At what age do normal weight Canadian children become overweight adults? Differences according to sex and metric.

BACKGROUND: The prevalence of overweight and obesity doubles between adolescence and young adulthood; however, the exact age, and appropriate metric to use to identify when overweight develops is still debated. AIM: To examine the age of onset of overweight by sex and four metrics: body mass index (BMI), fat mass (%FM), waist circumference (WC) and waist-to-height ratio (WHtR). SUBJECTS AND METHODS: Between 1991 and 2017, serial measures of body composition were taken on 237 (108 males) individuals (aged 8-40 years of age). Hierarchical random effects models were used to develop growth curves. Curves were compared to BMI, %FM and WC overweight age- and sex-specific cut-points. RESULTS: In males, the BMI growth curve crossed the cut-point at 22.0 years, compared to 23.5 and 26.5 years for WHtR and %FM, respectively; WC cut-off was not reached until 36 years. In females, the BMI growth curve crossed the overweight cut-point at 21.5 years, compared to 14.2 years for %FM and 21.9 and 27.5 years for WC and WHtR, respectively. CONCLUSION: In summary, overweight onset occurs during young adulthood with the exception of WC in males. BMI in males and %FM in females were the metrics identifying overweight the earliest.

Are milk and alternatives and fruit and vegetable intakes during adolescence associated with cortical and trabecular bone structure, density, and strength in adulthood?

We investigated the impact of food group intake during adolescence on bone structure and strength during adulthood. In females, we found a beneficial effect of adolescent milk and alternatives and fruit and vegetable intake on adult radius shaft and distal tibia bone structure, respectively. No association was observed in males. INTRODUCTION: The purpose of this study was to investigate whether adolescents with high intake of milk and alternatives (M&A) or fruit and vegetables (F&V) had better adult bone structure and strength compared to those with low intake levels. METHODS: We analyzed data from 47 males and 69 females enrolled in the Pediatric Bone Mineral Accrual Study (PBMAS 1991-2011), who had one peripheral quantitative computed tomography scan at age 29 ± 2 years. We measured radius and tibia shaft total area (ToA), cortical area (CoA), cortical content (CoC), cortical density, bone strength (SSIp), and muscle area, as well as distal radius and tibia ToA, total density, trabecular area, trabecular content, trabecular density, and bone strength (BSIc). Sequential 24-h recalls were used to assess M&A and F&V intake; participants were grouped for their mean intake during adolescence (low = bottom quartile, moderate = middle quartiles, high = top quartile) and were compared using multivariate analysis of covariance while adjusting for adult height, muscle area, physical activity, energy and calcium intake and adolescent energy intake, and physical activity. RESULTS: Females with high M&A intake compared to low M&A intake group (mean 3.8 vs. 1.3 servings/day, respectively) had greater adult ToA (14 %, p < 0.05), CoA (15 %, p < 0.01), and CoC (16 %, p < 0.01) at radius shaft. Females with moderate F&V intake compared to low F&V intake group (mean 3.7 vs. 2.1 servings/day, respectively) had greater adult ToA (8.5 %, p < 0.05) at distal tibia. CONCLUSION: Higher intake of M&A or F&V during adolescence had a long-term beneficial effect on bone structure in females, an association not observed in males.

A longitudinal study of bone area, content, density, and strength development at the radius and tibia in children 4-12 years of age exposed to recreational gymnastics.

