title: Improvement of early vascular changes and cardiovascular risk factors in obese children after a six-month exercise program.
abstract: OBJECTIVE
  The present study aimed to assess the effect of a 6-month exercise program in obese children on flow-mediated vasodilation (FMD) carotid intima-media thickness (IMT) and cardiovascular risk factors (RF).
  
  
  BACKGROUND
  Childhood obesity contributes to adult obesity and subsequent cardiovascular disease. Physical inactivity is a major RF for obesity, endothelial dysfunction, and elevated carotid IMT, culminating in early atherosclerotic disease.
  
  
  METHODS
  Sixty-seven obese subjects (age 14.7 +/- 2.2 years) were randomly assigned to 6 months' exercise or non-exercise protocol. We examined the influence of exercises (1 h, 3 times/week) on FMD, IMT, and cardiovascular risk profile.
  
  
  RESULTS
  Compared with lean control subjects, obese children demonstrated at baseline significantly impaired FMD (4.09 +/- 1.76% vs. 10.65 +/- 1.95%, p < 0.001), increased IMT (0.48 +/- 0.08 mm vs. 0.37 +/- 0.05 mm, p < 0.001), and a number of obesity-related cardiovascular RF. Significant improvements were observed in the exercise group for IMT (0.44 +/- 0.08 mm, p = 0.012, -6.3%) and FMD (7.71 +/- 2.53%, p < 0.001, +127%). This improvement correlated with reduced RF, such as body mass index standard deviation scores, body fat mass, waist/hip ratio, ambulatory systolic blood pressure, fasting insulin, triglycerides, low-density lipoprotein/high-density lipoprotein ratio, and low-degree inflammation (C-reactive protein, fibrinogen).
  
  
  CONCLUSIONS
  The present study documented increased IMT, impaired endothelial function, and various elevated cardiovascular RF in young obese subjects. Regular exercise over 6 months restores endothelial function and improves carotid IMT associated with an improved cardiovascular risk profile in obese children.
authors.affiliation: Division of Pediatric Cardiology, Children's Hospital, University of Rostock, Rostock, Germany. andreas-alexander.meyer@medizin.uni-rostock.de
authors.forename: Andreas A
authors.initials: AA
authors.lastname: Meyer
authors.forename: Günther
authors.initials: G
authors.lastname: Kundt
authors.forename: Ute
authors.initials: U
authors.lastname: Lenschow
authors.forename: Peter
authors.initials: P
authors.lastname: Schuff-Werner
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Kienast
mesh_terms: D000293:Adolescent; D050197:Atherosclerosis / Q000209:etiology / Q000503:physiopathology* / Q000517:prevention & control; D001786:Blood Glucose / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D002648:Child; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000150:complications / Q000503:physiopathology* / Q000517:prevention & control; D012307:Risk Factors; D013997:Time Factors; D014664:Vasodilation / Q000502:physiology*
chemical_list: D001786:Blood Glucose