We investigated the influence of a program of exercise training consisting of three weekly sessions, each 45 min long, for 12 wk, on indices of physical fitness, glycemic control, and insulin sensitivity in nine adolescents with type I diabetes; six age-matched adolescents with diabetes of equivalent duration served as nonexercised controls. All subjects were instructed not to change dialy insulin dose or caloric intake. In the exercised group, maximal oxygen uptake during graded cycle ergometry to volitional exhaustion increased by 9 +/- 2.7% (P less than 0.01) and lean body mass increased by 4 +/- 1.8% (P less than 0.05). Insulin sensitivity, assessed via the euglycemic clamp technique at insulin infusion rates of 100 mU/M2/min, showed an increase of insulin-mediated glucose disposal from 274 +/- 33 to 338 +/- 28 mg/M2/min, representing an increase in insulin sensitivity of 23 +/- 5% (P less than 0.01). None of these indices changed in the control group. Despite increased insulin sensitivity, glycohemoglobin levels remained at 12 +/- 1% before and after the 12 wk of exercise training, indicating no improvement in overall glycemic control. No increase in hypoglycemic reactions was reported in either group. We conclude that exercise training may be a valuable adjunct in managing type I diabetes providing there is concomitant attention to diet and insulin. Exercise training alone, however, does not improve glycemic control, although it improves physical fitness and insulin sensitivity.

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In brief: Fourteen adolescents (eight females and six males) with insulin-dependent diabetes mellitus (IDDM) participated in a 12-week exercise program consisting of three 45-minute sessions per week. Exercise consisted of calisthenic warm-up and stretching (ten minutes), aerobic movement to music (25 minutes at 80% V o2 max), and cool-down (ten minutes). The purpose was to determine whether and to what degree such training would bring about changes in blood lipid and lipoprotein profiles in such patients. The authors found a significant decrease in low-density lipoprotein cholesterol concomitant to an increase in V o2 max with no change in glycemic control. These findings support the beneficial effects of regular exercise for individuals with IDDM.

OBJECTIVES: This study was done to assess changes in obesity and risk factors for cardiovascular disease (CVD) in Black and White children from 1975 through 1990. METHODS: A cross-sectional study of body composition and CVD risk factors conducted in a school district as part of the Lipid Research Clinics (LRC) Program Prevalence Study (1973-1975) was compared with a later study (1989-1990) conducted in the same school district, which remained demographically stable. The studies included 1456 third- and fifth-grade students and 300 LRC subjects within the same age ranges. RESULTS: Students in the 1989-1990 study had a significantly higher mean body mass index (BMI), total blood cholesterol concentration, and systolic and diastolic blood pressures and marginally higher resting heart rates than those in the earlier study. The prevalence of obesity increased from 12.5% to 25.3%, and of hypercholesterolemia from 8.0% to 14.8%. Black females had the largest increase in BMI and resting heart rate and the highest prevalence of elevated total cholesterol in the 1989-1990 study. CONCLUSIONS: The results of this study suggest a secular trend toward increased obesity in children and portend the potential development of a public health problem that could reverse the recent decline in morbidity from CVD.

EXERCISE RESPONSE IN TF/James et al. 13. Daly WJ, Bondurant S: Direct measurement of respiratory pleural pressure changes in man. J AppI The patient and control groups, subdivided by sex and body surface area (BSA), were similar in height and weight. When comparing males to males and females to females with BSA 2 1.2 m2, maximal heart rates and working capacities were lower in the patient groups than in the control groups. An inverse relationship was observed between maximal working capacity and age at surgery in both male and female patient groups. By contrast, especially in the males with BSA < 1.2 m2, the mean maximal heart rates and working capacities ADEQUATE RELIEF OF RIGHT VENTRICULAR OUTFLOW TRACT (RVOT) obstruction without the development of significant pulmonary incompetence and closure of the ventricular septal defect are major goals for successful surgical treatment of tetralogy of Fallot. After intracardiac repair, symptoms of hypoxemia and severe exercise intolerance are relieved even in the presence of residual