David B Allen

University of Wisconsin–Madison, Madison, Wisconsin, United States

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Publications (65)314.5 Total impact

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    ABSTRACT: To develop a risk assessment model for early detection of hepatic steatosis using common anthropometric and metabolic markers.
    The Journal of pediatrics. 05/2014;
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    ABSTRACT: Objective: In non-obese youth, to investigate whether hepatic fat deposition and its metabolic consequences vary between ethnic groups. Design and Methods: Thirty-two non-obese girls (12 Hispanic White [H] and 20 non-Hispanic White [NHW] girls), aged 11-14 years old were recruited. Outcome measures were MRI measured hepatic proton density fat fraction (hepatic PDFF), BMI Z-score, waist circumference, fasting insulin, glucose, adiponectin, sex hormone binding globulin [SHBG], ALT, AST, and triglycerides, and HOMA-IR. Results: There were no significant differences in mean BMI Z-scores (p=0.546) or hepatic PDFF (p=0.275) between H and NHW girls; however, H girls showed significant correlations between hepatic PDFF and markers of IR (fasting insulin, HOMA-IR, adiponectin, SHBG, triglycerides; all p<0.05), while NHW girls showed no significant correlations. Matched by hepatic PDFF or BMI-Z score, H girls had more evidence of IR for a given hepatic PDFF (mean insulin, HOMA-IR, and SHBG; all p<0.05) or BMI-Z score (mean insulin and HOMA-IR; all p<0.01) than NHW girls. Conclusions: In non-obese female youth, ethnicity-related differences in effects of hepatic fat on IR are evident, so that in H girls, a given amount of hepatic fat appears to result in a more predictable and greater degree of IR than in NHW girls.
    Obesity 06/2013; · 3.92 Impact Factor
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    ABSTRACT: PURPOSE OF REVIEW: Recombinant human growth hormone (hGH) therapy in children with Prader-Willi syndrome (PWS) improves linear growth, body composition, physical strength and agility, and other metabolic parameters. These benefits must be weighed against potential adverse effects, including rare occurrences of sudden death. This review summarizes recent evidence important to a benefit-risk analysis of hGH use in children with PWS. RECENT FINDINGS: Studies consistently show that hGH improves stature, body composition, fat percentage and distribution, and other metabolic markers in children with PWS. Preliminary reports of improved cognitive development during hGH have also emerged. Scoliosis progression is influenced by growth rate, but frequency of occurrence and severity are not increased by hGH exposure. PWS genotype does not appear to affect response to hGH. Concerns about hGH-associated sudden death persist, but recent studies show either absence of change in sleep-disordered breathing or improved sleep cardiovascular function during hGH therapy. SUMMARY: Recent studies confirm and expand reported benefits of hGH therapy in children with PWS, including a possible salutary role in cognitive development. These findings support previous assertions that hGH can reduce morbidity and improve function in children with PWS, and suggest that potential risks of such treatment are favorably balanced by its benefits.
    Current opinion in pediatrics 06/2013; · 2.01 Impact Factor
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    ABSTRACT: Context:rhGH therapy in Prader-Willi syndrome (PWS) has been used by the medical community and advocated by parental support groups since its approval in the US in 2000 and in Europe in 2001. Its use in PWS represents a unique therapeutic challenge which includes treating individuals with cognitive disability, varied therapeutic goals that are not focused exclusively on increased height, and concerns about potential life-threatening adverse events.Objective:To formulate recommendations for the use of rhGH in children and adult patients with PWS.Evidence:A systematic review of the clinical evidence in the pediatric population, including randomized controlled trials (RCTs), comparative observational studies and long term studies (>3.5 years). Adult studies included RCTs of rhGH treatment for [mteq] 6 months and uncontrolled trials. Safety data were obtained from case reports, clinical trials and pharmaceutical registries.Methodology:Forty-three international experts and stakeholders followed clinical practice guideline development recommendations outlined by the AGREE Collaboration (www.agreetrust.org). Evidence was synthesized and graded using a comprehensive multicriteria methodology (EVIDEM) (www.evidem.org/praderwilli).Conclusions:Following a multi-disciplinary evaluation preferably by experts, rhGH treatment should be considered for patients with genetically-confirmed PWS in conjunction with dietary, environmental and lifestyle interventions. Cognitive impairment should not be a barrier to treatment, and informed consent/assent should include benefit/risk information. Exclusion criteria should include severe obesity, uncontrolled diabetes mellitus, untreated severe obstructive sleep apnea, active cancer or psychosis. Clinical outcome priorities should vary depending upon age and the presence of physical, mental and social disability, and treatment should be continued for as long as demonstrated benefits outweigh the risks.
