. Porto Alegre, Rio Grande do Sul 90620-000, Brazil.
| | - Bruna Eibel
- Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia, Avenida Princesa Isabel, 370/3 andar. Porto Alegre, Rio Grande do Sul 90620-000, Brazil.
| | - Natássia Bigolin Machado
- Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia, Avenida Princesa Isabel, 370/3 andar. Porto Alegre, Rio Grande do Sul 90620-000, Brazil; Universidade Federal de Ciências da Saúde de Porto Alegre, Avenida Osvaldo Aranha, 245. Porto Alegre, Rio Grande do Sul 90050-170, Brazil.
| | - Renata das Virgens Marques
- Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia, Avenida Princesa Isabel, 370/3 andar. Porto Alegre, Rio Grande do Sul 90620-000, Brazil; Universidade Federal de Ciências da Saúde de Porto Alegre, Avenida Osvaldo Aranha, 245. Porto Alegre, Rio Grande do Sul 90050-170, Brazil.
| | - Gabriela Tortato
- Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia, Avenida Princesa Isabel, 370/3 andar. Porto Alegre, Rio Grande do Sul 90620-000, Brazil; Universidade Federal de Ciências da Saúde de Porto Alegre, Avenida Osvaldo Aranha, 245. Porto Alegre, Rio Grande do Sul 90050-170, Brazil.
| | - Tiago Jerônimo dos Santos
- Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia, Avenida Princesa Isabel, 370/3 andar. Porto Alegre, Rio Grande do Sul 90620-000, Brazil.
| | - Carina Leiria
- Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia, Avenida Princesa Isabel, 370/3 andar. Porto Alegre, Rio Grande do Sul 90620-000, Brazil.
| | - Beatriz D'Agord Schaan
- Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia, Avenida Princesa Isabel, 370/3 andar. Porto Alegre, Rio Grande do Sul 90620-000, Brazil; Endocrine Division, Hospital de Clínicas de Porto Alegre, Medical School, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2350, prédio 12, 4 andar, Porto Alegre, Rio Grande do Sul 90035-003, Brazil.
| | - Lucia Campos Pellanda
- Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia, Avenida Princesa Isabel, 370/3 andar. Porto Alegre, Rio Grande do Sul 90620-000, Brazil; Universidade Federal de Ciências da Saúde de Porto Alegre, Avenida Osvaldo Aranha, 245. Porto Alegre, Rio Grande do Sul 90050-170, Brazil.
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Ickes MJ, McMullen J, Haider T, Sharma M. Global school-based childhood obesity interventions: a review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:8940-61. [PMID: 25170684 PMCID: PMC4198999 DOI: 10.3390/ijerph110908940] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2014] [Revised: 08/19/2014] [Accepted: 08/20/2014] [Indexed: 01/15/2023]
Abstract
BACKGROUND The issue of childhood overweight and obesity has become a global public health crisis. School-based interventions have been developed and implemented to combat this growing concern. The purpose of this review is to compare and contrast U.S. and international school-based obesity prevention interventions and highlight efficacious strategies. METHODS A systematic literature review was conducted utilizing five relevant databases. Inclusion criteria were: (1) primary research; (2) overweight or obesity prevention interventions; (3) school-based; (4) studies published between 1 January 2002 through 31 December 2013; (5) published in the English language; (6) child-based interventions, which could include parents; and (7) studies that reported outcome data. RESULTS A total of 20 interventions met the inclusion criteria. Ten interventions each were implemented in the U.S. and internationally. International interventions only targeted elementary-aged students, were less likely to target low-income populations, and were less likely to be implemented for two or more years in duration. However, they were more likely to integrate an environmental component when compared to U.S. interventions. DISCUSSION Interventions implemented in the U.S. and internationally resulted in successful outcomes, including positive changes in student BMI. Yet, varying approaches were used to achieve success, reinforcing the fact that a one-size-fits-all approach is not necessary to impact childhood obesity. However, building on successful interventions, future school-based obesity prevention interventions should integrate culturally specific intervention strategies, aim to incorporate an environmental component, and include parents whenever possible. Consideration should be given to the potential impact of long-term, frequent dosage interventions, and subsequent follow-up should be given attention to determine long-term efficacy.
