Comparison between CDC and WHO BMI z-score and their relation with metabolic risk markers in Northern Portuguese obese adolescents

Growth-curves are an important tool for evaluating the anthropometric development in pediatrics. The different growth-curves available are based in different populations, what leads to different cut-offs. Pediatric obesity tracks into adulthood and is associated with increased cardiovascular risk. The accurate assessment of a child nutritional status using growth-curves can indicate individuals that are either obese or in risk of becoming obese, allowing an early intervention. Moreover, the association between the data obtained from growth-curves with specific metabolic risk factors further highlights the importance of these charts. This study aimed to evaluate the associations between body mass index z-score (BMIzsc), determined using the growth-curves from the Centre for Disease Control and Prevention (CDC) and from the World Health Organization (WHO), with cardiovascular risk factors, represented here by metabolic syndrome (MS) and insulin resistance (IR) related parameters. The study involved 246 obese adolescents (10-18 years, 122 females). MS was defined according to the International Diabetes Federation. IR was considered for HOMA-IR greater than 2.5.

Risco metabólico em crianças de 7 a 12 anos

Introdução – A frequência de dislipidemia em crianças e adolescentes tem vindo a aumentar rapidamente nos últimos anos, estando o seu aparecimento associado a fatores genéticos e ambientais. Este indicador, associado a outras doenças como a obesidade, constituem a síndrome metabólica e são considerados fatores de risco para doença cardiovascular e diabetes, que quando presentes na infância podem conduzir precocemente ao aparecimento destas doenças. Objetivos – Avaliar o perfil de indicadores de saúde de crianças no início de um Programa de Educação Contínua; Verificar os efeitos do Programa de Educação Contínua aplicado durante 36 meses (ginástica funcional, brincadeiras de rua e das aulas de natação), sobre os resultados dos exames iniciais de colesterol, triglicerídeos e do IMC. Métodos - Estudo quantitativo, exploratório e descritivo de corte transversal, realizado entre 2012 e 2015 numa amostra não probabilística por conveniência de 165 crianças, 70,0% da população-alvo. As crianças tinham entre 7 a 12 anos de idade, 40,59% entre 11 e 12 anos e 54% eram do sexo feminino. Eram beneficiárias de um plano de saúde que integrava um programa de intervenção (educação contínua e atividade física), designado Crescendo com Saúde e foram selecionadas através de critérios, como: dislipidemia (colesterol total e/ou triglicerídeos elevados), sobrepeso e/ou obesidade, e história familiar de HAS e DM. Os dados clínicos foram obtidos na consulta de enfermagem, utilizando-se a recolha de sangue para dosemanento do perfil lipídico no início do programa e a cada 6 meses e avaliação do IMC na fase inicial do programa e semanalmente. Para classificação do estado nutricional foram utilizados os pontos de corte da OMS (2007). Resultados – no início do programa 69% das crianças apresentavam hipercolesterolémia, 32% aumento do colesterol, 45% tinham excesso de peso (sobrepeso e obesidade) e 12% risco de sobrepeso. Após o programa de intervenção, das 53% crianças que participaram de forma regular, 29% apresentaram redução do colesterol, 16% dos triglicerídeos e o excesso de peso reduziu em 9%, aumentando contudo o risco de sobrepeso para 22%. Das que participaram de forma irregular, apenas 3% reduziram o perfil lipídico e 1% o estado nutricional. Conclusões – O programa de intervenção permitiu uma redução dos fatores de risco de doença metabólica e permitiu melhorar os hábitos das crianças estudadas e suas famílias. Estes resultados comprovam a eficácia a curto e médio prazo dos programas de intervenção na comunidade, e realçam o papel das intervenções preventivas de educação contínua e de atividade física regular, para o processo de redução dos indicadores de risco metabólico desde a infância. Palavra-chave: Crianças; Perfil lipídico; Obesidade; Programa de intervenção .

