Pascale Duché

Muscle Fatigue during High-Intensity Exercise in Children

AbstractChildren are able to resist fatigue better than adults during one or several repeated high-intensity exercise bouts. This finding has been reported by measuring mechanical force or power output profiles during sustained isometric maximal contractions or repeated bouts of high-intensity dynamic exercises. The ability of children to better maintain performance during repeated high-intensity exercise bouts could be related to their lower level of fatigue during exercise and/or faster recovery following exercise. This may be explained by muscle characteristics of children, which are quantitatively and qualitatively different to those of adults.Children have less muscle mass than adults and hence, generate lower absolute power during high-intensity exercise. Some researchers also showed that children were equipped better for oxidative than glycolytic pathways during exercise, which would lead to a lower accumulation of muscle by-products. Furthermore, some reports indicated that the lower ability of children to activate their type II muscle fibres would also explain their greater resistance to fatigue during sustained maximal contractions.The lower accumulation of muscle by-products observed in children may be suggestive of a reduced metabolic signal, which induces lower ratings of perceived exertion. Factors such as faster phosphocreatine resynthesis, greater oxidative capacity, better acid-base regulation, faster readjustment of initial cardiorespiratory parameters and higher removal of metabolic by-products in children could also explain their faster recovery following high-intensity exercise.From a clinical point of view, muscle fatigue profiles are different between healthy children and children with muscle and metabolic diseases. Studies of dystrophic muscles in children indicated contradictory findings of changes in contractile properties and the muscle fatigability. Some have found that the muscle of boys with Duchenne muscular dystrophy (DMD) fatigued less than that of healthy boys, but others have reported that the fatigue in DMD and in normal muscle was the same. Children with glycogenosis type V and VII and dermatomyositis, and obese children tolerate exercise weakly and show an early fatigue. Studies that have investigated the fatigability in children with cerebral palsy have indicated that the femoris quadriceps was less fatigable than that of a control group but the fatigability of the triceps surae was the same between the two groups.Further studies are required to elucidate the mechanisms explaining the origins of muscle fatigue in healthy and diseased children. The use of non-invasive measurement tools such as magnetic resonance imaging and magnetic resonance spectroscopy in paediatric exercise science will give researchers more insight in the future.

Changes in Basal and Insulin and Amino Acid Response of Whole Body and Skeletal Muscle Proteins in Obese Men

CONTEXT Obesity-related insulin resistance of glucose and lipid metabolism may also affect protein kinetics, notably at the muscle level. OBJECTIVE We hypothesized that muscle protein response to insulin and amino acid is blunted during obesity. RESEARCH DESIGN AND METHODS Total (Tot) and mitochondrial (Mit) muscle proteins fractional synthesis rates (FSR) together with whole-body protein kinetics (WB) have been determined in postabsorptive state (PA) and during a hyperinsulinemic, hyperaminoacidemic, euglycemic clamp by using a continuous infusion of (13)C-leucine in six obese and eight nonobese subjects. RESULTS Responses of WB glucose disposal rate and protein breakdown to insulin and amino acid infusion were significantly lower in obese than in nonobese subjects (P < 0.05). In PA, Tot and Mit FSR were significantly lower (P < 0.05) in obese (Tot, 0.044 +/- 0.005% . h(-1); Mit, 0.064 +/- 0.008% . h(-1)) in comparison with nonobese subjects (Tot, 0.082 +/- 0.010% . h(-1); Mit, 0.140 +/- 0.006% . h(-1)). Tot FSR was similarly stimulated by insulin and amino acid in both groups (0.094 +/- 0.013 vs. 0.117 +/- 0.006% . h(-1), obese vs. nonobese; P < 0.05). Mit FSR was increased in nonobese subjects (0.179 +/- 0.007% . h(-1); P < 0.05) but not in obese subjects (0.078 +/- 0.012% . h(-1); P = not significant). CONCLUSIONS The obesity-related impairment of protein metabolism is characterized by 1) a reduced turnover rate of skeletal muscle proteins in PA; 2) a lack of stimulation of mitochondrial protein synthesis by insulin and amino acid; and 3) a lower inhibition of WB proteolysis by insulin and amino acid. Alterations of selective muscle protein kinetics may predispose obese subjects to muscle metabolic dysfunction leading to type 2 diabetes.

Effect of android to gynoid fat ratio on insulin resistance in obese youth.

