Effect of asthma and six-months high-intensity interval training on heart rate variability during exercise in adolescents.

Little is known regarding the influence of asthma and exercise, and their interaction, on heart rate variability (HRV) in adolescents. Thirty-one adolescents with asthma (13.7±0.9 years; 21.9±3.9 kg·m-2; 19 boys, 12 girls) and thirty-three healthy adolescents (13.8±0.9 years; 20.3±3.2 kg·m-2; 16 boys, 17 girls) completed an incremental ramp test and three heavy-intensity constant-work-rate cycle tests. Thirteen adolescents (7 boys, 6 girls; 6 asthma, 7 control) completed six-months high-intensity interval training (HIIT) and were compared to age- and sex-matched controls. Standard time-domain, frequency-domain and non-linear indices of HRV were derived at baseline, three- and six-months. Asthma did not influence HRV at baseline or following HIIT. Total power, low frequency and normalised low frequency power, and sympathovagal balance increased at three-months in HIIT, subsequently declining towards baseline at six-months. Normalised high frequency power was reduced at three-months in both groups, which was sustained at six-months. No effects of HIIT were observed in the time-domain nor in the non-linear indices. HRV was not influenced by asthma, potentially because such derangements are a function of disease progression, severity or duration. HIIT may be associated with a short-term shift towards greater sympathetic predominance during exercise, perhaps caused by physiological overload and fatigue.

Associations between anthropometric indicators in early life and low-grade inflammation, insulin resistance and lipid profile in adolescence.

BACKGROUND AND AIMS: The long-term relations between excessive adiposity in early childhood and unfavourable cardiometabolic profiles in later ages are not yet completely understood. We aimed to assess the associations between birth weight (BW) and BMI from 6 months to 6 years of age, with biomarkers indicative of low-grade inflammation, insulin resistance and lipid profiles in adolescence. METHODS AND RESULTS: Retrospective school-based study with 415 Portuguese adolescents (220 girls), mean age of 14.08 ± 1.6 years old. Anthropometric data from birth to 6 years old was extracted from individual child health book records. Actual weight and height were measured and BMI calculated. Participants were classified at each time point as normal weight or overweight according to WHO reference values. Biomarkers were obtained from venous blood samples. Linear regressions were used to explore the associations between the biomarkers and early life anthropometric indicators. From 2 years onwards, BMI associated positively with the inflammatory score and HOMA-IR in adolescence. Children who were overweight/obese from 2 to 6 years of age presented significantly higher inflammatory score and HOMA-IR later in adolescence. TC/HDL ratio was also positively associated with BMI from the age of 5 years onwards. The associations between BMI and cardiometabolic outcomes remained positive in adolescence, with overweight adolescents presenting a higher inflammatory score, HOMA-IR and TC/HDL than normal weight adolescents. CONCLUSION: A high BMI from an early age was consistently associated with worse inflammatory and lipid profiles and insulin resistance in adolescence. No associations were found between BW and the same studied outcomes.

Prevalence of Cryptosporidium spp. in asymptomatic small ruminants in Grenada, West Indies.

Cryptosporidium spp. is a protozoan parasite that causes enteric infection in a wide range of hosts, including livestock and humans. The aim of this cross-sectional study was to estimate the prevalence of Cryptosporidium spp. in small ruminants in Grenada, West Indies. Fecal samples were collected from 100 sheep and 202 goats from 32 farms. The fecal samples were tested using an Enzyme-linked immunosorbent assay (ELISA) for qualitative detection of antigens in feces (Diagnostic Automation Inc., USA). The overall prevalence of Cryptosporidium spp. was 19.5% [95% confidence interval (CI): 15.4% to 24.4%] in both sheep and goats. The prevalence of Cryptosporidium spp. in sheep and goats was 14% (95% CI: 8.4% to 22.3%) and 22.3% (95% CI: 17.1% to 28.5%), respectively. There was no significant difference in the prevalence of Cryptosporidium spp. infection between sheep and goats (p = .42, Fisher's exact test) in Grenada. Of the 32 farms visited, 19 (59.4%) had at least one Cryptosporidium spp. positive animal.

Perceptions of asthma and exercise in adolescents with and without asthma.