Cardiorespiratory fitness and cardiometabolic risk factors in schoolchildren from Colombia: The FUPRECOL Study

The objectives of this study are to investigate the association between cardiorespiratory fitness and cardiovascular risk factors in schoolchildren and to evaluate the degree of association between overall and abdominal adiposity and cardiorespiratory fitness. A total of 1,875 children and adolescents attending public schools in Bogota, Colombia (56.2% girls; age range of 9–17.9 years). A cardiovascular risk score (Z-score) was calculated and participants were divided into tertiles according to low and high levels of overall (sum of the skinfold thicknesses) and abdominal adiposity. Schoolchildren with a high level of overall adiposity demonstrated significant differences in seven of the 10 variables analyzed (i.e. systolic and diastolic blood pressure, triglycerides, triglycerides/HDL-c ratio, total cholesterol, glucose and cardiovascular risk score). Schoolchildren with high levels of both overall and abdominal adiposity and low cardiorespiratory fitness had the least favorable cardiovascular risk factors score. These findings may be relevant to health promotion in Colombian youth.

Imaginarios sociales de adolescentes y docentes en torno al cuerpo, la corporalidad y la actividad física. Estudio cualitativo en un colegio de Bogotá, 2014-2015.

Problema. Esta investigación se aproxima al entorno escolar con el propósito de avanzar en la comprensión de los imaginarios de los adolescentes y docentes en torno al cuerpo, la corporalidad y la AF, como un elemento relevante en el diseño de programas y planes efectivos para fomento de la práctica de AF. Objetivo. Analizar los imaginarios sociales de docentes y adolescentes en torno a los conceptos de cuerpo, corporalidad y AF. Métodos. Investigación de corte cualitativo, descriptivo e interpretativo. Se realizaron entrevistas semi-estructuradas a docentes y a estudiantes entre los 12 y 18 años de un colegio público de Bogotá. Se realizó análisis de contenido. Se compararon los resultados de estudiantes por grupos de edades y género. Resultados. Docentes y estudiantes definen el cuerpo a partir de las características biológicas, las diferencias sexuales y las funciones vitales. La definición de corporalidad en los estudiantes se encuentra ligada con la imagen y la apariencia física; los docentes la entienden como la posibilidad de interactuar con el entorno y como la materialización de la existencia. La AF en los estudiantes se asocia con la práctica de ejercicio y deporte, en los docentes se comprende como una práctica de autocuidado que permite el mantenimiento de la salud. Conclusiones. Para promover la AF tempranamente como una experiencia vital es necesario intervenir los espacios escolares. Hay que vincular al cuerpo a los procesos formativos con el propósito de desarrollar la autonomía corporal, este aspecto implica cambios en los currículos.

Factores asociados al desplazamiento activo en bicicleta al colegio en el Distrito Bogotá, Colombia. Estudio FUPRECOL

Introducción: El transporte activo (TA) puede ser una oportunidad para incrementar los niveles de actividad física diarios de los niños y adolescentes, además de destacarse como una estrategia práctica, accesible y sostenible a largo plazo. Objetivos: El objetivo del presente estudio es doble: Analizar los patrones de desplazamiento activo en bicicleta al y desde el centro educativo, y b) Identificar los factores asociados al uso de la bicicleta como TA; en una muestra de niños y jóvenes pertenecientes a escuelas oficiales de Bogotá, Colombia. Material y métodos: Se trata de un sub-análisis del estudio FUPRECOL en 8060 niños y adolescentes entre los 9-17 años de edad). El modo de desplazamiento del escolar fue determinado a través de la pregunta: “¿Durante los últimos 7 días, usaste bicicleta para ir al colegio/escuela y volver a la casa?. Dicha respuesta se categorizó en activos “Si” (si se desplazan en bicicleta) y pasivos “No” (si se desplazan en vehículo motorizado). Se midieron parámetros antropométricos de peso, talla y perímetro de cintura. El máximo nivel de estudios alcanzados por la madre/padre (no reporta, primaria o secundaria/técnico o tecnólogo/universitario o postgrado) y la composición del hogar (vive con padre/vive con madre/con ambos padres/con abuelos/otros familiares) se auto-reportó por los padres. Las relaciones entre el TA y los factores anteriormente descritos se analizaron mediante regresión logística binaria. Resultados: El 21,9% del total de la muestra reporta usar la bicicleta como medio de transporte y el 7,9% acumula más de 120 minutos al día. Se observó una mayor probabilidad de usar la bicicleta como medio de desplazamiento activo a la escuela en los varones, en los jóvenes entre 9 y 12 años, y en aquellos cuyo padre/madre reportaron mayor grado académico, es decir, “universitario/postgrado”. 3 Conclusión: Los hallazgos del presente estudio sugieren que es necesario promover el TA desde la niñez, poniendo mayor énfasis en el paso a la adolescencia y en las jóvenes, para así aumentar los niveles diarios de AF de estos.

