human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: PURPOSE The purpose of this study was to describe levels of inflammation markers in Norwegian children and to examine the associations of adiposity , aerobic fitness , and muscle fitness with markers of inflammation . METHODS In 2005 - 2006 , 1467 nine-year-olds were r and omly selected from all regions in Norway . The participation rate was 89 % . The inflammatory markers evaluated included C-reactive protein ( CRP ) , leptin , adiponectin , plasminogen activator inhibitor-1 , tumor necrosis factor-α , hepatocyte growth factor , resistin , and interleukin-6 . We assessed muscular strength by measuring  explosive , isometric , and endurance strength . Aerobic fitness was measured directly during a maximal cycle ergometer test .  Adiposity was expressed as waist circumference ( WC ) . RESULTS The girls had significantly higher levels of CRP , leptin , adiponectin , and resistin and lower levels of tumor necrosis factor-α compared with the boys . We observed a grade d association of CRP and leptin levels across quintiles of WC , aerobic fitness , and muscle fitness ( P ≤ 0.001 for all participants ) . The regression analyses revealed that WC , aerobic fitness , and muscle fitness were independently associated with the CRP ( WC β = 0.158 , P < 0.001 ; aerobic fitness β = -0.190 , P < 0.001 ; muscle fitness β = -0.122 , P < 0.002 ) after adjustments for sex , age , Tanner pubertal stage , and the other independent variables . The same pattern was observed for leptin levels ( WC β = 0.406 , P < 0.001 ; aerobic fitness β = -0.298 , P < 0.001 ; muscle fitness β = -0.064 , P < 0.036 ) . CONCLUSIONS These data represent a reference material with respect to inflammatory markers . Our results show that adiposity , aerobic fitness , and muscle fitness were independently associated with the CRP and leptin levels Our aim is to analyse the effect on bone mass of : ( 1 ) physical fitness performance on a specific group of physical activity ( PA ) and , ( 2 ) PA on a specific physical fitness performance group . Bone mineral content ( BMC ) by dual energy X-ray absorptiometry ( DXA ) and PA by accelerometers was assessed in 373 Spanish adolescents ( 182 males ) . Adolescents were classified as : active and non-active ( ≥60 or < 60 min day−1 of moderate-vigorous PA ) . Fitness was assessed through speed/agility , strength and cardiorespiratory tests . Adolescents were classified by tertiles ( T1 , T2 and T3 ) . ANCOVA was used for the analysis with sex , height , lean mass , calcium intake and pubertal status as covariates . Adolescents with lower strength , speed/agility and cardiorespiratory fitness ( CRF ) showed lower BMC in the whole body and extremities compared with adolescents with better results in these tests , mainly those non-active adolescents . Non-active adolescents with high fitness levels showed higher BMC ( whole body and upper limbs ) than active ones . The conclusions included : ( 1 ) within the non-active group , lower levels of fitness were associated with lower BMC ; this might be through PA or trough an effect of PA on muscle mass . ( 2 ) Non-active adolescents with high level of fitness in most fitness tests showed higher BMC than their active peers , in spite of their lower PA levels . These unexpected results could be influenced by several factors such as genetics , nutrition , type of exercise or sport , hormones and skeletal age OBJECTIVE The purpose of this study was to examine differences in cardiovascular disease ( CVD ) risk factors across four cross-tabulated groups of cardiorespiratory fitness and body mass index in 8- to 18-year-old children and adolescents . METHODS The sample included 296 boys and 188 girls ( mean age=15.7 years ) participating in the Aerobics Center Longitudinal Study . Participants were cross tabulated into four groups using a median split of age-adjusted treadmill time to exhaustion ( TM ) and body mass index ( BMI ) . Group differences in CVD risk factors ( blood pressure [ BP ] , fasting total cholesterol [ TC ] , low density lipoprotein-cholesterol [ LDL-C ] , high density lipoprotein-cholesterol [ HDL-C ] , TC : HDL-C , triglycerides [ TG ] , glucose , and a metabolic syndrome score ) were examined by ANCOVA , controlling for age . RESULTS In males , significant differences across groups were observed for systolic BP , mean arterial pressure ( MAP ) , TC , LDL-C , TC : HDL-C and the metabolic syndrome score ( p<0.05 ) . In females , only TG was significantly different across