OBJECTIVE: To elicit the views of adolescents, with and without asthma, about exercise and asthma, and the perceived benefits of and barriers to participation. The adolescent views elicited would subsequently inform the design of a high-intensity exercise intervention to improve asthma control. METHODS: Fifty-four adolescents (age 13.1 ± 0.9 years; 26 with asthma) participated in twelve semi-structured group interviews. Questions were structured around knowledge, attitudes and beliefs towards asthma and its impact on exercise participation and lifestyle. The interviews were transcribed verbatim, thematically analysed and presented via diagrams of emergent themes. Ethical approval was granted by the institutional research ethics committee. RESULTS: Fear of an asthma attack emerged as the main barrier to exercise, with many adolescents with asthma withdrawing from exercise as a coping strategy; many healthy adolescents perceived this withdrawal as laziness or an excuse. Despite this, the majority (81%) of adolescents with asthma reported exercise to be their most enjoyable activity. Adolescents suggested incorporating mixed activities, such as team games (e.g., rounders, football, netball), for future interventions to ensure adherence. CONCLUSIONS: Whilst exercise is important in the management of asthma, the tendency of those with asthma to withdraw from exercise to avoid adverse events could be addressed through a games-based high-intensity exercise intervention. Furthermore, educating all adolescents on asthma could simultaneously reduce stigmatisation and enhance exercise engagement.

Effect of a 6-Week Active Play Intervention on Fundamental Movement Skill Competence of Preschool Children.

This study examined the effectiveness of an active play intervention on fundamental movement skills of 3- to 5-year-old children from deprived communities. In a cluster randomized controlled trial design, six preschools received a resource pack and a 6-week local authority program involving staff training with help implementing 60-minute weekly sessions and postprogram support. Six comparison preschools received a resource pack only. Twelve skills were assessed at baseline, postintervention, and at a 6-month follow-up using the Children's Activity and Movement in Preschool Study Motor Skills Protocol. One hundred and sixty-two children (Mean age = 4.64 ± 0.58 years; 53.1% boys) were included in the final analyses. There were no significant differences between groups for total fundamental movement skill, object-control skill or locomotor skill scores, indicating a need for program modification to facilitate greater skill improvements.

The association between dog ownership or dog walking and fitness or weight status in childhood.

BACKGROUND: Health benefits of dog walking are established in adults: dog owners are on average more physically active, and those walking their dogs regularly have lower weight status than those who do not. However, there has been little research on children. OBJECTIVES: This study aimed to examine the association between dog ownership or dog walking and childhood fitness or weight status. METHODS: A survey of pet ownership and involvement in dog walking was combined with fitness and weight status measurements of 1021 9 to 10-year-old children in the Liverpool SportsLinx study. RESULTS: We found little evidence to support that children who live with, or walk with, dogs are any fitter or less likely to be obese than those who do not. CONCLUSIONS: This is an important finding, as it suggests that the activity that children currently do with dogs is not sufficient enough to impact weight status or fitness.

Objective measurement of sedentary behaviour using accelerometers.

BACKGROUND: Sedentary behaviour (SB) is an important risk factor for a number of chronic diseases. Although gaps remain in our knowledge of the elements of SB most associated with reduced health outcomes, measuring SB is important, especially in less active patient populations where treatment-related changes may be seen first in changes in SB. METHODS: We review current published work in the measurement of SB to make recommendations for SB measurement in clinical studies. RESULTS: To help move our understanding of the area forward, we propose a set of derived measures of SB that can be easily understood and interpreted. CONCLUSION: Although there is more work required to determine and validate the most clinically relevant and sensitive measures of SB, there is enough understanding of how to measure SB to enable its inclusion in study protocols.

Physical activity guidelines and cardiovascular risk in children: a cross sectional analysis to determine whether 60 minutes is enough.

