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Isacco L, Lambert C, Fearnbach N, Fillon A, Masurier J, Lowe M, Benson L, Duclos M, Pereira B, Boirie Y, Thivel D. Patterns of body weight change affect weight loss during a multidisciplinary intervention in adolescents with obesity. Obes Res Clin Pract 2022; 16:400-406. [PMID: 36088251 DOI: 10.1016/j.orcp.2022.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 07/27/2022] [Accepted: 08/29/2022] [Indexed: 10/14/2022]
Abstract
AIM The current pediatric obesity health challenge necessitates a better understanding of the factors affecting weight loss success during interventions. The aim of this observational study was to test the impact of the rate of initial weight loss and body weight variability on weight loss during a 9-month residential, multidisciplinary weight loss program in adolescents with obesity. METHODS This retrospective study considered a whole sample of 510 adolescents with obesity (12-16 years, 435 girls). Body weight assessment was performed before (T0) and each week during the 9 months of a multidisciplinary weight loss program. Initial weight change (week 4-W4) and overall weight change at week 12 (T1) and the end of the intervention (T2) were considered. Participants were divided into three groups (tertiles), based on their percentage of weight loss between T0 and W4; and weight variability was expressed by the root mean square error (RMSE) around each participant's regression line at each considered period (W4, T1, T2). RESULTS Adolescents with lower initial weight loss at W4 (tertile 3) displayed the lesser weight loss at T1 and T2 compared with adolescents in tertile 1 and 2. The RMSE was positively associated with the percentage of weight loss of the period considered, but when the analyses were adjusted for age and initial body weight, there was no more significant association. CONCLUSIONS The rate of weight loss during the first few weeks is crucial for weight loss success, and weight variability is positively associated with weight loss in adolescents with obesity. Overall, results show that initial body weight is a determinant characteristic to consider during a lifestyle intervention. Further studies are thus needed to better understand the relationship between body weight change patterns and weight loss during the dynamic state that is adolescence.
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Affiliation(s)
- Laurie Isacco
- Clermont Auvergne University, UPR 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), CRNH Auvergne, Clermont-Ferrand, France.
| | - Céline Lambert
- Biostatistics Unit, DRCI, CHU Clermont-Ferrand, Clermont-Ferrand, France.
| | - Nicole Fearnbach
- Clinical Sciences Division, Pennington Biomedical Research Center, Baton Rouge, LA, USA.
| | - Alicia Fillon
- Clermont Auvergne University, UPR 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), CRNH Auvergne, Clermont-Ferrand, France.
| | - Julie Masurier
- UGECAM Nutrition Obesity Ambulatory Hospital, Clermont-Ferrand, France; CSO-CALORIS, CHU Clermont-Ferrand, Clermont-Ferrand, France.
| | - Michael Lowe
- Department of Psychology, Drexel University, Philadelphia, PA, USA.
| | - Leora Benson
- Department of Psychology, Drexel University, Philadelphia, PA, USA.
| | - Martine Duclos
- Observatoire National de l'Activité Physique et de la Sédentarité (ONAPS), Faculty of Medicine, Clermont Auvergne University, Clermont-Ferrand, France; CHU Clermont-Ferrand, Department of Sport Medicine and Functional Explorations, Clermont-Ferrand, France; International Research Chair Health in Motion, Clermont Auvergne University Foundation, Clermont-Ferrand, France.
| | - Bruno Pereira
- Biostatistics Unit, DRCI, CHU Clermont-Ferrand, Clermont-Ferrand, France.
| | - Yves Boirie
- CSO-CALORIS, CHU Clermont-Ferrand, Clermont-Ferrand, France; Department of Human Nutrition, CHU Clermont-Ferrand, Clermont-Ferrand, France.
| | - David Thivel
- Clermont Auvergne University, UPR 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), CRNH Auvergne, Clermont-Ferrand, France; CSO-CALORIS, CHU Clermont-Ferrand, Clermont-Ferrand, France; International Research Chair Health in Motion, Clermont Auvergne University Foundation, Clermont-Ferrand, France.
