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Obesity-Related Factors that Affect 6-Minute Walk Test Performance in Thai Obese Children

Jitti Hirunpoom, Darunwan Nimpun, Worawan Jittham

Background: Obesity is a significant health issue that negatively impacts the cardiovascular system and quality of life. Six-minute walk test (6MWT) is one of the most used non-invasive tests for evaluating cardiovascular function in determining the impact of obesity on an individual’s physical fitness.

Objective: To identify any obesity-related factors that affect 6MWT in Thai overweight and obese children.

Method: This is a prospective, cross-sectional study that enrolled 70 children with % weight for height (W/H) above 120 were assessed using 6MWT at Naresuan University Hospital. The participants were divided according to their W/H as overweight (15 children, 21.4%), obese (41 children, 60%), and morbidly obese (14 children, 20%). Data were collected from medical records and categorized as follows:

1. Anthropometric data, including weight, height, body mass index (BMI) and body fat percentage (%Fat)

2. Metabolic profile, including fasting blood sugar (FBS), triglyceride levels (TG), total cholesterol levels (TC) and HDL

3. Cardiac function using echocardiography.

Global Physical Activity Questionnaires (GPAQ) was used to assess physical activity and sedentary time. The Six-minute Walk Distance (6MWD) was compared to the reference value based on age and gender.

Results: The majority of the overweight and obese children had a lower 6MWD compared to the reference value (65 children, 92.9%). The mean 6MWD was considerably lower among children with morbid obesity (365.07 ± 37.06 m) compared to those with overweight (392.73 ± 41.02 m) and obesity (408.12 ± 55.16 m) (P=0.022). Higher %Fat (r=-0.396, P=0.001) and elevated TC (r=-0.386, P=0.001) were also related to a lower 6MWD. There was no correlation between cardiac function, physical activity, and sedentary time in the 6MWD.

Conclusion: The 6MWT performance of morbidly obese children was lower than that of healthy children. Higher %Fat and TC were also associated with reduced 6MWD. Lifestyle modification for children, who are overweight or obese, including fat restriction and nutrition control, will not only aid in weight loss but also enhance the child’s physical fitness and quality of life over time.