    The Journal of clinical endocrinology and metabolism 03/2013; · 6.50 Impact Factor
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    David B Allen
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    ABSTRACT: Caloric intake that exceeds energy expended and its consequences, particularly development of type 2 diabetes mellitus, is emblematic of a climate change for modern medicine - a phenomenon so complex, embedded in culture and economics, and intertwined with conflicts between individual freedom and societal health that solutions are difficult to envision. Chronic caloric surplus (rather than obesity itself) is a central cause of epidemic type 2 diabetes,(1) but differences in response to energy excess,(2)-(4) disproportionately present among disadvantaged youth, increase susceptibility to type 2 diabetes in early life. Indeed, the percentage of type 2 diabetes in cases of new-onset . . .
    New England Journal of Medicine 04/2012; 366(24):2315-6. · 51.66 Impact Factor
  • David B Allen, Norman Fost
    The Journal of pediatrics 04/2012; 160(6):898-9. · 4.02 Impact Factor
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    ABSTRACT: Increasing obesity and poor cardiovascular fitness (CVF) contribute to higher rates of type 2 diabetes mellitus (T2DM) in children. While the relative contributions of fitness and body fat on development of insulin resistance (IR) in children and adolescents remains unresolved, gender- and race-specific differences likely exist in the degree to which CVF influences IR and risk for T2DM. Better understanding of how gender and race affect interactions between body fat, CVF, and metabolic health would be helpful in designing effective and targeted strategies to reduce obesity-associated disease risk. We evaluated whether metabolic benefits of fitness on reducing inflammation and insulin resistance (IR) are affected by gender and race. This cross-sectional study included 203 healthy children (mean age 12.2 y, 50% male, 46% non-Hispanic white (NHW), 54% racially diverse (RD)). Fasting insulin, glucose, hsCRP, and adiponectin were measured; race was self-reported; cardiovascular fitness (CVF) was evaluated by the Progressive Aerobic Cardiovascular Endurance Run. Associations between inflammation and gender, race, and CVF were evaluated using analysis of covariance. Multivariate regression analysis identified independent predictors of IR. Fitness and inflammation were inversely related in both males and females (p < 0.01); this effect was marginally stronger in RD children (p = 0.06) and non-overweight males (p = 0.07). High BMI (p < 0.001), low fitness (p = 0.006), and (female) gender (p = 0.003) were independently associated with higher HOMA-IR. In males, BMI and fitness, but not race independently predicted HOMA-IR. In females, BMI and race, but not fitness independently predicted HOMA-IR. In middle school children, the beneficial effects of fitness vary based on gender and race. High CVF has an enhanced anti-inflammatory effect in male and RD children. While BMI is the strongest predictor of IR in the study group as a whole, fitness is a significant predictor of IR only in males, and race is a significant predictor of IR only in females.
    International Journal of Pediatric Endocrinology 03/2012; 2012(1):4.
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    ABSTRACT: To develop a statewide school-based program of measuring and reporting cardiovascular fitness levels in children, and to create age- and sex-specific cardiovascular fitness percentile-based distribution curves. A pilot study validated cardiovascular fitness assessment with Progressive Aerobic Cardiovascular Endurance Run (PACER) testing as an accurate predictor of cardiovascular fitness measured by maximal oxygen consumption treadmill testing. Schools throughout the state were then recruited to perform PACER and body mass index (BMI) measurement and report de-identified data to a centralized database. Data on 20 631 individual students with a mean age 12.1 ± 2.0 years, BMI of 21.4 ± 5.1, and a cardiovascular fitness measured with PACER of 29.7 ± 18.2 laps (estimated maximal oxygen consumption of 36.5 mL/kg/min) were submitted for analysis. Standardized fitness percentiles were calculated for age and sex. This study demonstrates the feasibility of performing, reporting, and recording annual school-based assessments of cardiovascular fitness to develop standardized childhood fitness percentiles on the basis of age and sex. Such data can be useful in comparing populations and assessing initiatives that aim to improve childhood fitness. Because health consequences of obesity result from both adiposity and physical inactivity, supplementation of BMI measurement with tracking of cardiovascular fitness adds a valuable tool for large-scale health assessment.