groups ( p<0.05 ) . A trend for significance was also observed for DBP and TG in males ( p=0.09 to 0.11 ) and diastolic BP , MAP , HDL-C , and the metabolic syndrome score in females ( p=0.14 to 0.16 ) . In general , males and females in the low BMI group , either fit or unfit , had lower BP and blood lipid values than those in the high BMI group . In both sexes , the high BMI /low fit group had the highest ( most adverse ) metabolic syndrome score . CONCLUSION This study utilized a unique approach to examine the possible interaction of fitness and fatness on CVD risk factors in children and adolescents . The results provide some evidence for the consideration of both variables when interpreting CVD risk factors in young people Aims : To investigate how physical activity , physical performance and sociodemographic characteristics at the age of 16 are related to adult health habits ( physical activity , dietary intake , smoking ) and biological risk factors for cardiovascular diseases ( being overweight , low aerobic fitness , unfavorable levels of serum lipids , high blood pressure ) . Methods : A r and omly selected group of 220 male and 205 female students at 16 years of age was tested in 1974 , and reinvestigated 18 years later . Results : The predictive health profiles for adult lifestyle and biological risk factors were different in men and women . Leisure sports activity along with high performance in the nine-minute run among the boys and in the two-h and lift test among the girls were significant predictors of adult physical activity . A positive attitude to aerobic exercise  and high performance in the nine-minute run test among the boys and high marks in physical education among the girls decreased the risk of smoking .  Leisure sports activities together with body mass index at young ages were the most powerful predictors of adult biological risk factors , but attitudes to sports and educational level were also significant determinants . Conclusion : These results contribute to the knowledge of which factors at young ages may promote adult healthy habits in particular physical activities Cardiovascular disease is recognized as a serious public health problem . Because the underlying pathological processes start shortly after birth , tracking of recognized cardiovascular disease indicators during childhood and adolescence can help in developing preventive pediatric strategies . A prospect i ve follow-up of both genetic and behavioral lifestyle parameters ( serum cholesterol , blood pressure , percentage body fat , maximal oxygen uptake ( VO2max ) , smoking , physical inactivity , and type A behavior ) was design ed . In the Amsterdam Growth and Health Study a population of 93 males and 107 females was measured annually from 1977 to 1980 and a fifth measurement was made in 1985 . In that way longitudinal data covering a period of 8 years was collected for a group of adolescents/adults between 13 and 21 years of age . Analyses of these parameters provided the following results : The stability over the 9 years of tracking cardiovascular disease indicators , measured as the interperiod correlations , is fairly high . It varies from 0.4 to 0.8 in percentage body fat , cholesterol , and VO2max . Blood pressure values are low ( between 0.3 and 0.4 ) . The probability of 13-year-olds having relatively high values of cardiovascular disease indicators on the basis of a quartile distribution with that at age 21 indicated a moderate to high predictive value . According to the literature , the levels of subjects that are continuously relatively high over the years are more in the direction of optimal health than risk values . The exception is for percentage body fat . Interrelation of the seven cardiovascular disease indicators in constantly relatively high-risk and relatively low-risk groups during the teenage period , measured during young adulthood ( 21.5 years ) , appeared to be weak : only males and females with a high percentage body fat and a low VO2max showed significantly high total cholesterol , low high-density lipoprotein cholesterol , and high total cholesterol/high-density lipoprotein cholesterol levels . From the three environmental cardiovascular disease indicators ( smoking , physical activity , and type A/B behavior ) measured in 1985 , only physical activity was significantly correlated among males and females with high-density lipoprotein cholesterol , percentage body fat , and VO2max . It can be concluded that measurement of percentage body fat in the early teenage period seems to be the most important cardiovascular disease indicator in predicting risk levels in the young adult . The amount of physical activity measured at young adult age is the only behavioral parameter to show a significant interrelation with other cardiovascular disease risk indicators . ( ABSTRACT TRUNCATED AT 400 WORDS BACKGROUND Childhood obesity has been inconsistently associated with decreased levels of physical activity and fitness . Moreover , little is known about this relationship among Filipino preteens . METHODS This cross sectional study reports the association between childhood obesity , measures of physical activity , and fitness .  