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Aim: Adipokines seem to play a role in bone morphogenesis, although this also depends on the mechanical forces applied to the skeleton. The aim was to assess the relationships of resting leptin and adiponectin with bone parameters and whether high muscular fitness levels affect these relationships in children with overweight or obesity. Methods: This cross-sectional study took part from 2014 to 2016 in Granada, Spain. Participants were recruited from University Hospitals, and we also used advertisements in local media and school contacts in the city. Adipokines were analysed in plasma. Muscular fitness was assessed by one repetition maximum in bench and leg press tests. Dual-energy X-ray absorptiometry was used to measure bone parameters. Results: We included 84 children (10.0 ± 1.2y; 63% boys) in this analysis. Leptin was negatively associated with lumbar spine bone mineral content (β = −0.162, p = 0.053).No significant interaction was found for muscular fitness. Simple slope estimates suggested that children performing more than 133.3 kg in leg press test ameliorated the negative association between leptin and lumbar spine bone mineral content. Conclusion: Leptin levels were negatively associated with lumbar spine bone mineral content in children with overweight or obesity. A high muscular fitness at the lower body could counteract this association. This study was mainly supported by grants from the Spanish Ministry of Economy and Competitiveness (DEP2013-47540, DEP2016-79512-R, DEP2017-91544-EXP and RYC-2011-09011), European Regional Development Fund (ERDF) of the European Commission (No 667302) and the Alicia Koplowitz Foundation. Additional funding was obtained from the Andalusian Operational Programme supported with ERDF (FEDER in Spanish, B-CTS-355-UGR18). Additional support was obtained from University of Granada, Plan Propio de Investigación 2016, Excellence actions: Units of Excellence, Unit of Excellence on Exercise and Health, the Junta de Andalucía, Consejería de Conocimiento, Investigación y Universidades (SOMM17/6107/UGR); the EXERNET Research Network on Exercise and Health in Special populations (DEP2005-00046/ACTI); and the HL-PIVOT network - Healthy Living for Pandemic Event Protection. Funding for open access charge: Universidad de Granada / CBUA.

The relationship between inflammatory markers and bone turnover in adults is well known, whilst a negative association between cardiorespiratory fitness (CRF) and inflammatory markers has also been described. Hence, we tested whether the association between CRF and bone turnover markers is mediated by inflammatory markers in adults with metabolic syndrome. A total of 81 adults (58.5±5.0 yrs, 62.7% women) were included in the analysis. CRF was measured by the six-minute walking test. Serum interleukine (IL)-1β, IL-6, IL-10, tumor necrosis factor alpha, high-sensitivity c-reactive protein (hsCRP) and vascular endothelial growth factor, collagen type I cross-linked C-telopeptide, procollagen type I N-terminal propeptide (P1NP) and total osteocalcin were assessed using a sensitive ELISA kit. Body composition was assessed by dual-energy x-ray absorptiometry. Partial correlation was used to test the relationship between CRF, inflammatory markers and bone turnover markers, controlling for sex, lean mass and fat mass. Boot-strapped mediation procedures were performed and indirect effects with confidence intervals not including zero were interpreted as statistically significant. CRF was positively correlated with P1NP levels (r=0.228, p=0.044) and osteocalcin levels (r=0.296, p=0.009). Furthermore, CRF was positively correlated with IL-1β levels (r=0.340, p=0.002) and negatively correlated with hsCRP levels (r=-0.335, p=0.003), whereas IL-1β levels were positively correlated with P1NP levels (r=0.245, p=0.030) and hsCRP levels were negatively correlated with P1NP levels (r=-0.319, p=0.004). Finally, the association between CRF and P1NP levels was totally mediated by hsCRP (PM=39.9). Therefore, CRF benefits on bone formation could be dependent on hsCRP concentrations in this population., Heart and Diseases Foundation (Fondation 234 Coeur et Artères) 59200 Loos, France

ImportanceChildhood obesity is a risk factor for type 2 diabetes (T2D), cardiovascular disease, and mental disorders later in life. To investigate the parallel effects on cardiometabolic and mental health in children with overweight or obesity will provide new insights on the benefits of exercise on overall health.ObjectiveThis study aimed to investigate the effects of a 20-week exercise program on cardiometabolic and mental health in children with overweight or obesity.DesignParallel-group randomized clinical trial (RCT) conducted in Granada (Spain) from November 2014 to June 2016.SettingClinical setting.ParticipantsEligibility criteria included children with overweight or obesity aged 8 to 11.9 years from Granada (Spain) and surrounding areas.InterventionThe exercise program included 3-5 sessions/week (90 min/session) of aerobic plus resistance training for 20-weeks. The wait-list control group continued with their usual routines.Main Outcomes and MeasuresCardiometabolic outcomes included body composition (fat mass, fat-free mass, and visceral adipose tissue), physical fitness (cardiorespiratory, speed-agility, and muscular), and traditional risk factors (waist circumference, blood lipids biomarkers, glucose, insulin, and blood pressure). Cardiometabolic risk score (z-score) was calculated based on age and sex reference values for triglycerides, inverted high-density lipoprotein cholesterol, glucose, the average of systolic and diastolic blood pressure, and waist circumference. An additional cardiometabolic risk score also included cardiorespiratory fitness. Mental health outcomes included an array of psychological well-being and ill-being indicators.ResultsThe ActiveBrains exercise program reduced the cardiometabolic risk score by ∼0.4 (95% confidence interval [CI95%]: −0.75, −0.03) standard deviations (SD). The exercise program had a positive effect on low-density lipoprotein cholesterol (−7.40 [CI95%: −14.82, 0.016] mg/dL), body mass index (−0.60 [CI95%: −1.07, −0.13] kg/m2), fat mass index (−0.70 [CI95%: −1.03 to −0.36] kg/m2), visceral adipose tissue (−34.05 [CI95%: −61.38, −6.73] g), and cardiorespiratory fitness (+3.07 [CI95%: 0.68, 5.45] laps) in the exercise group compared to controls. No effects were observed on mental health outcomes.Conclusions and RelevanceThe ActiveBrains exercise program improved cardiometabolic health in children with overweight or obesity, yet it had no effect on mental health. These findings support public health initiatives promoting exercise programs in children with excess body weight to prevent future cardiovascular comorbidities.Trial RegistrationClinicalTrials.gov Identifier: NCT02295072.Key PointsQuestionWhat are the parallel effects of exercise on cardiometabolic and mental health in children with excess of adiposity?FindingsIn this parallel-group randomized clinical trial of 109 children with overweight or obesity, a 20-week exercise program including aerobic plus resistance training improved body composition, cardiorespiratory fitness, and cardiometabolic risk factors. No effects on mental health were observed.MeaningExercise programs should be promoted in children with excess adiposity to improve their cardiometabolic health.