A sedentary lifestyle puts strain on young hearts CREDIT University of Jyväskylä.
According to a recent Finnish study, high levels of sedentary behaviour and physical inactivity from childhood strain the heart in adolescence. High cardiac workload predicts heart failure and other heart diseases. In light of the findings, increasing moderate and vigorous physical activity from childhood onwards is particularly important in preventing heart diseases.
In a collaborative study by the Faculty of Sport Sciences at the University of Jyväskylä and the Institute of Biomedicine at the University of Eastern Finland, sedentary behaviour and physical activity were followed from childhood to adolescence for eight years. The study showed that adolescents accumulating high levels of sedentary behaviour and low levels of moderate to vigorous physical activity from childhood onwards had a higher cardiac workload in adolescence. Cardiac workload was particularly high in adolescents, who accumulated low vigorous physical activity levels.
In addition, high levels of sedentary behaviour and low levels of physical activity were associated with a higher total body fat percentage. Body fat percentage partly explained the associations between sedentary behaviour, physical activity, and cardiac workload. Light physical activity was not associated with cardiac workload.
The results emphasise the importance of increasing physical activity, especially moderate and vigorous activity, reducing sedentary behaviour, and preventing overweight from childhood to prevent heart diseases.
“Youth spend nine to ten hours a day being sedentary,” says Dr Eero Haapala from the Faculty of Sport and Health Sciences at the University of Jyväskylä, “and only one in ten adolescents accumulated 60 minutes of daily moderate to vigorous physical activity. These are worrying figures.”
“High levels of daily moderate to vigorous physical activity should be a normal part of childhood and adolescence as it improves heart health, but also general well-being,” Haapala emphasises.
Record levels of obesity and physical inactivity among children mean they are set to bear the brunt of poorer health effects from rising global temperatures – that’s the stark warning in a new comprehensive review of current studies on the topic.
Publishing her findings in the peer-reviewed journal Temperature, Dr Shawnda Morrison, an environmental exercise physiologist, argues that while physical fitness is key to tolerating higher temperatures, children are more obese and less fit than ever before.
Publishing her findings in the peer-reviewed journal Temperature, Dr Shawnda Morrison, an environmental exercise physiologist, argues that while physical fitness is key to tolerating higher temperatures, children are more obese and less fit than ever before.
This could put them at greater risk of suffering heat-related health problems, such as dehydration, heat cramps, heat exhaustion or heat stroke.
She says that current climate change policies fail to adequately address child health needs and that encouraging children to make exercise part of their everyday lives must be prioritised if they are to cope with living in a hotter world.
From Slovenia’s University of Ljubljana, Faculty of Sport, Dr Morrison is an expert in adaptive and integrative human physiology in extreme environments. She has over 20 years’ experience investigating sport performance and exercise physiology, especially in hot environments.
Her assessments are based on a comprehensive review of more than 150 medical and scientific studies into how children maintain physical activity, exercise, cope with heat, and how this might change as global temperatures rise.
The research she highlights includes a study of 457 primary school 5-12 year old boys in Thailand, which found that overweight youngsters were more than twice as likely to have difficulty regulating their body temperature as those of normal weight when exercising outdoors.
In another study, data from emergency departments at children’s hospitals in the US, found attendance was higher during hotter days. Younger children were particularly likely to need emergency care.
The research has also found:
Children’s aerobic fitness is 30% lower than that of their parents at the same age.
There are rapid declines in child physically activity globally, especially over the last 30 years
Most children are not meeting the World Health Organization’s guideline of performing an average of at least 60 minutes of physical activity each day.
Physical inactivity was accelerated, especially in Europe, during the Covid-19 pandemic when schools and other societal infrastructures were closed.
Rising temperatures could restrict physical activity further when parents of children perceive outdoor temperatures to be ‘too hot to play’, making it more uncomfortable for untrained or unfit children to meet the minimum physical activity levels to stay healthy, says Dr Morrison, who is also the Founder of Active Healthy Kids Slovenia.
