Fellow Oregon Health & Science University Oregon Healthy & Science University Portland, Oregon, United States
Background: Children with congenital heart disease, including those who have previously undergone the Fontan procedure, are at risk for obesity and low levels of activity. As these children age into adulthood, sedentary behaviors and inactivity are associated with increased risk of poor outcome. Participation in organized sports is an important avenue for children to maintain physical activity, though the relationship of sports participation and obesity has not been examined in the Fontan population.
Objective: To examine the relationship between sports participation and obesity in children who have undergone a Fontan procedure.
Design/Methods: We performed a retrospective cohort study in children ages 8 to 18 years who had been evaluated between January 1, 2015 and October 1, 2019 at Doernbecher Children’s Hospital outpatient pediatric cardiology clinic and had previously undergone a Fontan. Patients were excluded if they were unable to ambulate independently or if they had undergone a heart transplant. Patient characteristics, including BMI, were recorded from the electronic medical record. Parents were interviewed via a telephone survey and asked to describe their child’s activity levels, sports participation and provider recommendations.
Results: Our final cohort included 40 individuals, 74% were male with 37% in elementary school, 35% in middle school, 28% in high school or post graduate. Compared to the published average obesity for children ages 11 to 17 years in Oregon of 12.9%, 23% were obese (CDC BMI >95% for age/gender) and 33% of the group was overweight (CDC BMI >85% for age/gender). One third (33%) of the population reported participation in competitive sports within the last 12 months. Children who participated in sports were less likely to be obese (CDC BMI >85%) (P = 0.02). Conclusion(s): Fontan patients are significantly more obese than their peers. Children who participated in competitive sports were less likely to be obese. This is the first study to demonstrate the protective effect of competitive sports participation against obesity in the Fontan population. More studies are needed to understand whether or not prescribing sports participation will lead to decreased obesity and improved outcomes in this population.
Authors/Institutions: Marica Baleilevuka-Hart, Oregon Healthy & Science University, Portland, Oregon, United States; Ayesha Khader, Oregon Health & Science University, Portland, Oregon, United States; Cesar Gonzalex de Alba, University of Colorado, Denver, Colorado, United States; Kathryn W. Holmes, Oregon Healthy & Science University, Portland, Oregon, United States; Jennifer H. Huang, Oregon Healthy & Science University, Portland, Oregon, United States
