Abstract

Children with obesity are at higher risk for developing cardiometabolic diseases that once were considered health conditions of adults. Obesity is commonly associated with cardiometabolic risk factors such as dyslipidemia, hyperglycemia, hyperinsulinemia and hypertension that contribute to the development of endothelial dysfunction. Endothelial dysfunction, characterized by reduced nitric oxide (NO) production, precedes vascular abnormalities including atherosclerosis and arterial stiffness. Thus, early detection and treatment of cardiometabolic risk factors are necessary to prevent deleterious vascular consequences of obesity at an early age. Non-pharmacological interventions including L-Citrulline (L-Cit) supplementation and aerobic training stimulate endothelial NO mediated vasodilation, leading to improvements in organ perfusion, blood pressure, arterial stiffness, atherosclerosis and metabolic health (glucose control and lipid profile). Few studies suggest that the combination of L-Cit supplementation and exercise training can be an effective strategy to counteract the adverse effects of obesity on vascular function in older adults. Therefore, this review examined the efficacy of L-Cit supplementation and aerobic training interventions on vascular and metabolic parameters in obese individuals.

Highlights

  • IntroductionPublisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations

  • L-Cit supplementation increases the bioavailability of L-Arg and nitric oxide (NO) to enhance vasodilation [22,23,26], improve arterial stiffness, and regulate blood pressure by having an antihypertensive effect in adults [23,24], and may improve endothelial function in children and adolescents with obesity with lower NO production and endothelial dysfunction [102,103]

  • Children and adolescents with obesity may have early vascular aging characterized by endothelial dysfunction, elevated blood pressure, arterial stiffness, and multiple cardiometabolic risk factors that increases the risk of cardiovascular diseases (CVD) development in adulthood

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Summary

Introduction

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Overweight and obesity are defined as abnormal or excessive fat accumulation [1]. The World Health Organization (WHO) defines obesity as a Body Mass Index (BMI). Greater than or equal to 30 kg/m2 , and for children aged between 5–19 years, obesity is considered two standard deviations above the WHO Growth Reference median [1]. 340 million children and adolescents worldwide were classified as overweight or obese in 2016 and the prevalence is dramatically increasing [1,2]. The prevalence of hypertension is greater than 70% and increases with progression of obesity grade in adults [3]

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