Exercise effects on arterial stiffness and heart health in children with excess weight: The SMART RCT
Introduction Childhood obesity and inactivity are associated with cardiovascular risk. Evidence is limited for exercise effects on arterial health in children. Methods One hundred and seventy-five inactive children with overweight or obesity (8–11 years, ≥85th percentile BMI, 61% female, 87% Black,...
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| Veröffentlicht in: | International Journal of Obesity 2020-05, Vol.44 (5), p.1152-1163 |
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| creator | Davis, Catherine L. Litwin, Sheldon E. Pollock, Norman K. Waller, Jennifer L. Zhu, Haidong Dong, Yanbin Kapuku, Gaston Bhagatwala, Jigar Harris, Ryan A. Looney, Jacob Williams, Celestine F. Armento, Aubrey Schmidt, Michael D. Bassali, Reda |
| description | Introduction
Childhood obesity and inactivity are associated with cardiovascular risk. Evidence is limited for exercise effects on arterial health in children.
Methods
One hundred and seventy-five inactive children with overweight or obesity (8–11 years, ≥85th percentile BMI, 61% female, 87% Black, 73% with obesity) were randomized to an 8-month daily after-school aerobic exercise program (40 min/day,
n
= 90) or a sedentary control condition (
n
= 85). Carotid-femoral pulse wave velocity (PWV, primary outcome, arterial stiffness), fitness, adiposity, blood pressure (BP), glucose, insulin resistance, lipids, and C-reactive protein were measured at baseline and posttest (8 months). Adiposity, fitness, and BP were measured again at follow-up, 8–12 months later. Intent-to-treat analyses were conducted using mixed models.
Results
The study had 89% retention, with attendance of 59% in exercise and 64% in the control condition, and vigorous exercise participation (average heart rate 161 ± 7 beats/min). Compared with controls, the exercise group had twice the improvement in fitness (VȮ
2
peak, 2.7 (95% CI 1.8, 3.6) vs. 1.3 (0.4, 2.3) mL/kg/min) and adiposity (−1.8 (−2.4, −1.1) vs. −0.8 (−1.5, −0.1)%), each
p
= 0.04, and a large improvement in HDL-cholesterol (0.13 (0.075, 0.186) vs. −0.028 (−0.083, 0.023) mmol/L,
p
|
| doi_str_mv | 10.1038/s41366-019-0482-1 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7192762</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A622295823</galeid><sourcerecordid>A622295823</sourcerecordid><originalsourceid>FETCH-LOGICAL-c596t-31a9157765ba508bad6c01c3d785f1c612d777f5e5cdbf0bdc0868e40d7bd18b3</originalsourceid><addsrcrecordid>eNp9kl1rFDEUhgdR7Fr9Ad5IQBBvpuZjkky8EJalfkBFqOt1yGROdlJmk5rM2vrvzbC17YpKIIGc57zJOeetqucEnxDM2je5IUyIGhNV46alNXlQLUgjRc0bJR9WC8ywrDEX_Kh6kvMFxphzTB9XR4xI3lDWLio4vYZkfQYEzoGdMooBmTRB8mZEefLOBcgZmdCjAUpg3sdpQD4gO_ixTxDQlS8XcG1n8Ar8ZpjeovUA6Ovn5fkana_WT6tHzowZnt2cx9W396fr1cf67MuHT6vlWW25ElPNiFGESyl4ZzhuO9MLi4llvWy5I1YQ2kspHQdu-87hrre4FS00uJddT9qOHVfv9rqXu24LvYUwJTPqy-S3Jv3U0Xh9GAl-0Jv4Q0uiqBS0CLy-EUjx-w7ypLc-WxhHEyDusqZz55QiihX05R_oRdylUMrTtMxAMlUk_0sxxXkjG8rvqI0ZQfvgYvmdnZ_WS0EpVbyl84snf6HK6mHrbQzgfLk_SHh1L2E_uBzH3eRjyIcg2YM2xZwTuNuWEaxnq-m91XSxmp6tpknJeXG_17cZv71VALoHcgmFDaS70v-t-gswuNu5</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2395547425</pqid></control><display><type>article</type><title>Exercise effects on arterial stiffness and heart health in children with excess weight: The SMART RCT</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><source>Springer Nature - Connect here FIRST to enable access</source><creator>Davis, Catherine L. ; Litwin, Sheldon E. ; Pollock, Norman K. ; Waller, Jennifer L. ; Zhu, Haidong ; Dong, Yanbin ; Kapuku, Gaston ; Bhagatwala, Jigar ; Harris, Ryan A. ; Looney, Jacob ; Williams, Celestine F. ; Armento, Aubrey ; Schmidt, Michael D. ; Bassali, Reda</creator><creatorcontrib>Davis, Catherine L. ; Litwin, Sheldon E. ; Pollock, Norman K. ; Waller, Jennifer L. ; Zhu, Haidong ; Dong, Yanbin ; Kapuku, Gaston ; Bhagatwala, Jigar ; Harris, Ryan A. ; Looney, Jacob ; Williams, Celestine F. ; Armento, Aubrey ; Schmidt, Michael D. ; Bassali, Reda</creatorcontrib><description>Introduction
Childhood obesity and inactivity are associated with cardiovascular risk. Evidence is limited for exercise effects on arterial health in children.