Au1to-reporte de la condición física relacionada con la salud en una muestra de escolares del distrito Bogotá: estudio FUPRECOL

Introducción y objetivo: La escala de auto-reporte de la condición física (IFIS) “The International FItness Scale”, fue creada como parte del proyecto financiado por la unión europea HELENA Study “Healthy Lifestyle in Europe by Nutrition in Adolescence”. A la fecha, no se conoce ningún estudio que haya examinado el auto-reporte de la condición física en un contexto distinto al Europeo. Este trabajo evalúa por auto-reporte la condición física relacionada con la salud (CFRS) en una muestra de niños y adolescentes del distrito de Bogotá pertenecientes al grupo FUPRECOL. Materiales y Método: Estudio transversal en 1.922 escolares (54.3% mujeres). Se aplicó de manera auto-administrada la escala “IFIS”. Se midió el peso, talla, circunferencia de cintura y se calculó el índice de masa corporal (IMC) en kg/m2. La capacidad aeróbica, el índice general de fuerza (z-score fuerza prensil + z-score salto de longitud), la velocidad/agilidad y la flexibilidad fueron como indicadores objetivos de la CFRS objetiva y directa. Resultados: La muestra estuvo conformada por 1.922 escolares, de los cuales 1.045 fueron mujeres (54.3%) y 877 hombres (45.6%). El análisis ANOVA mostró que los varones tenían mayores valores de peso (p<0.003), estatura (p<0.001), CC (p<0.001), capacidad aeróbica (p<0.001), velocidad/agilidad (p<0.001) e índice general de fuerza (p<0.001), mientras que las mujeres presentaron exceso de peso por IMC (sobrepeso y obesidad). En el componente de condición física general, las puntuaciones más altas en la escala “IFIS” se encontraron en la categoría buena (40%), seguido de aceptable (34%), mientras que la puntuación más baja se encontró en la categoría muy mala/mala (6%). En población general, relaciones lineales fueron observadas entre el auto-reporte de la CFRS por la escala “IFIS” y la mayoría de los indicadores del fitness evaluado objetivamente. El análisis post-hoc ajustado por sexo, edad y etapa de maduración reveló que los escolares que acusaron mejores valores en la auto-percepción de los dominios del “IFIS”, presentaron mejor desempeño en los indicadores de CFRS objetivos. Conclusión: Este trabajo describe por primera vez en población Latina, que el auto-reporte con la escala “IFIS”, es un instrumento válido para evaluar la CFRS, y además posee una adecuada capacidad para clasificar la aptitud física en población escolar de Bogotá, Colombia. Esta escala se encuentra disponible para otros investigadores interesados en evaluar la condición física muscular en América Latina.

Prevalencia y factores asociados al consumo de bebidas azucaradas en escolares de 9 a 17 años de Bogotá, Colombia: Estudio FUPRECOL

Objetivo: Determinar la prevalencia y los factores asociados al consumo de bebidas azucaradas en una población escolar de Bogotá, Colombia, pertenecientes al estudio FUPRECOL. Métodos: Estudio descriptivo y transversal, realizado en 8136 niños y adolescentes en edad escolar entre 9 y 17 años de Bogotá, Colombia. El peso, la estatura, el índice de masa corporal (IMC), la circunferencia de cintura y el porcentaje de grasa, se recogieron como marcadores antropométricos y de composición corporal. El consumo de bebidas azucaradas (bebidas carbonatadas, jugos ultra-procesados y/o Té), y los factores asociados (sexo, edad, obesidad abdominal, clasificación del IMC, grado de estudios de la madre/padre, y nivel nutricional por cuestionario “Krece plus”), se recogieron por encuesta estructurada. Se establecieron asociaciones mediante la construcción de modelos de regresión logística simple. Resultados: De la población general, el 58,4% eran mujeres. En función al sexo, los varones acusaron la mayor ingesta de “bebidas carbonatadas” con una frecuencia semanal y diaria de 70,9% y 21,0%, respectivamente, seguido de “jugos ultra- procesados” (64,4% semanal vs. 11,3% diario). En ambos sexos, la prevalencia de obesidad abdominal fue mayor en los escolares que respondieron consumir diariamente “bebidas carbonatadas” (23,3%), “jugos ultra-procesados” (13,2%) y “bebidas Té” (9,7%). La edad, el grado de educación de los padres y el nivel nutricional, se asociaron como factores predisponentes al consumo diario de “bebidas carbonatadas”. Conclusión: El consumo de bebidas azucaradas cambia por los factores analizados. Se recomiendan intervenciones integrales en las que estén involucrados los componentes nutricional y educativo entre los niños y adolescentes de Bogotá, Colombia.