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Affiliation(s)
- Melinda J Ickes
- Department of Kinesiology and Health Promotion, College of Education, University of Kentucky, Lexington, KY 40506, USA.
| | - Jennifer McMullen
- Department of Kinesiology and Health Promotion, College of Education, University of Kentucky, Lexington, KY 40506, USA.
| | - Taj Haider
- The Legal Aid Society, 199 Water Street, New York, NY 10038, USA.
| | - Manoj Sharma
- Behavioral & Environmental Health, Jackson State University, Jackson, MS 39213, USA.
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Rexen CT, Ersbøll AK, Møller NC, Klakk H, Wedderkopp N, Andersen LB. Effects of extra school-based physical education on overall physical fitness development - the CHAMPS study DK. Scand J Med Sci Sports 2014; 25:706-15. [DOI: 10.1111/sms.12293] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2014] [Indexed: 11/28/2022]
Affiliation(s)
- C T Rexen
- Centre of Research in Childhood Health, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, Denmark
| | - A K Ersbøll
- National Institute of Public Health, University of Southern Denmark, København K, Denmark
| | - N C Møller
- Centre of Research in Childhood Health, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, Denmark
| | - H Klakk
- Centre of Research in Childhood Health, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, Denmark.,University College Lillebaelt, Odense M, Denmark
| | - N Wedderkopp
- Centre of Research in Childhood Health, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, Denmark.,Institute of Regional Health Services Research, University of Southern Denmark, Odense M, Denmark.,Sport Medicine Clinic, Orthopedic Department, Hospital of Lillebaelt, Middelfart, Denmark
| | - L B Andersen
- Centre of Research in Childhood Health, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, Denmark.,Department of Sports Medicine, The Norwegian School of Sport Sciences, Oslo, Norway
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46
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Sacheck JM, Hall M. Current Evidence for the Impact of Physical Fitness on Health Outcomes in Youth. Am J Lifestyle Med 2014. [DOI: 10.1177/1559827614537780] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Physical fitness is tightly linked to our ability to be physically active, and poor fitness is tied to increased risk of lifestyle diseases such as diabetes and cardiovascular disease in adulthood. In 2011, the Institute of Medicine appointed an expert committee to review the evidence between physical fitness and health outcomes in youth. Specifically, experimental and longitudinal studies published between 2000 and 2010 were reviewed in the areas of body composition, cardiorespiratory fitness, musculoskeletal fitness, and flexibility. Specific fitness tests that were linked to health risk factors or health outcomes in each of these areas were identified. Recommendations for the best fitness test items for use in schools and also for a national survey were given. In addition, guidance was provided for interpretation of fitness test scores along with recommendations for areas of needed future research. Key findings from the final report “Fitness Measures and Health Outcomes in Youth” will be reviewed.
