Effects of an exercise intervention using Dance Dance Revolution on endothelial function and other risk factors in overweight children

Int J Pediatr Obes. 2009;4(4):205-14. doi: 10.3109/17477160902846187.


Objective: To determine whether an exercise intervention using an active video game (Dance Dance Revolution [DDR]) is effective in improving endothelial dysfunction (EDF) and other risk factors in overweight children.

Design: Thirty-five children (Body mass index > or = 85(th) percentile, mean age 10.21+/-1.67 years, 17 females) with EDF were assessed for flow-mediated dilation (FMD), lipids, insulin, glucose, NO(2)+NO(3), asymmetric dimethylarginine, symmetric dimethylarginine, l-arginine, height, weight, aerobic fitness, and blood pressure. In a subsample, tumor necrosis factor alpha, interleukin-6, C-reactive protein, and adiponectin were also assessed. Subjects were randomly assigned to 12-weeks of aerobic exercise (EX) using DDR or to a non-exercising delayed-treatment control group (DTC).

Results: EX had significant improvements in FMD ( 5.56+/-5.04% compared with 0.263+/-4.54%, p=0.008), exercise time on the graded exercise test (53.59+/-91.54 compared with -12.83+/-68.10 seconds, p=0.025), mean arterial pressure (MAP) (-5.62+/-7.03 compared with -1.44+/-2.16 mmHg, p=0.05), weight (0.91+/-1.53 compared with 2.43+/-1.80 kg, p=0.017) and peak VO(2) (2.38+/-3.91 compared with -1.23+/-3.18 mg/kg/min, p=0.005) compared with the DTC. Thirteen EX subjects achieved normal EDF while ten did not. These groups differed at baseline with regard to total cholesterol (TC) and low-density lipoprotein (LDL).

Conclusion: Twelve weeks of DDR-use improved FMD, aerobic fitness, and MAP in overweight children. Improvements occurred without changes in inflammatory markers or nitric oxide production. The results document the need to explore relationships between obesity, endothelial function, inflammation, lipids, exercise intensity, and gender in a larger sample of overweight children.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Arginine / analogs & derivatives
  • Arginine / blood
  • Biomarkers / blood
  • Blood Glucose / metabolism
  • Blood Pressure
  • Body Height
  • Body Mass Index
  • Body Weight
  • Brachial Artery / diagnostic imaging
  • Brachial Artery / metabolism
  • Brachial Artery / physiopathology*
  • Child
  • Dance Therapy*
  • Endothelium, Vascular / metabolism
  • Endothelium, Vascular / physiopathology*
  • Exercise Therapy*
  • Female
  • Humans
  • Inflammation Mediators / blood
  • Insulin / blood
  • Lipids / blood
  • Male
  • Nitrates / blood
  • Nitrites / blood
  • Overweight / blood
  • Overweight / etiology
  • Overweight / physiopathology
  • Overweight / therapy*
  • Oxygen Consumption
  • Patient Compliance
  • Physical Fitness
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • Ultrasonography
  • Vasodilation*
  • Video Games*


  • Biomarkers
  • Blood Glucose
  • Inflammation Mediators
  • Insulin
  • Lipids
  • Nitrates
  • Nitrites
  • symmetric dimethylarginine
  • N,N-dimethylarginine
  • Arginine