UNLABELLED: This study investigated the long-term relationship between the exposure to childhood recreational gymnastics and bone measures and bone strength parameters at the radius and tibia. It was observed that individuals exposed to recreational gymnastics had significantly greater total bone content and area at the distal radius. No differences were observed at the tibia. INTRODUCTION: This study investigated the relationship between exposure to early childhood recreational gymnastics with bone measures and bone strength development at the radius and tibia. METHODS: One hundred twenty seven children (59 male, 68 female) involved in either recreational gymnastics (gymnasts) or other recreational sports (non-gymnasts) between 4 and 6 years of age were recruited. Peripheral quantitative computed tomography (pQCT) scans of their distal and shaft sites of the forearm and leg were obtained over 3 years, covering the ages of 4-12 years at study completion. Multilevel random effects models were constructed to assess differences in the development of bone measures and bone strength measures between those exposed and not exposed to gymnastics while controlling for age, limb length, weight, physical activity, muscle area, sex, and hours of training. RESULTS: Once age, limb length, weight, muscle area, physical activity, sex, and hours of training effects were controlled, it was observed that individuals exposed to recreational gymnastics had significantly greater total bone area (18.0 ± 7.5 mm(2)) and total bone content (6.0 ± 3.0 mg/mm) at the distal radius (p < 0.05). This represents an 8-21 % benefit in ToA and 8-15 % benefit to ToC from 4 to 12 years of age. Exposure to recreational gymnastics had no significant effect on bone measures at the radius shaft or at the tibia (p > 0.05). CONCLUSIONS: Exposure to early life recreational gymnastics provides skeletal benefits to distal radius bone content and area. Thus, childhood recreational gymnastics exposure may be advantageous to bone development at the wrist.

Bone strength and muscle properties in postmenopausal women with and without a recent distal radius fracture.

UNLABELLED: Distal radius (wrist) fracture (DRF) in women over age 50 years is an early sign of bone fragility. Women with a recent DRF compared to women without DRF demonstrated lower bone strength, muscle density, and strength, but no difference in dual-energy x-ray absorptiometry (DXA) measures, suggesting DXA alone may not be a sufficient predictor for DRF risk. INTRODUCTION: The objective of this study was to investigate differences in bone and muscle properties between women with and without a recent DRF. METHODS: One hundred sixty-six postmenopausal women (50-78 years) were recruited. Participants were excluded if they had taken bone-altering medications in the past 6 months or had medical conditions that severely affected daily living or the upper extremity. Seventy-seven age-matched women with a fracture in the past 6-24 months (Fx, n = 32) and without fracture (NFx, n = 45) were measured for bone and muscle properties using the nondominant (NFx) or non-fractured limb (Fx). Peripheral quantitative computed tomography (pQCT) was used to estimate bone strength in compression (BSIc) at the distal radius and tibia, bone strength in torsion (SSIp) at the shaft sites, muscle density, and area at the forearm and lower leg. Areal bone mineral density at the ultradistal forearm, spine, and femoral neck was measured by DXA. Grip strength and the 30-s chair stand test were used as estimates of upper and lower extremity muscle strength. Limb-specific between-group differences were compared using multivariate analysis of variance (MANOVA). RESULTS: There was a significant group difference (p < 0.05) for the forearm and lower leg, with the Fx group demonstrating 16 and 19% lower BSIc, 3 and 6% lower muscle density, and 20 and 21% lower muscle strength at the upper and lower extremities, respectively. There were no differences between groups for DXA measures. CONCLUSIONS: Women with recent DRF had lower pQCT-derived estimated bone strength at the distal radius and tibia and lower muscle density and strength at both extremities.

Does lean tissue mass accrual during adolescence influence bone structural strength at the proximal femur in young adulthood?