BACKGROUND: Physical activity reduces cardiovascular mortality and morbidity. The World Health Organisation (WHO) recommends children engage in 60 min daily moderate-to-vigorous physical activity (MVPA). The effect of compliance with this recommendation on childhood cardiovascular risk has not been empirically tested. To evaluate whether achieving recommendations results in reduced composite-cardiovascular risk score (CCVR) in children, and to examine if vigorous PA (VPA) has independent risk-reduction effects. METHODS: PA was measured using accelerometry in 182 children (9-11 years). Subjects were grouped according to achievement of 60 min daily MVPA (active) or not (inactive). CCVR was calculated (sum of z-scores: DXA body fat %, blood pressure, VO2peak, flow mediated dilation, left ventricular diastolic function; CVR score ≥ 1SD indicated 'higher risk'). The cohort was further split into quintiles for VPA and odds ratios (OR) calculated for each quintile. RESULTS: Active children (92 (53 boys)) undertook more MVPA (38 ± 11 min, P < 0.001), had greater VO2peak (4.5 ± 0.8 ml/kg/min P < 0.001), and lower fat % (3.9 ± 1.1 %, P < 0.001) than inactive. No difference were observed between active and inactive for CCVR or OR (P > 0.05). CCVR in the lowest VPA quintile was significantly greater than the highest quintile (3.9 ± 0.6, P < 0.05), and the OR was 4.7 times higher. CONCLUSION: Achievement of current guidelines has positive effects on body composition and cardiorespiratory fitness, but not CCVR. Vigorous physical activity appears to have beneficial effects on CVD risk, independent of moderate PA, implying a more prescriptive approach may be needed for future VPA guidelines.

FUNDAMENTAL MOVEMENT SKILLS OF PRESCHOOL CHILDREN IN NORTHWEST ENGLAND.

This cross-sectional study examined fundamental movement skill competency among deprived preschool children in Northwest England and explored sex differences. A total of 168 preschool children (ages 3-5 yr.) were included in the study. Twelve skills were assessed using the Children's Activity and Movement in Preschool Motor Skills Protocol and video analysis. Sex differences were explored at the subtest, skill, and component levels. Overall competence was found to be low among both sexes, although it was higher for locomotor skills than for object-control skills. Similar patterns were observed at the component level. Boys had significantly better object-control skills than girls, with greater competence observed for the kick and overarm throw, while girls were more competent at the run, hop, and gallop. The findings of low competency suggest that developmentally appropriate interventions should be implemented in preschool settings to promote movement skills, with targeted activities for boys and girls.

Digit ratio (2D:4D) and physical fitness (Eurofit test battery) in school children.

BACKGROUND: The relative lengths of the index finger to the ring finger (2D:4D) is sexually dimorphic and is thought to be a correlate of prenatal sex steroids (low 2D:4D=high prenatal testosterone and low prenatal oestrogen). In adults there have been reports that low 2D:4D is consistently associated with high sports performance. AIMS: To investigate correlations between 2D:4D and fitness levels in children. STUDY DESIGN: Right 2D:4D and body size were measured, in addition to flexibility, speed, endurance and strength (Eurofit tests). SUBJECTS: 922 boys and 835 girls (mean ages (years): 10.8 ± 1.01 and 10.07 ± 1.00 respectively). OUTCOME MEASURES: height, mass, BMI, triceps and subscapular skinfolds, 20 m shuttle run, sit and reach, standing broad jump, hand grip strength, 10 × 5m sprint, and the sit and reach test. RESULTS: Boys significantly outperformed the girls in the 10 × 5m sprints, the 20 m shuttle run, standing broad jump, and hand grip strength. In boys but not girls, 2D:4D was significantly negatively correlated with scores in all these tests except the standing broad jump. In girls but not boys, 2D:4D was significantly positively correlated to stature, mass, BMI and waist circumference. CONCLUSIONS: It is suggested that high prenatal testosterone and low prenatal oestrogen (low 2D:4D) is implicated in high sprinting speed, endurance and hand grip strength in boys. In girls low prenatal testosterone and high prenatal oestrogen is associated with large body size.

Long-term soccer-specific training enhances the rate of physical development of academy soccer players independent of maturation status.

