Mild to moderate hypohydration reduces boys' high-intensity cycling performance in the heat.

PURPOSE: To evaluate the effect of 1 and 2 % hypohydration on high-intensity cycling performance of 10- to 12-year-old boys in the heat. METHODS: In a counterbalanced order, nine boys attended three sessions in which they cycled intermittently (6 × 10-min bouts at 40-45 % [Formula: see text]) in a climate chamber. During each session, environmental conditions and water intake were individually adjusted to achieve a target hypohydration level of 0, 1 or 2 %, based on change in body weight (BW). Following 45 min of rest in thermoneutral conditions when the target hypohydration was maintained, each boy re-entered the climate chamber (35 °C and 50-55 % RH) to perform the cycling performance test at 90 % [Formula: see text] until exhaustion. Heart rate (HR) and rectal temperature (T re) were recorded continuously throughout each session. Total mechanical work (TMW) was taken as a measure of cycling performance. RESULTS: Actual hypohydration level at the start of the cycling performance test in each session was: 0.1 ± 0.0 %, 1.1 ± 0.1 % and 2.0 ± 0.1 %. With 2 % hypohydration, TMW (35.5 ± 6.8 kJ) was significantly (p < 0.05) lower than with 0 % hypohydration (49.3 ± 9.8 kJ). When expressed as a percentage of TMW with 0 % hypohydration, TMW was reduced by 15.5 and 23.3 % with 1 and 2 % hypohydration, respectively (p < 0.05 for both). At the start of the cycling performance test, HR was 13 and 15 bpm higher, and T re was 0.3 °C higher (p < 0.05 for all) with 1 and 2 % hypohydration, respectively, compared with 0 % hypohydration. CONCLUSION: Mild (~1 %) to moderate (~2 %) hypohydration reduces high-intensity cycling performance of healthy young boys in the heat.

Influence of pubertal stage on local sweating patterns of girls exercising in the heat.

The influence of puberty on sweating patterns of girls exercising in the heat is not known. Nine- to 17-year-old girls, representing 4 stages of breast development: T1 (n = 21); T2 (n = 22); T3 (n = 25); and T4 (n = 22), cycled for 20 min at 60% in 35 °C. The population density of heat activated sweat glands was higher in T1 vs T3 and T4 and in T2 vs T4. Sweat drop area was lower in T1 vs T3 and in T1 vs T4, T2 vs T4 and T3 vs T4. The proportion of skin covered by sweat was lower in T1 vs T4. Sweating patterns of girls exercising in the heat are influenced by pubertal stage.

Body weight changes in child and adolescent athletes during a triathlon competition.

We examined young athletes during a triathlon performed in a hot climate. Complete or partial data were available for 95 athletes competing in the National Triathlon Championship in Costa Rica. Mean ± SD for age and body weight (BW) were 13.1 ± 2.5 years and 46.3 ± 11.5 kg, respectively. Race requirements included: 500 m swimming, 15 km cycling, 3.5 km running for juniors (9-13 years); 800 m swimming, 30 km cycling, 8 km running for seniors (14-17 years). WBGT on race day was >31 °C. BW recorded pre- and post-race was available for 92 athletes and performance data were available for 83 of these. Information regarding symptoms experienced during the race was available for 95 athletes. Change in BW (%ΔBW) was calculated and ranged from +0.6 to -2.4 % for junior boys (-1.2 ± 0.9 %), +0.7 to -2.5 % for junior girls (-1.3 ± 0.9 %), 0 to -2.8 % for senior girls (-1.3 ± 0.9 %), and +0.6 to -4.5 % for senior boys (-1.7 ± 1.1 %). Eighteen participants reported no medical symptoms. Of 77 participants who reported symptoms, 42.9 % reported exhaustion/fatigue, 36.4 % reported side stitch/cramp, and 23.4 % reported dizziness. Participants reporting no medical symptoms achieved almost identical (P = 0.99) %ΔBW as those reporting at least one symptom. %ΔBW was more negative (P = 0.005) in participants who reported dizziness (-1.9 %ΔBW) compared with those who did not (-1.4 %ΔBW). %ΔBW was associated with performance in junior girls (r = 0.47, P = 0.02) and senior boys (r = 0.51, P = 0.01), with a trend in junior boys (r = 0.41, P = 0.053) but not in senior girls (r = 0.004, P = 0.99). Young athletes participating in a triathlon in a hot climate can tolerate mild to moderate levels of dehydration, without detrimental effects to self-assessed health.