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Association of protein-energy partitioning with body weight and body composition changes in adolescents with severe obesity. Int J Obes (Lond) 2022; 46:2021-2028. [PMID: 36045150 DOI: 10.1038/s41366-022-01218-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 08/18/2022] [Accepted: 08/19/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND/OBJECTIVES Body composition and protein-energy partitioning changes are important factors of body weight regulation, but have not been studied in the context of clinical obesity treatment setting. Thus, the aim of the present study was to investigate the pattern of body weight loss, body composition, and energy partitioning changes during a 9-month multidisciplinary weight loss program and 4-month follow up and to test the associations among these changes in adolescents with severe obesity. SUBJECTS/METHODS Twenty-five adolescents (14.1 ± 1.5 years old; 13 girls) with severe obesity joined a pediatric obesity center for a 9-month inpatient multidisciplinary weight loss program. All participants performed body composition assessment (i.e. fat mass-FM, and fat-free mass-FFM) and completed a 36-h session in indirect calorimetric chamber before the start (T0), at the end of the intervention (T1) and 4 months follow-up to the intervention (T2). The protein-energy partitioning (P ratio) was calculated as urinary nitrogen loss/total energy expenditure over 24 hours. INTERVENTIONS 9-month individualized multidisciplinary weight loss program consisting of lifestyle education, psychological support, physical activity, and dietary intervention. RESULTS Initial P ratio was positively associated with changes in body weight from T0 to T1 (p = 0.038). The changes in FFM/FM were negatively associated with body weight changes in boys (p = 0.006) from T0 to T1 and in girls (p < 0.001) from T1 to T2. Urinary nitrogen excretion (p < 0.001) and total energy expenditure (p < 0.001) significantly decreased during the weight loss program while the P ratio did not significantly change. CONCLUSION The present results suggest that baseline and changes in energy partitioning may be associated with changes in body weight in adolescents with severe obesity. In addition, sexual dimorphism in these patterns of change suggest the need for specific dietary and physical activity strategies in boys and girls to optimize body weight loss and to prevent or slow weight regain.
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Leite N, Tadiotto MC, Corazza PRP, de Menezes Junior FJ, Carli MEC, Milano-Gai GE, Lopes WA, Gaya AR, Brand C, Mota J, Radominski RB. Responsiveness on metabolic syndrome criteria and hepatic parameters after 12 weeks and 24 weeks of multidisciplinary intervention in overweight adolescents. J Endocrinol Invest 2022; 45:741-752. [PMID: 34780051 DOI: 10.1007/s40618-021-01699-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 11/01/2021] [Indexed: 12/14/2022]
Abstract
PURPOSE This study aimed to evaluate the effect and individual responsiveness after 12 (12wk) and 24 weeks (24wk) of physical exercise (PE) and nutritional guidance (NG) on metabolic syndrome (MetS) criteria and hepatic parameters in overweight adolescents. METHODS The study comprised 94 overweight adolescents, aged between 10 and 16 years old, from both sexes, allocated into groups: PE and NG (PENGG, n = 64) and control with NG (NGCG, n = 30). Variables were collected at baseline, 12wk, and 24wk. Weight, height, abdominal circumference (AC), blood pressure, and peak oxygen consumption (VO2peak), as well as insulin, triglycerides (TAG), high-density lipoprotein (HDL-c), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were evaluated. HOMA-IR and QUICKI were calculated. PE session consisted of 45 min of indoor cycling, 45 min of walking, and 20 min of stretching, three times a week. The NG consisted of three collective sessions in the first 12wk. Anova, effect size, and prevalence of responders were used for statistical analysis. RESULTS The PENGG12wk reduced anthropometric and metabolic measurements, while increased VO2peak and HDL-c. The PEG24wk promoted anthropometric, blood pressure, metabolic, and VO2peak improvements, but participants without PE returned to pre-exercise status and presented worsening AST and ALT concentrations. Frequencies of respondents in PENGG12wk versus (vs) NGCG12wk were, respectively, AC (69.1% vs 17.6%, p < 0.01), HDL-c (87.2% vs 23.5%, p < 0.01), TAG (67.3% vs 41.7%, p = 0.05) and ALT (45.5% vs 5,9%; p = 0.003). CONCLUSION Interventions with PE were effective to reduce MetS components in 12wk and maintenance in 24wk, showing anthropometric, metabolic, and VO2peak improvements. Higher individual responses were observed in 12wk and in 24wk, important changes in overweight adolescent's therapy. LEVEL OF EVIDENCE Level I, evidence obtained from well-designed controlled trials randomization. TRIAL REGISTRATION NUMBER AND DATE OF REGISTRATION Brazilian Registry of Clinical Trials (RBR-4v6h7b) and date of registration April 4th, 2020.
