title: Impaired Physical Function Associated with Childhood Obesity: How Should We Intervene?
abstract: BACKGROUND
  This study examined relationships between adiposity, physical functioning, and physical activity.
  
  
  METHODS
  Obese (N = 107) and healthy-weight (N = 132) children aged 10-13 years underwent assessments of percent body fat (%BF, dual energy X-ray absorptiometry); knee extensor strength (KE, isokinetic dynamometry); cardiorespiratory fitness (CRF, peak oxygen uptake by cycle ergometry); physical health-related quality of life (HRQOL); and worst pain intensity and walking capacity [six-minute walk (6MWT)]. Structural equation modelling was used to assess relationships between variables.
  
  
  RESULTS
  Moderate relationships were observed between %BF and (1) 6MWT, (2) KE strength corrected for mass, and (3) CRF relative to mass (r -0.36 to -0.69, p ≤ 0.007). Weak relationships were found between %BF and physical HRQOL (r -0.27, p = 0.008); CRF relative to mass and physical HRQOL (r -0.24, p = 0.003); physical activity and 6MWT (r 0.17, p = 0.004). Squared multiple correlations showed that 29.6% variance in physical HRQOL was explained by %BF, pain, and CRF relative to mass; while 28.0% variance in 6MWT was explained by %BF and physical activity.
  
  
  CONCLUSIONS
  It appears that children with a higher body fat percentage have poorer KE strength, CRF, and overall physical functioning. Reducing percent fat appears to be the best target to improve functioning. However, a combined approach to intervention, targeting reductions in body fat percentage, reductions in pain, and improvements in physical activity and CRF may assist physical functioning.
authors.affiliation: 1 Alliance for Research in Exercise, Nutrition and Activity, Sansom Institute for Health Research, University of South Australia , Adelaide, South Australia, Australia .
authors.forename: Margarita D
authors.initials: MD
authors.lastname: Tsiros
authors.affiliation: 1 Alliance for Research in Exercise, Nutrition and Activity, Sansom Institute for Health Research, University of South Australia , Adelaide, South Australia, Australia .
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Buckley
authors.affiliation: 1 Alliance for Research in Exercise, Nutrition and Activity, Sansom Institute for Health Research, University of South Australia , Adelaide, South Australia, Australia .
authors.forename: Timothy
authors.initials: T
authors.lastname: Olds
authors.affiliation: 2 School of Biomedical Sciences and Pharmacy, University of Newcastle , Callaghan, New South Wales, Australia .
authors.forename: Peter R C
authors.initials: PR
authors.lastname: Howe
authors.affiliation: 3 Mater Research Institute, University of Queensland , South Brisbane, Queensland, Australia .|4 School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia .
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Hills
authors.affiliation: 5 School of Health Sciences, RMIT University , Bundoora, Victoria, Australia .
authors.forename: Jeff
authors.initials: J
authors.lastname: Walkley
authors.affiliation: 6 Bond Institute of Health and Sport, Faculty of Health Sciences and Medicine, Bond University, Robina, Queensland, Australia .|7 School of Exercise and Nutrition Sciences, Queensland University of Technology , Kelvin Grove, Queensland, Australia .
authors.forename: Rachel
authors.initials: R
authors.lastname: Wood
authors.affiliation: 7 School of Exercise and Nutrition Sciences, Queensland University of Technology , Kelvin Grove, Queensland, Australia .|8 Institute of Nutrition Sciences, Kagawa Nutrition University , Saitama, Japan .
authors.forename: Masaharu
authors.initials: M
authors.lastname: Kagawa
authors.affiliation: 7 School of Exercise and Nutrition Sciences, Queensland University of Technology , Kelvin Grove, Queensland, Australia .
authors.forename: Anthony
authors.initials: A
authors.lastname: Shield
authors.affiliation: 5 School of Health Sciences, RMIT University , Bundoora, Victoria, Australia .
authors.forename: Lara
authors.initials: L
authors.lastname: Taylor
authors.affiliation: 9 School of Sport and Exercise, Massey University , Wellington, New Zealand .
authors.forename: Sarah P
authors.initials: SP
authors.lastname: Shultz
authors.affiliation: 10 School of Mechanical Engineering, University of Adelaide , Adelaide, South Australia, Australia .
authors.forename: Paul N
authors.initials: PN
authors.lastname: Grimshaw
authors.affiliation: 5 School of Health Sciences, RMIT University , Bundoora, Victoria, Australia .
authors.forename: Kaine
authors.initials: K
authors.lastname: Grigg
authors.affiliation: 1 Alliance for Research in Exercise, Nutrition and Activity, Sansom Institute for Health Research, University of South Australia , Adelaide, South Australia, Australia .
authors.forename: Alison M
authors.initials: AM
authors.lastname: Coates
mesh_terms: D015502:Absorptiometry, Photon; D050154:Adiposity; D000293:Adolescent; D001315:Australia / Q000453:epidemiology; D015992:Body Mass Index; D016022:Case-Control Studies; D002648:Child; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D053580:Muscle Strength / Q000502:physiology; D010101:Oxygen Consumption / Q000502:physiology; D063766:Pediatric Obesity / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D010809:Physical Fitness / Q000502:physiology; D011788:Quality of Life