title: Effectiveness of physical exercise to reduce cardiovascular risk factors in youths: a randomized clinical trial.
abstract: BACKGROUND
  The aim of the current study was to test the effectiveness of a physical activity and exercise-based program in a clinical context to reduce cardiovascular risk factors in children and adolescents.
  
  
  METHODS
  A randomized clinical trial was conducted in a pediatric preventive outpatient clinic. Intervention was 14 weeks of exercise for the intervention group or general health advice for the control group. The primary and the secondary outcomes were reduction of cardiovascular risk factors and the feasibility and the effectiveness of clinical advice plan to practice physical exercises at home.
  
  
  RESULTS
  A total of 134 children were screened; 26 met eligibility criteria. Of these, 10 were allocated in the exercise intervention group and nine were included in the control group until the end of the intervention. Those patients who discontinued the intervention had the lowest scores of z-BMI (P = 0.033) and subscapular skin fold (P = 0.048). After 14 weeks of intervention, no statistical differences were found between the groups. High-density lipoprotein cholesterol (HDL-C) was higher in the exercise group, with a mild tendency to be significant (P = 0.066). Patients who adhere to treatment had diastolic blood pressure decreased from baseline to the end of the follow-up period in the control group (P = 0.013). Regardless of this result, the other comparisons within the group were not statistically different between T0 and T14.
  
  
  CONCLUSIONS
  A low-cost physical activity advice intervention presented many barriers for implementation in routine clinical care, limiting its feasibility and evaluation of effectiveness to reduce cardiovascular risk factors.
authors.affiliation: Instituto de Cardiologia, Fundacao Universitaria de Cardiologia, Avenida Princesa Isabel, 370, 3º andar, Porto Alegre, Rio Grande do Sul 90620-000, Brazil.
authors.forename: Claudia Ciceri
authors.initials: CC
authors.lastname: Cesa
authors.affiliation: Instituto de Cardiologia, Fundacao Universitaria de Cardiologia, Avenida Princesa Isabel, 370, 3º andar, Porto Alegre, Rio Grande do Sul 90620-000, Brazil.
authors.forename: Sandra Mari
authors.initials: SM
authors.lastname: Barbiero
authors.affiliation: Instituto de Cardiologia, Fundacao Universitaria de Cardiologia, Avenida Princesa Isabel, 370, 3º andar, Porto Alegre, Rio Grande do Sul 90620-000, Brazil.
authors.forename: Rosemary de Oliveira
authors.initials: Rde O
authors.lastname: Petkowicz
authors.affiliation: Instituto de Cardiologia, Fundacao Universitaria de Cardiologia, Avenida Princesa Isabel, 370, 3º andar, Porto Alegre, Rio Grande do Sul 90620-000, Brazil ; Universidade Federal de Ciencias da Saude de Porto Alegre, Avenida Osvaldo Aranha, 245, Porto Alegre, Rio Grande do Sul 90050-170, Brazil.
authors.forename: Carla Correa
authors.initials: CC
authors.lastname: Martins
authors.affiliation: Instituto de Cardiologia, Fundacao Universitaria de Cardiologia, Avenida Princesa Isabel, 370, 3º andar, Porto Alegre, Rio Grande do Sul 90620-000, Brazil ; Universidade Federal de Ciencias da Saude de Porto Alegre, Avenida Osvaldo Aranha, 245, Porto Alegre, Rio Grande do Sul 90050-170, Brazil.
authors.forename: Renata das Virgens
authors.initials: Rd
authors.lastname: Marques
authors.affiliation: Instituto de Cardiologia, Fundacao Universitaria de Cardiologia, Avenida Princesa Isabel, 370, 3º andar, Porto Alegre, Rio Grande do Sul 90620-000, Brazil ; Universidade Federal de Ciencias da Saude de Porto Alegre, Avenida Osvaldo Aranha, 245, Porto Alegre, Rio Grande do Sul 90050-170, Brazil.
authors.forename: Allana Abreu Martins
authors.initials: AA
authors.lastname: Andreolla
authors.affiliation: Instituto de Cardiologia, Fundacao Universitaria de Cardiologia, Avenida Princesa Isabel, 370, 3º andar, Porto Alegre, Rio Grande do Sul 90620-000, Brazil ; Universidade Federal de Ciencias da Saude de Porto Alegre, Avenida Osvaldo Aranha, 245, Porto Alegre, Rio Grande do Sul 90050-170, Brazil.
authors.forename: Lucia Campos
authors.initials: LC
authors.lastname: Pellanda
keywords: Atherosclerosis; Children; Exercise; Risk factors