Voluntary fluid intake, hydration status, and aerobic performance of adolescent athletes in the heat.

We determined whether beverage flavoring and composition would stimulate voluntary drink intake, prevent dehydration, and maintain exercise performance in heat-acclimated adolescent males running in the heat. Eight adolescent (age, 13.7 ± 1.1 years) runners (peak oxygen uptake, 59.5 ± 4.0 mL·kg-1·min-1) underwent at least four 80-min exercise heat-acclimation sessions before completing 3 experimental sessions. All sessions were performed at 30 °C and 60%-65% relative humidity. Each experimental session consisted of five 15-min treadmill runs at a speed eliciting 65% peak oxygen uptake, with a 5 min rest prior to each run. Ten minutes after the final run, a time to exhaustion test was performed at a speed eliciting 90% peak oxygen uptake. Counterbalanced experimental sessions were identical, except for fluid intake, which consisted of tap water (W), flavored water (FW), and FW with 6% carbohydrate and 18 mmol·L-1 NaCl (CNa) consumed ad libitum. Fluid intake and body weight were monitored to calculate dehydration. Voluntary fluid intake was similar to fluid losses in W (1032 ± 130 vs. 1340 ± 246 g), FW (1086 ± 86 vs. 1451 ± 253 g), and CNa (1259 ± 119 vs. 1358 ± 234 g). As a result, significant dehydration was avoided in all trials (-0.45% ± 0.68% body weight in W, -0.66% ± 0.50% body weight in FW, and -0.13% ± 0.71% body weight in CNa). Core temperature increased by ~1 °C during exercise, but was not different between trials. Time to exhaustion was not different between trials and averaged 8.8 ± 1.7 min. Under exercise conditions more closely reflecting real-life situations, heat-acclimatized adolescent male runners can appropriately gauge fluid intake regardless of the type of beverage made available, resulting in consistency in exercise performance.

Voluntary drinking and hydration in trained, heat-acclimatized girls exercising in a hot and humid climate.

This study examined the effects of beverage composition on the voluntary drinking pattern, body fluid balance and body temperature responses of heat-acclimatized trained girls exercising intermittently in outdoor conditions (WBGT = 30.9 +/- 0.2 degrees C). Twelve trained, heat-acclimatized girls (age = 10.6 +/- 0.2 years) performed three 3-h sessions, each consisting of four 20-min cycling bouts at 60% VO2max, alternating with 25-min rest. One of three beverages was assigned: unflavored water (W), flavored water (FW) or flavored water plus 6% carbohydrate and 18 mmol/l NaCl (CNa). Drinking was ad libitum. Total intake was similar among conditions (W = 953.3 +/- 107.8 ; FW = 1026.5 +/- 138.1; CNa = 906.4 +/- 107.5 g). A mild hypohydration occurred during the three conditions (W = -1.12%; FW = -0.95%; CNa = -0.74% BW, P > 0.05). Sweat loss, higher than previously reported for sedentary girls, was not different among conditions (W = 1,051.5 +/- 90.8; FW = 979.9 +/- 72.8; CNa = 1,052.7 +/- 52.6 g). The average amount of urine produced (W = 269.8 +/- 85.9; FW = 320.8 +/- 87.2; CNa = 85.6 +/- 9.3 g) was 73 and 68% lower [corrected] during CNa compared to [corrected] FW and W, respectively, [corrected] (CNa vs. FW, P < 0.05), CNa vs W, P = 0.06) [corrected] The increase in rectal temperature, heart rate and all perceptual variables did not differ among conditions. In conclusion, flavoring of the water and addition of 6% carbohydrate plus 18 mmol/l NaCl do not prevent mild hypohydration in trained, heat-acclimatized girls with high sweating rates. However, there is a tendency towards a greater fluid retention with the CNa beverage.