UNLABELLED: The purpose of this study was to identify whether young adult bone structural strength at the hip is associated with adolescent lean tissue mass (LTM) accrual. It was observed that those individuals who accrued more LTM from adolescence to adulthood had significantly greater adult bone structural strength at the hip. INTRODUCTION: The purpose of this study was to identify whether young adult bone cross-sectional area (CSA), section modulus (Z), and outer diameter (OD) at the hip were associated with adolescent LTM accrual. METHODS: One hundred three young adult participants (55 males, 48 females) were tertiled into adolescent LTM accrual groupings. LTM accrual was assessed by serial measures using dual energy X-ray absorptiometry (DXA) from adolescence to young adulthood (21.3 ± 1.3 years). CSA, Z, and OD at the narrow neck (NN) and femoral shaft (S) sites of the proximal femur were assessed in young adulthood (21.3 ± 4.5 years), using hip structural analysis. Group differences were assessed using an analysis of covariance, controlling for adult height, weight, sex, and physical activity levels. RESULTS: It was found that individuals with higher adjusted adolescent LTM accrual had significantly greater adult adjusted values of NNCSA (2.49 ± 0.06 vs 2.77 ± 0.07 cm(2)), NN Z (1.18 ± 0.04 vs 1.37 ± 0.04 cm(3)), NN OD (3.07 ± 0.04 vs 3.21 ± 0.04 cm), SCSA (3.45 ± 0.08 vs 3.88 ± 0.09 cm(3)), and SZ (1.77 ± 0.05 vs 2.00 ± 0.05 cm(3)) than individuals with lower LTM accrual (p < 0.05). CONCLUSIONS: These findings suggest that the amount of LTM accrued from adolescence to young adulthood has a positive influence on adult bone structural strength at the proximal femur.

Tracking of aerobic fitness from adolescence to mid-adulthood.

BACKGROUND: Although adults' aerobic fitness is known to be correlated with cardiovascular disease risk, the longitudinal relationship with adolescent aerobic fitness is poorly described. AIM: To longitudinally investigate the relationship between aerobic fitness during adolescence and adulthood. SUBJECTS AND METHODS: Participants (207 boys, 149 girls) aged 7-17 years performed annual measures of VO2peak. In adulthood (40 and 50 years), 78 individuals (59 males and 18 females) were reassessed. Serial height measurements were used to estimate age at peak height velocity (APHV). During adolescence, VO2peak was measured via a treadmill test to voluntary exhaustion; adult VO2peak was assessed using submaximal predictive tests. Correlations were tested using Spearman's rho. ANCOVA was used to assess adult VO2peak group differences based off APHV VO2peak groupings (low, average or high). RESULTS: When sexes were pooled, moderate tracking existed from 2 years prior to APHV to APHV and APHV to 2 years after APHV (0.46, p < 0.001 and 0.35, p < 0.01, respectively). Correlations between APHV and adult values were low when sexes were pooled (p < 0.05). Comparisons of aggregated sexes revealed the low adolescent VO2peak group had lower values in adulthood relative to other groups (p < 0.05). CONCLUSION: Aerobic fitness has a low tracking between APHV and adulthood.

Precompetitive and recreational gymnasts have greater bone density, mass, and estimated strength at the distal radius in young childhood.

UNLABELLED: Young recreational and precompetitive gymnasts had, on average, 23% greater bone strength at the wrist compared to children participating in other recreational sports. Recreational gymnastics involves learning basic movement patterns and general skill development and as such can easily be implemented into school physical education programs potentially impacting skeletal health. INTRODUCTION: Competitive gymnasts have greater bone mass, density, and estimated strength. The purpose of this study was to investigate whether the differences reported in the skeleton of competitive gymnasts are also apparent in young recreational and precompetitive gymnasts. METHODS: One hundred twenty children (29 gymnasts, 46 ex-gymnasts, and 45 non-gymnasts) between 4 and 9 years of age (mean = 6.8 ± 1.3) were measured. Bone mass, density, structure, and estimated strength were determined using peripheral quantitative computed tomography at the distal (4%) and shaft (65%, 66%) sites in the radius and tibia. Total body, hip, and spine bone mineral content (BMC) was assessed using dual energy X-ray absorptiometry. Analysis of covariance (covariates of sex, age and height) was used to investigate differences in total bone content (ToC), total bone density (ToD), total bone area (ToA), and estimated strength (BSI) at the distal sites and ToA, cortical content (CoC), cortical density (CoD), cortical area (CoA), cortical thickness, medullary area, and estimated strength (SSIp) at the shaft sites. RESULTS: Gymnasts and ex-gymnasts had 5% greater adjusted total body BMC and 6-25% greater adjusted ToC, ToD, and BSI at the distal radius compared to non-gymnasts (p < 0.05). Ex-gymnasts had 7-11% greater CoC and CoA at the radial shaft and 5-8% greater CoC and SSIp at the tibial shaft than gymnasts and non-gymnasts. Ex-gymnasts also had 12-22% greater ToC and BSI at the distal tibia compared to non-gymnasts (p < 0.05). CONCLUSION: This data suggests that recreational and precompetitive gymnastics participation is associated with greater bone strength.

