Cardiometabolic Markers and Physical Fitness in Children: the MI-Energy Study

Authors: RIVERA, JENY - Arkansas Children'S Nutrition Research Center (ACNC); BØRSHEIM, ELISABET - Arkansas Children'S Nutrition Research Center (ACNC); DIAZ, EVA - Arkansas Children'S Nutrition Research Center (ACNC)

Submitted to: Meeting Abstract
Publication Type: Abstract Only
Publication Acceptance Date: 8/27/2025
Publication Date: N/A
Citation: N/A

Interpretive Summary:

Technical Abstract: BACKGROUND: There is increasing recognition that peak aerobic capacity is a key determinant of pediatric health, especially in children at risk for cardiometabolic diseases. However, inconsistent methodologies and limited reproducibility have hindered the development of tailored, evidence-based recommendations. The purpose of this study was to evaluate the association of VO2 peak, adiposity, and their interaction with markers of cardiometabolic health of children. METHODS: Children (n=196) aged 8 to 10 years attended a single visit at the Arkansas Children’s Nutrition Center. Fasting blood was collected to measure lipids, glucose, insulin, and hsCRP. HOMA-IR and blood pressure percentiles were calculated. Body composition [% fat mass (%FM) and fat-free mass index (FFMI, Kg/m2)] was assessed by DXA. VO2 peak was measured using a cycle ergometer test, and endothelial function by brachial artery flow-mediated dilation (FMD). Generalized linear models examined associations of VO2 peak (O2·mL-1·FFMI-1) and %FM with cardiometabolic outcomes. RESULTS: Children were 9.4 ± 0.9 years old; 54% were male, 66% were White, and 21.5% had high blood pressure (elevated or hypertensive). Sixty percent had normal weight, 23% were overweight, and 17% had obesity. VO2 peak interacted with %FM in association with hsCRP (ß = 0.003, p = 0.0269) and HOMA-IR (ß = -0.002, p = 0.0046)]. Specifically, hsCRP concentrations and HOMA-IR were higher in children with greater adiposity but only at lower levels of VO2 peak. VO2 peak was inversely associated with diastolic blood pressure percentiles (ß = -0.246, p = 0.0062) after controlling for %FM. There was no association with other markers of cardiometabolic health. CONCLUSIONS: Systemic inflammation and insulin resistance linked to adiposity are modifiable in children and may improve with higher peak VO2. Peak VO2 showed an inverse association with diastolic blood pressure independently of adiposity. FUNDING: USDA-ARS 6026-10700-001-000D; NIH-5P20GM109096