Reliability of exercise testing and functional activity questionnaires in children with juvenile arthritis.

OBJECTIVE: To determine the reliability of formal exercise testing and the reliability of functional and activity questionnaires in children with juvenile idiopathic arthritis (JIA). METHODS: Children with JIA of any subtype ages 8-16 years who were recruited to a randomized trial comparing different exercise therapies participated in 2 preintervention sessions of exercise testing 2-6 weeks apart. Exercise testing included 1) submaximal oxygen uptake (VO(2submax)), 2) peak VO(2) (VO(2peak)), and 3) anaerobic power using modified Wingate tests (W(ant)). Two physical function questionnaires (the Childhood Health Assessment Questionnaire [C-HAQ] and Revised Activity Scale for Kids [ASK]) and 1 daily physical activity questionnaire (the Habitual Activity Estimation Scale [HAES]) were also completed at these times. Test-retest reliability was assessed using type 3, intrarater intraclass correlation coefficient (ICC(3,1)) and Bland and Altman plots were used to determine limits of agreement. RESULTS: Data were available for 74 patients (58 girls). VO(2submax), VO(2peak), and W(ant) demonstrated high reliability (ICC(3,1) 0.82, 0.91, and 0.94, respectively). C-HAQ and ASK questionnaires also had very high reliability (ICC(3,1) 0.82 and 0.91, respectively). The HAES demonstrated low reliability for total activity score (ICC(3,1) 0.15) and moderate reliability when the number of very active hours was analyzed separately (ICC(3,1) 0.59). CONCLUSION: Results of this investigation suggest that exercise testing and functional questionnaires in children with JIA are consistent and reliable. Reliability of the HAES total score was poor, but moderate when the very active hours subscale score was used.

The effects of vigorous exercise training on physical function in children with arthritis: a randomized, controlled, single-blinded trial.

OBJECTIVE: To examine the effectiveness of high-intensity aerobic training compared with low-intensity training in terms of energy cost of locomotion, peak oxygen uptake, peak power, and self-reported physical function in children with juvenile idiopathic arthritis (JIA). METHODS: Eighty children with JIA, ages 8-16 years, were enrolled in a randomized, single-blind controlled trial. Both groups participated in a 12-week, 3-times-weekly training program consisting of high-intensity aerobics in the experimental group and qigong in the control group. Subjects underwent exercise testing measuring submaximal oxygen uptake at 3 km/hour (VO(2submax)) as the primary outcome, maximal oxygen uptake, and peak power at the beginning and end of the program. Physical function was measured using the Child Health Assessment Questionnaire (C-HAQ). RESULTS: The exercise program was well tolerated in both groups. There was no difference in VO(2submax) or any other exercise testing measures between the groups through the study period and no indication of improvement. Both groups showed significant improvements in C-HAQ with no difference between the groups. Adherence was higher in the control group than the experimental group. CONCLUSION: Our findings suggest that activity programs with or without an aerobic training component are safe and may result in an important improvement in physical function. The intensity of aerobic training did not seem to provide any additional benefits, but higher adherence in the qigong program may suggest that less intensive regimens are easier for children with JIA to comply with, and provide a degree of benefit equivalent to more intensive programs.

Voluntary drinking and hydration in non-acclimatized girls exercising in the heat.

