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Sports participation, activity, and obesity in children who have undergone the Fontan procedure

Published online by Cambridge University Press:  03 September 2021

Marica E. Baleilevuka-Hart*
Oregon Health and Science University, Division of Pediatric Cardiology, Portland, USA
Ayesha Khader
Oregon Health and Science University School of Medicine, Portland, USA
Cesar E Gonzalez De Alba
University of Colorado, Pediatric Heart Institute, Children’s Hospital Colorado, Denver, USA
Kathryn W. Holmes
Oregon Health and Science University, Division of Pediatric Cardiology, Portland, USA
Jennifer H. Huang
Oregon Health and Science University, Division of Pediatric Cardiology, Portland, USA
Author for correspondence: M. Baleilevuka-Hart, 707 SW Gaines St, Mail code CDRC-P, Portland, OR 97239, USA. Tel: +1 (503) 494-2153. E-mail:



Children with CHD are at risk for obesity and low levels of activity. These factors are associated with an increased risk of poor outcome. Participation in organised sports is an important avenue for children to maintain physical activity, though the relationship between sports participation and obesity has not been examined in the Fontan population.


We performed a cross-sectional study of children aged 8–18 who had been evaluated between January 1, 2015 and October 1, 2019 at the Doernbecher Children’s Hospital outpatient paediatric 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 were recorded from the electronic medical record. Parents were interviewed via a telephone survey and asked to describe their child’s activity levels and sports participation.


Our final cohort included 40 individuals, 74% were male. The overall prevalence of obesity (CDC BMI >95% for sex/age) in the cohort (23%) was significantly higher in non-athletes (33%) than athletes (0) (p = 0.02). There was no difference in cardiac complications or comorbidities between athletes and non-athletes. Athletes were more likely to meet daily activity recommendations (p = 0.05).


Fontan patients who do not participate in sports are significantly more likely to be obese and less likely to be active than those who do. This is the first study to demonstrate the association between competitive sports participation and decreased likelihood of obesity in the Fontan population.

Original Article
© The Author(s), 2021. Published by Cambridge University Press

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