Francisco José de Menezes-Junior

Background The effects of different exercise intensities on cognitive outcomes and brain-derived neurotrophic factor (BDNF) concentrations in adolescents with overweight/obesity are not yet fully elucidated. This study aimed: (a) to compare the prevalence of responders to cognitive function and BDNF concentration in adolescents with overweight/obesity participating in a 12-week intervention with high-intensity interval training (HIIT) or moderate-intensity continuous training (MICT), and (b) to analyze whether cardiorespiratory fitness (CRF) can explain differences in inter-individual variability between responders and non-responders. Methods Adolescents with overweight/obesity were assigned to HIIT (n = 15), MICT (n = 14), or CG (n = 24). Anthropometrics, body composition, CRF, basal BDNF, and cognitive performance (Trial Making Test (TMT) and Stroop Test (ST)) were evaluated pre- and post-intervention. Training was performed on stationary bikes (3×/week for 12 weeks). Results The prevalence of responders in ST and TMT was higher in the HIIT group than in CG (93–62%, p = 0.029; 67–33%, p = 0.043), with no differences in MICT. No group differences were found for BDNF responders (HIIT:73%-MICT:71%-CG:46%, p = 0.263). ST and TMT responders had greater CRF improvements than non-responders. Conclusion HIIT elicited a higher prevalence of cognitive responders than CG. CRF improvements may partially explain individual variability in responsiveness to cognitive outcomes. Impact This is the first study to examine and compare inter-individual variability in cognitive function and BDNF levels following MICT and HIIT interventions in adolescents with overweight/obesity; Exercise intensity and improvements in cardiorespiratory fitness are key factors for optimizing the cognitive effects of interventions in youth with overweight; Twelve weeks of supervised HIIT and MICT training led to increased rates of cognitive responders among adolescents with overweight/obesity.

The purpose of this meta-analysis was to systematically review studies in the literature that evaluated the effect of different exercise programs on blood pressure in overweight children and adolescents. In September 2024, studies were searched in six electronic databases (PubMed, Web of Science, Scopus, Sportdiscus, Lilacs, and Scielo) and in reference lists. Randomized and non-randomized controlled trials with interventions involving physical exercise programs and assessment of systolic blood pressure (SBP) and diastolic blood pressure (DBP) in children and adolescents with overweight and/or obesity were considered for synthesis. The quality of studies was assessed using the PEDro scale for studies with randomized clinical trials. Meta-analysis was conducted using a random model in the Review Manager Software. Seventeen studies were selected that involved 1,125 children and adolescents. The risk of bias score was considered moderate (five to eight points out of 11). The high-intensity interval training (HIIT) showed the largest effect, indicating a greater impact on BP reduction, while moderate-intensity continuous training (MICT) also had a significant effect, although with greater heterogeneity. No significant effects were found for the other types of exercise. For SBP, a summary effect of -0.44 (95% CI=-0.68; -0.20; I2 = 73%) was observed. For DBP, the metanalysis indicated − 0.52 (95% CI=-0.73; -0.31; I2 = 63%). There was a publication time limitation of ten years, and the search was restricted to articles published in journals indexed in databases, and there was also significant heterogeneity for the intervention subgroups, which can be explained by the moderate methodological quality of the studies. Considering the significant effects of exercise interventions on blood pressure, we suggest the development of more interventions based on physical exercise practice for overweight and obese children and adolescents, which may also add environmental elements, lasting at least 12 weeks, with three 60-minute sessions per week, better control of exercise intensity, as HIIT and MICT were more effective in promoting a reduction in blood pressure when compared to other types of exercise. The implementation of these programs must be carried out in a multicomponent and multiprofessional approach to guarantee the adherence of participants and promote significant and sustainable changes in the cardiovascular health of children and adolescents. PROSPERO no CRD42023469222.

