Fat Mass Index and Body Mass Index Affect Peak Metabolic Equivalent Negatively during Exercise Test among Children and Adolescents in Taiwan

Abstract

Peak metabolic equivalent (MET) is the most reliable indicator of cardiorespiratory fitness (CRF). The aim of this study was to examine the association between CRF indicated by peak MET and body mass index (BMI) or fat mass index (FMI) in Taiwanese children and adolescents (C-A). Data of 638 C-A aged 10–18 that received symptom-limited treadmill exercise testing was analyzed. Anthropometry-body composition was measured by vector bioelectrical impedance analysis. BMI was defined as body weight (kg)/body height (m)2 and FMI was defined as fat mass (kg)/body height (m)2. BMI was grouped by Taiwanese obesity cut-off points. FMI Class-I was categorized by percentage of body fat. FMI Class-II used the reference values from Korean C-A. Excess adiposity was defined as (1) “overweight” and “obesity” by BMI, (2) greater than the sex- and age-specific 75th percentile of whole subjects by FMI Class-I, and (3) greater than 95th percentiles of reference value by FMI Class-II. Boys had significantly higher fat mass and FMI, and had more excess adiposity than girls (all p < 0.05). Both boys and girls with excess adiposity (by any definition) had lower MET at anaerobic threshold (AT MET) and peak MET (all p < 0.001). BMI and FMI were significantly negatively associated with both AT MET and peak MET significantly (all p < 0.001). FMI (95% CI: −0.411~−0.548) correlated with peak MET more than BMI (95% CI: −0.134~ −0.372) did. Excess adiposity affected CRF negatively. It is concluded that weight management should start early in childhood.

Relationship Between Obesity, Physical Activity, and Cardiorespiratory Fitness Levels in Children and Adolescents in Bosnia and Herzegovina: An Analysis of Gender Differences

“…Furthermore, it is reported (e.g., Ostojic et al, 2011 ; Esmaeilzadeh et al, 2013 ; Tuan et al, 2018 ) that there is a negative correlation between central obesity (WC and WHtR) and cardiovascular fitness which is in line with our findings. Those children with higher central obesity have shown to have lower CRF estimated by using the maximal multistage 20 m shuttle run test.…”

“…In the current study, girls had lower values in obesity indices than boys, which was in accordance with some previous studies ( Ortega et al, 2007 ; Gomes et al, 2014 , 2015 ; World Health Organization, 2017 ; Tuan et al, 2018 ) and at odds with others ( Al-Nakeeb et al, 2007 ; Ostojic et al, 2011 ; Dencker et al, 2012 ). Lower obesity indices among girls in this age range may not necessarily pertain to their healthier lifestyle as our results showed that girls had a lower level of PA and CRF compared to boys across all age groups with a more prominent difference in age of 12 and 13.…”

“…Our findings were in agreement with research revealing that school age boys performed better in the maximal multistage fitness test across all age groups and therefore they had a higher estimated VO2max ( Ruiz et al, 2007 ; Ostojic et al, 2011 ; Dencker et al, 2012 ; Tuan et al, 2018 ). PA level, body composition (greater muscle mass), cardiac size and function as well as mechanical efficiency (e.g., larger levers) may explain the gender differences in cardiovascular fitness among children ( Rowland et al, 2000 ; Manna, 2014 ).…”

“…Unfortunately, the major concern with children obesity is that 80% of obese children become obese adults ( Whitaker et al, 1997 ) and that overweight children and adolescents show an increased rate of mortality due to cardiovascular and digestive diseases in adulthood ( Mossberg, 1989 ). Additionally, obese children are at increased risk to be diagnosed asthma at school age ( Loid et al, 2015 ), they are more likely to have extremity fractures, to die of traumatic injuries than nonobese children ( Kim et al, 2016 ) and to have a lower cardiorespiratory fitness (CRF) in childhood ( Tuan et al, 2018 ) and more than 10 years later ( Pahkala et al, 2013 ).…”

Differences in Aerobic Fitness between an Obese Adolescent with Prader-Willi Syndrome and Other Obese Adolescents and Exercise Training Results

“…When compared to other, similar obese adolescents, the PWS patient showed much declined aerobic fitness (See Table 3). BMI was significantly negatively associated with both AT MET and peak MET [9]. However, the PWS patient still showed much declined AT MET and peak MET even though his age, gender and BMI were similar to the control group.…”