A cardiovascular comorbidity in obese adolescents is increased aortic pulse wave velocity (aPWV), carotid intima-media thickness (cIMT) and left ventricular mass (LVM). We investigated in obese adolescents 1) the risk factors associated with aPWV, cIMT and LVM, and 2) the effects of aerobic (AE) versus resistance (RE) exercise alone (without calorie restriction) on aPWV, cIMT, LVM index (LVMI) and cardiometabolic risk factors. Eighty-one obese adolescents (12–18 yrs, BMI ≥95th percentile) were randomized to 3 months of AE (n = 30), RE (n = 27) or a control group (n = 24). Outcome measures included aPWV, cIMT, LVMI, body composition, cardiorespiratory fitness (CRF), blood pressure (BP) and lipids. At baseline, the strongest correlates of aPWV were body weight (r = .31) and diastolic BP (r = .28); of cIMT were body weight (r=0.26) and CRF (r=-0.25); and of LVMI was CRF (r=0.32) after adjusting for sex and race (p < .05 for all). Despite significant reductions in total fat and improvements in CRF in the AE and RE groups, aPWV, cIMT, LVMI, BP, lipids and body weight did not change as compared with controls (p > .05 for all). Interventions of longer duration or together with weight loss may be required to improve these early biomarkers of CVD in obese adolescents.
Katy Horner, Emma Barinas-Mitchell, Curt DeGroff, Jennifer L. Kuk, Stacey Drant and SoJung Lee
Jennifer L Kuk, Shahnaz Davachi, Andrea M. Kriska, Michael C. Riddell and Edward W. Gregg
This article briefly summarizes the “Pre-Diabetes Detection and Intervention Symposium” that described ongoing and past pre-diabetes interventions, and outlined some considerations when deciding to target specific populations with pre-diabetes. The success of type 2 diabetes (T2D) prevention clinical trials provides clear evidence that healthy lifestyle change can prevent the development of T2D in a cost effective manner in high risk individuals. However, who to target and what cut-points should be used to identify individuals who would qualify for these T2D prevention programs are not simple questions. More stringent cut-offs are more efficient in preventing T2D, but less equitable. Interventions will likely need to be adapted and made more economical for local communities and health care centers if they are to be adopted universally. Further, they may need to be adapted to meet the specific needs of certain high-risk populations such as ethnic minorities. The Chronic Disease Management & Prevention Program for Diverse Populations in Alberta and the Pre-diabetes Detection and Physical Activity Intervention Delivery project in Toronto represent 2 examples of specialized interventions that are targeted at certain high risk populations. To reverse the current T2D trends will require continued efforts to develop and refine T2D prevention interventions.