Cardiovascular risks associated with obesity in children and adolescents

<p><b>INTRODUCTION</b>The aim of this paper is to review the cardiovascular (CVS) risks associated with obesity in children and adolescents. Both short-term and long-term CVS consequences, the mechanisms of how these develop and the measures that can alter or reverse these CVS events are reviewed.</p><p><b>MATERIALS AND METHODS</b>Selected publications include original articles and review papers that report on studies of CVS risks and consequences related to childhood obesity. Some papers that contain data from adults studies are also included if the contents help to explain some underlying mechanisms or illustrate the continuation of related CVS changes into adulthood.</p><p><b>RESULTS</b>Obese children and adolescents have an increased risk for CVS complications that include elevation of blood pressure, clustering of CVS risk factors (Metabolic Syndrome), changes to arterial wall thickness, elasticity and endothelium, as well as changes in left ventricular structure and function. Some of these cardiovascular problems may be initiated or potentiated by obstructive sleep apnoea that can accompany obesity in children. Many of such changes have been noted to reverse or improve with weight reduction.</p><p><b>CONCLUSIONS</b>Early development of CVS risks in obese children and the possible continuation of CVS complications into adulthood have been observed. Obstructive sleep apnoea in obese children can further contribute to such CVS risks. These findings underscore the importance of prevention of childhood obesity as a priority over management of obesity in children.</p>

Plasma endotoxin and immune responses during a 21-km road race under a warm and humid environment

<p><b>INTRODUCTION</b>This study investigated the responses of plasma endotoxin and pro- and antiinflammatory cytokines during a 21-km road race in warm and humid conditions. The influence of carbohydrate-electrolyte (CE)-water (WA) drink mix ingested on leukocyte subset responses and the association between plasma lipopolysaccharide (LPS) concentration and fluid balance, exercise intensity, and body core temperature (Tc) were also studied.</p><p><b>MATERIALS AND METHODS</b>Thirty runners provided blood samples before and after the half-marathon for leukocyte, LPS and cytokine analyses. Tc was measured by the ingestible telemetric temperature sensor and fluid intake and split-times were recorded at 3 km intervals. Exercise intensity was determined by matching running speed and heart rate during the race with the corresponding speed-oxygen uptake relationship and heart rate measured in the laboratory 2 to 6 weeks before the race.</p><p><b>RESULTS</b>Plasma LPS concentration increased from 1.9 +/- 1.9 pg/mL before, to 2.5 +/- 1.9 pg/mL after running (P <0.05). Peak plasma LPS concentration was 7.5 pg/mL. Plasma IL-1beta and TNF-concentration did not change significantly, whereas significant increases in IL-10 (50%), IL-1ra (23.2%) and IL-6 (65.2%) were observed after the race. No significant correlation between plasma LPS concentration and exercise intensity, hydration and Tc was observed.</p><p><b>CONCLUSION</b>Leukocyte subset responses were not related to the ratio of CE and water drink mix ingested. Running a half-marathon can induce mild endotoxaemia, which is not related to exercise intensity, fluid balance, and Tc responses. Mixing CE drink with water did not mitigate postexercise leukocytosis and lymphopenia.</p>