Media use and obesity in adolescent females.

OBJECTIVE: In the context of growing public health concern with the obesity rates among children and adolescents, much attention has focused on the role of television as a contributor to the problem. Less attention has been devoted to interactive media (internet surfing and video games), despite the fact that these forms of entertainment are fast gaining in popularity among youth. This study investigated the relative associations of TV viewing and interactive media use with body fat and BMI, controlling for both physical activity participation and cardiovascular fitness. RESEARCH METHODS AND PROCEDURES: Female high-school adolescents (N = 194) were assessed for cardiovascular fitness (cycle ergometer), percent body fat (DXA), and BMI. Time spent in moderate, vigorous, and sedentary activities was assessed with a 3-day recall. RESULTS: Multivariate regression analysis showed that only interactive media use was associated with percentage body fat and BMI, and the relationship remained strong even after controlling for physical activity participation and cardiovascular fitness. DISCUSSION: It appears that, among this group of adolescent females, the association between interactive media use and obesity is not explained by a reduction in moderate or vigorous activity commensurate with media use.

Physical activity, growth, and inflammatory mediators in BMI-matched female adolescents.

PURPOSE: Physical inactivity is deleterious to health, but it has been difficult to determine the extent to which these effects are attributable to abnormal body composition or to factors related to physical activity alone. To begin to gauge independent effects of physical activity on health risk, we matched by BMI two groups of normal-weight adolescent females, one physically active (all participants in high school sports), and one sedentary. METHODS: Thirty-seven sedentary and 37 physically active adolescent females (mean 15.5 yr) were matched for age and BMI percentile (mean = 58.8). Comparisons included fitness, body composition and bone mineralization (by DEXA), circulating inflammatory cytokines, growth factors, bone-turnover markers, leptin, and adiponectin. RESULTS: Compared with the normal-weight sedentary girls, active girls had significantly (P < 0.05) higher fitness level (peak VO2 35.5 +/- 5.2 vs 24.4 +/- 4.1 mL.kg(-1).min(-1)), lean body mass (43.2 +/- 4.4 vs 38.7 +/- 3.6 kg), bone mineralization (spinal BMD z-scores 0.04 +/- 0.88 vs -0.41 +/- 0.85), and lower percent body fat (25.4 +/- 04.6 vs 29.7 +/- 03.7%). Additionally, active girls had lower inflammatory cytokines levels (e.g., TNF-alpha 1.7 +/- 1.3 vs 2.6 +/- 2.2 pg.mL(-1)), and leptin (17.4 +/- 11.2 vs 24.7 +/- 14.7 ng.mL(-1)), and higher bone-turnover markers (e.g. osteocalcin 12.6 +/- 7.6 vs 7.8 +/- 3.0 U.L(-1)), IGFBP-3 (6416 +/- 21280 vs 4247 +/- 1082 ng.mL(-1)), and adiponectin levels (11919 +/- 3935 vs 9305 +/- 2843 ng.mL(-1)). CONCLUSION: The normal-weight, physically active group was fitter and had greater lean body mass, stronger bones, and lower levels of inflammatory markers than did the normal-weight, sedentary group. In adolescent girls, the choice of a lifestyle involving high school sports is characterized by a circulating mediator and body composition pattern that, if sustained, is associated with generally lower long-term risk of cardiovascular disease and osteoporosis.

Dangerous exercise: lessons learned from dysregulated inflammatory responses to physical activity.

Exercise elicits an immunological "danger" type of stress and inflammatory response that, on occasion, becomes dysregulated and detrimental to health. Examples include anaphylaxis, exercise-induced asthma, overuse syndromes, and exacerbation of intercurrent illnesses. In dangerous exercise, the normal balance between pro- and anti-inflammatory responses is upset. A possible pathophysiological mechanism is characterized by the concept of exercise modulation of previously activated leukocytes. In this model, circulating leukocytes are rendered more responsive than normal to the immune stimulus of exercise. For example, in the case of exercise anaphylaxis, food-sensitized immune cells may be relatively innocuous until they are redistributed during exercise from gut-associated circulatory depots, like the spleen, into the central circulation. In the case of asthma, the prior activation of leukocytes may be the result of genetic or environmental factors. In the case of overuse syndromes, the normally short-lived neutrophil may, because of acidosis and hypoxia, inhibit apoptosis and play a role in prolongation of inflammation rather than healing. Dangerous exercise demonstrates that the stress/inflammatory response caused by physical activity is robust and sufficiently powerful, perhaps, to alter subsequent responses. These longer term effects may occur through as yet unexplored mechanisms of immune "tolerance" and/or by a training-associated reduction in the innate immune response to brief exercise. A better understanding of sometimes failed homeostatic physiological systems can lead to new insights with significant implication for clinical translation.

Exercise, stress, and inflammation in the growing child: from the bench to the playground.

PURPOSE OF REVIEW: It is becoming increasingly clear that physical activity in children plays a critical role in growth and development, therapy for certain chronic diseases and disabilities, and in the pediatric origins of a variety of bone, metabolic, and cardiovascular diseases. New mechanistic insights have created the opportunity for a phase shift in understanding of the links between exercise and health in the context of the growing child. RECENT FINDINGS: Exercise even in healthy children profoundly alters stress, immune, and inflammatory mediators including peripheral blood mononuclear cells and circulating pro- and anti-inflammatory cytokines (like interleukin-6). Moreover, exercise even in healthy adults stimulates the production of reactive oxygen species (ROS) and mediators that attenuate them. Oxidative stress, in turn, alters growth and stress mediators. Both ROS and stress/inflammatory factors interact with powerful growth mediators like growth hormone and insulinlike growth factor-I. These findings suggest specific ways in which the balance between pro- and anti-inflammatory, catabolic, and anabolic factors associated with exercise can influence health and growth in children. SUMMARY: To address the current epidemic of physical inactivity and obesity in children and to optimize the therapeutic effects of exercise in children with disease and disability will require real changes in environments (eg, schools and playgrounds); innovative approaches to rehabilitation of children with chronic disease and disability; and enlightened training of child health professionals. Identifying novel exercise mechanisms involving stress, inflammation, and growth factors will help guide these efforts.

Assessing the perceived environment among minimally active adolescent girls: validity and relations to physical activity outcomes.

PURPOSE: This study examined how adolescents' perceptions of exercise resources in the environment relate to physical activity outcomes. METHODS: Perceptions of the availability and use of environmental resources, vigorous physical activity (VIG), daily energy expenditure (KCAL), lifestyle activities (LA), and cardiovascular fitness (Vo2peak) were assessed cross-sectionally among 87 minimally active adolescent girls (ages 14-17). To validate adolescent reports, the perceived availability of environmental resources was also assessed from 47 parents. RESULTS: Adolescent-parent agreement over the availability of resources was modest for the home domain (r = .62, p < .001) and weak for the community domain (r = .14, p > .05). Adolescents' perceptions of resource availability in both the home and community domains were positively associated with VO2peak (p < .05) but unrelated to VIG, KCAL, and LA. Adolescents' use of home resources was positively correlated with both VIG and LA (p < .05). CONCLUSION: Minimally active adolescent girls were more attuned to and likely to use the resources for physical activity located in their home environment as opposed to the community environment.