The intent of this study was to assess the influence of drink flavor and composition on voluntary drinking and hydration status in girls exercising intermittently in the heat (35 +/- 1 degrees C, 45-50% relative humidity). Twelve physically active, nonacclimatized girls (9-12 years) performed three 3 h identical sessions, each consisting of four 20 min cycling bouts at 50% (VO(2max)), separated by 25 min of rest. One of the three beverages (chilled to 8-10 degrees C) was assigned to each session: unflavored water (W), grape-flavored water (FW) and grape-flavored water plus 6% carbohydrate and 18 mmol l(-1) NaCl (CNa). Drinking was ad libitum. Body weight (BW), drink intake (DI), heart rate, rectal and skin temperatures, and perceptions of thirst and stomach fullness were monitored periodically. Total DI was 759, 940, 1,045 g in W, FW and CNa, respectively (P < 0.05 for CNa-W and FW-W). BW changes were -0.15, 0.16, and 0.45% in W, FW and CNa, respectively, but only the difference between CNa and W was significant (P < 0.05). Other physiological and perceptual variables were not different between trials. In conclusion, beverage flavoring regardless if its combination with carbohydrate and NaCl, mildly enhanced voluntary drinking in young non-acclimatized girls. In contrast to previous research in young boys, euhydration was maintained in the girls by an adequate intake of unflavored water.

Energy substrate utilization during prolonged exercise with and without carbohydrate intake in preadolescent and adolescent girls.

Little information is available on energy metabolism during exercise in girls, particularly the contribution of exogenous carbohydrate (CHO(exo)). The purpose of this study was to determine substrate utilization during exercise with and without CHO(exo) intake in healthy girls. Twelve-yr-old preadolescent (YG; n = 12) and 14-yr-old adolescent (OG; n = 10) girls consumed flavored water (WT) or (13)C-enriched 6% CHO (CT) while cycling for 60 min at approximately 70% maximal aerobic power (Vo(2max)). Substrate utilization was calculated for the final 15 min of exercise. CHO(exo) decreased fat oxidation by approximately 50% in YG but not in OG (P < 0.001) and decreased endogenous CHO oxidation by approximately 15% in OG but not in YG (P = 0.006). Endogenous CHO oxidation was lower in YG than in OG regardless of trial (P < or = 0.01), whereas fat oxidation was higher in YG only during WT (P < 0.001). CHO(exo) oxidation rate was similar between YG and OG (7.1 +/- 0.5 and 6.8 +/- 0.4 mg.kg(-1).min(-1), respectively, P = 0.67), contributing approximately 19% to total energy expenditure. Serum estradiol levels in all girls correlated with fat (r = -0.50 to -0.59, P = 0.03 to 0.005) and endogenous CHO oxidation (r = 0.50 to 0.63, P = 0.03 to 0.005) but not with CHO(exo) oxidation (r = -0.09, P = 0.71). We conclude that CHO(exo) influences endogenous substrate utilization in an age-dependent manner in healthy girls but that total CHO(exo) oxidation during exercise is not different between YG and OG. Our results also point to potential sex-related differences in energy substrate utilization even during childhood.

Evidence of sex-based differences in natural killer cell responses to exercise and carbohydrate intake in children.

Distinct natural killer (NK) cell subsets (CD56bright and CD56dim) are mobilized with exercise and these cells may serve adaptive functions. We determined the distribution of NK cell subsets in response to exercise and carbohydrate (CHO) intake in young girls and compared these responses with previous findings in young boys of the same age. Twelve girls (12 years old) cycled for 60 min at 70% VO2max while drinking 6% CHO or flavoured water. Blood was collected at rest, during (30 and 60 min) and following (30 and 60 min) exercise to identify NK cells as CD3-CD56bright or CD3-CD56dim. CD69 expression on total CD3-CD56+ cells was also determined. A trend (P=0.07) was found for a trial x time interaction in CD56dim cell counts, with values lower with CHO than with water. CHO intake did not influence CD56bright responses (P>or=0.39). The CD56bright:CD56dim ratio increased during recovery from exercise (P<0.001), compared to rest, with no effect of CHO intake (P=0.48). CD69 expression was not different between exercise or recovery and rest. Like young boys, girls experience an elevated CD56bright:CD56dim ratio during recovery from exercise and CHO intake attenuates the exercise-induced CD56dim but not CD56bright cell response. Unlike young boys, girls do not experience a CHO-induced increase in the CD56bright:CD56dim ratio during recovery and CD69 expression does not increase on CD3-CD56+ cells during recovery. We conclude that even in young children sex-based differences exist in the NK cell response to exercise and CHO intake.