The aim of the study was to compare 3-year changes in physical performance between junior soccer players selected for an elite academy and age-matched controls. The 3-year changes in indicators of the physical performance were quantified in 12-16-year-old Premier League Academy (n=27) and non-academy soccer players (n=18). Data were analysed with an age-group×competitive level general linear model, covariate-adjusted for initial performance level and change in maturation. Covariate adjusted mean±SD changes were greater (standardised effect size>0.7) for the academy players in terms of countermovement jump (7.3±2.6 vs. 5.4±2.5 cm), 10 m sprint (- 0.15±0.05 vs. - 0.10±0.04 s), 20 m sprint (- 0.30±0.16 s vs. - 0.15±0.13 s), agility (- 0.19±0.01 s vs. - 0.08±0.08 s), repeated sprint (- 0.60±0.26 s vs. - 0.41±2.1 s) and intermittent endurance capacity (1 128±406 vs. 315±370 m). These data indicate that a 3-year programme of training in an elite soccer academy is associated with greater changes in physical performance indicators independently from the initial performance level of the child and change in maturation over the same period of time.

Assessment of biochemical liver markers, physical activity, fitness and body mass index for a cardiometabolic risk model in childhood.

AIM: The aim of this study was to investigate clustered cardiometabolic risk scores in healthy 10- to 12-year-olds using anthropometric characteristics, measurements of cardiorespiratory fitness (CRF) and physical activity and blood markers of metabolic disease. We also evaluated how including markers of liver cell injury would affect the clustered cardiometabolic risk assessment model. METHODS: This cross-sectional study focused on 99 children aged 10-12 years. The main outcome included assessing participants with increased and low cardiometabolic risk factors using a clustered risk score model that incorporated markers implicated in metabolic syndrome pathogenesis. Two clustered risk scores were calculated, one incorporating markers of liver cell injury. RESULTS: Children classified as 'increased risk' exhibited significantly lower CRF and higher body mass index Z-scores than their 'low-risk' peers. No significant differences in physical activity were observed. This trend remained unchanged when markers of liver injury were included in the clustered risk assessment model. CONCLUSION: The clustered risk score model is a scientifically robust method of cardiometabolic risk assessment, which reiterates the importance of weight reduction and CRF promotion in childhood. Our study did not show a significant contribution of liver injury markers, and further research is needed to evaluate their effect on cardiometabolic risk stratification in childhood.

Ten-year changes in positive and negative marker food, fruit, vegetables, and salad intake in 9-10 year olds: SportsLinx 2000-2001 to 2010-2011.

BACKGROUND: To investigate changes in intakes of 'negative' and 'positive' foods, fruit, vegetables, and salad in serial cohorts of 9-10-year-old children from 2000-2001 to 2010-2011. METHODS: For this serial, cross-sectional study, children in school year 5 (9-10 years of age) completed the SportsLinx Lifestyles Survey [n = 30,239 (15,336 boys and 14,903 girls)]. Changes in positive and negative food scores, and the proportion of boys and girls reportedly consuming fruit, vegetables and salad on the previous day to surveying, were investigated annually from 2000 to 2011. RESULTS: The consumption of negative foods declined and positive foods increased significantly compared to baseline. Positive changes in fruit, vegetables and salad consumption were observed over time, with the most recent cohort more likely to consume fruit, vegetables and salad compared to the 2000-2001 baseline. Girls displayed more favourable positive and negative food scores and were more likely to consume fruit, salad and vegetables across several study years compared to boys. CONCLUSIONS: The consumption of negative and positive foods, fruit, vegetables, and salad has improved over the last 10 years. In addition, girls appear to have better positive and negative food scores, and were more likely to consume fruit, vegetables and salad, across a number of study years or cohorts compared to boys. These encouraging findings suggest that children's food intake has improved since 2000. Furthermore, the data indicate that boys and girls may require separate or different healthy eating messages to further improve food intake.

The relationship between body mass index, aerobic performance and asthma in a pre-pubertal, population-level cohort.

PURPOSE: To assess the relationship between asthma, body mass index (BMI) and aerobic performance, as indicated by a shuttle test. METHODS: 20,577 participants (10,413 boys) from the SportsLinx serial cross-sectional study participated. Parental reports of asthma status and home postcode data were gathered from consent forms. Stature, sitting stature and body mass were measured and BMI, somatic maturity and indices of multiple deprivation scores (IMD) were derived. Performance on the 20 m multi-stage shuttle runs test (20mSRT) was used to estimate cardiorespiratory fitness (CRF). RESULTS: Asthma [F (1, 17,015) = 82.26, P < 0.01] and gender [F (1, 17,015) = 678.491, P < 0.001] significantly influenced 20mSRT. The addition of BMI, maturity and IMD to the model did not alter these significant effects. There was a significant interaction between 20mSRT and BMI [F (1, 16,723) = 132.80, P < 0.01], with a significant decrease in 20mSRT from the 50th BMI percentile upwards [t (16,699) = 36.88, P < 0.01]. Binary logistic regression revealed gender and 20mSRT to be significant predictors of asthma occurrence; BMI SDS just reached significance whilst maturity and IMD were not significant contributors to the model. CONCLUSIONS: This study demonstrates the negative influences of low CRF and high BMI on the risk of asthma occurrence in pre-pubertal children. Furthermore, it highlights the significant influence of BMI on CRF, revealing these effects to be manifest considerably below those BMI percentiles conventionally associated with being overweight or obese.

