Gas exchange kinetics in obese adolescents. Inferences on exercise tolerance and prescription.

A functional evaluation of skeletal muscle oxidative metabolism was performed in a group of obese adolescents (OB). The various components of pulmonary O(2) uptake (Vo(2)) kinetics were evaluated during 10-min constant-load exercises (CLE) on a cycloergometer at different percentages of Vo(2max). The relationships of these components with the gas exchange threshold (GET) were determined. Fourteen male OB [age 16.5 ± 1.0 (SD) yr, body mass index 34.5 ± 3.1 kg·m(-2)] and 13 normal-weight, age-matched nonathletic male volunteers (control group) were studied. The time-constant (τf) of the fundamental component and the presence, pattern, and relative amplitude of the slow component of Vo(2) kinetics were determined at 40, 60, and 80% of Vo(2max), previously estimated during an incremental test. Vo(2max) (l/min) was similar in the two groups. GET was lower in OB (55.7 ± 6.7% of Vo(2max)) than in control (65.1 ± 5.2%) groups. The τf was higher in OB subjects, indicating a slower fundamental component. At CLE 60% (above GET in OB subjects, below GET in control subjects) a slow component was observed in nine out of fourteen OB subjects, but none in the control group. All subjects developed a slow component at CLE 80% (above GET in both OB and control). Twelve OB subjects did not complete the 10-min CLE 80% due to voluntary exhaustion. In nine OB subjects, the slow component was characterized by a linear increase in Vo(2) as a function of time. The slope of this increase was inversely related to the time to exhaustion. The above findings should negatively affect exercise tolerance in obese adolescents and suggest an impairment of skeletal muscle oxidative metabolism. Also in obese adolescents, exercise evaluation and prescription at submaximal loads should be done with respect to GET and not at a given percentage of Vo(2max).

Fat oxidation rate during and after a low- or high-intensity exercise in severely obese Caucasian adolescents.

The objective is to study the effects of low-intensity (LI) or high-intensity (HI) equicaloric exercises on energy expenditure (EE) and substrate oxidation rate during and after the exercises in severely obese Caucasian adolescents. Twenty obese boys (BMI-SDS 3.04 +/- 0.52, %Fat Mass 38.2 +/- 2.1%) aged 14-16 years (pubertal stage >3) participated in this study. Maximal oxygen uptake (V'O(2max)) and maximal fat oxidation rate were determined with indirect calorimetry using a graded exercise test on a treadmill. EE and substrate oxidation rate during equicaloric low-intensity (LI, 42% V'O(2max) for 45 min) and high-intensity (HI, 67% V'O(2max) for 30 min) exercises on a treadmill and during post-exercise recovery period (60 min) were determined with indirect calorimetry. Maximal fat oxidation rate was observed at 42 +/- 6% V'O(2max) (62 +/- 5% HR(max)) and fat oxidation rate was 0.45 +/- 0.07 g/min. The total amounts of EE, during the LI and HI exercises, and the post-exercise recovery periods were not significantly different (1,884 +/- 250 vs. 1,973 +/- 201 kJ, p = 0.453), but the total amount of fat oxidised was significantly higher (+9.9 g, +55.7%, p < 0.001) during the LI exercise than during the HI exercise. However, fat oxidation rates during the post-exercise recovery periods were not significantly different following LI and HI exercises. Total fat oxidised was significantly higher during the LI than during the HI exercise in obese adolescents. However, the equicaloric exercise intensity did not influence EE, fat and carbohydrate oxidation rate during the recovery period.

Relationship between basal metabolic rate, gender, age, and body composition in 8,780 white obese subjects.

The objective of the present study was to explore the relationship between basal metabolic rate (BMR), gender, age, anthropometric characteristics, and body composition in severely obese white subjects. In total, 1,412 obese white children and adolescents (BMI > 97 degrees percentile for gender and age) and 7,368 obese adults (BMI > 30 kg/m(2)) from 7 to 74 years were enrolled in this study. BMR was measured using an indirect calorimeter equipped with a canopy and fat free mass (FFM) were obtained using tetrapolar bioelectrical impedance analysis (BIA). Using analysis of covariance, we tested the effect of gender on the relationship between BMR, age, anthropometry, and body composition. In children and adolescents, the predictor x gender interaction was significant in all cases except for FFM x gender. In adults, all predictor x gender interactions were significant. A prediction equation based on body weight (BW), age, and gender had virtually the same accuracy of the one based on FFM, age, and gender to predict BMR in both children and adults (R(2)(adj) = 0.59 and 0.60, respectively). In conclusion, gender was a significant determinant of BMR in children and adolescents but not in adults. Our results support the hypothesis that the age-related decline in BMR is due to a reduction in FFM. Finally, anthropometric predictors of BMR are as accurate as body composition estimated by BIA.