Influence of age and pubertal status on substrate utilization during exercise with and without carbohydrate intake in healthy boys.

Substrate utilization during exercise is known to differ between children and adults, but whether these differences are related to pubertal status is unclear. The objective of this study was to investigate the effects of pubertal status on endogenous (CHOendo) and orally ingested exogenous (CHOexo) carbohydrate and fat oxidation rates during exercise. Twenty boys at the same chronological age (12 y) were divided into three pubertal groups (pre-pubertal, PP: n=7; early-pubertal, EP: n=7; mid- to late-pubertal, M-LP: n=6) and consumed either a placebo or 13C-enriched 6% CHO drink while cycling for 60 min at approximately 70% of their maximal aerobic power (VO2 max). Another group of 14-year-old boys (pubertal, n=9) completed all procedures. Substrate utilization was calculated for the final 15 min of exercise using indirect calorimetry and stable isotope methodology. CHOexo decreased fat (p<0.001) and increased total CHO (p<0.001) oxidation, irrespective of group. Fat oxidation was higher (p=0.01) in younger boys than in older boys, but similar (p>or=0.33) among PP, EP, and M-LP boys. CHOexo contributed to approximately 30% of energy expenditure (EE) in PP and EP, but to only 24% in M-LP (p=0.02), which was identical to the older boys (24%). CHOexo oxidation rate as a percentage of EE was inversely related to testosterone levels (r=-0.51, p=0.005, n=29). It was concluded that reliance on CHOexo during exercise is particularly sensitive to pubertal status, with the highest oxidation rates observed in pre- and early-pubertal boys, independent of chronological age.

Lymphocyte expression of CD95 at rest and in response to acute exercise in healthy children and adolescents.

CD95 is essential in regulating the immune system, and its reduced expression has been associated with anthracycline resistance in some childhood leukemias. We determined whether an acute bout of exercise would influence the mixed lymphocyte expression of CD95 in healthy children and adolescents. Fifty healthy pediatric subjects (female n=25) cycled for 60 min @ 70% V O(2max). Blood was collected before, during, and after exercise to determine CD95 expression on T (CD3(+)CD19(-)) and B (CD3(-)CD19(+)) cells using flow cytometry. At rest, the percentage of CD95(hi) T cells was 29% higher in girls versus boys (p<0.001). The percentage of CD95(hi) T cells and the median fluorescence intensity (MFI) of CD95(hi) were higher during recovery versus rest (p<0.0001). The percentage of CD95(lo) T cells was lower during recovery versus rest, whereas the MFI of CD95(lo) was higher during exercise versus rest. The CD95(hi) T cell count increased during exercise, but only in 14-yr-old girls, whereas CD95(lo) T cell counts increased similarly in all groups. CD95(+) B cells were relatively unresponsive to exercise. We conclude that lymphocyte expression of CD95 is influenced by acute exercise in healthy children and adolescents. Exercise-induced alterations in CD95 expression may have clinical implications for some pediatric conditions.

Puberty effects on NK cell responses to exercise and carbohydrate intake in boys.

