ESPE Abstracts

Children and adolescents with obesity and clustering of cardiometabolic risk factors, such as hypertension, dyslipidemia, and prediabetes are exposed to endothelial damage, vascular and myocardial remodeling, and atherosclerosis. If not adequately treated, these alterations may contribute to early morbility and mortality for adverse cardiovascular events in adulthood. Physical activity (PA) plays an important role in the treatment of obesity and its cardiometabolic comorbidities. Youths with obesity are less active and are as much as sedentary than their healthy weight peers. Their poor motor skills reduce PA, sustaining a vicious circle of inactivity, low self esteem, poor quality of life and weight gain. Both inactivity and body fat excess significantly impair several components of the health-related physical fitness, such as cardiorespiratory and muscular fitness, which have been associated to an unhealthy cardiometabolic profile. PA and exercise increase energy expenditure, improve physical fitness and reduce cardiometabolic risk. During exercise, a variety of “exerkines” are secreted, activating a complex cross-talk between muscles, adipose tissue, liver, vasculature and pancreas. The resulting adaptations contribute to the systemic metabolic health effects of exercise. Aerobic and/or resistance exercises may improve cardiorespiratory fitness and muscular strenght/endurance in youths with obesity with positive effects on insulin resistance, blood lipid and arterial pressure. Children and adolescents should accumulate at least 60 min per day of moderate-vigorous PA, involving aerobic activities. Exercises that promote flexibility and muscle strenght should be performed at least 3 days per week. Aerobic and/or resistance training can be started at moderate intensity, gradually increasing in frequency, intensity and duration. Type and amount of PA should be developmentally specific, enjoiable and should limit the overload to the muscle skeletal system.