Children aged 11 to 12 from r and omly selected schools from San Juan , Metromanila were included . Outcome measures were body mass index , Filipino modified Physical Activity Question naire for Older children ( F_PAQ-C ) ,  st and ing broad jump , 50 m sprint  and  20 m multistage shuttle run .  RESULTS 380 children participated in the study . Obese children had significantly lower median scores in the F_PAQ-C compared with overweight children . Overweight children had lower scores in the st and ing broad jump , 50 m sprints and predicted VO2max as compared with children with normal BMI . There were modest associations between the 50 m sprint , predicted VO2max , and F_PAQ-C. CONCLUSION Our study has showed that physical activity and fitness scores were strongly correlated with childhood obesity . If childhood physical fitness is a predictor of physical fitness in adulthood which is a risk factor in cardiovascular diseases , there is a strong possibility that the prevalence of cardiovascular disease in the Philippines will increase dramatically in the future OBJECTIVES We sought to characterize the impact of obesity on vascular function in adolescents and to determine whether an exercise program reverses abnormalities in endothelial function . BACKGROUND Obesity , a major modifiable risk factor for cardiovascular disease , is epidemic in Western societies , with rapid rates of increase in the young . Atherosclerosis begins in childhood , and endothelial dysfunction is its earliest detectable manifestation . METHODS The influence of eight weeks of circuit training ( CT ) was examined in 19 obese subjects ( 14.3 + /- 1.5 years ) , using a r and omized , crossover protocol . Functional capacity and muscular strength were assessed by st and ard techniques .  Body composition was examined using anthropometric measures and dual-energy X-ray absorptiometry .  Conduit vessel endothelial function was assessed using high-resolution ultrasound and flow-mediated dilation ( FMD ) of the brachial artery . RESULTS Circuit training decreased abdominal and trunk fat and significantly improved fitness and muscular strength ( p < 0.05 ) . In the obese group , FMD was significantly impaired relative to control subjects ( n = 20 ) at entry ( 5.3 + /- 0.9 % vs. 8.9 + /- 1.5 % , p < 0.05 ) and was normalized after CT ( 8.8 + /- 0.8 % , p < 0.05 ) . CONCLUSIONS Circuit training improved functional capacity , muscular strength , and body composition in obese adolescents . Furthermore , conduit vessel function was normalized after exercise training . If vascular dysfunction is an integral component of the pathogenesis of vascular disease , this study supports the value of an exercise program in the management of obese adolescents ABSTRACT The primary purpose of this study was to compare two  mother-daughter interventions design ed to increase fitness and activity and improve physical self-perception ( PSP ) . A secondary purpose was to test two of the proposed mechanisms for using physical activity to enhance PSP .  Twenty mother-daughter pairs ( n = 40 ) were r and omly assigned to a  university-based ( UB ) or home-based ( HB ) group . Initially , both groups received classroom training design ed to improve PSP . Then , the UB group met three times per week , whereas the HB group received information concerning home-based activities . The Fitnessgram ® activity question naire and fitness test battery were used to measure physical activity and fitness level . The Physical Self-Perception Profile ( PSPP ) was used to detect changes in PSP . Separate 2 ( group ) × 2 ( age ) × 2 ( time ) ANOVAs with repeated measures on the last factor were conducted to examine changes in PSP , 
    Output:
    
agent
Results Strong evidence was found for an inverse association between MF and total and central adiposity , and CVD and metabolic risk factors .