The relationship between girls' (8-14 years) physical activity and maternal education.

BACKGROUND: Mothers with higher levels of education are more likely to engage in health-promoting behaviour; thus, it is intuitive that a child's physical activity would be positively related to maternal education. The literature on this area, however, is inconclusive and may be due to the methods used to assess physical activity (i.e. the use of aggregated and self-reported physical activity that may not reflect the true and detailed variation of physical activity). AIM: To profile the physical activity behaviours of girls with mothers of differing educational attainment. SUBJECTS AND METHODS: 77 girls (grades 4-8) wore an Actical accelerometer for 7 days. Minutes spent sedentary and in light, moderate and vigorous physical activity per day over 7 days, 5 weekdays, 2 weekends, and 1 h commuting period to and from school of girls of University educated (UE) and non-UE mothers were analysed. RESULTS: After controlling for confounders, girls with UE mothers were more likely to participate in vigorous physical activity at the weekend and moderate-to-vigorous physical activity during the morning commute to school. CONCLUSIONS: Research investigating the relationship between maternal education and child's physical activity should explore, at higher resolution, when activity is accumulated, in particular separating weekday and weekend physical activity.

Adolescent Trajectories of Aerobic Fitness and Adiposity as Markers of Cardiometabolic Risk in Adulthood.

Purpose: The aim of this study was to investigate whether adolescent growth trajectories of aerobic fitness and adiposity were associated with mid-adulthood cardiometabolic risk (CMR). Methods: Participants were drawn from the Saskatchewan Growth and Development Study (1963-1973). Adolescent growth trajectories for maximal aerobic capacity (absolute VO2 (AbsVO2)), skinfolds (SF), representing total body (Sum6SF) and central adiposity (TrunkSF), and body mass index (BMI) were determined from 7 to 17 years of age. In mid-adulthood (40 to 50 years of age), 61 individuals (23 females) returned for follow-ups. A CMR score was calculated to group participants as displaying either high or a low CMR. Multilevel hierarchical models were constructed, comparing the adolescent growth trajectories of AbsVO2, Sum6SF, TrunkSF, and BMI between CMR groupings. Results: There were no significant differences in the adolescent development of AbsVO2, Sum6SF, TrunkSF, and BMI between adult CMR groupings (p > 0.05). Individuals with high CMR accrued 62% greater adjusted total body fat percentage from adolescence to adulthood (p=0.03). Conclusions: Growth trajectories of adolescent aerobic fitness and adiposity do not appear to be associated with mid-adulthood CMR. Individuals should be encouraged to participate in behaviours that promote healthy aerobic fitness and adiposity levels throughout life to reduce lifelong CMR.

Height, weight, body composition, and waist circumference references for 7- to 17-year-old children from rural Portugal.

The purpose of this study was (1) to develop references of height, weight, body mass index (BMI), waist circumference and body fat for rural Portuguese children and adolescents and (2) to compare these results with other international references. The sample comprised 3094 children and adolescents aged 7-17 years from Vouzela, a central region in Portugal. Height, weight, BMI, waist circumference and body fat were measured. Centile curves were constructed using the LMS method. The Vouzela sample showed similar height median values compared to Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) percentile curves but greater values for weight and BMI. Percent body fat 50th percentile was greater in Vouzela children and adolescents compared to their international peers, except for boys aged 8-12 years. Boys' waist circumference median values were similar to those from the USA, whilst girls were similar until 12 years of age, after which the differences increased with age. The percentile curves constructed provide population specific references for growth and body composition of children and adolescents from rural Portugal. It is expected that they will be a useful tool for clinical and public health settings in rural Portugal.

