title: The impact of physical fitness and body mass index in children on the development of acute mountain sickness: A prospective observational study.
abstract: BACKGROUND
  Acute mountain sickness (AMS) is commonly found among people traveling above 2500 m. We investigated whether the occurrence of AMS is related to differences in individual physical fitness and BMI in subjects 11-13 years of age.
  
  
  METHODS
  This study was conducted at Xue Mountain, Taiwan (elevation of 3886 m) between June 13, 2011 and June 17, 2011. Subjects were asked to ascend from Taipei City (25 m) to the summit (3886 m) over 3 days and 2 nights. Gender, age, weight, height, and fitness index (determined using a 3-minute step test) were recorded at sea level before ascent. The Lake Louise AMS score was used to record symptoms and diagnose AMS.
  
  
  RESULTS
  A total of 179 subjects (mean age: 11.8 years; 102 males, 77 females) were included in the analysis. A total of 44.7% of subjects were diagnosed with AMS. Male gender (p = 0.004) and elevated body mass index (BMI) (p < 0.001) were each associated with the development of AMS. However the physical fitness index was comparable in subjects with and without AMS (67.8 ± 10.1 vs. 68.0 ± 9.3, p = 0.9).
  
  
  CONCLUSIONS
  This study shows that both BMI and male gender were associated with the development of AMS in 11-13 year old children. Physical fitness was not associated with the occurrence of AMS.
authors.affiliation: Department of Emergency Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan. ambertwu@gmail.com.|Chang Gung University School of Medicine, Taoyuan, Taiwan. ambertwu@gmail.com.
authors.forename: Shih-Hao
authors.initials: SH
authors.lastname: Wu
authors.affiliation: Chang Gung University School of Medicine, Taoyuan, Taiwan. sirius@adm.cgmh.org.tw.|Department of Physical and Rehabilitation Medicine, Chang Gung Memorial Hospital at Taoyuan, Taoyuan, Taiwan. sirius@adm.cgmh.org.tw.
authors.forename: Yin-Chou
authors.initials: YC
authors.lastname: Lin
authors.affiliation: Department of Emergency Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan. wengym33@gmail.com.|Chang Gung University School of Medicine, Taoyuan, Taiwan. wengym33@gmail.com.
authors.forename: Yi-Ming
authors.initials: YM
authors.lastname: Weng
authors.affiliation: Department of Emergency Medicine, Mackay Memorial Hospital, Taipei, Taiwan. yhchiu2@tmu.edu.tw.|Institute of Environmental and Occupational Health Science, National Yang-Ming University, Taipei, Taiwan. yhchiu2@tmu.edu.tw.
authors.forename: Yu-Hui
authors.initials: YH
authors.lastname: Chiu
authors.affiliation: Chang Gung University School of Medicine, Taoyuan, Taiwan. 620313@cgmh.org.tw.|Department of Occupation Medicine, Chang-Gung Memorial Hospital at Keelung, Keelung, Taiwan. 620313@cgmh.org.tw.|Department of Occupation Medicine, Chang-Gung Memorial Hospital at Linkou, Taoyuan, Taiwan. 620313@cgmh.org.tw.
authors.forename: Wen-Cheng
authors.initials: WC
authors.lastname: Li
authors.affiliation: Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Chiayi, Chiayi, Taiwan. mountainwangsh@gmail.com.|Department of Emergency Medicine, National Yang-Ming University Hospital, Yilan, Taiwan. mountainwangsh@gmail.com.|Altitude Research Center, Department of Emergency Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA. mountainwangsh@gmail.com.|Taiwan Wilderness Medical Association, Taipei, Taiwan. mountainwangsh@gmail.com.
authors.forename: Shih-Hao
authors.initials: SH
authors.lastname: Wang
authors.affiliation: Department of Emergency Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan. wherego2010@gmail.com.|Chang Gung University School of Medicine, Taoyuan, Taiwan. wherego2010@gmail.com.
authors.forename: Chang-Wei
authors.initials: CW
authors.lastname: Chan
authors.affiliation: Department of Emergency Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan. tefachiu@gmail.com.|Chang Gung University School of Medicine, Taoyuan, Taiwan. tefachiu@gmail.com.
authors.forename: Te-Fa
authors.initials: TF
authors.lastname: Chiu
authors.affiliation: Department of Physical Education, National Taitung University, Taitung, Taiwan. myt2812@yahoo.com.tw.|Department of Emergency Medicine, Taiwan Adventist Hospital, Taipei, Taiwan. myt2812@yahoo.com.tw.
authors.forename: Kuo-Feng
authors.initials: KF
authors.lastname: Huang
authors.affiliation: Chang Gung University School of Medicine, Taoyuan, Taiwan. chenchunghsien@gmail.com.|Department of Family Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan. chenchunghsien@gmail.com.
authors.forename: Chung-Hsien
authors.initials: CH
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D000532:Altitude Sickness / Q000453:epidemiology*; D015992:Body Mass Index; D002648:Child; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D010809:Physical Fitness; D011446:Prospective Studies; D017678:Sex Distribution; D013624:Taiwan / Q000453:epidemiology