Methods
One hundred and seventy-five inactive children with overweight or obesity (8–11 years, ≥85th percentile BMI, 61% female, 87% Black, 73% with obesity) were randomized to an 8-month daily after-school aerobic exercise program (40 min/day,
n
= 90) or a sedentary control condition (
n
= 85). Carotid-femoral pulse wave velocity (PWV, primary outcome, arterial stiffness), fitness, adiposity, blood pressure (BP), glucose, insulin resistance, lipids, and C-reactive protein were measured at baseline and posttest (8 months). Adiposity, fitness, and BP were measured again at follow-up, 8–12 months later. Intent-to-treat analyses were conducted using mixed models.
Results
The study had 89% retention, with attendance of 59% in exercise and 64% in the control condition, and vigorous exercise participation (average heart rate 161 ± 7 beats/min). Compared with controls, the exercise group had twice the improvement in fitness (VȮ
2
peak, 2.7 (95% CI 1.8, 3.6) vs. 1.3 (0.4, 2.3) mL/kg/min) and adiposity (−1.8 (−2.4, −1.1) vs. −0.8 (−1.5, −0.1)%), each
p
= 0.04, and a large improvement in HDL-cholesterol (0.13 (0.075, 0.186) vs. −0.028 (−0.083, 0.023) mmol/L,
p
< 0.0001). There was no group × time effect on other outcomes at 8 months, or on any outcomes at follow-up. The change in PWV at 8 months correlated with changes in insulin and insulin resistance (both
r
= 0.32), diastolic BP (
r
= 0.24), BMI (
r
= 0.22), and adiposity (
r
= 0.18).
Conclusions
Eight months of aerobic exercise training improved fitness, adiposity, and HDL-cholesterol levels, but did not reduce arterial stiffness in children with excess weight. PWV improved as a function of insulin resistance, BP, BMI, and adiposity. Weight loss may be required to improve arterial stiffness. Exercise benefits waned after discontinuing the program.</description><identifier>ISSN: 0307-0565</identifier><identifier>ISSN: 1476-5497</identifier><identifier>EISSN: 1476-5497</identifier><identifier>DOI: 10.1038/s41366-019-0482-1</identifier><identifier>PMID: 31754238</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>59 ; 692/163/2743/2037 ; 692/308/575 ; 692/499 ; 692/699/1702/393 ; 692/699/2743/393 ; 96/21 ; Adipose tissue ; Aerobics ; Analysis ; Blood pressure ; Blood Pressure - physiology ; Body weight ; Body weight loss ; C-reactive protein ; Cardiovascular diseases ; Child ; Children ; Cholesterol ; Epidemiology ; Exercise ; Exercise - physiology ; Female ; Health aspects ; Health Promotion and Disease Prevention ; Health risks ; Heart beat ; Heart rate ; High density lipoprotein ; Humans ; Insulin ; Insulin resistance ; Insulin Resistance - physiology ; Internal Medicine ; Lipids ; Male ; Medicine ; Medicine & Public Health ; Metabolic Diseases ; Obesity ; Overweight ; Overweight - physiopathology ; Overweight - therapy ; Pediatric Obesity - physiopathology ; Pediatric Obesity - therapy ; Physical fitness ; Physical training ; Public Health ; Pulse Wave Analysis ; Stiffness ; Vascular Stiffness - physiology ; Wave velocity ; Weight control ; Weight loss</subject><ispartof>International Journal of Obesity, 2020-05, Vol.44 (5), p.1152-1163</ispartof><rights>The Author(s), under exclusive licence to Springer Nature Limited 2019</rights><rights>COPYRIGHT 2020 Nature Publishing Group</rights><rights>The Author(s), under exclusive licence to Springer Nature Limited 2019.