Higher temperatures and changes in weather patterns are projected to also lead to outbreaks of new diseases entering the human population. If there are more movement restrictions put in place to contain novel diseases, this will have potentially devastating consequences to children’s physical fitness, mental and physical health.
Dr Morrison also points out that, in terms of thermoregulation – how the body maintains its internal, or core, temperature – young children are not simply smaller adults. When exposed to the heat, children sweat less than adults; they lose heat by increasing blood flow to their skin – a process which can require the heart to work relatively harder.
Despite these differences, most of the research into how the body adapts to higher temperatures has been carried out on adults. The little mechanistic research done in children has mostly been conducted 15-30 years ago, when children’s fitness levels were much higher than they are today.
Dr Morrison concludes: “Fitter adults are better able to tolerate higher temperatures, due to a combination of physiological, behavioural and psychological factors.
“Yet, as the world warms, children are the least fit they have ever been. It is imperative that children are encouraged to do daily physical activity to build up, and maintain, their fitness, so that they enjoy moving their bodies and it doesn’t feel like ‘work’ or ‘a chore’ to them.”
Activities can be a combination of structured games, such as football, basketball and baseball, and active play with friends and family, preferably taking place outdoors.
Physical education (PE) lessons taught by PE teachers are the best and most cost-effective way to increase fitness levels and equip children to continue exercising throughout their lives. Families have a role to play, too, especially if schools offer little PE.
Dr Morrison says: “Do what you love to do, whether it’s a family bike ride or rollerblade, a stroll through the woods or walking the dog.
“Make sure the activity raises everyone’s heart rate, enthusiasm, and positive energy and importantly, try not to completely avoid the heat but choose times of the day that are less hot (mornings/evenings) to keep active, since we need to keep ourselves moving in this new warming world.”
As part of Dr Morrison’s ongoing work, she is looking to determine how physically active children and adults are during heatwaves, and how hot, uncomfortable, or thirsty they feel when performing these activities.
In an analysis of data from national Swedish registries for extremely preterm babies (born before 24 weeks) from 2007–2018, most had neurodevelopmental disorders and/or other diagnoses during childhood and were referred for habilitational care.
In the Acta Paediatrica study of 383 children, 75% had neurodevelopmental disorders (including speech disorders, intellectual disabilities, attention deficit hyperactivity disorder, autism s, visual impairment, cerebral palsy, epilepsy, and hearing impairment).
More boys than girls had intellectual disabilities (45% versus 27%) and visual impairment (25% versus 14%). Fifty-five percent of children were referred for habilitation services, and 88% had additional diagnoses such as asthma and short stature.
“Due to improved medical care, an increasing number of extremely preterm infants survive. Our study shows that a large proportion of the most immature new survivors suffer from persisting somatic and neurodevelopmental disorders,” said senior author Ann Hellström, MD, PhD, of Gothenburg University.
Such an understanding the long-term consequences of preterm birth will help clinicians and healthcare systems optimize care. “Awareness of the lifelong needs of these children is also necessary for society at large to provide adequate resources and support for the tiniest of our children and their families,” said lead author Eva Morsing, MD, PhD of Lund University.
Have you ever wondered why it is so different how quickly and how much small babies put on weight during the first years of life? Now researchers at the University of Bergen in Norway have found that this is largely controlled by our genes. The findings provide insight into the mechanisms that control appetite and energy metabolism early in life and can help us find better treatment for obesity in adolescence and adulthood.
After birth, we grow fast. The length increases by about 50% and the weight doubles during infancy. Then the growth slows down and goes into a stable phase in childhood until a growth spurt in puberty. But what drives this dynamic growth?
Researchers at the Center for Diabetes Research, University of Bergen, Norway have now found the explanation. They studied the genes of 30,000 children and their parents from the Norwegian Mother, Father and Child Cohort of Norway. Many millions of genetic variants from each individual was examined and linked to growth data from a series of measurements of height and weight from birth to eight years of age.
The findings have attracted a great deal of attention.
“It turned out that genes linked to extreme obesity, appetite and the body’s energy consumption are responsible for the growth regulation”, professor Pål R. Njølstad says.