Effect of a school-based active play intervention on sedentary time and physical activity in preschool children.

Early childhood is a critical time for promoting physical activity. Few studies have investigated the effect of interventions in this population. The aim of this study was to investigate the effect of a school-based active play intervention on preschool children's sedentary time and physical activity. Preschool children were recruited from randomly selected preschools. Schools were randomly assigned to an intervention or comparison group. One teacher per intervention school received training from active play professionals in the delivery of a 6-week active play programme. Comparison schools continued their usual practice. Children wore a uni-axial accelerometer for 7 days at baseline, immediately after and at 6-month post-intervention. No significant intervention effects were observed for sedentary time or physical activity. However, sex and hours spent at school were significant predictors of physical activity. Children who spent fewer hours (half-day children) at school were significantly more active than their full-day counterparts. Physical activity during the intervention classes was high even though neither daily physical activity nor sedentary time changed. Notably children who spent more time at preschool were less active suggesting that preschool was not as conducive to physical activity engagement as other environments.

Reliability of a field based 2D:4D measurement technique in children.

BACKGROUND: There is limited literature on the relationship between second to fourth finger digit ratio (2D:4D) and health- and skill-related fitness in children. To examine this relationship it is important to establish a reliable method of assessing 2D:4D for use with large groups of children. AIM: The aim of the study was to examine the reliability of a field-based 2D:4D measure in children. METHODS/RESEARCH DESIGN: Fifty 8-11 year olds had 2D:4D of the right hand measured using a Perspex table top, a digital camera, and Adobe Photoshop software. Second to fourth finger digit ratio (and 2D and 4D) intra-observer and inter-observer reliabilities were assessed on the same day and intraobserver reliability was measured between days. Limits of agreement (LoA), coefficient of variation (CV) and Pearson's correlation coefficient were used for statistical analysis. RESULTS: High correlation coefficients (r=0.95-0.99) and low CV's (0.4-1.2%) were reported for intra- and inter-observer reliabilities on the same day and between days. LoA revealed negligible systematic bias with random error ranging from 0.02 to 0.12. CONCLUSION: These findings suggest that 2D:4D (and 2D and 4D) assessment in children using digital photography provides a reliable measure of 2D:4D that can be used during field-based testing.

Lack of relationship between sedentary behaviour and vascular function in children.

Some evidence suggests that sedentary behaviour is independently associated with cardiovascular (CV) risk. Endothelial dysfunction is the earliest detectable manifestation of CVD and a strong independent predictor of CV events. No previous study has examined the relationship between sedentary behaviour and endothelial function. We assessed the basal association between conduit artery endothelial function and sedentary behaviour in children, along with the correlation between changes in sedentary behaviour and endothelial function. We studied 116 children (70♀: 10.7 ± 0.3; 46♂: 10.7 ± 0.3 years) on two occasions; in the summer (June) and late autumn (November). We assessed endothelial function via flow-mediated dilation (FMD) using high-resolution Doppler ultrasound. Sedentary behaviour (SB) was assessed using objective uni-axial accelerometry. At baseline, there were no significant differences between girls and boys for any measured variables with the exception of total physical activity time. FMD was not associated with sedentary behaviour in either group or in the cohort as a whole. Although FMD decreased (10.0 ± 4.3-7.9 ± 3.9%, P < 0.001) and SB increased (499.1 ± 103.5-559 ± 81.6 min/day, P < 0.001) between the seasons, no relationship existed between changes in these variables. Our data suggest that sedentary behaviour and changes in sedentary behaviour are not associated with endothelial function in children.