    The Journal of pediatrics 02/2012; 161(1):120-4. · 4.02 Impact Factor
  • David B Allen
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    ABSTRACT: Today, many medical interventions that begin as treatments for disease often expand into therapies that reduce disability, lessen disadvantage, or even confer advantage. Forces that propel profitable drugs, devices, and procedures dominate over considerations of efficient and equitable distribution of resources. This dominance is fueled by industry-physician collaborations often biased by prior assumptions, reliant on surrogate outcomes, and advantageous to marketing. Interventions are justified by "medicalization" of physiologic variations (e.g. short stature) as defects or disease, and nudged into "standard practice" by key opinion leaders. The story below of recombinant human growth hormone (hGH) treatment of short stature is one vivid example, but others (e.g. expansion of drug treatment to "optimize" cholesterol profiles, bone health, psychological well-being) can be found throughout medicine. In the new obesity era, lessons learned from the hGH era will be needed to keep the field of pediatric endocrinology empowered to make the key clinical decisions, and free of unintended consequences for patients and runaway health care inflation for society.
    The Journal of clinical endocrinology and metabolism 08/2011; 96(10):3042-7. · 6.50 Impact Factor
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    ABSTRACT: The effect on linear growth of daily long-term inhaled corticosteroid therapy in preschool-aged children with recurrent wheezing is controversial. We sought to determine the effect of daily inhaled corticosteroid given for 2 years on linear growth in preschool children with recurrent wheezing. Children aged 2 and 3 years with recurrent wheezing and positive modified Asthma Predictive Index scores were randomized to a 2-year treatment period of chlorofluorocarbon-delivered fluticasone propionate (176 μg/d) or masked placebo delivered through a valved chamber with a mask and then followed for 2 years off study medication. Height growth determined by means of stadiometry was compared between treatment groups. In the study cohort as a whole, the fluticasone group did not have significantly less linear growth than the placebo group (change in height from baseline difference, -0.2 cm; 95% CI, -1.1 to 0.6) 2 years after discontinuation of study treatment. In post hoc analyses children 2 years old who weighed less than 15 kg at enrollment and were treated with fluticasone had less linear growth compared with those treated with placebo (change in height from baseline difference, -1.6 cm; 95% CI, -2.8 to -0.4; P = .009). Linear growth was not significantly different in high-risk preschool-aged children with recurrent wheezing treated with 176 μg/d chlorofluorocarbon-delivered fluticasone compared with placebo 2 years after fluticasone is discontinued. However, post hoc subgroup analyses revealed that children who are younger in age and of lesser weight relative to the entire study cohort had significantly less linear growth, possibly because of a higher relative fluticasone exposure.
    The Journal of allergy and clinical immunology 08/2011; 128(5):956-63.e1-7. · 12.05 Impact Factor
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    Vanessa A Curtis, David B Allen
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    ABSTRACT: CONTEXT: The indications for use of growth hormone (GH) have broadened with the availability of unlimited recombinant human growth hormone (rhGH). The FDA's approval for use of growth hormone in GH-sufficient patients with idiopathic short stature includes some children with constitutional delay of growth and puberty (CGD), a normal growth pattern variation which includes delayed puberty and prolonged linear growth, usually leading to normal adult height. Use of rhGH to increase growth in short-statured children with CGD has been challenged for its modest efficacy in increasing ultimate height, high cost, limited evidence for psychosocial benefit, and some unresolved concerns about long-term post-treatment safety. An additional controversy for the young athlete with CGD is the concern for fairness in competition. EVIDENCE ACQUISITION: Data sources were limited to peer-reviewed publications. RESULTS: RhGH is a safe and effective therapy for increasing growth rate in very short children with CGD, but does not markedly increase ultimate stature nor confer a clear benefit in athletic performance. (SORT A) CONCLUSIONS: Prescribing physicians should use rhGH treatment responsibly to bring children disabled by short stature just into the "normal" range. (SORT C).
    Sports health. 01/2011; 3(1):32-40.