BACKGROUND Upper body fat distribution is associated with the early development of insulin resistance in obese children and adolescents. OBJECTIVE To determine if an android to gynoid fat ratio is associated with the severity of insulin resistance in obese children and adolescents, whereas peripheral subcutaneous fat may have a protective effect against insulin resistance. SETTING The pediatric department of University Hospital, Clermont-Ferrand, France. DESIGN A retrospective analysis using data from medical consultations between January 2005 and January 2007. PARTICIPANTS Data from 66 obese children and adolescents coming to the hospital for medical consultation were used in this study. MAIN OUTCOME MEASURES Subjects were stratified into tertiles of android to gynoid fat ratio determined by dual-energy x-ray absorptiometry. Insulin resistance was assessed by the homeostasis model of insulin resistance (HOMA-IR) index. RESULTS There were no differences in weight, body mass index, and body fat percentage between tertiles. Values of HOMA-IR were significantly increased in the 2 higher tertiles (mean [SD], tertile 2, 2.73 [1.41]; tertile 3, 2.89 [1.28]) compared with the lower tertile (tertile 1, 1.67 [1.24]) of android to gynoid fat ratio (P < .001). The HOMA-IR value was significantly associated with android to gynoid fat ratio (r = 0.35; P < .01). CONCLUSIONS Android fat distribution is associated with an increased insulin resistance in obese children and adolescents. An android to gynoid fat ratio based on dual-energy x-ray absorptiometry measurements is a useful and simple technique to assess distribution of body fat associated with an increased risk of insulin resistance.

Effect of physical activity intervention on body composition in young children: influence of body mass index status and gender.

Aim: To fight overweight and obesity in childhood, this study proposes an additional physical activity (PA) in young children aged 6–10 years. The objective was to evaluate the effect of school‐based PA on the body composition according to body mass index (BMI) categories (nonobese vs. obese) and gender.

The 24-h Energy Intake of Obese Adolescents Is Spontaneously Reduced after Intensive Exercise: A Randomized Controlled Trial in Calorimetric Chambers

Background Physical exercise can modify subsequent energy intake and appetite and may thus be of particular interest in terms of obesity treatment. However, it is still unclear whether an intensive bout of exercise can affect the energy consumption of obese children and adolescents. Objective To compare the impact of high vs. moderate intensity exercises on subsequent 24-h energy intake, macronutrient preferences, appetite sensations, energy expenditure and balance in obese adolescent. Design This randomized cross-over trial involves 15 obese adolescent boys who were asked to randomly complete three 24-h sessions in a metabolic chamber, each separated by at least 7 days: (1) sedentary (SED); (2) Low-Intensity Exercise (LIE) (40% maximal oxygen uptake, VO2max); (3) High-Intensity Exercise (HIE) (75%VO2max). Results Despite unchanged appetite sensations, 24-h total energy intake following HIE was 6–11% lower compared to LIE and SED (p<0.05), whereas no differences appeared between SED and LIE. Energy intake at lunch was 9.4% and 8.4% lower after HIE compared to SED and LIE, respectively (p<0.05). At dinner time, it was 20.5% and 19.7% lower after HIE compared to SED and LIE, respectively (p<0.01). 24-h energy expenditure was not significantly altered. Thus, the 24-h energy balance was significantly reduced during HIE compared to SED and LIE (p<0.01), whereas those of SED and LIE did not differ. Conclusions In obese adolescent boys, HIE has a beneficial impact on 24-h energy balance, mainly due to the spontaneous decrease in energy intake during lunch and dinner following the exercise bout. Prescribing high-intensity exercises to promote weight loss may therefore provide effective results without affecting appetite sensations and, as a result, food frustrations. Trial Registration ClinicalTrial.gov NCT01036360

Do mechanical gait parameters explain the higher metabolic cost of walking in obese adolescents

Net metabolic cost of walking normalized by body mass (C(W.BM(-1)); in J.kg(-1).m(-1)) is greater in obese than in normal-weight individuals, and biomechanical differences could be responsible for this greater net metabolic cost. We hypothesized that, in obese individuals, greater mediolateral body center of mass (COM) displacement and lower recovery of mechanical energy could induce an increase in the external mechanical work required to lift and accelerate the COM and thus in net C(W.BM(-1)). Body composition and standing metabolic rate were measured in 23 obese and 10 normal-weight adolescents. Metabolic and mechanical energy costs were assessed while walking along an outdoor track at four speeds (0.75-1.50 m/s). Three-dimensional COM accelerations were measured by means of a tri-axial accelerometer and gyroscope and integrated twice to obtain COM velocities, displacements, and fluctuations in potential and kinetic energies. Last, external mechanical work (J.kg(-1).m(-1)), mediolateral COM displacement, and the mechanical energy recovery of the inverted pendulum were calculated. Net C(W.BM(-1)) was 25% higher in obese than in normal-weight subjects on average across speeds, and net C(W.BM(-67)) (J.kg(-0.67).m(-1)) was significantly related to percent body fat (r(2) = 0.46). However, recovery of mechanical energy and the external work performed (J.kg(-1).m(-1)) were similar in the two groups. The mediolateral displacement was greater in obese subjects and significantly related to percent body fat (r(2) = 0.64). The mediolateral COM displacement, likely due to greater step width, was significantly related to net C(W.BM(-67)) (r(2) = 0.49). In conclusion, we speculate that the greater net C(W.BM(-67)) in obese subjects may be partially explained by the greater step-to-step transition costs associated with wide gait during walking.