Strong evidence was also found for a positive association between MF and bone health and self-esteem .
Conclusion The findings of this review highlight the importance of developing MF in youth for a number of health-related benefits
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: PURPOSE The purpose of this study was to describe levels of inflammation markers in Norwegian children and to examine the associations of adiposity , aerobic fitness , and muscle fitness with markers of inflammation . METHODS In 2005 - 2006 , 1467 nine-year-olds were r and omly selected from all regions in Norway . The participation rate was 89 % . The inflammatory markers evaluated included C-reactive protein ( CRP ) , leptin , adiponectin , plasminogen activator inhibitor-1 , tumor necrosis factor-α , hepatocyte growth factor , resistin , and interleukin-6 . We assessed muscular strength by measuring  explosive , isometric , and endurance strength . Aerobic fitness was measured directly during a maximal cycle ergometer test .  Adiposity was expressed as waist circumference ( WC ) . RESULTS The girls had significantly higher levels of CRP , leptin , adiponectin , and resistin and lower levels of tumor necrosis factor-α compared with the boys . We observed a grade d association of CRP and leptin levels across quintiles of WC , aerobic fitness , and muscle fitness ( P ≤ 0.001 for all participants ) . The regression analyses revealed that WC , aerobic fitness , and muscle fitness were independently associated with the CRP ( WC β = 0.158 , P < 0.001 ; aerobic fitness β = -0.190 , P < 0.001 ; muscle fitness β = -0.122 , P < 0.002 ) after adjustments for sex , age , Tanner pubertal stage , and the other independent variables . The same pattern was observed for leptin levels ( WC β = 0.406 , P < 0.001 ; aerobic fitness β = -0.298 , P < 0.001 ; muscle fitness β = -0.064 , P < 0.036 ) . CONCLUSIONS These data represent a reference material with respect to inflammatory markers . Our results show that adiposity , aerobic fitness , and muscle fitness were independently associated with the CRP and leptin levels Our aim is to analyse the effect on bone mass of : ( 1 ) physical fitness performance on a specific group of physical activity ( PA ) and , ( 2 ) PA on a specific physical fitness performance group . Bone mineral content ( BMC ) by dual energy X-ray absorptiometry ( DXA ) and PA by accelerometers was assessed in 373 Spanish adolescents ( 182 males ) . Adolescents were classified as : active and non-active ( ≥60 or < 60 min day−1 of moderate-vigorous PA ) . Fitness was assessed through speed/agility , strength and cardiorespiratory tests . Adolescents were classified by tertiles ( T1 , T2 and T3 ) . ANCOVA was used for the analysis with sex , height , lean mass , calcium intake and pubertal status as covariates . Adolescents with lower strength , speed/agility and cardiorespiratory fitness ( CRF ) showed lower BMC in the whole body and extremities compared with adolescents with better results in these tests , mainly those non-active adolescents . Non-active adolescents with high fitness levels showed higher BMC ( whole body and upper limbs ) than active ones . The conclusions included : ( 1 ) within the non-active group , lower levels of fitness were associated with lower BMC ; this might be through PA or trough an effect of PA on muscle mass . ( 2 ) Non-active adolescents with high level of fitness in most fitness tests showed higher BMC than their active peers , in spite of their lower PA levels . These unexpected results could be influenced by several factors such as genetics , nutrition , type of exercise or sport , hormones and skeletal age OBJECTIVE The purpose of this study was to examine differences in cardiovascular disease ( CVD ) risk factors across four cross-tabulated groups of cardiorespiratory fitness and body mass index in 8- to 18-year-old children and adolescents . METHODS The sample included 296 boys and 188 girls ( mean age=15.7 years ) participating in the Aerobics Center Longitudinal Study . Participants were cross tabulated into four groups using a median split of age-adjusted treadmill time to exhaustion ( TM ) and body mass index ( BMI ) . Group differences in CVD risk factors ( blood pressure [ BP ] , fasting total cholesterol [ TC ] , low density lipoprotein-cholesterol [ LDL-C ] , high density lipoprotein-cholesterol [ HDL-C ] , TC : HDL-C , triglycerides [ TG ] , glucose , and a metabolic syndrome score ) were examined by ANCOVA , controlling for age . RESULTS In males , significant differences