Altered Cardiovascular Autonomic Regulation in Overweight Children Engaged in Regular Physical Activity

Study Questions:

Does being overweight influence the autonomic nervous system (ANS) regulation among young boys who regularly perform exercise?

Methods:

This was an observational study of young male soccer players who all belonged to the same soccer club in Milan, Italy. The health information was collected as part of a health screening program provided to all boys enrolled in the junior team from the Rozzano Calcio Club. All boys were subjected to the same training routine, consisting of three structured sessions per week of 1.5 hours (endurance training at moderate/vigorous intensity) and one soccer game/week of at least 1 hour. The subjects were grouped by weight into two groups: normal weight and overweight, based on the International Obesity Task Force criteria. Accumulated weekly Metabolic Equivalents (METs) and time spent in sedentary activities were estimated by survey instrument. ANS was evaluated by autoregressive spectral analysis of heart rate and systolic arterial pressure (SAP) variability.

Results:

A total of 103 boys (mean age 11.2 ± 1 years) were included in this analysis; of these, 10.7% of the total group was overweight. No differences between groups were observed for reported weekly active time and estimated METs, whereas a slight, not significantly greater sedentary time was reported for the overweight group. The overweight boys had an altered profile of autonomic cardiovascular regulation characterized by higher values of SAP (113 ± 4 vs. 100 ± 1 mm Hg, 39.7 ± 3 vs. 66.2 ± 10%), higher Low Frequency variability power of SAP (an index of vasomotor sympathetic regulation) (12 ± 3 vs. 4.5 mm Hg2) and smaller spontaneous baroreflex gain (an index of cardiac vagal regulation) (19 ± 3 vs. 33 ± 3 ms/mm Hg) (all p < 0.02) compared to the normal weight boys. Correlation analysis on the entire study population showed a significant link between anthropometric and autonomic indices.

Conclusions:

The investigators concluded that these data demonstrated an association between overweight and autonomic impairment among children who performed regular exercise.

Perspective:

These data provide further evidence that overweight and obese children are likely to develop unhealthy cardiovascular profiles. The question remains whether weight loss among this group would result in improved ANS regulation.

Clinical Topics: Congenital Heart Disease and Pediatric Cardiology, Diabetes and Cardiometabolic Disease, Heart Failure and Cardiomyopathies, Prevention, Sports and Exercise Cardiology, CHD & Pediatrics and Prevention, Exercise, Sports & Exercise and Congenital Heart Disease & Pediatric Cardiology

Keywords: Child, Soccer, Overweight, Weight Loss, Arterial Pressure, Exercise, Baroreflex, Obesity, Metabolic Equivalent, Heart Rate, Autonomic Nervous System, Italy


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