Poor Skeletal Robustness on Lower Extremities and Weak Lean Mass Development on Upper Arm and Calf: Normal Weight Obesity in Middle-School-Aged Children (9 to 12)

Despite the health-related implications of normal-weight obesity in children, very little research has explored the fundamental associations between this status and important long-term health parameters. Therefore, the aim of the current study was to investigate the physical fitness of children with normal-weight obesity, in comparison to normal-weight non obese and overweight and obese counterparts. A total of 328 middle-school-aged children (9.8 ± 0.5 y) took part in this study (n = 44 normal-weight obese; n = 237; normal-weight non obese; n = 47 overweight and obese). Height, weight, and body-fatness were measured. Four physical fitness tests were conducted: (1) Multistage fitness test; (2) shuttle run 4 × 10 m; (3) sit-ups for 60 s; (4) the broad jump. Welch’s analysis of variance (ANOVA), stratified by sex, with post-hoc testing where necessary, was performed. Children with normal-weight obesity had significantly (p < 0.01) lower cardio-respiratory and muscular fitness than normal-weight non obese peers. In addition, normal-weight obese and overweight and obese boys had comparable deficits in strength and explosiveness of lower limbs, speed coordination, and endurance, compared to normal-weight non obese counterparts. Normal-weight obese children appear to have similar deficits in PF as their overweight and obese peers, compared to normal-weight non obese counterparts, whilst boys had larger deficits than girls.

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Normal-Weight Obesity: A Novel CVD Risk Factor

Family Practice News ◽

10.1016/s0300-7073(08)70519-x ◽

2008 ◽

Vol 38 (7) ◽

pp. 9

Author(s):

BRUCE JANCIN

Keyword(s):

Risk Factor ◽

Normal Weight ◽

Cvd Risk ◽

Normal Weight Obesity

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Wellness and middle-school aged children

Journal of the American Dietetic Association ◽

10.1016/j.jada.2004.05.187 ◽

2004 ◽

Vol 104 ◽

pp. 62

Author(s):

D.F Vanata

Keyword(s):

Middle School ◽

School Aged Children

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Body composition in childhood: effects of normal growth and disease

Proceedings of The Nutrition Society ◽

10.1079/pns2003261 ◽

2003 ◽

Vol 62 (2) ◽

pp. 521-528 ◽

Cited By ~ 38

Author(s):

J. C. K. Wells

Keyword(s):

Body Composition ◽

Childhood Obesity ◽

Fat Mass ◽

Lean Mass ◽

Normal Weight ◽

Fat Free Mass ◽

General Interest ◽

Childhood And Adolescence ◽

Adult Disease ◽

Increased Risk

Body composition in children is of increasing interest within the contexts of childhood obesity, clinical management of patients and nutritional programming as a pathway to adult disease. Energy imbalance appears to be common in many disease states; however, body composition is not routinely measured in patients. Traditionally, clinical interest has focused on growth or nutritional status, whereas more recent studies have quantified fat mass and lean mass. The human body changes in proportions and chemical composition during childhood and adolescence. Most of the weight gain comprises lean mass rather than fat. In general, interest has focused on percentage fat, and less attention has been paid to the way in which lean mass varies within and between individuals. In the general population secular trends in BMI have been widely reported, indicating increasing levels of childhood obesity, which have been linked to reduced physical activity. However, lower activity levels may potentially lead not only to increased fatness, but also to reduced lean mass. This issue merits further investigation. Diseases have multiple effects on body composition and may influence fat-free mass and/or fat mass. In some diseases both components change in the same direction, whereas in other diseases, the changes are contradictory and may be concealed by relatively normal weight. Improved techniques are required for clinical evaluations. Both higher fatness and reduced lean mass may represent pathways to an increased risk of adult disease.

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Adiposity, Aerobic and Anaerobic Fitness in Middle School Aged Children

The FASEB Journal ◽

10.1096/fasebj.29.1_supplement.276.4 ◽

2015 ◽

Vol 29 (S1) ◽

Author(s):

David Nieman ◽

Dustin Dew ◽

Pamela Krasen

Keyword(s):

Middle School ◽

School Aged Children ◽

Aerobic And Anaerobic

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The Concept of Normal Weight Obesity

Progress in Cardiovascular Diseases ◽

10.1016/j.pcad.2013.10.003 ◽

2014 ◽

Vol 56 (4) ◽

pp. 426-433 ◽

Cited By ~ 204

Author(s):