Development and formative evaluation of an obesity prevention intervention for the pediatric primary care setting: Helping HAND (Healthy Activity and Nutrition Directions)

As the obesity epidemic continues to increase, the pediatric primary care office setting remains a relatively unexplored arena to offer obesity prevention interventions for children. The increased risk for adult obesity among 10 to 14 year-old children who are overweight, suggests obesity prevention programs should be introduced just before this age or early in this age period. Research is also accumulating on the importance of targeting parents along with children, since parents are in charge of the home environment for children. Therefore, the aim of this project was to develop an obesity prevention program called Helping HAND (Healthy Activity and Nutrition Directions) based on Social Cognitive Theory and authoritative parenting techniques for the pediatric primary care setting and conduct one-on-one interviews with parents as the initial formative evaluation of the intervention material for the obesity prevention intervention. A secondary aim of the project was to determine the feasibility of identifying appropriate subjects for the intervention, and conducting qualitative evaluations of the materials through recruitment through pediatric primary care settings. ^

Pediatric motivational interviewing to address obesity and overweight

Not only are obesity and overweight associated with a myriad of medical and psychological concerns in childhood, but these health problems can persist even into adulthood. With the obvious need for better approaches in tackling childhood obesity and overweight and the strong evidence of motivational interviewing's effectiveness in the adult population, it is likely that an updated review will provide a more complete picture of the application of motivational interviewing in the pediatric population. The objective of this review is whether or not motivational interviewing will be instrumental in promoting factors that help in reducing the number of children who are or become overweight or obese. A literature search was completed that identified ten studies that incorporated MI as an intervention. Studies focused on either behavior health changes like increased physical activity, improved nutrition, or reducing parameters of weight like BMI or body composition. Three out of the 10 articles were still in progress and no results were provided. Five studies were able to achieve statistical significance in health benefits to control childhood overweight and obesity. Results revealed the overall feasibility of applying MI in the pediatric overweight and obese population, but the scarce number of studies limits conclusions about its efficacy. Therefore, additional scientific evidence is necessary to fully understand MI's role in affecting behavior changes in this population.^

The relationship of cardiorespiratory fitness, birth weight and parental BMI on adolescents’ obesity status

The aims of this study were as follows: (1) to analyze differences in cardiorespiratory fitness (CRF), parents' body mass index (BMI) and birth weight (BW) between non-overweight (NOW) and overweight/obese (OV/OB) adolescents, and (2) to investigate the association of those variables with the risk of their biological offspring being OV/OB. This study comprised 788 adolescents (477 girls and 311 boys), aged between 12 and 18 years. CRF was predicted by maximal multistage 20-m shuttle-run test according to the procedures described in FITNESSGRAM. Children's BMI was classified according to the International Obesity Task Force. Adolescents' BW was assessed from each child's pediatric record at birth. Parents' OV/OB status was defined and classified according to the World Health Organization. Socioeconomic status was defined by parental education. The prevalence OV/OB was 21.4 and 5.3%, respectively, and there were no gender differences. The OV/OB adolescents (girls and boys) had significantly (Pobesity, in girls. Furthermore, our data suggested that low CRF and high BW were strong predictors of OV/OB in adolescence.

