Headid Iii Ronald J, Park Song-Young
School of Health and Kinesiology, University of Nebraska at Omaha, Omaha, NE, USA.
Clin Exp Pediatr. 2021 May;64(5):196-207. doi: 10.3345/cep.2020.00997. Epub 2020 Aug 4.
Over the last few decades, the rates of pediatric obesity have more than doubled regardless of sociodemographic categorization, and despite these rates plateauing in recent years there continues to be an increase in the severity of obesity in children and adolescents. This review will discuss the pediatric obesity mediated cardiovascular disease (CVD) risk factors such as attenuated levels of satiety and energy metabolism hormones, insulin resistance, vascular endothelial dysfunction, and arterial stiffness. Additionally, early intervention to combat pediatric obesity is critical as obesity has been suggested to track into adulthood, and these obese children and adolescents are at an increased risk of early mortality. Current suggested strategies to combat pediatric obesity are modifying diet, limiting sedentary behavior, and increasing physical activity. The effects of exercise intervention on metabolic hormones such as leptin and adiponectin, insulin sensitivity/resistance, and body fat in obese children and adolescents will be discussed along with the exercise modality, intensity, and duration. Specifically, this review will focus on the differential effects of aerobic exercise, resistance training, and combined exercise on the cardiovascular risks in pediatric obesity. This review outlines the evidence that exercise intervention is a beneficial therapeutic strategy to reduce the risk factors for CVD and the ideal exercise prescription to combat pediatric obesity should contain both muscle strengthening and aerobic components with an emphasis on fat mass reduction and long-term adherence.
在过去几十年中，无论社会人口统计学分类如何，儿童肥胖率都增加了一倍多，尽管近年来这些比率趋于平稳，但儿童和青少年肥胖的严重程度仍在持续上升。本综述将讨论儿童肥胖介导的心血管疾病（CVD）危险因素，如饱腹感和能量代谢激素水平降低、胰岛素抵抗、血管内皮功能障碍和动脉僵硬度。此外，对抗儿童肥胖的早期干预至关重要，因为肥胖被认为会持续到成年期，这些肥胖儿童和青少年的早期死亡风险增加。目前建议的对抗儿童肥胖的策略是改变饮食、限制久坐行为和增加体育活动。将讨论运动干预对肥胖儿童和青少年瘦素和脂联素等代谢激素、胰岛素敏感性/抵抗以及体脂的影响，以及运动方式、强度和持续时间。具体而言，本综述将重点关注有氧运动、阻力训练和联合运动对儿童肥胖心血管风险的不同影响。本综述概述了运动干预是降低心血管疾病危险因素的有益治疗策略的证据，对抗儿童肥胖的理想运动处方应同时包含肌肉强化和有氧运动成分，重点是减少脂肪量和长期坚持。