The aim of this study was to examine the moderating role of cardiorespiratory fitness (CRF) between the relationship of cardiometabolic risk factors and adiponectin in adolescents. This is a cross-sectional study conducted with 255 adolescents of both sexes, aged 11 to 17 years. Anthropometric and biochemical parameters such as body mass, height, fat mass (FM), fat-free mass, high-density lipoprotein, low-density lipoprotein, triglycerides, glucose, insulin, adiponectin, systolic blood pressure, diastolic blood pressure, and peak oxygen consumption (VO2peak) were measured. Body mass index z-score (BMI-z), tri-ponderal mass index (TMI), homeostasis model assessment insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), and age peak height velocity were calculated. The moderation analyses were tested using linear regression models. Interaction was observed with low CRF, indicating that those who achieved more than 2.27 (BMI-z), 2.18 (TMI), 2.10 (FM), 2.57 (insulin), 2.65 (HOMA-IR), and 2.81 (QUICKI) in L·min−1 on the CRF test may experience reduced risks in cardiometabolic risk factors. Conclusion: The deleterious effects attributed to excess adiposity and unfavorable changes related to insulin resistance and sensitivity may be attenuated by CRF. What is Known: • Adiponectin, a protein derived from adipose tissue, may play a role as a potential marker of protection and predictor of cardiometabolic disorders and its relationship with cardiorespiratory fitness is controversial. What is New: • The deleterious effects attributed to overweight and unfavorable changes related to insulin resistance and sensitivity may be attenuated by high cardiorespiratory fitness in adolescents.

Strategies for controlling hypertension include reducing excess fat and increasing muscle mass. However, the effects of exercise interventions on hypertension in adolescents have been little investigated. The purpose was to evaluate the effect of 12 weeks of aerobic exercise on systolic blood pressure (SBP) and diastolic blood pressure (DBP) and the cardiometabolic profile of overweight hypertensive and non-hypertensive boys. The sample included 107 boys diagnosed as overweight, aged between 12 and 17, divided into two non-hypertension groups, one control (GCN, n = 14) and one with exercise (GEN, n = 55), as well as two groups of hypertensives, one control (GCH, n = 12) and one with exercise (GEH, n = 26). The boys were assessed at the study baseline and after 12 weeks in terms of anthropometric parameters, biological maturation, SBP, DBP and mean blood pressure (MBP), lipid, and metabolic profile. The aerobic training programs lasted 12 weeks and were carried out in three weekly sessions at different intensities. The high-intensity interval training session lasted around 35 min at an intensity of 80–100% of the reserve heart rate, and the moderate-intensity of continuous training session lasted 60 min at an intensity of 35–75% of the reserve heart rate. Caloric expenditure was equivalent between the exercises (p = 0.388). CGN and CGH participated only in school physical activities. Repeated measures analysis of variance and clinical effect analysis using Cohen’s effect size were used, with a significance level established at p < 0.05. After 12 weeks, all groups increased their height (p < 0.05), but only the exercise groups showed a reduction in anthropometric variables (p < 0.05), with a possibly beneficial effect in GEN (d = − 0.203; p = 0.003). No differences were found in the variables for the GCN. The GCH and GEH groups reduced SBP (p < 0.05), but only GEH showed a reduction in DBP (p = 0.005) and MBP (p = 0.001). In relation to the lipid profile, GEH maintained HDL-c close to baseline values, while GCH showed a reduction in HDL-c (p = 0.021). Regarding the clinical effect of exercise on hypertension, GEH showed a large and very beneficial effect size on DBP (d = − 0.916; p = 0.006) and MBP (d = − 0.926; p = 0.005). Conclusion: Hypertensive boys who practiced physical exercise showed greater effects in reducing blood pressure, indicating the importance of non-drug therapeutic management in overweight adolescents. Trial registration: Brazilian Registry of Clinical Trials RBR-4v6h7b / RBR-6343y7.

The aim of this study was to evaluate the mediation role of muscle quantity in the relationship between physical fitness and cardiometabolic risk factors (CMRF) in adolescents. This cross-sectional study conducted with 120 adolescents of both sexes, aged between 10 and 17 years. Body mass, height, fat mass (FM), lean mass, blood pressure, high-density lipoprotein, low-density lipoprotein, triglycerides, glucose, insulin, cardiorespiratory fitness (CRF) and 1 repetition maximum strength (1-RM) with evaluation of the leg press 45° (RM-leg), bench press (RM-bench) and arm curl (RM-arm). Body mass index z-score, appendicular skeletal muscle mass, appendicular skeletal muscle mass index, lean mass index (LMI), muscle-to-fat ratio (MFR), age at peak height velocity, and CMRF z-score were calculated. The direct relation between FM and CMRF was mediated by the LMI (26%) and inverse relation between CRF and CMRF was mediated by the LMI (26%). For girls, the direct relation between FM and CMRF was mediated by the LMI (32%); the inverse relation between CRF, RM-leg, RM-arm and CMRF was mediated by the LMI (32%, 33%, and 32%, respective). For boys, the indirect effect was not significant, indicating that LMI is not a mediator in the relation between FM, CRF, 1-RM with CMRF. The direct relation between RM-leg and CMRF was mediated by the MRF (16%). This finding evidenced the importance of promoting a healthy lifestyle to improve physical fitness levels and the quantity of muscle mass in adolescents.