across groups were observed for systolic BP , mean arterial pressure ( MAP ) , TC , LDL-C , TC : HDL-C and the metabolic syndrome score ( p<0.05 ) . In females , only TG was significantly different across groups ( p<0.05 ) . A trend for significance was also observed for DBP and TG in males ( p=0.09 to 0.11 ) and diastolic BP , MAP , HDL-C , and the metabolic syndrome score in females ( p=0.14 to 0.16 ) . In general , males and females in the low BMI group , either fit or unfit , had lower BP and blood lipid values than those in the high BMI group . In both sexes , the high BMI /low fit group had the highest ( most adverse ) metabolic syndrome score . CONCLUSION This study utilized a unique approach to examine the possible interaction of fitness and fatness on CVD risk factors in children and adolescents . The results provide some evidence for the consideration of both variables when interpreting CVD risk factors in young people Aims : To investigate how physical activity , physical performance and sociodemographic characteristics at the age of 16 are related to adult health habits ( physical activity , dietary intake , smoking ) and biological risk factors for cardiovascular diseases ( being overweight , low aerobic fitness , unfavorable levels of serum lipids , high blood pressure ) . Methods : A r and omly selected group of 220 male and 205 female students at 16 years of age was tested in 1974 , and reinvestigated 18 years later . Results : The predictive health profiles for adult lifestyle and biological risk factors were different in men and women . Leisure sports activity along with high performance in the nine-minute run among the boys and in the two-h and lift test among the girls were significant predictors of adult physical activity . A positive attitude to aerobic exercise  and high performance in the nine-minute run test among the boys and high marks in physical education among the girls decreased the risk of smoking .  Leisure sports activities together with body mass index at young ages were the most powerful predictors of adult biological risk factors , but attitudes to sports and educational level were also significant determinants . Conclusion : These results contribute to the knowledge of which factors at young ages may promote adult healthy habits in particular physical activities Cardiovascular disease is recognized as a serious public health problem . Because the underlying pathological processes start shortly after birth , tracking of recognized cardiovascular disease indicators during childhood and adolescence can help in developing preventive pediatric strategies . A prospect i ve follow-up of both genetic and behavioral lifestyle parameters ( serum cholesterol , blood pressure , percentage body fat , maximal oxygen uptake ( VO2max ) , smoking , physical inactivity , and type A behavior ) was design ed . In the Amsterdam Growth and Health Study a population of 93 males and 107 females was measured annually from 1977 to 1980 and a fifth measurement was made in 1985 . In that way longitudinal data covering a period of 8 years was collected for a group of adolescents/adults between 13 and 21 years of age . Analyses of these parameters provided the following results : The stability over the 9 years of tracking cardiovascular disease indicators , measured as the interperiod correlations , is fairly high . It varies from 0.4 to 0.8 in percentage body fat , cholesterol , and VO2max . Blood pressure values are low ( between 0.3 and 0.4 ) . The probability of 13-year-olds having relatively high values of cardiovascular disease indicators on the basis of a quartile distribution with that at age 21 indicated a moderate to high predictive value . According to the literature , the levels of subjects that are continuously relatively high over the years are more in the direction of optimal health than risk values . The exception is for percentage body fat . Interrelation of the seven cardiovascular disease indicators in constantly relatively high-risk and relatively low-risk groups during the teenage period , measured during young adulthood ( 21.5 years ) , appeared to be weak : only males and females with a high percentage body fat and a low VO2max showed significantly high total cholesterol , low high-density lipoprotein cholesterol , and high total cholesterol/high-density lipoprotein cholesterol levels . From the three environmental cardiovascular disease indicators ( smoking , physical activity , and type A/B behavior ) measured in 1985 , only physical activity was significantly correlated