Testing peak cycling performance: effects of braking force during growth.

The purpose of this study was to investigate the relationship between cycling peak power (CPP; flywheel inertia included) and the applied braking force (F(B)) on a friction-loaded cycle ergometer in male children, adolescents, and adults. A total of 520 male subjects aged 8-20 yr performed three brief maximal sprints against three F(B): 0.245, 0.491, and 0.736 N x kg(-1) body mass (BM) (corresponding applied loads: 25 [F(B)25], 50 [F(B)50], and 75 [F(B)75] g x kg(-1) BM). For each F(B), peak power (PP) was measured (PP25, PP50 and PP75). For each subject, the highest PP was defined as CPP. Results showed that PP was dependent on F(B). In young adults PP25 underestimated CPP by more than 10%, and consequently, F(B)25 seemed to be too low for this population. However, in children, PP75 underestimated CPP by about 20%. A F(B) of 0.736 N x kg(-1) BM was definitively too high for the pediatric population. Therefore, the optimal F(B), even corrected for BM, was lower in children than in adults. The influence of growth and maturation on the force-generating capacity of the leg muscles may explain this difference. In this study, however, it was shown that the difference between PP50 and CPP was independent of age for the whole population investigated. Consequently, when flywheel inertia is included, one cycling sprint with a F(B) of 0.495 N x kg(-1) BM (corresponding applied load: 50 g x kg(-1) BM) is a feasible method for testing both children, adolescents, or young adults.

Fat and Carbohydrate Metabolism during Submaximal Exercise in Children

During exercise, the contribution of fat and carbohydrate to energy expenditure is largely modulated by the intensity of exercise. Age, a short- or long-term diet enriched in carbohydrate or fat substrate stores, training and gender are other factors that have also been found to affect this balance. These factors have been extensively studied in adults from the perspective of improving performance in athletes, or from a health perspective in people with diseases. During the last decade, lifestyle changes associated with high-energy diets rich in lipid and reduced physical activity have contributed to the increase in childhood obesity. This lifestyle change has emerged as a serious health problem favouring the early development of cardiovascular diseases, insulin resistance or type 2 diabetes mellitus. Increasing physical activity levels in young people is important to increase energy expenditure and promote muscle oxidative capacity. Therefore, it is surprising that the regulation of balance between carbohydrate and lipid use during exercise has received much less attention in children than in adults. In this review, we have focused on the factors that affect carbohydrate and lipid metabolism during exercise and have identified areas that may be relevant in explaining the higher contribution of lipid to energy expenditure in children when compared with adults. Low muscle glycogen content is possibly associated with a low activity of glycolytic enzymes and high oxidative capacity, while lower levels of sympathoadrenal hormones are likely to favour lipid metabolism in children. Changes in energetic metabolism occurring during adolescence are also dependent on pubertal events with an increase in testosterone in boys and estrogen and progesterone in girls. The profound effects of ovarian hormones on carbohydrate and fat metabolism along with their effects on oxidative enzymes could explain that differences in substrate metabolism have not always been observed between girls and women. Finally, although the regulatory mechanisms of fat and carbohydrate balance during exercise are quite well identified, there are a lack of data specific to children and most of the evidences reported in this review were drawn from studies in adults. Isotope tracer techniques and nuclear magnetic resonance will allow non-invasive investigation of the metabolism of the different substrate sources in skeletal muscle.

Saliva cortisol, physical exercise and training: influences of swimming and handball on cortisol concentrations in women

The aim of this study was to observe the influence of physical exercise and training on saliva cortisol concentrations in women. Three groups of adult women were studied: one group of sedentary controls (n = 7) and two groups of sportswomen who competed in either handball (n = 14) or swimming (n = 10) at a national level. These sportswomen gave six saliva samples during a day that included exercise which was part of their annual training programme. We noticed a significant increase in saliva cortisol concentration after exercise in the handball players (6 p.m. vs 7.30 p.m. P < 0.05) which did not appear in the swimmers or the sedentary group. There was no difference between the sedentary group and the swimmers for each sample of the day. These results showed that the type of sport played seemed to influence the concentration of saliva cortisol, the type of stress involved, the respective haemodynamic conditions of swimming and running and thermal stress also playing a part. Moreover, it seemed that the level of performance influenced the secretion of cortisol in the saliva.

Age differences in human skeletal muscle fatigue during high-intensity intermittent exercise

It has been shown at similar relative work rates that children have higher resistance to fatigue than adults during repeated bouts of high‐intensity exercise. This age‐related difference in fatigue resistance may be explained by factors including muscle mass, muscle morphology, energy metabolism and neuromuscular activation.