UNLABELLED: Previous research has demonstrated that younger versus older animals and humans experience smaller perturbations in natural killer (NK) cells in response to physiological stress. PURPOSE: To determine whether the smaller perturbations in NK cells induced by strenuous exercise and carbohydrate (CHO) intake, previously reported in children, are influenced by puberty. METHODS: Twenty 12-yr-old boys, distinguished as prepubertal (Tanner (T) 1, N = 7), early pubertal (T2, N = 7), or pubertal (T3-5, N = 6), cycled for 60 min at 70% VO(2max) while drinking 6% CHO (CT) or flavored water (WT). Blood was collected at rest and during (30 and 60 min) and following (30 and 60 min) exercise to identify NK cells as CD3(-)CD56(dim) or CD3(-)CD56(dim). CD69 expression on CD3(-)CD56(+) cells was also determined. RESULTS: A puberty x CHO x exercise interaction was found for the proportion, but not number, of CD56(dim) cells (P = 0.06). CD56(dim) cell counts were lower in CT versus WT (P < 0.001). Responses of CD56(bright) proportions (P = 0.007) and counts (P = 0.03) depended on pubertal status, but not CHO. The CD56(bright):CD56(dim) ratio remained stable during exercise, but during recovery was higher in T1 and T3-5 versus T2 (P = 0.08) and in CT versus WT (P = 0.04). During recovery, CD3(-)CD56(+) cells expressed higher levels of CD69 (P = 0.01), with no change in the proportion of CD69(+) cells. CONCLUSION: These results confirm the influence of puberty on the distribution of NK cell subsets in response to exercise and CHO intake. Increased CD69 expression suggests that NK cells increase activation status during recovery from physiological stress.

Immunological changes in response to exercise: influence of age, puberty, and gender.

PURPOSE: This study tested the hypothesis that exercise-induced perturbation and recovery of the immune system would vary with age, puberty, and gender in healthy children and adolescents. METHODS: Twelve-year-old girls (YG; N = 14) and boys (YB; N = 20), and 14-yr-old girls (OG; N = 11) and boys (OB; N = 13) cycled for 60 min at 70% VO2max. Blood was collected before, at 30 and 60 min of exercise, and at 30 and 60 min of recovery to measure total leukocytes, leukocyte and lymphocyte subsets, and cytokines. Age and pubertal (Tanner stage) effects within genders and gender effects within age and pubertal groups were determined. RESULTS: Exercise-induced increases in lymphocytes, CD3-CD16+CD56+ counts, and IL-6 were approximately 83, 90, and 390% greater in OG versus YG (P < 0.05). Recovery leukocytosis and neutrophilia were approximately 56 and 35% greater in OB versus YB (P < 0.05). Pubertal stage did not have a statistically significant influence on responses in girls, but the lowest pubertal stage consistently showed smaller changes in lymphocytes and CD3-CD16+CD56+ counts. Recovery neutrophilia was approximately 120% greater in postpubertal boys versus prepubertal or pubertal boys (P < 0.05). Responses of lymphocytes and CD3-CD16+CD56+ counts, respectively, were approximately 120 and 82% greater in OG versus OB (P < 0.05), with no differences between YG and YB. Exercise-induced increases in total leukocytes, lymphocytes, and CD3-CD16+CD56+ counts were at least 35% greater in girls versus boys of similar pubertal status (P < 0.05). Regardless of age, puberty, or gender, IL-8 levels were significantly higher during recovery versus rest (P < 0.05). CONCLUSION: These results highlight the need to control for age, puberty, and gender when interpreting immunologic responses to exercise in a pediatric population.

Sex-based effects on the distribution of NK cell subsets in response to exercise and carbohydrate intake in adolescents.

