A 12-week after-school physical activity programme improves endothelial cell function in overweight and obese children: a randomised controlled study

Abstract

BackgroundEndothelial dysfunction is associated with childhood obesity and is closely linked to the amount and function of endothelial progenitor cells. However, it remains unclear whether endothelial progenitor cells increase with after-school exercise in overweight and obese children. The purpose of this study was to investigate the effects of an after-school exercise programme on endothelial cell function in overweight and obese children.MethodsA total of 29 overweight/obese children (12.2 ± 0.1 years) were randomly divided into control (i.e. no after-school exercise, n = 14) and after-school exercise (n = 15) groups. The 12-week after-school exercise intervention consisted of 3 days of combined aerobic and resistance exercise per week. Each 80-minute exercise programme included 10 minutes of warm-up and 10 minutes of cool-down after school. CD34+ (a cell surface marker on hematopoietic stem cells), CD133+ (a cell surface marker on hematopoietic progenitor cells) and CD34+/CD133+ (considered as endothelial progenitor cells) were measured at baseline and after 12 weeks using flow cytometry.ResultsIncreased percentages of CD34+, CD133+ and CD34+/CD133+ cells were observed in the after-school exercise group (p = 0.018; p = 0.001; p = 0.002, respectively) compared with the control group. Carotid intima-media thickness decreased after 12 weeks in the after-school exercise group (p = 0.020) compared with the control group.ConclusionsThis study provides preliminary evidence that a combined after-school exercise programme may represent an effective intervention strategy for improving vascular repair and endothelial cell function, leading to improved cardiovascular health in overweight and obese children.Trial registrationCurrent Controlled Trials ISRCTN19037201

Diet, Exercise, and Endothelial Function in Obese Adolescents

“…A significant rise in EPCs had been observed previously in obese adolescents after 12 weeks of exercise training. 24 The EPC phenotype, however, differed from what is currently accepted. 22 In accordance with the latest recommendations, Walther et al demonstrated that 1 year of additional exercise during school time is an effective means to markedly increase the number of circulating CD45low/CD34+/KDR+ EPC.…”

Pediatric Interventions Using Noninvasive Vascular Health Indices

“…37,40,41,57 Subjects participating in interventions with vitamin supplements, exercise, and diet displayed greater improvements in PWV (3.7±0.1 versus 4.1±0.1 m/s; P<0.05) than those only involved in exercise and dieting (no significant reduction in PWV). 59 National Cholesterol Education Program-II diet with vitamin-C and E supplements showed improved FMD from baseline (9.5±4.2 versus 5.7±2.9%; P<0.001); however, there was no significant alteration in FMD from diet alone. 57 Another trial demonstrated that exercising and dieting subjects developed better FMD alterations from baseline (8.0±1.8 versus 6.8±2.0%; P<0.0001) than those only dieting (7.5±1.9 versus 6.9±2.0%; P<0.002).…”

“…The majority of these studies demonstrated a significant improvement in at least 1 noninvasive measure of vascular health, 27,29,35,37,39,42,47,55,58,59 with 6 showing a significant improvement in at least 1 marker of inflammation or oxidative stress. 32,35,37,47,55,58 In the interventions that did not demonstrate a significant improvement in any vascular health index, 28,32,33,36,54 all but 1 did not result in a significant change in inflammatory or oxidative stress biomarkers.…”

“…Several studies measured biomarkers of oxidative stress or inflammation, [27][28][29]32,33,[35][36][37]39,42,47,54,55,58,59 including C-reactive protein and oxidized LDL. The majority of these studies demonstrated a significant improvement in at least 1 noninvasive measure of vascular health, 27,29,35,37,39,42,47,55,58,59 with 6 showing a significant improvement in at least 1 marker of inflammation or oxidative stress.…”

Exercise and Stem Cells

“…Two studies have examined the effects of long-term physical activity interventions in children and both demonstrated an increase in HSPC quantity with increased physical activity. 45,46 Additionally, in young healthy adults, exercise training increased HSPC quantity, and the effects of exercise were augmented by training under hypoxic conditions. 47 These data suggest that in response to a properly designed training program under wellcontrolled conditions, HSPC content may indeed increase with exercise training.…”