Initial screening of children treated with second-generation antipsychotics points to an association between physical...

Second-generation antipsychotic (SGA) medications, used to treat youth for a wide-range of mental health conditions, are associated with excessive weight gain and other comorbidities, placing these individuals at high risk for cardiovascular disease. Little is known about the effect of physical activity (PA) on cardiovascular risk in these children. Anthropometrics, fasting blood sample and self-report PA were obtained in 386 children diagnosed with mental health conditions (6-18 y). PA was classified as below (<60 min/day) or meets (≥60 min/day) current recommended guidelines for daily PA in children. SGA-treated (n = 166) and SGA-naïve (n = 220) were compared in the analysis. The SGA-treated children had higher (p < .05) BMI z-score, waist-to-height ratio, fasting glucose, and LDL-cholesterol than SGA-naïve children. Waist circumference, waist-to-height ratio, HDL cholesterol, fasting insulin, and HOMA-IR were significantly different by PA status. After adjusting for SGA-treatment duration, sex, age, and ethnicity, higher PA was associated with lower insulin resistance (HOMA-IR) in SGA-treated (mean, 95% CI; below vs. meets: 2.10 [1.84, 2.37] vs. 1.59 [1.37, 1.81], p = .046) but not in SGA-naïve (1.70 [1.47, 1.94] vs. 1.55 [1.35, 1.75], p = .707) children. Upon initial screening, SGA-treated children that reported meeting the minimal recommendations for daily PA displayed lower measures of adiposity and improved insulin resistance.