title: Long-term follow-up of cardiovascular risk factors after exercise training in obese children.
abstract: OBJECTIVE
  We previously demonstrated beneficial effects of physical activity on cardiovascular disease (CVD) risk factors, body mass index (BMI) and fat mass in pre-pubescent obese children. The aim of this study was to determine whether these changes were maintained 2 years later.
  
  
  METHODS
  Two years after the Randomised Controlled Trial, we performed a follow-up study with 20 of 38 subjects (11.4 ± 1.8 years). Outcomes included blood pressure (BP) by ambulatory monitoring; arterial function and structure using high-resolution ultrasound, BMI, body composition by dual-energy x-ray absorptiometry (DXA), physical activity using accelerometer, and biological markers.
  
  
  RESULTS
  During the 2-year follow-up period, mean 24-hour diastolic BP z-score significantly decreased (1.4 ± 1.2 vs. 0.3 ± 1.4, p = 0.04), while systolic BP z-score was slightly reduced (2.4 ± 1.5 vs. 1.4 ± 1.7, p = 0.067). Blood pressure changes were greater in children who diminished their BMI z-score compared with the ones who did not. Systolic hypertension rates dropped from 50 to 28% and diastolic hypertension from 42 to 6%. In addition, arterial intima-media thickness (0.51 ± 0.03 vs. 0.51 ± 0.06, p = 0.79), BMI z-score (2.9 ± 0.8 vs. 2.9 ± 1.1 kg.cm(-2), p = 0.27), body fat (41.9 ± 6.9 vs. 42.8 ± 6.7%; p = 0.39) and physical activity count (703 ± 209 vs. 574 ± 244 cpm, p = 0.30) were stable.
  
  
  CONCLUSIONS
  To our knowledge, this is the first study reporting that beneficial effects on adiposity and CVD risk factors of a physical activity centred intervention are sustained 2 years after the cessation of training in obese children. Subjects stabilized BMI z-score and maintained physical activity with further improvement of BP and stabilization of arterial wall remodelling. We conclude that it is important to encourage physical activity in this population. Effects of Aerobic Exercise Training on Arterial Function and Insulin Resistance Syndrome in Obese Children: A Randomised Controlled Trial: NCT00801645.
authors.affiliation: Department of Child and Adolescent, University of Geneva, Switzerland. albane.maggio@hcuge.ch
authors.forename: Albane B R
authors.initials: AB
authors.lastname: Maggio
authors.forename: Yacine
authors.initials: Y
authors.lastname: Aggoun
authors.forename: Xavier E
authors.initials: XE
authors.lastname: Martin
authors.forename: Laetitia M
authors.initials: LM
authors.lastname: Marchand
authors.forename: Maurice
authors.initials: M
authors.lastname: Beghetti
authors.forename: Nathalie J
authors.initials: NJ
authors.lastname: Farpour-Lambert
mesh_terms: D015502:Absorptiometry, Photon; D056044:Actigraphy / Q000295:instrumentation; D050154:Adiposity; D000293:Adolescent; D000367:Age Factors; D000704:Analysis of Variance; D001158:Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D016009:Chi-Square Distribution; D002648:Child; D005080:Exercise Test; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016014:Linear Models; D008297:Male; D009043:Motor Activity; D009765:Obesity / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D010101:Oxygen Consumption; D010809:Physical Fitness; D018570:Risk Assessment; D012307:Risk Factors; D013557:Switzerland; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography