The effects of exercise on vascular markers and C-reactive protein among obese children and adolescents: An evidence-based review

Abstract

Numerous studies have evaluated the effects of exercise training on obese children and adolescents. However, the impact of aerobic and/or resistance exercise alone, without any other interventions, on vascular markers and C-reactive protein (CRP) in obese children and adolescents is still not clear. We performed a literature search in Ovid Medline, PubMed, and SCOPUS databases to identify articles on the effects of exercise on vascular markers and CRP among obese children and adolescents, published between January 2009 and May 2019. Only full-text articles in English that reported on the effect of aerobic and/or resistance exercise on the vascular markers pulse wave velocity (PWV), carotid intima-media thickness (CIMT), flow-mediated dilatation (FMD), augmentation index (AIx) or CRP in obese children and adolescents (5–19 years old) were included. The literature search identified 36 relevant articles; 9 articles that fulfilled all the inclusion criteria were selected by two independent reviewers. Aerobic exercise or a combination of aerobic and resistance exercise training significantly improved CIMT and PWV in obese children and adolescents in all studies in which they were measured (2 studies for PWV and 4 studies for CIMT). However, the effects of exercise on FMD and CRP levels were inconclusive, as only half of the studies demonstrated significant improvements (1/2 studies for FMD and 4/8 studies for CRP). The results of our review support the ability of exercise to improve vascular markers such as PWV and CIMT in obese children and adolescents. This finding is important as obesity is a modifiable risk factor of CVD, and exercise may help in reducing the future occurrence of CVD in this population.

Benefits of physical activity on cardiometabolic diseases in obese children and adolescents

“…However, studies found that a combination of aerobic exercise and resistance exercise in treating obesity improved both cardiorespiratory fitness and life quality in patients with obesity-related cardiometabolic diseases. [71] Numerous clinical studies examined the effect of exercise therapy alone or combined lifestyle intervention therapies, including excise therapy, nutrition limitation, and surgical procedures. A total of 109 children with a mean age of 11 years were enrolled in a clinical study to assess 5 weeks of exercise training.…”

“…Regular exercise could improve energy metabolism, strengthen the function of various organs, including the heart, blood vessels, lung, brain, bone, and muscle, improve cardiovascular disease risk profile, reduce cardiovascular events, and decrease hospitalization of patients with obesity-related diseases. [ 70 , 71 , 72 ] There are two significant types of exercise, aerobic exercise and resistance exercise. Aerobic exercise induces multiple beneficial effects, including improvement in maximal oxygen consumption (VO 2 max) and cardiorespiratory fitness without significantly affecting the muscle strength.…”

“…However, studies found that a combination of aerobic exercise and resistance exercise in treating obesity improved both cardiorespiratory fitness and life quality in patients with obesity-related cardiometabolic diseases. [ 71 ]…”

Effect of Exercise Training on Arterial Stiffness in Overweight or Obese Populations

“…A meta-analysis revealed that the effects of aerobic endurance exercise on IMT did not show any statistical significance in healthy adults 15 . The decrease of IMT was proved in obese children and adolescents 9 17 . In this meta-analysis, ET improved IMT in overweight or obese participants who were younger than 60 years, but the effect was insignificant in aged participants.…”

Physical activity and eating behaviors patterns associated with high blood pressure among Chinese children and adolescents

“…Regular moderate-high intensity physical activity is considered to be bene cial to control blood pressure. Studies showed that the planned physical activity lowered SBP and DBP in children [9,10], which may be related to the effect of aerobic exercise on improving vascular markers ( pulse wave velocity, PWV; carotid intima-media thickness, CIMT) [11]. Torrance et al [12] recommended 40 minutes of moderate to vigorous aerobic exercise 3-5 days per week to improve vascular function and lower blood pressure in obese children.…”