Background: Adiponectin is an anti-inflammatory cytokine secreted by adipose tissue, has been associated with adiposity and cardiometabolic risk, and has controversial results with muscular fitness. The aim of this study was to analyze the interaction of 1-minute abdominal test in the relationship between adiposity, body composition, cardiometabolic risk and adiponectin concentration in adolescents. Methods: This is a cross-sectional study conducted with 62 adolescents of both sexes, aged 11 to 16 years, approved by the Ethics Committee of Research in Humans (CAEE: 62963916.0.0000.5223). Body mass, height, abdominal circumference (AC), waist circumference (WC), fat mass (FM), fat-free mass (FFM), high density lipoprotein (HDL-c), low density lipoprotein (LDL-c), triglycerides (TG), adiponectin, systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean blood pressure (MBP), 1-minute abdominal test (ABD) were measured. Body mass index (BMI), z-score BMI (BMI-z), triponderal mass index (TMI), and waist-to-height ratio (WHtR) were calculated. The macro PROCESS for SPSS v.24.0 was used for moderation analyses, with linear regression models. Results: Inverse interactions were found for adiposity (BMI, BMI-z, TMI, AC, WC, WHtR), body composition (FM, FFM) and CMRF (SBP, DBP, MBP, TG) versus 1-minute abdominal test with adiponectin concentration, demonstrating that abdominal test is a moderator in these relationships. Conclusion: We conclude that 1-minute abdominal test may play an important role in the relationship between obesity and cardiometabolic risk. We found that muscular fitness can confer a protective effect on adolescents with high levels of abdominal test.

Purpose The aim of this study was to analyze the relationship between adiposity, cardiometabolic risk and cardiorespiratory fitness (CRF) according to different groups of adiponectin concentration. Methods 255 adolescents of both sexes, aged 11–17 years old, participated. Anthropometric and biochemical parameters such as body mass, height, abdominal circumference (AC), waist circumference (WC), fat mass, fat-free mass, total cholesterol (TC), high-density lipoprotein (HDL-c), low-density lipoprotein (LDL-c), triglycerides (TG), glucose, insulin, adiponectin, blood pressure, peak oxygen consumption (VO_2peak) were measured. Body mass index (BMI), z-score BMI (BMI-z), triponderal mass index (TMI), waist-to-height ratio (WHtR), homeostasis model to assessment insulin resistance (HOMA-IR), and quantitative insulin sensitivity check index (QUICKI) were calculated. Adiponectin was categorized: low adiponectin concentration (LAC ≤ 5.18 µg/mL⁻¹), intermediate (IAC = 5.18 and 7.63 µg/mL⁻¹) and high (HAC ≥ 7.63 µg/ml⁻¹). Results LAC showed higher BMI, BMI-z and TMI than the other groups (p < 0.05) and higher AC, WC and WHtR that the HAC (p < 0.05). IAC showed lower values of TC, LDL-c and TG, and the LAC presented the highest values of insulin, HOMA-IR and QUICKI (p < 0.05) to the IAC and HAC. HAC presented the lower VO_2peak than the other groups (p < 0.01). BMI, TMI, glucose, insulin, HOMA-IR showed inverse, and QUICKI a direct and weak correlation with adiponectin (p < 0.05). No significant association was found between adiponectin and VO_2peak (p > 0.05). Conclusion The LAC group had higher means in the anthropometric variables and the worst results related to insulin resistance and sensitivity. Thus, adiponectin may play an important role in obesity and reduced concentration may be a factor in the development of obesity-associated morbidities.