“This is dynamic in that specific genes have an effect only on some of the different phases of growth. We believe that this is probably one of the reasons why parents have always noted that some children are born with a naturally higher appetite than others and have significantly more fat mass in infancy. It seems that these dynamic effects are especially important in the first years of life, and that they do not increase the risk of later obesity”, Njølstad says.
Some of the genes are linked to drugs that are being tested to slow weight gain in extreme obesity. The findings may thus be important for the treatment of normal obesity. The results are now published in the journal Nature Metabolism.
According to the Centers for Disease Control and Prevention (CDC), children generally appear to be less severely impacted by COVID-19 than adults. But a new study from Children’s Hospital Los Angeles shows that the pandemic could be affecting children’s health in unexpected ways. The study reveals a surge of patients presenting with diabetic ketoacidosis, a severe complication of type 2 diabetes. Published today in Diabetes Care, these data offer additional insights into how the pandemic may be impacting the nation’s children.
Diabetic ketoacidosis, or DKA, is life-threatening. “DKA happens when insulin levels in the blood drop too low for too long,” says Lily Chao, MD, MS, Interim Medical Diabetes Director at CHLA. “Insulin helps the body utilize glucose. So when there’s not enough insulin, the body starts breaking down fat as a source of energy.”
This process, she says, causes dangerously high levels of acids in the blood. If untreated, this can lead to cerebral edema, coma, or even death. “Kids are coming in with dehydration and DKA. But DKA is preventable and reversible if we treat it early and appropriately,” says Dr. Chao, who is lead author on the paper.
Dr. Chao and her colleagues noticed back in March of 2020 that more and more patients were coming in with DKA and type 2 diabetes. “We used to see a few DKA cases in type 2 diabetes a year,” she says, “and all of a sudden we were seeing a spike, so we began keeping track. Now we have the numbers to confirm that there are more children with type 2 diabetes who present with this very serious complication of DKA.”
Yet the question remains: What is the cause of the increased incidence of Type 2 diabetes with DKA?
A year into the COVID-19 pandemic, many children are used to wearing masks and attending online classes. But other changes have affected them, too. Fewer children may be making it to the doctor’s office for their routine well-child exams, possibly due to the fear families may feel about exposure to SARS-CoV-2, the virus that causes COVID-19.
“Parents are worried about going outside of the house,” says Dr. Chao. “Some families have to take public transportation to go the pediatrician and they are hesitant to do so during the pandemic.”
This, she says, may be one of the reasons for the shift she and her colleagues have seen.
In addition to missing doctor visits, other factors may be involved, such as less physical activity during lockdown or reduced access to fresh, healthy foods. But there may also be a biological relationship between exposure to the virus and diabetes.
“There is definitely a link between COVID-19 and diabetes,” says Senta Georgia, PhD, an investigator in The Saban Research Institute of Children’s Hospital Los Angeles and senior author on the paper. Dr. Georgia runs a basic and translational research program aimed at understanding the cellular biology of diabetes and developing novel therapeutics. “We don’t know whether SARS-CoV-2 infects insulin-secreting cells in the pancreas,” she says. “There are some reports of a link between COVID-19 and diabetes in adults, but no pediatric studies have been published to date.”
As a physician scientist and a laboratory scientist, respectively, Dr. Chao and Dr. Georgia come with unique perspectives–but their objectives converge on getting answers to help children diagnosed with diabetes.
“Our work together at Children’s Hospital Los Angeles allows us to address pediatric health on multiple levels,” says Dr. Georgia. “I help Dr. Chao design her clinical studies and she works with me on our basic and translational research. So we’re coming at the problem of increased incidence of diabetes with both a clinical and a scientific perspective.”
Future translational and clinical studies may determine whether increased DKA in patients could be caused by infection with SARS-CoV-2. But for now, the data clearly point to an emerging trend toward more severe diabetes complications during the global pandemic.
The team hopes that these findings will increase vigilance. “It’s critical for pediatricians to recognize that when a child presents with symptoms of diabetes, the child needs to be evaluated right away,” says Dr. Chao. “The sooner we see these kids, the better chance we have to prevent DKA.”
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