The energetic and cardiovascular response to treadmill walking and cycle ergometer exercise in obese women.

Physical activity is essential in obesity management, but exercise capacity is compromised in obese individuals due to the excessive body mass, impacting on body movement's energetics, and to the dysfunctions of regulatory mechanisms, affecting cardiovascular responses. This study aims to compare the energetics and cardiovascular responses of walking and cycling in obese women, and to formulate recommendations regarding the most suitable type of exercise for obesity. Fifteen obese (OB) and six normal weight (NW) women exercised on treadmill (TM) and cycle ergometer (CE). During both exercise modalities, metabolic rate was higher in OB than in NW and correlated with measures of body mass. Leg movement metabolic rate during cycling depended upon individual adiposity, and when accounted for, mechanical efficiency was similar in the two groups. When accounting for extra mass, differences in metabolic rate among groups are abolished for CE, indicating no obesity impairment of muscle efficiency, but not for TM, suggesting that differences in biomechanics may explain the higher net cost of transport of OB. In both groups, HR was higher during CE than TM at the same oxygen uptake (VO(2)), but in OB the HR increment over VO(2) was greater for CE than for TM. Therefore, due to different cardiovascular responses to TM and CE in OB, walking is more convenient, enabling OB to attain target energy expenditure at lower HR or in a shorter time.

Muscle strength and power, maximum oxygen consumption, and body composition in middle-aged short-stature adults with childhood-onset growth hormone deficiency.

BACKGROUND: Growth hormone (GH) replacement in adult GH-deficient (GHD) patients is reported to have a long-term beneficial effect on muscle mass and function, these effects being greater in young males and in adult-onset compared with those with childhood-onset GHD. To date, more discordant data are reported on the degree of muscle impairment in untreated GHD patients, due to the large heterogeneity of this syndrome. METHODS: Muscle maximum total isotonic strength (ST), lower limb maximum power output (W), maximum aerobic capacity (VO(2)max) and body composition (by tetrapolar bio-impedentiometry) were evaluated in seven short-stature adults with childhood-onset GHD and in seven age-matched normal-stature controls with comparable lifestyle and daily physical activity. RESULTS: Significant differences were found in body composition between control subjects and GHD patients, who presented higher adiposity (mean BMI+/-SD: GHD, 27.8+/-5.8 kg/m(2); controls, 22.1+/-0.8 kg/m(2); p=0.047), larger fat mass (GHD, 21.8+/-10.7 kg; controls, 8.8+/-3.5 kg; p=0.008), and lower fat-free mass (GHD, 65.8+/-11.4 %; controls, 87.0+/-6.5 %; p=0.002). In absolute terms, GHD patients attained significantly lower values in ST (GHD, 2479+/-493 N; controls, 4578+/-1476 N; p=0.008), W (GHD, 1092+/-452 W; controls, 1910+/-781 W; p=0.035) and VO(2)max (GHD, 1.68+/-0.40 l/min; controls, 2.67+/-0.84 l/min; p=0.035) than those attained by controls. The differences were still evident when the results were normalized by unit body mass, whereas they disappeared when the parameters were expressed per unit fat-free mass, suggesting for these patients the presence of an intrinsic muscle function in the same range as that of control subjects. CONCLUSIONS: Middle-aged and short-stature adults with childhood-onset GHD, who received discontinuous pit-GH substitution therapy only during childhood and have uncorrected long-lasting GHD, still retain a normal intrinsic muscle capability in attaining isotonic strength, generating anaerobic power as well as accomplishing oxidative processes. Nonetheless, it is not known which age-dependent evolution in motor dysfunction could be expected in this subgroup of GHD patients, when ageing processes add up to hormonal deficiencies.