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c596t-31a9157765ba508bad6c01c3d785f1c612d777f5e5cdbf0bdc0868e40d7bd18b3</citedby><cites>FETCH-LOGICAL-c596t-31a9157765ba508bad6c01c3d785f1c612d777f5e5cdbf0bdc0868e40d7bd18b3</cites><orcidid>0000-0002-0854-1413 ; 0000-0002-5887-8161 ; 0000-0002-2942-8233 ; 0000-0002-5465-2018 ; 0000-0003-4066-4541</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1038/s41366-019-0482-1$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1038/s41366-019-0482-1$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,776,780,881,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31754238$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Davis, Catherine L.</creatorcontrib><creatorcontrib>Litwin, Sheldon E.</creatorcontrib><creatorcontrib>Pollock, Norman K.</creatorcontrib><creatorcontrib>Waller, Jennifer L.</creatorcontrib><creatorcontrib>Zhu, Haidong</creatorcontrib><creatorcontrib>Dong, Yanbin</creatorcontrib><creatorcontrib>Kapuku, Gaston</creatorcontrib><creatorcontrib>Bhagatwala, Jigar</creatorcontrib><creatorcontrib>Harris, Ryan A.</creatorcontrib><creatorcontrib>Looney, Jacob</creatorcontrib><creatorcontrib>Williams, Celestine F.</creatorcontrib><creatorcontrib>Armento, Aubrey</creatorcontrib><creatorcontrib>Schmidt, Michael D.</creatorcontrib><creatorcontrib>Bassali, Reda</creatorcontrib><title>Exercise effects on arterial stiffness and heart health in children with excess weight: The SMART RCT</title><title>International Journal of Obesity</title><addtitle>Int J Obes</addtitle><addtitle>Int J Obes (Lond)</addtitle><description>Introduction
Childhood obesity and inactivity are associated with cardiovascular risk. Evidence is limited for exercise effects on arterial health in children.
Methods
One hundred and seventy-five inactive children with overweight or obesity (8–11 years, ≥85th percentile BMI, 61% female, 87% Black, 73% with obesity) were randomized to an 8-month daily after-school aerobic exercise program (40 min/day,
n
= 90) or a sedentary control condition (
n
= 85). Carotid-femoral pulse wave velocity (PWV, primary outcome, arterial stiffness), fitness, adiposity, blood pressure (BP), glucose, insulin resistance, lipids, and C-reactive protein were measured at baseline and posttest (8 months). Adiposity, fitness, and BP were measured again at follow-up, 8–12 months later. Intent-to-treat analyses were conducted using mixed models.
Results
The study had 89% retention, with attendance of 59% in exercise and 64% in the control condition, and vigorous exercise participation (average heart rate 161 ± 7 beats/min). Compared with controls, the exercise group had twice the improvement in fitness (VȮ
2
peak, 2.7 (95% CI 1.8, 3.6) vs. 1.3 (0.4, 2.3) mL/kg/min) and adiposity (−1.8 (−2.4, −1.1) vs. −0.8 (−1.5, −0.1)%), each
p
= 0.04, and a large improvement in HDL-cholesterol (0.13 (0.075, 0.186) vs. −0.028 (−0.083, 0.023) mmol/L,
p
< 0.0001). There was no group × time effect on other outcomes at 8 months, or on any outcomes at follow-up. The change in PWV at 8 months correlated with changes in insulin and insulin resistance (both
r
= 0.32), diastolic BP (
r
= 0.24), BMI (
r
= 0.22), and adiposity (
r
= 0.18).