Estefania Oliveros ◽

Virend K. Somers ◽

Ondrej Sochor ◽

Kashish Goel ◽

Francisco Lopez-Jimenez

Keyword(s):

Normal Weight ◽

Normal Weight Obesity

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PRINCESS ELIZABETH, SECOND DAUGHTER OF KING CHARLES I, AND RICKETS

PEDIATRICS ◽

10.1542/peds.64.2.241 ◽

1979 ◽

Vol 64 (2) ◽

pp. 241-241

Author(s):

T. E. C.

Keyword(s):

Relative Proportion ◽

Spinal Column ◽

Lower Extremities ◽

Long Bone ◽

Upper Arm ◽

Charles I ◽

King Charles I ◽

The Right ◽

Shoulder Blade ◽

Unequal Length

In 1856 the coffin of Princess Elizabeth (1635-1650) was discovered during the demolition of old St. Thomas's Church at Newport, Isle of Wight, England. Mr. Ernest P. Wilkins, MRCS, examined the remains of the Princess and noted:1 The bones of the upper arm were slightly curved outwards—more particularly the right humerous—while those of the forearm were somewhat twisted and considerably curved outwards. The spinal column, retaining the relative position of the vertebrae during life, presented an extremely curved condition constituting the double lateral or S curvature of pathologists, which must have caused considerable projection of the right shoulder-blade and its attendant deformity .... The condyles of the lower extremities were very large in relative proportion. The femur or thigh bone of the left side was curved forwards and inwards, that of the right side was more distorted than any other long bone. It was very much curved forwards and inwards. This bone was much flattened, its greatest diameter being from before, obliquely outwards and backwards; the concavity of the curve was somewhat filled in, and the bone thus strengthened by additional osseous deposit in accordance with the natural reparative tendency of Nature's laws. The bones of the leg, the tibia and fibula, were much curved outwards. The bones of the skeleton indicate the great deformity which existed during life—there was evidently considerable "growing out" of the right shoulder-blade and corresponding flattening of the left side of the back. The lower extremities were contorted and of unequal length, the knees were what is termed "knocked"; below the knees the legs were bowed, the heels thrown outwards and the toes inverted.

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Cardiorespiratory Fitness May Influence Metabolic Inflexibility During Exercise in Obese Persons

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2019-01225 ◽

2019 ◽

Vol 104 (12) ◽

pp. 5780-5790 ◽

Cited By ~ 3

Author(s):

Francisco J Amaro-Gahete ◽

Guillermo Sanchez-Delgado ◽

Ignacio Ara ◽

Jonatan R. Ruiz

Keyword(s):

Cardiorespiratory Fitness ◽

Lean Mass ◽

Normal Weight ◽

Whole Body ◽

Graded Exercise ◽

Obese Subjects ◽

Maximal Fat Oxidation ◽

Metabolic Inflexibility ◽

Overweight Subjects ◽

Body Lean Mass

Abstract Context We examined whether obese individuals have a reduced maximal fat oxidation (MFO) and the intensity that elicit MFO (Fatmax) compared with normal weight and overweight persons, taking into account their level of cardiorespiratory fitness. Methods The study subjects were 138 sedentary adults (87 women) aged 30.1 ± 13.6 years. Based on their body mass index, subjects were categorized as being of normal weight (n = 66), overweight (n = 48), or obese (n = 24). MFO and Fatmax were determined for all subjects by indirect calorimetry, using a walking graded exercise test. MFO was expressed in absolute terms (g/min) and relative to whole-body lean mass (mg/kgleanmass/min). Cardiorespiratory fitness was assessed via a maximal treadmill test. Results No differences in absolute MFO and Fatmax values were seen between the obese, normal weight, and overweight subjects (all P > 0.2), although after adjusting for cardiorespiratory fitness, the obese subjects returned significantly higher values than did their normal weight and overweight counterparts (all P < 0.03). However, when expressed with respect to lean mass, the MFO of the normal weight subjects was significantly greater than that of the overweight and obese subjects, independent of age, sex, or cardiorespiratory fitness. Conclusions Obese individuals have higher absolute MFO values when cardiorespiratory fitness is taken into account, but when expressed with respect to lean mass, normal weight individuals show a greater capacity to oxidize fat during exercise per unit of metabolically active tissue independent of age, sex, or cardiorespiratory fitness. These findings suggest that obese individuals may suffer from metabolic inflexibility during exercise.

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