The development of aerobic power in young athletes.

Previous studies investigating the effects of training in children have been hampered in their interpretation by the confounding effects of growth and development. We followed the development of maximal aerobic power (VO2max) in 453 athletes drawn from soccer, swimming, gymnastics, and tennis. Study design was of a mixed longitudinal type with five age cohorts (8, 10, 12, 14 and 16 yr) followed for 3 consecutive years. A multilevel regression modeling procedure was used to identify the independent effects of predictor variables while accounting for the effects of growth, such as changes in body size. When age, height, and weight were controlled for, VO2max in males significantly increased with pubertal status, indicated by the coefficient value of 0.15 l/min being greater than its associated SE of 0.07 l/min. Females showed a similar pattern, with a coefficient value of 0.13 +/- 0.07 l/min, although the significant increase in VO2max (P < 0.05) found in males in the latter stages of puberty was not shown in females. Swimmers had the highest VO2max values (P < 0.001) at all ages.

Modeling developmental changes in strength and aerobic power in children.

The present study examined two contrasting multilevel model structures to describe the developmental (longitudinal) changes in strength and aerobic power in children: 1) an additive polynomial structure and 2) a multiplicative structure with allometric body size components. On the basis of the maximum log-likelihood criterion, the multiplicative "allometric" model was shown to be superior to the additive polynomial model when fitted to the data from two published longitudinal studies and to provide more plausible solutions within and beyond the range of observations. The multilevel regression analysis of study 1 confirmed that aerobic power develops approximately in proportion to body mass, m1/3. The analyses from study 2 identified a significant increase in quadriceps and biceps strength, in proportion to body size, plus an additional contribution from age, centered at about peak height velocity (PHV). The positive "age" term for boys suggested that at PHV the boys were becoming stronger in the quadriceps and biceps in relation to their body size. In contrast, the girls' age term was either negligible (quadriceps) or negative (biceps), indicating that at PHV the girls' strength was developing in proportion to or, in the case of the biceps, was becoming weaker in relation to their body size.

Early asthma prophylaxis, natural history, skeletal development and economy (EASE): a pilot randomised controlled trial.

