PubMed · 8581102
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J O Hill, J C Peters. 1995. Exercise and macronutrient balance.. https://pubmed.ncbi.nlm.nih.gov/8581102/
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OBJECTIVE: To investigate the outcome of school-age children with bronchopulmonary dysplasia (BPD) in terms of nutrition, pulmonary function, and intelligence, and to compare the results with a preterm cohort matched for gestational age and birth weight, and with a term control group. DESIGN: Cross-sectional. SETTING: Follow-up clinic at level III neonatal intensive care unit, university-affiliated hospital, Children's Hospital. SUBJECTS: Twelve children who had BPD as infants and 2 control groups of 12 children each. MAIN OUTCOME VARIABLES: Anthropometric measurements, dietary intake, resting energy expenditure, pulmonary function, body composition measurements by dual energy x-ray absorptiometry, and Weschler intelligence test scores. RESULTS: Children with BPD had decreased forced expiratory volume at 1 second, decreased forced expiratory flow between 25% and 75% of vital capacity, and decreased maximal expiratory flow velocity at 50% of vital capacity compared with age-matched normal inborn subjects (p = 0.025, p = 0.005, and p = 0.0013, respectively). Both children with BPD and matched preterm control children were shorter than infants in the term control group (p = 0.018). There were no significant differences in the other anthropometric parameters studied. The groups did not differ in resting energy expenditure. Lean body mass was lower in the BPD group compared with the term control groups (p = 0.017). Bone mineral content was lower in the BPD group compared with both the preterm and term control infants (p = 0.050 and p = 0.059, respectively). The mean performance intelligence quotient (IQ) and full-scale IQ scores in the BPD group were lower than in the term control group (p = 0.011 and p = 0.029, respectively). The proportion of children with borderline or intellectually deficient scores was significantly higher in the preterm group compared with the term group for verbal, performance, and full-scale IQ scales (p = 0.046, p = 0.018, and p = 0.048 respectively). The proportion of children with BPD who had borderline or deficient performance IQ scores was higher than for the term group (p = 0.046). CONCLUSIONS: The lower height and intelligence scores in children with BPD may be related to prematurity and perinatal events rather than pulmonary disease. Subclinical pulmonary dysfunction in children with BPD persists at school age. The lower amount of lean body mass and possible decrease in bone mineral content in children with BPD may be related to their smaller size.
The effectiveness of endurance exercise training (without concomitant weight loss) for improving lipoprotein lipid levels in obese individuals remains controversial. The purpose of this study was to determine whether lipoprotein lipid responses to endurance exercise training are affected by obesity. Healthy middle-aged and older (57 +/- 2 years) lean (n = 16; body mass index [BMI], 22 to 26 kg/m2), moderately obese (n = 15; BMI, 27 to 30 kg/m2), and obese (n = 15; BMI, 31 to 37 kg/m2) men underwent a 9-month endurance exercise training program. The groups differed in the initial degree of obesity, waist circumference, and waist to hip ratio (WHR), but not in age or maximal aerobic capacity ( VO2max). The obese group had lower baseline levels of high-density lipoprotein cholesterol (HDL-C) and HDL2-C, and higher triglyceride (TG) levels than the lean group. Exercise training increased VO2max to a comparable degree in lean, moderately obese, and obese groups (18%, 24%, and 18%, respectively, P < .01). Exercise training significantly decreased TG levels in all groups, whereas total cholesterol and low-density lipoprotein cholesterol (LDL-C) decreased only in the obese group. Exercise training increased HDL-C and HDL2-C levels in lean (14% and 81%, respectively, P < .05) and moderately obese (7% and 59%, respectively, P < .05) men, whereas neither HDL-C nor HDL2-C changed in obese men. The change in HDL-C correlated negatively with initial BMI (r = -.42, P < .01) and waist circumference (r = -.43, P < .01). These results show that the effects of exercise training on HDL-C are blunted in obese middle-aged and older men, whereas improvements in TG occur independently of the degree of obesity.
The objective was to investigate metabolic (resting metabolic rate), behavioral (energy intake), and endocrine variables (fasting insulin and growth hormone levels) potentially responsible for a positive energy balance in obese children in a cross-sectional study. The study was in 25 obese children aged 8 to 12 years and 21 nonobese children of the same age range. Weight, height, lean body mass (LBM) and fatmass (FM) were measured by bioelectrical impedance analysis, resting metabolic rate (indirect calorimetry) for the duration of 25 min, 7-day food records and fasting levels of insulin and human growth hormone (HGH). In the total sample, no differences were found in resting metabolic rate (RMR controlled for differences in weight) and energy intake between groups, whereas fasting insulin level was significantly higher and basal growth hormone concentration was significantly lower in the obese children. In RMR, there were significant age-dependent differences only in 10-year-old children, with the obese subjects showing lower values. The results fit in a multidimensional model, taking into account a critical period in prepubertal age for the development of childhood obesity. This period may be characterized by a reduced RMR, which results in an increased body weight, even if there is no excessive energy intake.