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Affiliation(s)
- Jennifer M. Sacheck
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts (JMS, MH)
| | - Meghan Hall
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts (JMS, MH)
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47
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Schier R, El-Zein R, Cortes A, Liu M, Collins M, Rafat N, Teschendorf P, Wu HK, Heymach J, Mehran R, Riedel B. Endothelial progenitor cell mobilization by preoperative exercise: a bone marrow response associated with postoperative outcome. Br J Anaesth 2014; 113:652-60. [PMID: 24880828 DOI: 10.1093/bja/aeu135] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Preoperative anaemia is associated with increased morbidity in patients undergoing major surgery. Whether erythrocytes are the only bone-marrow-derived cell lineage that associates with increased surgical complications is unknown. This prospective observational trial studied the mobilization of endothelial progenitor cells (EPCs) in response to exercise in association with postoperative complications. METHODS After IRB approval, 60 subjects undergoing major thoracic surgery were exercised to exhaustion (peak V̇(O₂)). Peripheral blood collected before and after peak exercise was quantified for EPC lineages by fluorescence-activated cell sorter analysis. Complication analysis was based on the Clavien-Dindo classification. RESULTS Exhaustive exercise increased EPC [CD45-133+34+ cells=150 (0.00-5230) to 220 (0.00-1270) cells μl(-1); median change (range)=20 (-4,180-860) cells μl(-1); P=0.03] but not mature endothelial cell (EC) subpopulations. Pre-exercise levels [odds ratio (OR)=0.86, 95% confidence interval (CI): 0.37-2.00, P=0.72), change after exercise as a continuous variable (OR=0.95, 95% CI: 0.41-2.22, P=0.91) and a positive response after exercise (change >0 cells μl(-1); OR=0.41, 95% CI: 0.13-1.28, P=0.12) were not statistically significantly associated with the incidence of postoperative complications. Post-hoc receiver operating characteristic curve analyses revealed that subjects with a CD45-133+34+ increase ≥60 cells μl(-1) in response to exercise suffered fewer postoperative complications [86% sensitivity, 48% specificity and AUC=0.67 (95% CI: 0.52-0.81)]. CONCLUSIONS Preoperative exercise induces EPC into the peripheral circulation. Subjects with a poor EPC response had a pre-existing propensity for postoperative complications. This warrants further research into the role of bone marrow function as a critical component to endothelial repair mechanisms. CLINICAL TRIAL REGISTRATION IRB 2003-0434 (University of Texas M.D. Anderson Cancer Center, Houston, TX, USA).
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Affiliation(s)
- R Schier
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, Germany
| | | | | | - M Liu
- Department of Epidemiology
| | - M Collins
- Centre for Biostatistics and Clinical Trials and
| | - N Rafat
- Department of Pediatrics I, University Children's Heidelberg, Heidelberg, Germany
| | - P Teschendorf
- Department of Anaesthesiology and Intensive Care Medicine, Hospital of Osnabrueck, Osnabrueck, Germany
| | - Hua-Kang Wu
- Department of Thoracic/Head and Neck Oncology, and
| | - J Heymach
- Department of Thoracic/Head and Neck Oncology, and
| | - R Mehran
- Department of Thoracic Surgery, The University of Texas, M. D. Anderson Cancer Center, Houston, TX, USA
| | - B Riedel
- Department of Cancer Anaesthetics and Pain Medicine, Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Australia
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Guerra PH, Nobre MRC, da Silveira JAC, Taddei JAAC. School-based physical activity and nutritional education interventions on body mass index: a meta-analysis of randomised community trials - project PANE. Prev Med 2014; 61:81-9. [PMID: 24440161 DOI: 10.1016/j.ypmed.2014.01.005] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Revised: 01/07/2014] [Accepted: 01/08/2014] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To evaluate the effect of school-based physical activity (PA) and nutritional education (NE) interventions on children's and adolescents' body mass index. METHODS We conducted a systematic search in fourteen databases until September 2012 for randomised controlled trials on PA and NE, conducted in the school setting, and delivered to children and adolescents. Additionally, we performed a cross-reference check in related papers. The title and abstract review and the quality assessment were performed by two independent researchers. The software EPPI-Reviewer3 was used to store, manage and analyse all data. The meta-analysis was conducted using the random-effects model, and the outcomes were reported as standardised mean difference (SMD). As a secondary analysis, we pooled together the interventions that considered PA or NE alone. RESULTS Thirty-eight studies met the eligibility criteria. The main analysis showed a SMD between intervention and control groups of -0.03 (95% CI: -0.09, 0.04; n=28,870; I(2)=83%). When we considered all 57 trials, there was no difference between the results of the primary analysis. CONCLUSION The synthesis of school-based PA and NE interventions showed no statistically significant mean reduction on children's and adolescents' body mass index. The high heterogeneity among studies requires caution in the generalisation of the results.
