Childhood obesity: issues of weight bias.

Although the effects of obesity on children's physical health are well documented, the social consequences of obesity are less well described and may not be addressed in intervention programs. Weight bias may take several forms. It may result in teasing and discrimination and may affect employment and educational opportunities. Health care providers may limit care of overweight or obese children. The media promote weight bias in multiple ways. Some parents are biased against their obese children. In an effort to avoid weight bias, new efforts to reduce obesity must be evaluated to determine whether these efforts do, in fact, add to the problem. It is important to understand that the weight bias that obese youth face is just as serious as the physical consequences of excessive weight on the welfare of the child.

Anaerobic Threshold in Children.

The ventilatory anaerobic threshold (VAT) occurs when there is an isolated increase in the slope for ventilator equivalent for oxygen consumption (VE/VO2) with no change in the slope for ventilatoiy equivalent for carbon dioxide production (VE/VCO2) when both are plotted against time. The concept of anaerobic threshold remains controversial. However, it is a clinically useful tool in evaluating the exercise capacity of children. This paper will review the history, biochemistry, and methodology involved in determining the anaerobic threshold, as well as the ventilatory anaerobic threshold in children.

Most sudden deaths in adolescent athletes caused by cardiac conditions.

The majority of cases of sudden, unexpected death in athletes are related to cardiovascular anomalies. Some of these anomalies may be diagnosed with a preparticipation examination including a thorough history of previous symptoms that would suggest a cardiovascular diagnosis. In addition, a complete and thorough family history should be obtained, not only from the athlete but also from the athlete's parents. If any family members have the diagnosis of HCM or prolonged Q-T syndrome, a history of sudden, unexpected death, or have used a pacemaker, this should be a possible clue for diagnosis. Once a cardiovascular diagnosis is made, the athlete should be subject to the accepted guidelines for participation in athletics and competitive sports.

Sports and exercise cardiology in the United States: cardiovascular specialists as members of the athlete healthcare team.

In recent years, athletic participation has more than doubled in all major demographic groups, while simultaneously, children and adults with established heart disease desire participation in sports and exercise. Despite conferring favorable long-term effects on well-being and survival, exercise can be associated with risk of adverse events in the short term. Complex individual cardiovascular (CV) demands and adaptations imposed by exercise present distinct challenges to the cardiologist asked to evaluate athletes. Here, we describe the evolution of sports and exercise cardiology as a unique discipline within the continuum of CV specialties, provide the rationale for tailoring of CV care to athletes and exercising individuals, define the role of the CV specialist within the athlete care team, and lay the foundation for the development of Sports and Exercise Cardiology in the United States. In 2011, the American College of Cardiology launched the Section of Sports and Exercise Cardiology. Membership has grown from 150 to over 4,000 members in just 2 short years, indicating marked interest from the CV community to advance the integration of sports and exercise cardiology into mainstream CV care. Although the current athlete CV care model has distinct limitations, here, we have outlined a new paradigm of care for the American athlete and exercising individual. By practicing and promoting this new paradigm, we believe we will enhance the CV care of athletes of all ages, and serve the greater athletic community and our nation as a whole, by allowing safest participation in sports and physical activity for all individuals who seek this lifestyle.