Conclusions
Eight months of aerobic exercise training improved fitness, adiposity, and HDL-cholesterol levels, but did not reduce arterial stiffness in children with excess weight. PWV improved as a function of insulin resistance, BP, BMI, and adiposity. Weight loss may be required to improve arterial stiffness. Exercise benefits waned after discontinuing the program.</description><subject>59</subject><subject>692/163/2743/2037</subject><subject>692/308/575</subject><subject>692/499</subject><subject>692/699/1702/393</subject><subject>692/699/2743/393</subject><subject>96/21</subject><subject>Adipose tissue</subject><subject>Aerobics</subject><subject>Analysis</subject><subject>Blood pressure</subject><subject>Blood Pressure - physiology</subject><subject>Body weight</subject><subject>Body weight loss</subject><subject>C-reactive protein</subject><subject>Cardiovascular diseases</subject><subject>Child</subject><subject>Children</subject><subject>Cholesterol</subject><subject>Epidemiology</subject><subject>Exercise</subject><subject>Exercise - physiology</subject><subject>Female</subject><subject>Health aspects</subject><subject>Health Promotion and Disease Prevention</subject><subject>Health risks</subject><subject>Heart beat</subject><subject>Heart rate</subject><subject>High density lipoprotein</subject><subject>Humans</subject><subject>Insulin</subject><subject>Insulin resistance</subject><subject>Insulin Resistance - physiology</subject><subject>Internal Medicine</subject><subject>Lipids</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metabolic Diseases</subject><subject>Obesity</subject><subject>Overweight</subject><subject>Overweight - physiopathology</subject><subject>Overweight - therapy</subject><subject>Pediatric Obesity - physiopathology</subject><subject>Pediatric Obesity - therapy</subject><subject>Physical fitness</subject><subject>Physical training</subject><subject>Public Health</subject><subject>Pulse Wave Analysis</subject><subject>Stiffness</subject><subject>Vascular Stiffness - physiology</subject><subject>Wave velocity</subject><subject>Weight control</subject><subject>Weight loss</subject><issn>0307-0565</issn><issn>1476-5497</issn><issn>1476-5497</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kl1rFDEUhgdR7Fr9Ad5IQBBvpuZjkky8EJalfkBFqOt1yGROdlJmk5rM2vrvzbC17YpKIIGc57zJOeetqucEnxDM2je5IUyIGhNV46alNXlQLUgjRc0bJR9WC8ywrDEX_Kh6kvMFxphzTB9XR4xI3lDWLio4vYZkfQYEzoGdMooBmTRB8mZEefLOBcgZmdCjAUpg3sdpQD4gO_ixTxDQlS8XcG1n8Ar8ZpjeovUA6Ovn5fkana_WT6tHzowZnt2cx9W396fr1cf67MuHT6vlWW25ElPNiFGESyl4ZzhuO9MLi4llvWy5I1YQ2kspHQdu-87hrre4FS00uJddT9qOHVfv9rqXu24LvYUwJTPqy-S3Jv3U0Xh9GAl-0Jv4Q0uiqBS0CLy-EUjx-w7ypLc-WxhHEyDusqZz55QiihX05R_oRdylUMrTtMxAMlUk_0sxxXkjG8rvqI0ZQfvgYvmdnZ_WS0EpVbyl84snf6HK6mHrbQzgfLk_SHh1L2E_uBzH3eRjyIcg2YM2xZwTuNuWEaxnq-m91XSxmp6tpknJeXG_17cZv71VALoHcgmFDaS70v-t-gswuNu5</recordid><startdate>20200501</startdate><enddate>20200501</enddate><creator>Davis, Catherine L.</creator><creator>Litwin, Sheldon E.</creator><creator>Pollock, Norman K.</creator><creator>Waller, Jennifer L.</creator><creator>Zhu, Haidong</creator><creator>Dong, Yanbin</creator><creator>Kapuku, Gaston</creator><creator>Bhagatwala, Jigar</creator><creator>Harris, Ryan A.</creator><creator>Looney, Jacob</creator><creator>Williams, Celestine F.</creator><creator>Armento, Aubrey</creator><creator>Schmidt, Michael D.</creator><creator>Bassali, Reda</creator><general>Nature Publishing Group UK</general><general>Nature Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T2</scope><scope>7TK</scope><scope>7TS</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-0854-1413</orcidid><orcidid>https://orcid.org/0000-0002-5887-8161</orcidid><orcidid>https://orcid.org/0000-0002-2942-8233</orcidid><orcidid>https://orcid.org/0000-0002-5465-2018</orcidid><orcidid>https://orcid.org/0000-0003-4066-4541</orcidid></search><sort><creationdate>20200501</creationdate><title>Exercise effects on arterial stiffness and heart health in children with excess weight: The SMART RCT</title><author>Davis, Catherine L. ; Litwin, Sheldon E. ; Pollock, Norman K. ; Waller, Jennifer L. ; Zhu, Haidong ; Dong, Yanbin ; Kapuku, Gaston ; Bhagatwala, Jigar ; Harris, Ryan A. ; Looney, Jacob ; Williams, Celestine F. ; Armento, Aubrey ; Schmidt, Michael D. ; Bassali, Reda</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c596t-31a9157765ba508bad6c01c3d785f1c612d777f5e5cdbf0bdc0868e40d7bd18b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>59</topic><topic>692/163/2743/2037</topic><topic>692/308/575</topic><topic>692/499</topic><topic>692/699/1702/393</topic><topic>692/699/2743/393</topic><topic>96/21</topic><topic>Adipose tissue</topic><topic>Aerobics</topic><topic>Analysis</topic><topic>Blood pressure</topic><topic>Blood Pressure - physiology</topic><topic>Body weight</topic><topic>Body weight loss</topic><topic>C-reactive protein</topic><topic>Cardiovascular diseases</topic><topic>Child</topic><topic>Children</topic><topic>Cholesterol</topic><topic>Epidemiology</topic><topic>Exercise</topic><topic>Exercise - physiology</topic><topic>Female</topic><topic>Health aspects</topic><topic>Health Promotion and Disease Prevention</topic><topic>Health risks</topic><topic>Heart beat</topic><topic>Heart rate</topic><topic>High density lipoprotein</topic><topic>Humans</topic><topic>Insulin</topic><topic>Insulin resistance</topic><topic>Insulin Resistance - physiology</topic><topic>Internal Medicine</topic><topic>Lipids</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metabolic Diseases</topic><topic>Obesity</topic><topic>Overweight</topic><topic>Overweight - physiopathology</topic><topic>Overweight - therapy</topic><topic>Pediatric Obesity - physiopathology</topic><topic>Pediatric Obesity - therapy</topic><topic>Physical fitness</topic><topic>Physical training</topic><topic>Public Health</topic><topic>Pulse Wave Analysis</topic><topic>Stiffness</topic><topic>Vascular Stiffness - physiology</topic><topic>Wave velocity</topic><topic>Weight control</topic><topic>Weight loss</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Davis, Catherine L.</creatorcontrib><creatorcontrib>Litwin, Sheldon E.</creatorcontrib><creatorcontrib>Pollock, Norman K.</creatorcontrib><creatorcontrib>Waller, Jennifer L.</creatorcontrib><creatorcontrib>Zhu, Haidong</creatorcontrib><creatorcontrib>Dong, Yanbin</creatorcontrib><creatorcontrib>Kapuku, Gaston</creatorcontrib><creatorcontrib>Bhagatwala, Jigar</creatorcontrib><creatorcontrib>Harris, Ryan A.</creatorcontrib><creatorcontrib>Looney, Jacob</creatorcontrib><creatorcontrib>Williams, Celestine F.</creatorcontrib><creatorcontrib>Armento, Aubrey</creatorcontrib><creatorcontrib>Schmidt, Michael D.</creatorcontrib><creatorcontrib>Bassali, Reda</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Neurosciences Abstracts</collection><collection>Physical Education Index</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Databases</collection><collection>ProQuest Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biological Sciences</collection><collection>Agricultural Science Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Psychology</collection><collection>Biological Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>International Journal of Obesity</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Davis, Catherine L.</au><au>Litwin, Sheldon E.</au><au>Pollock, Norman K.</au><au>Waller, Jennifer L.</au><au>Zhu, Haidong</au><au>Dong, Yanbin</au><au>Kapuku, Gaston</au><au>Bhagatwala, Jigar</au><au>Harris, Ryan A.</au><au>Looney, Jacob</au><au>Williams, Celestine F.</au><au>Armento, Aubrey</au><au>Schmidt, Michael D.</au><au>Bassali, Reda</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Exercise effects on arterial stiffness and heart health in children with excess weight: The SMART RCT</atitle><jtitle>International Journal of Obesity</jtitle><stitle>Int J Obes</stitle><addtitle>Int J Obes (Lond)</addtitle><date>2020-05-01</date><risdate>2020</risdate><volume>44</volume><issue>5</issue><spage>1152</spage><epage>1163</epage><pages>1152-1163</pages><issn>0307-0565</issn><issn>1476-5497</issn><eissn>1476-5497</eissn><abstract>Introduction
Childhood obesity and inactivity are associated with cardiovascular risk. Evidence is limited for exercise effects on arterial health in children.