  • David B Allen
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    ABSTRACT: Recombinant human growth hormone (rhGH) is approved in the United States for treatment of idiopathic short stature (ISS). The occurrence of adverse events (AEs) and the long-term safety of rhGH treatment in this patient population are reviewed. Data were analyzed from postmarketing surveillance studies that included ISS patients, prospective ISS treatment trials and studies of specific AEs in smaller groups of rhGH-treated children. Frequency rates of targeted AEs (i.e., scoliosis, slipped capital femoral epiphysis, intracranial hypertension, pancreatitis) in patients with ISS are similar to or lower than the rates observed in other rhGH-treated conditions. At dosages of 0.24-0.37 mg/kg/week, rhGH treatment in children with ISS does not adversely affect blood glucose levels. At dosages ≥ 0.3 mg/kg/week, a dose-dependent increase in mean fasting and stimulated insulin levels is observed. Current evidence derived from 'on-treatment' surveillance studies suggests that rhGH does not increase the risk for new malignancies in children with ISS.The safety profile of rhGH at doses ≤ 0.37 mg/kg/week for the treatment of children with ISS is similar to or better than the profile seen in other rhGH-treated conditions and is not associated with any predictable AEs. Due to a continuing trend toward dose escalation to achieve greater height-promoting effects and the possibility of delayed post-treatment effects of hyperinsulinemia and/or heightened GH and insulin-like growth factor I exposure on cancer risk, caution and ongoing scrutiny of risks versus benefits are warranted.
    Hormone Research in Paediatrics 01/2011; 76 Suppl 3:45-7. · 1.55 Impact Factor
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    ABSTRACT: Conjugated linoleic acid (CLA) is a supplemental dietary fatty acid that decreases fat mass accretion in young animals. The aim of this study was to determine CLA's efficacy with regard to change in fat and body mass index (BMI; in kg/m(2)) in children. We conducted a 7 +/- 0.5-mo randomized, double-blind, placebo-controlled trial of CLA in 62 prepubertal children aged 6-10 y who were overweight or obese but otherwise healthy. The subjects were randomly assigned to receive 3 g/d of 80% CLA (50:50 cis-9,trans-11 and trans-10,cis-12 isomers) or placebo in chocolate milk. Fifty-three subjects completed the trial (n = 28 in the CLA group, n = 25 in the placebo group). CLA attenuated the increase in BMI (0.5 +/- 0.8) compared with placebo (1.1 +/- 1.1) (P = 0.05). The percentage change in body fat measured by dual-energy X-ray absorptiometry was smaller (P = 0.001) in the CLA group (-0.5 +/- 2.1%) than in the placebo group (1.3 +/- 1.8%). The change in abdominal body fat as a percentage of total body weight was smaller (P = 0.02) in the CLA group (-0.09 +/- 0.9%) than in the placebo group (0.43 +/- 0.6%). There were no significant changes in plasma glucose, insulin, or LDL cholesterol between groups. Plasma HDL cholesterol decreased significantly more (P = 0.05) in the CLA group (-5.1 +/- 7.3 mg/dL) than in the placebo group (-0.7 +/- 8 mg/dL). Bone mineral accretion was lower (P = 0.04) in the CLA group (0.05 +/- 0.03 kg) than in the placebo group (0.07 +/- 0.03 kg). Reported gastrointestinal symptoms did not differ significantly between groups. CLA supplementation for 7 +/- 0.5 mo decreased body fatness in 6-10-y-old children who were overweight or obese but did not improve plasma lipids or glucose and decreased HDL more than in the placebo group. Long-term investigation of the safety and efficacy of CLA supplementation in children is recommended.