OBJECTIVES: (1) To establish recruitment rates of newly presenting asthmatic children. (2) To establish acceptability of study protocols. (3) To pilot age-specific quality of life (QoL) assessment. (4) To assess short-term (6 months) outcomes of inhaled corticosteroids (ICS) treatment. (5) To refine sample size calculations for a definitive study. DESIGN: A randomised pragmatic longitudinal trial design was used, with no blinding or placebo, to examine early ICS introduction similar to its use in practice. Subjects were assessed at entry, 3 and 6 months. SETTING: Subjects were recruited from six general practices. Children under 6 years were assessed at the Craig Research and Investigation Unit, Royal Aberdeen Children's Hospital, or their family home, and subjects 6 years and over were assessed at their general practice. SUBJECTS: Children (aged 6 months-16 years) with symptoms suggestive of asthma/wheeze that had commenced no longer than 12 months before were identified retrospectively and prospectively from general practices. Subjects were also required to be naïve to prophylactic therapy with no other lung disease/concomitant illness. INTERVENTIONS: Subjects were randomised to ss2-agonist (ss2-only group) or ss2-agonist and ICS (ICS group) for 6 months. Physicians could later prescribe ICS in controls if needed. MAIN OUTCOME MEASURES: (1) Pulmonary function. (2) Asthma symptom diary. (3) Symptomatic health status questionnaire. (4) Caregiver's and child's QoL. (5) Growth. (6) Bone mass. (7) Bone turnover. (8) Economic issues. RESULTS: Of over 15,000 children yielded from general practice records, 11% had symptoms suggestive of asthma/wheeze, and two-thirds of these already used ICS. Of the remaining, 141 subjects met the criterion of early asthma, and 86 were randomised. Two-thirds of those randomised were < 6 years old, the males:females ratio was 2:1, and 67% had a family history of atopy. RESULTS - PHYSIOLOGICAL DEVELOPMENT: Pulmonary function did not significantly improve in the older children. Although tidal breathing measures in the pre-school children were significantly higher at 6 months in the ss2-only group, there was great variability. Incidence of wheeze and night-time cough reduced equally in both groups. Reduction of night-time symptom score and reliever use, and increase in symptom-free days were only significant in the ss2-only group. No significant differences were found in growth and bone mass between the two groups, but bone metabolism was significantly reduced at 6 months in the ICS group. RESULTS - PSYCHOLOGICAL DEVELOPMENT: The caregiver's QoL questionnaire was sensitive to child symptom changes over 3 months, but absolute impact of child symptoms on their QoL varied, whereas the child-centred questionnaire was not sensitive to change. RESULTS - ECONOMICS: There were no significant differences in medical consultation costs between the groups, but, as expected, prescription costs in the ICS group were higher over 6 months. Combined healthcare costs were significantly higher for patients assigned to ICS, but there were no significant differences in any effectiveness measures between the groups. CONCLUSIONS: Most (96%) of the proposed sample was recruited, and the low drop-out rate (8%) demonstrated acceptability of the study protocol. Most children first presenting with symptoms suggestive of asthma were < 6 years old and represented a group biased towards mild to moderate asthma, or virally induced wheeze. The caregiver's QoL questionnaire was found to better reflect a child's symptom changes than a child-centred instrument. In the short term, no adverse effects were seen on growth, but ICS treatment significantly reduced bone metabolism. Most of the young children with asthma/wheeze improved over time with ss2-agonist treatment alone, and clinical benefits of early ICS intervention amongst these children were not detected; however, there was inadequate power in this pilot study to establish this. (AB

Common skeletal injuries in young athletes.

The increasing frequency of injury in young athletes over the last 2 decades reflects the increases in sports participation of children of a young age. Physical injury is an inherent risk in sports participation at any age. In general, the factors causing sports injuries can be grouped in 2 separate broad categories: extrinsic and intrinsic factors. However, the great majority of injuries which are sustained are minor and self-limiting, suggesting that children and youth sports are safe. However, a increasing number of children undergo treatment because of the effects that injuries may have on their developing bodies. A child's skeletal system shows pronounced adaptive changes to intensive sports training. Sports injuries affect both growing bone and soft tissues, and could result in damage of the growth mechanisms with subsequent life-lasting damage. Adolescents are particularly vulnerable to injuries, at least partially due to an imbalance in strength and flexibility. During growth there are significant changes in the biomechanical properties of bone. In young athletes, as bone stiffness increases and resistance to impact diminishes, sudden overload may cause bones to bow or buckle. Epiphyseal injuries occur at the epiphyseal growth plates. They are usually due to shearing and avulsion forces, although compression also plays a significant role. Given the remarkable healing potential of bone in youngsters, fractures that initially united with some deformity can completely remodel and appear totally normal in later life. As the risk of injuries sustained by young athletes can be significant, it is essential that training programmes take into account their physical and psychological immaturity, so that the growing athlete can adjust to their own body changes.

Assessment of airway function in young children with asthma: comparison of spirometry, interrupter technique, and tidal flow by inductance plethsmography.

