Non-invasive methods in paediatric exercise physiology.

Oded Bar-Or's hypothesis that children may be "metabolic non-specialists", even when engaging in specialized sports, has stimulated the study of paediatric exercise metabolism since the publication of his classic text Pediatric sports medicine for the practitioner in 1983. Evidence drawn from several methodologies indicates an interplay of anaerobic and aerobic exercise metabolism in which children have a relatively higher metabolic contribution from oxidative energy pathways than adolescents or adults, whereas there is a progressive increase in glycolytic support of exercise with age, at least into adolescence and possibly into young adulthood. The picture is generally consistent but incomplete, as research with young people has been limited by both ethical and methodological constraints. The recent rigorous introduction of non-invasive techniques such as breath-by-breath respiratory gas analysis and magnetic resonance spectroscopy into paediatric exercise physiology promises to open up new avenues of research and generate unique insights into the metabolism of the exercising muscle during growth and maturation. It therefore appears that we might have available the tools necessary to answer some of the elegant questions raised by Professor Bar-Or over 25 years ago.