{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T06:43:18Z","timestamp":1791268998882,"version":"4.1.0"},"reference-count":41,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2005,6,1]]},"abstract":"<jats:p>Objective. Relatively little is known about how excess body mass affects adolescents' capacity to perform sustained exercise. We hypothesized that most of the difficulty that severely overweight adolescents have with sustained exercise occurs because the metabolic costs of moving excess mass result in use of a high proportion of their total oxygen reserve.<\/jats:p><jats:p>Methods. We compared results from a maximal cycle ergometry fitness test in 129 severely overweight adolescents who had BMIs of 41.5 \u00b1 9.7 kg\/m2 and ages of 14.5 \u00b1 1.8 years (range: 12.1\u201317.8 years) and 34 nonoverweight adolescents who had BMIs of 20.1 \u00b1 2.9 kg\/m2 and ages of 14.5 \u00b1 1.5 years (range: 12.0\u201318.1 years). Oxygen uptake (V\u0307o2) was compared at 3 times: during a 4-minute period of unloaded cycling (ULV\u0307o2), at the lactate threshold estimated by gas exchange (LTV\u0307o2), and at maximal exertion (V\u0307o2 max). Heart rate was obtained at rest and at V\u0307o2 max. Participants also completed a 12-minute walk\/run performance test to obtain distance traveled (D12) and heart rate.<\/jats:p><jats:p>Results. Absolute LTV\u0307o2 and V\u0307o2 max and LTV\u0307o2 as a percentage of V\u0307o2 max were not different in overweight and nonoverweight adolescents during the cycle test. However, absolute ULV\u0307o2 was significantly greater in overweight adolescents: ULV\u0307o2 accounted for 35 \u00b1 8% of V\u0307o2 max (and 63 \u00b1 15% of LTV\u0307o2) in overweight adolescents but only 20 \u00b1 5% of V\u0307o2 max (and 39 \u00b1 12% of LTV\u0307o2) in nonoverweight adolescents. Resting heart rate before initiating the cycle test was significantly greater in overweight than nonoverweight adolescents (94 \u00b1 14 vs 82 \u00b1 15 beats per minute). However, maximal heart rate during the cycle test was significantly lower in overweight adolescents (186 \u00b1 13 vs 196 \u00b1 11 beats per minute). During the walk\/run test, mean D12 was significantly shorter for overweight than for nonoverweight adolescents (1983 \u00b1 323 vs 1159 \u00b1 194 m). D12 was negatively related to BMI SDS (r = \u22120.81) and to ULV\u0307o2 (r = \u22120.98).<\/jats:p><jats:p>Discussion. Overweight and nonoverweight adolescents had similar absolute V\u0307o2 at the lactate threshold and at maximal exertion, suggesting that overweight adolescents are more limited by the increased cardiorespiratory effort required to move their larger body mass through space than by cardiorespiratory deconditioning. The higher percentage of oxygen consumed during submaximal exercise indicates that overweight adolescents are burdened by the metabolic cost of their excess mass. Their greater oxygen demand during an unloaded task predicted poorer performance during sustained exercise. Exercise prescriptions for overweight adolescents should account for the limited exercise tolerance imposed by excess body mass, focusing on activities that keep demands below lactate threshold so that exercise can be sustained.<\/jats:p>","DOI":"10.1542\/peds.2004-1543","type":"journal-article","created":{"date-parts":[[2005,6,1]],"date-time":"2005-06-01T17:19:46Z","timestamp":1117646386000},"page":"e690-e696","source":"Crossref","is-referenced-by-count":131,"title":["Influence of Excess Adiposity on Exercise Fitness and Performance in Overweight Children and Adolescents"],"prefix":"10.1542","volume":"115","author":[{"given":"Anne-Caroline","family":"Norman","sequence":"first","affiliation":[{"name":"Unit on Growth and Obesity, Developmental Endocrinology Branch, National Institute on Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland"},{"name":"Duke University School of Medicine, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bart","family":"Drinkard","sequence":"additional","affiliation":[{"name":"Rehabilitation Medicine Department, Clinical Center, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer R.","family":"McDuffie","sequence":"additional","affiliation":[{"name":"Unit on Growth and Obesity, Developmental Endocrinology Branch, National Institute on Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samareh","family":"Ghorbani","sequence":"additional","affiliation":[{"name":"Unit on Growth and Obesity, Developmental Endocrinology Branch, National Institute on Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa B.","family":"Yanoff","sequence":"additional","affiliation":[{"name":"Unit on Growth and Obesity, Developmental Endocrinology Branch, National Institute on Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack A.","family":"Yanovski","sequence":"additional","affiliation":[{"name":"Unit on Growth and Obesity, Developmental Endocrinology Branch, National Institute on Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2005,6,1]]},"reference":[{"key":"2021120819205745000_R1","doi-asserted-by":"crossref","unstructured":"Freedman DS, Srinivasan SR, Valdez RA, Williamson DF, Berenson GS. 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