    American Journal of Clinical Nutrition 03/2010; 91(5):1157-64. · 6.50 Impact Factor
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    ABSTRACT: Background: Children with Prader-Willi syndrome (PWS) have decreased muscle mass, hypotonia, and impaired linear growth. Recombinant human GH (hGH) treatment reportedly improves body composition and physical function in children with PWS, but these studies lack long-term control data. To assess the impact of hGH therapy begun early in life on the natural history of PWS, we compared height, body composition, and strength in similar-age children with PWS naïve to hGH with those treated with hGH for 6 yr. Objectives: Forty-eight children with PWS were studied: 21 subjects (aged 6-9 yr) treated with hGH for 6 yr (beginning at 4-32 months, mean 13 +/- 6 months) were compared with 27 children of similar age (5-9 yr) prior to treatment with hGH. Percent body fat, lean body mass, carbohydrate/lipid metabolism, and motor strength were compared using analysis of covariance. Results: PWS children treated with hGH demonstrated lower body fat (mean, 36.1 +/- 2.1 vs. 44.6 +/- 1.8%, P < 0.01), greater height (131 +/- 2 vs. 114 +/- 2 cm; P < 0.001), greater motor strength [increased standing broad jump 22.9 +/- 2.1 vs. 14.6 +/- 1.9 in. (P < 0.001) and sit-ups 12.4 +/- 0.9 vs. 7.1 +/- 0.7 in 30 sec (P < 0.001)], increased high-density lipoprotein cholesterol (58.9 +/- 2.6 vs. 44.9 +/- 2.3 mg/dl, P < 0.001), decreased low-density lipoprotein (100 +/- 8 vs. 131 +/- 7 mg/dl, P < 0.01), and no difference in fasting glucose or insulin. Conclusions: hGH treatment in children with PWS, begun prior to 2 yr of age, improves body composition, motor function, height, and lipid profiles. The magnitude of these effects suggests that long-term hGH therapy favorably alters the natural history of PWS to an extent that exceeds risks and justifies consideration for initiation during infancy.
    The Journal of clinical endocrinology and metabolism 03/2010; 95(3):1131-6. · 6.50 Impact Factor
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    ABSTRACT: Objectives. To determine the sedative and respiratory effects of clonidine when used to evaluate growth hormone (GH) secretion in children with Prader Willi Syndrome (PWS). Methods. The study prospectively evaluated children with PWS who received clonidine (0.15 mg/m(2)) to assess GH responsiveness. Patients were studied up to four times over three years. Vital signs, oxygen saturation, and sedation level were recorded at baseline and every five minutes following clonidine. Changes between baseline and post-clonidine were evaluated using a repeated measurement analysis. Results. Sixty studies were performed on 17 patients, mean age 30.4 +/- 15.0 months. The mean +/- SD dose of clonidine was 0.074 +/- 0.027 mg (5.3 +/- 1.72 mcg/kg). All patients achieved a sedation score of 4 to 5 (drowsy to asleep). Mean declines in respiratory rate (7.5 +/- 6.1 breaths/min; P < .001), and oxygen saturation (2.2 +/- 2.0%; P < .001) occurred following clonidine. Five patients (29%) experienced oxygen saturations </=94% on nine occasions. Three oxygen desaturations were accompanied by partial airway obstruction. Conclusions. Clonidine doses to assess GH secretion often exceed doses used for sedation and result in significant respiratory depression in some children with PWS. There was no association between oxygen desaturation and BMI.
    International Journal of Pediatric Endocrinology 01/2010; 2010:103742.
  • David B Allen
    The Journal of clinical endocrinology and metabolism 01/2010; 95(1):52-5. · 6.50 Impact Factor
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    ABSTRACT: Publication of an account of growth attenuation with high-dose estrogen in a child with profound physical and cognitive disability brought widespread attention to a common and complex issue faced by families caring for similarly affected children, namely, the potentially negative effect of the increasing size of a child on the ability of his or her family to provide independent care, which in turn makes it more difficult for parents to keep the child in the home and involved in family activities. In this article we explore the scientific rationale for, effectiveness and safety of, and ethical considerations bearing on growth-attenuation treatment of children with profound and permanent cognitive disability. Informed responses to key clinically relevant questions are proposed. Our analysis suggests that growth attenuation is an innovative and sufficiently safe therapy that offers the possibility of an improved quality of life for nonambulatory children with profound cognitive disability and their families. Pediatricians and other care providers should include discussion of these options as part of anticipatory guidance around the age of 3 years so that, if elected, potential clinically meaningful benefits of growth-attenuation therapy can be realized. Because of the publicity and debate surrounding the first reported case, ethics consultation is recommended.