among males and females with high-density lipoprotein cholesterol , percentage body fat , and VO2max . It can be concluded that measurement of percentage body fat in the early teenage period seems to be the most important cardiovascular disease indicator in predicting risk levels in the young adult . The amount of physical activity measured at young adult age is the only behavioral parameter to show a significant interrelation with other cardiovascular disease risk indicators . ( ABSTRACT TRUNCATED AT 400 WORDS BACKGROUND Childhood obesity has been inconsistently associated with decreased levels of physical activity and fitness . Moreover , little is known about this relationship among Filipino preteens . METHODS This cross sectional study reports the association between childhood obesity , measures of physical activity , and fitness .  Children aged 11 to 12 from r and omly selected schools from San Juan , Metromanila were included . Outcome measures were body mass index , Filipino modified Physical Activity Question naire for Older children ( F_PAQ-C ) ,  st and ing broad jump , 50 m sprint  and  20 m multistage shuttle run .  RESULTS 380 children participated in the study . Obese children had significantly lower median scores in the F_PAQ-C compared with overweight children . Overweight children had lower scores in the st and ing broad jump , 50 m sprints and predicted VO2max as compared with children with normal BMI . There were modest associations between the 50 m sprint , predicted VO2max , and F_PAQ-C. CONCLUSION Our study has showed that physical activity and fitness scores were strongly correlated with childhood obesity . If childhood physical fitness is a predictor of physical fitness in adulthood which is a risk factor in cardiovascular diseases , there is a strong possibility that the prevalence of cardiovascular disease in the Philippines will increase dramatically in the future OBJECTIVES We sought to characterize the impact of obesity on vascular function in adolescents and to determine whether an exercise program reverses abnormalities in endothelial function . BACKGROUND Obesity , a major modifiable risk factor for cardiovascular disease , is epidemic in Western societies , with rapid rates of increase in the young . Atherosclerosis begins in childhood , and endothelial dysfunction is its earliest detectable manifestation . METHODS The influence of eight weeks of circuit training ( CT ) was examined in 19 obese subjects ( 14.3 + /- 1.5 years ) , using a r and omized , crossover protocol . Functional capacity and muscular strength were assessed by st and ard techniques .  Body composition was examined using anthropometric measures and dual-energy X-ray absorptiometry .  Conduit vessel endothelial function was assessed using high-resolution ultrasound and flow-mediated dilation ( FMD ) of the brachial artery . RESULTS Circuit training decreased abdominal and trunk fat and significantly improved fitness and muscular strength ( p < 0.05 ) . In the obese group , FMD was significantly impaired relative to control subjects ( n = 20 ) at entry ( 5.3 + /- 0.9 % vs. 8.9 + /- 1.5 % , p < 0.05 ) and was normalized after CT ( 8.8 + /- 0.8 % , p < 0.05 ) . CONCLUSIONS Circuit training improved functional capacity , muscular strength , and body composition in obese adolescents . Furthermore , conduit vessel function was normalized after exercise training . If vascular dysfunction is an integral component of the pathogenesis of vascular disease , this study supports the value of an exercise program in the management of obese adolescents ABSTRACT The primary purpose of this study was to compare two  mother-daughter interventions design ed to increase fitness and activity and improve physical self-perception ( PSP ) . A secondary purpose was to test two of the proposed mechanisms for using physical activity to enhance PSP .  Twenty mother-daughter pairs ( n = 40 ) were r and omly assigned to a  university-based ( UB ) or home-based ( HB ) group . Initially , both groups received classroom training design ed to improve PSP . Then , the UB group met three times per week , whereas the HB group received information concerning home-based activities . The Fitnessgram ® activity question naire and fitness test battery were used to measure physical activity and fitness level . The Physical Self-Perception Profile ( PSPP ) was used to detect changes in PSP . Separate 2 ( group ) × 2 ( age ) × 2 ( time ) ANOVAs with repeated measures on the last factor were conducted to examine changes in PSP , 
    Output:
    