Prevention of overweight and obesity: a Spanish approach

Background. Obesity is considered a major public health issue in most developed countries nowadays. This paper provides an overview of current population data available in Spain and the approach to develop preventive strategies in the country. Methods. Review of population data available is based on individually measured weight and height as well as determinants. On this basis, the approach used in the country to develop preventive strategies is discussed. Results. According to the DORICA study, the prevalence of obesity (BMI ≥30 kg m−2) is 15.5% in Spanish adults aged 25–60 years (13.2% in men and 17.5% in women). Obesity rates are higher among women aged 45 years and older, low social class, living in semi-urban places. Population estimates for the prevalence of obesity in Spanish children and young people based on the enKid study are 13.9% for the whole group. In this study, overweight and obesity is related to absence of breastfeeding, low consumption of fruit and vegetables, high consumption of cakes, buns, softdrinks and butchery products, low physical activity levels and a positive association with time spent watching TV. In 2005, the Spanish Ministry of Health jointly with the Spanish Agency for Food Safety and Nutrition launched the multifaceted NAOS strategy for nutrition, physical activity and the prevention of obesity. The important role of the family and the school setting as well as the responsibility of the Health Administration and Pediatric Care in the prevention of obesity is highlighted in the document. The need for environmental actions is recognised. The PERSEO programme, a multicomponent school-based intervention project is part of the strategy currently in place. Conclusion. Obesity is a public health issue in Spain. A national multifaceted strategy was launched to counteract the problem. Environmental and policy actions are a priority. Young children and their families are among the main target groups.

Individual, family and environmental factors associated with pediatric excess weight in Spain: a cross-sectional study.

BACKGROUND There is a growing worldwide trend of obesity in children. Identifying the causes and modifiable factors associated with child obesity is important in order to design effective public health strategies.Our objective was to provide empirical evidence of the association that some individual and environmental factors may have with child excess weight. METHOD A cross-sectional study was performed using multi-stage probability sampling of 978 Spanish children aged between 8 and 17 years, with objectively measured height and weight, along with other individual, family and neighborhood variables. Crude and adjusted odds ratios were calculated. RESULTS In 2012, 4 in 10 children were either overweight or obese with a higher prevalence amongst males and in the 8-12 year age group. Child obesity was associated negatively with the socio-economic status of the adult responsible for the child's diet, OR 0.78 (CI95% 0.59-1.00), girls OR 0.75 (CI95% 0.57-0.99), older age of the child (0.41; CI95% 0.31-0.55), daily breakfast (OR 0.59; p = 0.028) and half an hour or more of physical activity every day. No association was found for neighborhood variables relating to perceived neighborhood quality and safety. CONCLUSION This study identifies potential modifiable factors such as physical activity, daily breakfast and caregiver education as areas for public health policies. To be successful, an intervention should take into account both individual and family factors when designing prevention strategies to combat the worldwide epidemic of child excess weight.

Overweight in Swiss children and associations with children's and parents' characteristics et Worldwide trends in childhood obesity

(1) Surpoids chez les enfants suisses et associations avec certaines caractéristiques chez les enfants et leurs parents Le but de cette étude était de mesurer la prévalence du surpoids et de l?obésité chez les enfants de sixième année du canton de Vaud (âge moyen de 12 ans) et les facteurs associés au surpoids. Les données ont été récoltées lors d?une étude menée par l?Institut universitaire de médecine sociale et préventive. Tous les enfants scolarisés en 6ème année à l?école publique du canton de Vaud entre septembre 2005 et mai 2006 étaient éligibles à participer à cette étude. Le taux de participation a atteint 76% (soit 5207 enfants de 12,3 ans en moyenne). Le poids et la taille des enfants ont été mesurés à l?école par des assistants de recherche et les enfants ont rempli, en classe, un questionnaire structuré sur leur mode de vie (notamment : temps quotidien passé à regarder la télévision, à jouer à des jeux sur écran; fréquence de la pratique de diverses activités physiques; fréquence de la consommation de fruits ou de légumes). Des informations sur les parents (niveau d?éducation, nationalité, poids et taille) ont été récoltées au moyen d?un questionnaire structuré envoyé par courrier à ceux-ci. Nous avons utilisé les critères de l?International Obesity Task Force, qui définit les valeurs-seuils de l'indice de masse corporelle pour le surpoids et pour l?obésité, par age et par sexe. La prévalence du surpoids (obésité incluse) dans la population était de 15% chez les garçons et de 12% chez les filles, et la prévalence de l?obésité était de 2% dans les deux sexes. Nous avons trouvé que le surpoids était associé de façon indépendante avec le temps passé à regarder la télévision, ainsi qu?avec certaines caractéristiques des parents, comme le surpoids, un bas niveau d?éducation et une nationalité étrangère. En conclusion, un enfant sur sept est en surpoids ou obèse dans le canton de Vaud. Ces chiffres indiquent un important défi de santé publique, même si cette prévalence dans le canton de Vaud est, actuellement, moindre que dans beaucoup d?autres pays d?Europe, et bien moindre qu?en Amérique du Nord. Les associations entre le surpoids infantile et le temps passé à regarder la télévision, ainsi que les associations avec des variables liées au milieu socio-culturel des parents indiquent plusieurs pistes d?intervention pour prévenir le surpoids chez les enfants. Il est probable que les mesures de prévention ne devraient pas se limiter aux approches individuelles, mais devraient aussi inclure des mesures structurelles sur l?environnement social, physique et économique visant à réduire les facteurs obésogènes dans la société.<br/><br/>Objective: The objective was to assess the prevalence of overweight and obesity in children in a canton of Switzerland and the association with various characteristics of the parents and the children. Research Methods and Procedures: A cross-sectional survey was conducted in all children of the sixth school grade of the canton of Vaud, Switzerland. Weight and height were measured, and selected lifestyle variables were assessed with a self-administered semiquantitative questionnaire. Information on children?s parents was gathered through a mailed structured questionnaire. Overweight and obesity were based on the International Obesity Task Force criteria. Results: Of 6873 eligible children, 5207 (76%) participated (2621 boys, 2586 girls; mean age, 12.3 years; standard deviation, 0.5 year). The prevalence of overweight (including obesity) was 15.0% (95% confidence interval, 13.7% to 16.4%) in boys and 12.4% (11.1% to 13.7%) in girls, and the prevalence of obesity was 1.8% (1.3% to 2.3%) and 1.7% (1.2% to 2.2%), respectively. In both univariate and multivariate analyses, overweight was strongly associated with high television viewing time and selected characteristics of the parents (overweight, low educational level, and foreign nationality). Discussion: The prevalence of pediatric overweight and obesity was lower in this region of Switzerland than in several European countries. The correlates of overweight found in this region suggest areas for potential interventions.