    PEDIATRICS 07/2009; 123(6):1556-61. · 4.47 Impact Factor
  • M Tracy Bekx, Ellen C Connor, David B Allen
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    ABSTRACT: To characterize patients referred to the adolescent polycystic ovarian syndrome (PCOS) clinic at the American Family Children's Hospital, University of Wisconsin, Madison, Wisconsin. Chart review of patients seen in the first 33 months for details of initial presentation, age, body mass index (BMI), menstrual pattern, clinical and laboratory features of androgen excess, insulin resistance, and dyslipidemia. Multidisciplinary clinic for adolescents with PCOS at the American Family Children's Hospital, Madison, Wisconsin. Adolescent girls with PCOS. Seventy patients (84% Caucasian) presented with an average age at referral of 16.2 years (range 11-22 y). Eighty four percent had a BMI > the 85(th) percentile and 70% had a BMI > 95(th) percentile. Menstrual pattern was quite varied, with some patients having primary amenorrhea, and over 50% experiencing hirsutism. There were 3 cases of type 2 diabetes, and over half of the patients had elevated fasting insulin levels and low HDL levels. Polycystic ovarian syndrome is a complex and heterogeneous disorder that requires multidisciplinary expertise. Knowing the unique features of the adolescent with PCOS and metabolic risks should permit earlier intervention with intensive counseling and medical therapy to address current health concerns and prevent future co-morbidities.
    Journal of pediatric and adolescent gynecology 07/2009; 23(1):7-10. · 0.90 Impact Factor
  • Aaron L Carrel, David B Allen
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    ABSTRACT: An increasingly pervasive environment of reduced activity and easy access to high caloric food is leading to an epidemic of poor cardiovascular fitness, obesity, insulin resistance and type 2 diabetes (T2DM) in children. Studies have shown that insulin resistance (IR) to be an independent predictor for morbidity as well as mortality. These serve as a strong stimulus for public health strategies to improve fitness in children and adolescents. Methods to assess IR, improve IR and understand complications are increasingly important in children.
    Reviews in Endocrine and Metabolic Disorders 06/2009; 10(3):189-96. · 4.58 Impact Factor
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    ABSTRACT: Poor cardiovascular fitness (CVF) is a risk factor for obesity, as well as insulin resistance (IR), inflammation, and cardiovascular disease. We have previously shown that a school-based fitness curriculum can improve CVF, as well as IR and body composition in obese children. Whether such a program improves CVF, IR, and other health indicators in non-obese children is unresolved. To determine whether a school-based fitness program improves body composition, CVF, markers of inflammation (e.g. CRP, TNF-alpha, adiponectin), and insulin sensitivity in nonobese children. 35 non-obese middle school children with body mass index below the 95th percentile for age were enrolled in a 'fitness-oriented' gym class. Children underwent fasting evaluation of insulin, glucose, adiponectin, CRP, TNF-alpha, body composition by dual X-ray absorptiometry (DXA), and maximal VO2 treadmill testing at baseline (prior to the school year) and again at end of the school year. Testing for CVF (maximal VO2 treadmill testing), DXA, and fasting evaluation of insulin, glucose, adiponectin, CRP and TNF-alpha. Children demonstrated a decrease in BMI z-score (-0.14 +/- 0.33, p = 0.02), HOMA-IR (-0.15 +/- 0.35, p = 0.016), and TNF-alpha (-2.55 +/- 1.79 pg/ml, p < 0.001), and an increase in VO2(max) (+1.58 +/- 2.34 ml/kg/min, p < 0.001), adiponectin (+7,553 +/- 11,100 ng/ml, p < 0.001), and muscle mass (+2,282 +/- 1,882.73 g, p < 0.001) after nine months of study. The school-based fitness oriented curriculum resulted in improved body composition and insulin sensitivity, increased CVF, and decreased inflammation in non-obese children. Combined with prior studies, these data demonstrate that school-based fitness curricula can benefit both obese and non-obese children. Partnerships with schools to promote fitness should be part of a public health approach to improving children's health.
    Journal of pediatric endocrinology & metabolism: JPEM 06/2009; 22(5):409-15. · 0.75 Impact Factor

Publication Stats

1k Citations
314.50 Total Impact Points

Institutions

  • 2002–2014
    • University of Wisconsin–Madison
      • Department of Pediatrics
      Madison, Wisconsin, United States
  • 2012
    • University of Iowa
      • Department of Pediatrics
      Iowa City, IA, United States
  • 2007
    • The Ohio State University
      Columbus, Ohio, United States
    • Saint Louis University
      • Department of Pediatrics
      Saint Louis, MI, United States
    • University of Cincinnati
      • Department of Internal Medicine
      Cincinnati, OH, United States
  • 2003–2007
    • Children's Hospital of Wisconsin
      Madison, Wisconsin, United States