Impact of exercise training on endothelial function and body composition in young people: a study of mono- and di-zygotic twins.

Flow mediated dilation (FMD) is a surrogate marker of arterial function which can be improved by exercise training. To date, no study has assessed the magnitude of FMD changes in response to exercise training between groups of mono- (MZ) and di-zygotic (DZ) twins. The purpose of this study was therefore to compare FMD in MZ- and DZ twins before and after identical exercise training interventions. At baseline, FMD was assessed using high resolution Duplex ultrasound in 12 twin pairs (6 MZ pairs 13.5 ± 0.8 years, 6 DZ pairs 13.4 ± 0.8 years). Twins completed 8 weeks of exercise training (65-85% HR(max)), consisting of three 45-min sessions per week. Change (Δ) scores were entered into twin versus twin intraclass correlation analyses by group. Change in %body fat (r = 0.63, P = 0.05) was significantly correlated in the MZ, but not the DZ group (r = 0.31, P = 0.23). Change in FMD was also highly correlated in MZ (r = 0.74, P = 0.02) but not in the DZ group (r = 0.37, P = 0.18). Heritability of ΔFMD was estimated at 0.74. Exercise induced changes in FMD were similar within sets of monozygotic twins but not dizygotic twins. These data suggest that a significant portion of the arterial function response to exercise training may be genetically determined.

Aerobic training programs and glycemic control in diabetic children in relation to exercise frequency.

AIM: The aim of this study was to assess the effect of an aerobic training on glycemic control and lipid profile in diabetic children. METHODS: Thirty-three children with type 1 diabetes mellitus (T1DM) were equally divided in three groups. The control group (CG) did not perform any training intervention during the period of the investigation and the subjects were instructed to continue with their daily lifestyle patterns. The second group (G1) and the third group (G2) completed a six-month aerobic training programs. During the period of the investigation, G1 participated in one daily session (~60 min) of aerobic exercise twice weekly, while G2 performed in the form of daily session four times a week (~60 min). HbA1c and lipid profile were measured before training intervention, then after three and six months. RESULTS: The three-month periods was without significant changes of HbA1c in the two groups but significantly increased high-density lipoprotein cholesterol (HDL-C) in G1 (P<0.05). In G2, an increase of HDL-C was accompanied by a decrease of serum triglyceride (TG) (P<0.05). After six months, only HDL-C and TG levels were significantly lower in G1 (P<0.01), while in G2 HDL-C increased (68.8±5.7 mg/dL vs. 56.7 ±7.2 mg/dL; P<0.01), low-density lipoprotein cholesterol (LDL-C) (69.2±8.5 mg/dL vs. 81.6±11.8 mg/dL; P<0.01), TG concentrations decreased (60.7±6.9 mg/dL vs. 77.4±9.3 mg/dL; P<0.01) and HbA1c was significantly lower (6.8±1.1% vs. 8.2±1.5%; P<0.05), comparatively to those before training. CONCLUSION: However, the six-month periods showed that children exercising more than two times weekly significantly improved HbA1c and lipid profile. These results must encourage children with T1DM to regularly practice sporty activities for long periods.

Seroprevalence of Toxoplasma gondii in pigs, sheep, goats, and cattle from Grenada and Carriacou, West Indies.

Prevalence of Toxoplasma gondii infection in pregnant women in Grenada is considered high. Little is known of the epidemiology of T. gondii infection in Caribbean Islands. Serum samples of 750 food animals in Grenada and Carriacou were tested for antibodies to T. gondii by the modified agglutination test (MAT). Antibodies to T. gondii (MAT, 1∶25 or higher) were found in 23.1% of 247 pigs, 44.1% of 204 sheep, 42.8% of 180 goats, and 8.4% of 119 cattle. Seroprevalence increased with age, indicating postnatal acquisition of T. gondii. Antibody titers of 1∶200 or higher were present in 65 of 90 seropositive sheep, 61 of 77 seropositive goats, and 23 of 57 seropositive pigs. However, none of the cattle had a MAT titer of 1∶200, suggesting that bovines are a poor host for T. gondii. Results indicate that pigs, sheep, and goats could be important sources of T. gondii infection if their meat is consumed undercooked.