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Affiliation(s)
- Paulo Henrique Guerra
- Programa de Pós-Graduação em Ciências, Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Avenida Enéas de Carvalho Aguiar 44, 1º subsolo - Bloco II, CEP 05403-900 São Paulo, Brazil; Group of Studies and Researches in Physical Activity Epidemiology (GEPAF EACH-USP), Brazil.
| | - Moacyr Roberto Cuce Nobre
- Unidade de Epidemiologia Clínica do Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, CEP 05403-900 São Paulo, Brazil
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Oberbach A, Neuhaus J, Inge T, Kirsch K, Schlichting N, Blüher S, Kullnick Y, Kugler J, Baumann S, Till H. Bariatric surgery in severely obese adolescents improves major comorbidities including hyperuricemia. Metabolism 2014; 63:242-9. [PMID: 24332707 DOI: 10.1016/j.metabol.2013.11.012] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Revised: 11/13/2013] [Accepted: 11/15/2013] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Serum uric acid (sUA) is believed to contribute to the pathogenesis of metabolic comorbidities like hypertension, insulin-resistance (IR) and endothelial dysfunction (EDF) in obese children. The present pilot study investigated the association between sUA concentrations and loss of body weight following laparoscopic sleeve gastrectomy (LSG) or laparoscopic Roux-en-Y-gastric bypass (RYGB) in severely obese adolescents. MATERIALS/METHODS 10 severely obese adolescents underwent either LSG (n=5) or RYGB (n=5). 17 normal weight, healthy, age- and gender-matched adolescents served as a normal weight peer group (NWPG). Pre- and 12 months postoperatively, sUA and relevant metabolic parameters (glucose homeostasis, transaminases, lipids) were compared. RESULTS Preoperatively, sUA was significantly elevated in patients with severe obesity compared to NWPG. Twelve months after LSG and RYGB, a significant decrease in sUA, BMI, CVD risk factors, hepatic transaminases, and HOMA-IR was observed. Reduction in SDS-BMI significantly correlated with changes in sUA. CONCLUSIONS sUA levels and metabolic comorbidities improved following bariatric surgery in severely obese adolescents. The impact of changes in sUA on long-term clinical complications of childhood obesity deserves further study.
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Affiliation(s)
- Andreas Oberbach
- Department of Cardiac Surgery, University of Leipzig, Heart Center Leipzig, Leipzig, Germany; University of Dresden, Department of Health Sciences/Public Health, Dresden, Germany
| | - Jochen Neuhaus
- Department of Urology, University of Leipzig, Leipzig, Germany
| | - Thomas Inge
- Division of Pediatric Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Katharina Kirsch
- Department of Cardiology, Heart Center, University of Leipzig, Leipzig, Germany
| | - Nadine Schlichting
- Integrated Research and Treatment Center (IFB) Adiposity Diseases, University Leipzig, Leipzig, Germany
| | - Susann Blüher
- Integrated Research and Treatment Center (IFB) Adiposity Diseases, University Leipzig, Leipzig, Germany; Department of Women and Child Health, Hospital for Children and Adolescents, University of Leipzig, Leipzig, Germany
| | - Yvonne Kullnick
- Integrated Research and Treatment Center (IFB) Adiposity Diseases, University Leipzig, Leipzig, Germany
| | - Joachim Kugler
- University of Dresden, Department of Health Sciences/Public Health, Dresden, Germany
| | - Sven Baumann
- Helmholtz Centre for Environmental Research, Department of Metabolomics, Leipzig, Germany
| | - Holger Till
- Department of Pediatric and Adolescent Surgery, Medical University of Graz, Graz, Austria.
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Fiuza-Luces C, Garatachea N, Berger NA, Lucia A. Exercise is the real polypill. Physiology (Bethesda) 2014; 28:330-58. [PMID: 23997192 DOI: 10.1152/physiol.00019.2013] [Citation(s) in RCA: 350] [Impact Index Per Article: 31.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
The concept of a "polypill" is receiving growing attention to prevent cardiovascular disease. Yet similar if not overall higher benefits are achievable with regular exercise, a drug-free intervention for which our genome has been haped over evolution. Compared with drugs, exercise is available at low cost and relatively free of adverse effects. We summarize epidemiological evidence on the preventive/therapeutic benefits of exercise and on the main biological mediators involved.
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