Carbohydrate (CHO) supplementation and female sex independently influence the natural killer (NK) cell response to acute exercise. Consequently, this study sought to elucidate sex-based differences in the distribution of NK cell subsets (i.e., CD56dim and CD56bright) in response to exercise and CHO intake. Twenty-two healthy 14-yr-old girls (n = 11) and boys (n = 11) cycled for 60 min at 70% maximal oxygen consumption while drinking 6% CHO (CT) or flavored water (WT). Blood was collected at rest, during exercise (30 and 60 min), and during recovery (30 and 60 min) to identify CD3- CD56dim and CD3- CD56bright NK cells. The activation marker CD69 was also determined on CD3- CD56+ cells. CD56dim responses, expressed as proportions or cell counts, were greater (P < or = 0.01) in girls by 67 and 105%, respectively. CD56bright cell counts (P = 0.006), but not CD56bright proportions (P = 0.89), were greater in girls by 82%. Both CD56dim and CD56bright subset responses, expressed as proportions or cell counts, were lower (P < or = 0.01) in CT vs. WT by 33-36%. The CD56bright-to-CD56dim ratio decreased at 30 min of exercise but increased during recovery (P < 0.001), with no effect of sex or CHO. Regardless of trial, CD3- CD56+ cells expressed approximately 18% higher levels of CD69 during recovery in girls but not boys (P = 0.03), despite similar proportions and counts of CD69+ cells. These results demonstrate sex-based differences in the distribution of NK cell subsets and activation status in response to exercise, but not CHO intake, and further support the need to control for sex in exercise immunology studies.

Overweight children reduce their activity levels earlier in life than healthy weight children.

OBJECTIVE: To determine differences in the time overweight and nonoverweight youth spend on light, moderate, hard, and very hard activity plus gender and age differences in activity patterns. DESIGN AND SETTING: This study was a cross-sectional design in a primary care hospital. PARTICIPANTS: A total of 197 children and adolescents (4-16 years) participated. The overweight group (n = 107) were on a waiting list for an obesity treatment program and were defined as overweight, with a body mass index >95th percentile, and the nonoverweight group (n = 90) were volunteers recruited via advertisements and had a body mass index <75th percentile. INTERVENTIONS AND OUTCOME MEASUREMENTS: To determine activity patterns and perception of activity level, an interview was conducted with the child and a parent using a validated 7-day recall. Body fat was measured with bioelectrical impedance. RESULTS: There was a negative correlation between adiposity and total amount of activity performed, with the amount of moderate activity the best predictor of obesity. Girls did less activity than boys whether overweight or not. Between the ages of 4 and 7 years, overweight and nonoverweight subjects did similar amounts of activity. In the older subjects, the activity of the overweight was less than in nonoverweight. The overweight subjects perceived themselves to be just as active as others their same age and sex. CONCLUSIONS: Clinicians need to be aware that overweight children and adolescents are less active than nonoverweight children at an earlier age, particularly females, but feel that their activity level is similar to that of nonobese children.

Aerobic and lung performance in premature children with and without chronic lung disease of prematurity.

OBJECTIVE: This study intended to identify pulmonary and exercise-related effects of chronic lung disease of infancy (CLD) versus prematurity (PRE) without CLD in children 5 to 7 years old who were born prematurely (24-30 weeks of gestation) with very low and extremely low birthweight of 500 to 1500 g (VLBW, ELBW). SUBJECTS: Seventeen CLD and 14 PRE were compared with 24 term controls (CON). The premature children had no overt manifestations of a neuromuscular disease. METHODS: Pulmonary function at rest and following exercise, and aerobic exercise performance were measured. RESULTS: Peak [latin capital V with dot above]O2 and maximal aerobic power were not different among the groups, but O2 uptake at a given mechanical power was higher in the CLD than in PRE and in CON (P < 0.05). At rest, forced vital capacity was significantly lower in CLD than in PRE (P < 0.05) and CON (P < 0.0005), and FEV1 and FEF25-75 were lower in CLD than CON (P < 0.0005 and P < 0.005, respectively). Exercise-induced bronchoconstriction (EIB) was more prevalent among the 2 premature groups (P < 0.05). CONCLUSIONS: Our children 5 to 7 years old born at VLBW or ELBW, with or without CLD, have some degree of pulmonary dysfunction at rest and following exercise and a higher prevalence of EIB with no reduction in maximal aerobic exercise performance. The findings suggest that the pulmonary limitations are associated with low birthweight even in the absence of CLD. The higher O2 uptake at a given mechanical power in the CLD group may cause early fatigability during prolonged exercise, even when aerobic performance is normal.