Examining the potential application of childhood stature in assessing adolescent overweight and obesity

Background: Increasing Overweight and Obesity (OwOb) prevalence in pediatric populations is becoming a public health concern in many countries. The purpose of this study was to determine if childhood stature components, particularly the Leg Length Index (LLI = [height - sitting height]! height), were useful in assessing risk of OwOb in adolescence. Methods: Data was from a longitudinal study conducted in south Ontario since 2004. Approximately 2360 students had body composition measurements including sitting height and standing height at baseline. Among them, 1167 children (573 girls, 594 boys) who had weight and height measured at the 5 th year follow-up, were included in this analysis. OwOb was defined using age and sex specific BMI (kg!m 2 ) cut-off points corresponding to adults' BMI ~ 25. Results: Overall, 34% (n=298) of adolescents were considered as OwOb. The results from logistic regression analysis indicated that with 1 unit increase in LLI the odds of OwOb decreased 24% (Odds Ratio, [95% Confidence Interval], 0.76, [0.66-0.87]) after adjusted for age, sex and baseline waist circumference. Further adjusting for birth weight, birth order, breastfeeding, child's physical activity, maternal smoking, education, mother's age at birth and mother's BMI, did not change the relationship. Our results also indicated that mother's smoking status is associated with LLI. Discussion: Although LLI measured at childhood in this study is related to OwOb risk in adolescents, the underlying mechanism is unclear and further study is needed.

Cardiorespiratory fitness, but not central obesity or C-reactive protein, is related to liver function in obese children

Nonalcoholic fatty liver disease (NAFLD) is one of the most frequent complications associated with excess adiposity. Its pathogenesis is complex and there are multiple factors that may contribute to it. AIM: To analyze whether cardiorespiratory ftness (CRF), waist circumference (WC), and C-reactive protein (CRP) are associated with alanine aminotransferase (ALT) in children with obesity. METHODS: 79 overweight/obese children of both genders, 11-13 year-olds, with abnormal serum ALT from Porto public schools comprised the sample. Measurements included CRF (20-m Shuttle Run Test), WC (NHANES protocol), CRP and ALT (Cholestech LDX analyzer). Logistic regression adjusted for gender, maturation, and weight with ALT levels as dependent variable (risk vs. non risk), and WC (risk vs. non risk), CRP (risk vs. non risk), and CRF (fit vs. unfit) as independent variables. Level of significance was set at 95%. RESULTS: Logistic regression showed that obese fit children were less likely to have abnormal ALT values (OR=.031) CONCLUSION: In obese children, higher cardiovascular fitness appears to reduce the chance of decreased liver function. © 2013 Human Kinetics, Inc.