Physical Fitness and Metabolic Syndrome in Children with Repaired Congenital Heart Disease Compared with Healthy Children

A cardiovascular disease risk factor in children with congenital heart disease: unmasking elevated waist circumference - a CHAMPS* study *CHAMPS: Children’s Healthy-Heart Activity Monitoring Program in Saskatchewan

“…In one of the few studies specifically investigating waist circumference in children with CHD, Haapala et al [26] measured children with chronic disease (including CHD) and found that waist circumference explained some of the relationship between arterial stiffness and decreased exercise capacity which was unaffected by sport participation (a surrogate measure of physical activity). These reports suggest that waist circumference may be a contributor, underpinning decreased fitness and elevated cardiovascular disease risk in pediatric clinical populations [26,40]. Our study extends the prior work of Haapala et al [41] by demonstrating that children with CHD have elevated waist circumference despite no difference in level of physical activity compared to healthy controls.…”

“…Our findings do; however, contrast those of Ray et al [13] who reported that physical activity in children with CHD 10-14 years was lower than levels reported in agematched healthy children. Discrepant findings may reflect the known error susceptibility of self-reporting physical activity, or differences between self-reported and objectively measured physical activity as in the study by Zaqout et al [40]. Such discrepancies may also reflect recent changes to exercise prescription for children with CHD [12].…”

“…Consistent with our observations, a recent study by Stone et al [42] in a younger population (3-5 years) with CHD reported similar levels of physical activity to healthy controls. The study by Zaqout et al [40] showed greater self-reported physical activity levels in children with CHD compared to healthy controls but no difference in accelerometer-measured physical activity. Our findings do; however, contrast those of Ray et al [13] who reported that physical activity in children with CHD 10-14 years was lower than levels reported in agematched healthy children.…”

“…The implication of waist circumference on the health of individuals with CHD is suggested by findings in one of the few studies of cardiometabolic health in children with CHD by Zaqout et al [40]. These investigators reported higher waist circumference, in addition to fasting insulin, and insulin resistance-homeostasis model in children with CHD compared to healthy controls, despite similar levels of objectively measured physical activity [40]. In one of the few studies specifically investigating waist circumference in children with CHD, Haapala et al [26] measured children with chronic disease (including CHD) and found that waist circumference explained some of the relationship between arterial stiffness and decreased exercise capacity which was unaffected by sport participation (a surrogate measure of physical activity).…”

“…Waist circumference confers cardiovascular and metabolic disease risks above and beyond body fat or BMI, even in children with obesity [38,39]. The implication of waist circumference on the health of individuals with CHD is suggested by findings in one of the few studies of cardiometabolic health in children with CHD by Zaqout et al [40]. These investigators reported higher waist circumference, in addition to fasting insulin, and insulin resistance-homeostasis model in children with CHD compared to healthy controls, despite similar levels of objectively measured physical activity [40].…”