Methods
One hundred and seventy-five inactive children with overweight or obesity (8–11 years, ≥85th percentile BMI, 61% female, 87% Black, 73% with obesity) were randomized to an 8-month daily after-school aerobic exercise program (40 min/day,
n
= 90) or a sedentary control condition (
n
= 85). Carotid-femoral pulse wave velocity (PWV, primary outcome, arterial stiffness), fitness, adiposity, blood pressure (BP), glucose, insulin resistance, lipids, and C-reactive protein were measured at baseline and posttest (8 months). Adiposity, fitness, and BP were measured again at follow-up, 8–12 months later. Intent-to-treat analyses were conducted using mixed models.
Results
The study had 89% retention, with attendance of 59% in exercise and 64% in the control condition, and vigorous exercise participation (average heart rate 161 ± 7 beats/min). Compared with controls, the exercise group had twice the improvement in fitness (VȮ
2
peak, 2.7 (95% CI 1.8, 3.6) vs. 1.3 (0.4, 2.3) mL/kg/min) and adiposity (−1.8 (−2.4, −1.1) vs. −0.8 (−1.5, −0.1)%), each
p
= 0.04, and a large improvement in HDL-cholesterol (0.13 (0.075, 0.186) vs. −0.028 (−0.083, 0.023) mmol/L,
p
< 0.0001). There was no group × time effect on other outcomes at 8 months, or on any outcomes at follow-up. The change in PWV at 8 months correlated with changes in insulin and insulin resistance (both
r
= 0.32), diastolic BP (
r
= 0.24), BMI (
r
= 0.22), and adiposity (
r
= 0.18).
Conclusions
Eight months of aerobic exercise training improved fitness, adiposity, and HDL-cholesterol levels, but did not reduce arterial stiffness in children with excess weight. PWV improved as a function of insulin resistance, BP, BMI, and adiposity. Weight loss may be required to improve arterial stiffness. Exercise benefits waned after discontinuing the program.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>31754238</pmid><doi>10.1038/s41366-019-0482-1</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-0854-1413</orcidid><orcidid>https://orcid.org/0000-0002-5887-8161</orcidid><orcidid>https://orcid.org/0000-0002-2942-8233</orcidid><orcidid>https://orcid.org/0000-0002-5465-2018</orcidid><orcidid>https://orcid.org/0000-0003-4066-4541</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0307-0565 |
| ispartof | International Journal of Obesity, 2020-05, Vol.44 (5), p.1152-1163 |
| issn | 0307-0565 1476-5497 1476-5497 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7192762 |
| source | MEDLINE; Springer Nature - Complete Springer Journals; Springer Nature - Connect here FIRST to enable access |
| subjects | 59 692/163/2743/2037 692/308/575 692/499 692/699/1702/393 692/699/2743/393 96/21 Adipose tissue Aerobics Analysis Blood pressure Blood Pressure - physiology Body weight Body weight loss C-reactive protein Cardiovascular diseases Child Children Cholesterol Epidemiology Exercise Exercise - physiology Female Health aspects Health Promotion and Disease Prevention Health risks Heart beat Heart rate High density lipoprotein Humans Insulin Insulin resistance Insulin Resistance - physiology Internal Medicine Lipids Male Medicine Medicine & Public Health Metabolic Diseases Obesity Overweight Overweight - physiopathology Overweight - therapy Pediatric Obesity - physiopathology Pediatric Obesity - therapy Physical fitness Physical training Public Health Pulse Wave Analysis Stiffness Vascular Stiffness - physiology Wave velocity Weight control Weight loss |
| title | Exercise effects on arterial stiffness and heart health in children with excess weight: The SMART RCT |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-24T18%3A27%3A15IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Exercise%20effects%20on%20arterial%20stiffness%20and%20heart%20health%20in%20children%20with%20excess%20weight:%20The%20SMART%20RCT&rft.jtitle=International%20Journal%20of%20Obesity&rft.au=Davis,%20Catherine%20L.&rft.date=2020-05-01&rft.volume=44&rft.issue=5&rft.spage=1152&rft.epage=1163&rft.pages=1152-1163&rft.issn=0307-0565&rft.eissn=1476-5497&rft_id=info:doi/10.1038/s41366-019-0482-1&rft_dat=%3Cgale_pubme%3EA622295823%3C/gale_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2395547425&rft_id=info:pmid/31754238&rft_galeid=A622295823&rfr_iscdi=true |