This study aimed to evaluate the effect and individual responsiveness after 12 weeks of high-intensity interval training (HIIT) and moderate-intensity of continuous training (MICT) on adiponectin, cardiometabolic risk factors and physical fitness in overweight adolescents. This study was participated by 52 adolescents, both sexes, 11 and 16 years old, separated into HIIT (n = 13), MICT (n = 15), and control group (CG, n = 24). Body mass, height, waist circumference (WC), fat mass (FM), fat-free mass (FFM), blood pressure, high-density lipoprotein (HDL-c), low-density lipoprotein (LDL-c), triglycerides, glucose, insulin, adiponectin, and C-reactive protein (CRP) were evaluated. Body mass index z-score (BMI-z), waist-to-height ratio (WHtR), insulin resistance, and insulin sensitivity were calculated. Resting heart rate (HR_rest), peak oxygen consumption (VO_2peak), right handgrip strength (HGS-right), left handgrip strength (HGS-left), and abdominal resistance (ABD) was evaluated. HIIT session lasted around 35 min and MICT of 60 min of exercises on stationary bicycle, three times a weekday for 12 weeks. ANOVA, effect size, and prevalence of responders were used for statistical analysis. HIIT reduced BMI-z, WHtR, LDL-c, and CRP, while increased of physical fitness. MICT reduced HDL-c, while increased of physical fitness. CG reduced FM, HDL-c, and CRP, while increased FFM and HR_rest. Frequencies of respondents in HIIT were observed for CRP, VO_2peak, HGS-right, and HGS-left. Frequencies of respondents in MICT were observed for CRP and HGS-right. Frequencies of no-respondents in CG were observed for WC, WHtR, CRP, HR_rest, and ABD.   Conclusion: Interventions with exercises were effective to adiposity, metabolic health, and physical fitness improvements. Individual responses were observed in inflammatory process and physical fitness, important changes in overweight adolescent’s therapy. Trial registration number and date of registration: This study was registered with the Brazilian Registry of Clinical Trials (REBEC), the number RBR-6343y7, date of registration May 3, 2017. What is Known: • Effect of regular physical exercise positively affects overweight, comorbidities, and metabolic diseases, recommended mainly for children and adolescents. What is New: • Due to the great inter-individual variability, the same stimulus can provide different responses; adolescents who benefit from the stimulus are considered responsive. • Intervention of HIIT and MICT did not alter the concentrations of adiponectin; however, the adolescents presented responsiveness to the inflammatory process and physical fitness.

Objective: The aim of this study was to analyze which equation best estimates maximal heart rate (HRmax) for the pediatric population according to body mass. Data source: We performed a meta-analysis (PROSPERO No. CRD42020190196) of cross-sectional studies that aimed to validate or develop HRmax equations and that had children and adolescents as samples. The search was conducted in Scopus, Science Direct, Web of Science, PubMed, and Biblioteca Virtual em Saúde with the descriptors “prediction or equation,” “maximal heart rate,” “maximum heart rate,” “determination of heart rate,” children, and adolescent. The TRIPOD Statement tool was used to assess the methodological quality and the relevant data were extracted for analysis. The meta-analysis was conducted in the Comprehensive Meta-Analysis, adopting p<0.05 and a 95% confidence interval (CI). Data synthesis: In total, 11 studies were selected, of which 3 developed predictive equations, 10 performed external validity of the preexisting models, and 1 incremented values related to equations already developed. The results of the methodological quality analysis showed a moderate rating in most studies. The 164 + (0.270 × HRres) – (0.155 × body mass) + (1.1 × METs) + (0.258 × body fat percent) (r=0.500, 95%CI 0.426–0.567, p<0.001) and 166.7+ (0.46 × HRres) + (1.16 × maturation) (r=0.540, 95%CI 0.313–0.708, p<0.001) equations presented stronger correlations with measured HRmax in nonobese adolescents. The predictive model developed by 208 – (0.7 × age) showed a greater accuracy among the possible models for analysis (SDM=-0.183, 95%CI -0.787 to -0.422, p=0.554). No specific predictive equation was found for obese adolescents. Conclusions: Future research should explore new possibilities for developing predictive equations for this population as a tool to control exercise intensity in the therapeutic management of childhood and adolescent obesity.