The assessment of airway function in young children requires adaptation of techniques designed for adults and/or application of techniques that do not require complex respiratory maneuvers. We sought to assess two methods of measuring airway function: time to peak expiratory flows as a ratio of expiratory time (T(PTEF)/T(E)), derived from respiratory inductance plethysmography, and total respiratory resistance by the interrupter technique (Rint), both obtained during quiet tidal breathing. Both techniques were referenced to FEV1 and flow at 50% expired volume (FEF50) from conventional spirometry in 30 children aged 4-8 years (median age, 6.9; range, 4.5-8.5 years) with a physician diagnosis of asthma and who were able to perform FEV1 with a repeatability of at least 8%. T(PTEF)/T(E) and Rint were performed in random order followed by spirometry, in order to reduce the possible effects of pulmonary stretch on tidal breathing measures. Coefficients of variation (CV) and mean absolute change/baseline standard deviation were derived for each measurement. Baseline FEV1 did not correlate significantly with T(PTEF)/T(E) (r = 0.025), but did correlate with Rint (r = 0.737, P < 0.001); respective relationships for change after bronchodilator were r = 0.09 (ns) and r = 0.64 (P < 0.001). FEF50 also correlated significantly with Rint (R = 0.769, P < 0.001) but not with T(PTEF)/T(E). FEV1 and FEF50 both increased postbronchodilator, with respective mean changes of 11.4% and 28% (P < 0.001), while Rint decreased by 24.3% (P < 0.001). No significant changes were noted for T(PTEF)/T(E). T(PTEF)/T(E) derived from inductance plethysmography does not detect mild airway obstruction or modest changes in airway caliber following bronchodilator in young children with asthma. The interrupter technique may have a role in assessing baseline airway function and response to therapy in children unable to perform reliable spirometry, and/or when the investigator wishes to avoid the possible influence of forced maneuvers on airway tone.

Parental influence on sport participation in elite young athletes.

AIM: To ascertain how talented young British swimmers, gymnasts, tennis and soccer players are introduced to their sport, and to identify how they are encouraged into intensive systematic training. METHODS: Two hundred and eighty-two elite young athletes (aged 8 to 17 yrs) and their parents were interviewed in their homes to identify how and why they started intensive training. RESULTS: Of the 4 sports studied (soccer, gymnastics, tennis, and swimming), parents of swimmers were more likely introduce their children to the sport (70%), while parents of gymnasts (42%) were the least likely to do so. However, in this sports parents played a lesser role in the transition to intensive training (6% and 5%, respectively). Nearly half the soccer players (47%) became involved in the sport because of their own interest, with the majority making the transition to intensive training because of encouragement by a coach (65%). Self-motivation (27%) and parental influence (57%) brought children into tennis with 25% of the young athletes in the sample autonomously deciding to start intensive training. Children from the lower socio-economic classes were underrepresented, and the total number of 1-parent families (5.3%) was considerably less than current British national norms (16.1%). CONCLUSION: In Britain, young athletes' involvement in high level sport is heavily dependent on their parents, with sports clubs and coaches playing an important later role. In the present socio-economic and cultural situation, many talented youngsters with less motivated parents will not undertake sport. Talented youngsters from a poorer economic background will be heavily disadvantaged, especially in sports such as tennis.

Adiposity in children and adolescents: correlates and clinical consequences of fat stored in specific body depots.

The 2011 Pennington Biomedical Research Center's Scientific Symposium focused on adiposity in children and adolescents. The symposium was attended by 15 speakers and other invited experts. The specific objectives of the symposium were to (i) integrate the latest published and unpublished findings on the laboratory and clinical assessment of depot-specific adiposity in children and adolescents, (ii) understand the variation in depot-specific adiposity and related health outcomes associated with age, sex, maturation, ethnicity and other factors and (iii) identify opportunities for incorporating new markers of abdominal obesity into clinical practice guidelines for obesity in children and adolescents. This symposium provided an overview of important new advances in the field and identified directions for future research. The long-term goal of the symposium is to aid in the early identification of children and adolescents who are at increased health risk because of obesity and obesity-related conditions.