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Affiliation(s)
- N Leite
- Department of Physical Education, Federal University of Parana, Street Cel. Francisco H. dos Santos, 100, Jardim das Américas, Curitiba, Paraná, 81531-980, Brazil.
- Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sports, University of Porto, Porto, Portugal.
| | - M C Tadiotto
- Department of Physical Education, Federal University of Parana, Street Cel. Francisco H. dos Santos, 100, Jardim das Américas, Curitiba, Paraná, 81531-980, Brazil
| | - P R P Corazza
- Department of Physical Education, Federal University of Parana, Street Cel. Francisco H. dos Santos, 100, Jardim das Américas, Curitiba, Paraná, 81531-980, Brazil
| | - F J de Menezes Junior
- Department of Physical Education, Federal University of Parana, Street Cel. Francisco H. dos Santos, 100, Jardim das Américas, Curitiba, Paraná, 81531-980, Brazil
| | - M E C Carli
- Department of Physical Education, Federal University of Parana, Street Cel. Francisco H. dos Santos, 100, Jardim das Américas, Curitiba, Paraná, 81531-980, Brazil
| | - G E Milano-Gai
- Department of Physical Education, Federal University of Parana, Street Cel. Francisco H. dos Santos, 100, Jardim das Américas, Curitiba, Paraná, 81531-980, Brazil
| | - W A Lopes
- Department of Physical Education, Federal University of Parana, Street Cel. Francisco H. dos Santos, 100, Jardim das Américas, Curitiba, Paraná, 81531-980, Brazil
- Department of Physical Education, State University of Maringá, Maringá, Paraná, Brazil
| | - A R Gaya
- Department of Physical Education, Federal University of Rio Grande Do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - C Brand
- Graduate Program in Health Promotion, University of Santa Cruz Do Sul, Santa Cruz Do Sul, Rio Grande do Sul, Brazil
| | - J Mota
- Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sports, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - R B Radominski
- Department of Nutrition, Federal University of Paraná, Curitiba, Paraná, Brazil
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Dyslipidemia Diagnosis and Treatment: Risk Stratification in Children and Adolescents. J Nutr Metab 2022; 2022:4782344. [PMID: 35237450 PMCID: PMC8885266 DOI: 10.1155/2022/4782344] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 12/27/2021] [Accepted: 01/18/2022] [Indexed: 12/21/2022] Open
Abstract
Dyslipidemias or dyslipoproteinemias are quantitative changes in total cholesterol concentration, respective fractions, or triglycerides in the plasma. Evidence supported that dyslipidemia in childhood is associated with atherosclerosis in adulthood, and early identification and treatment potentially reduce cardiovascular risk in adulthood, which is the principal cause of morbidity and mortality in developed countries. Dyslipidemias can result from primary lipoprotein metabolism changes due to different genetic causes (primary dyslipidemias) or as a consequence of exogenous factors or other pathologies (secondary dyslipidemias). Therefore, the combined dyslipidemias result from the association of important epigenetic and environmental influences with risk factors for cardiovascular disease. The criterion for lipid metabolism screening at young ages is not widely accepted and possibly follows a universal or directed screening strategy. Additionally, little is known about its long-term effects or possible risk-benefit despite the growing tendency to start pharmacological therapy. Therefore, this study aimed to review the available bibliography on dyslipidemia in pediatric age to present a practical and structured approach to dyslipidemia that focuses on screening, risk stratification for atherosclerotic disease, and therapeutic approach.
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Truong K, Park S, Tsiros MD, Milne N. Physiotherapy and related management for childhood obesity: A systematic scoping review. PLoS One 2021; 16:e0252572. [PMID: 34125850 PMCID: PMC8202913 DOI: 10.1371/journal.pone.0252572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 05/18/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Despite targeted efforts globally to address childhood overweight/obesity, it remains poorly understood and challenging to manage. Physiotherapists have the potential to manage children with obesity as they are experts in movement and physical activity. However, their role remains unclear due to a lack of physiotherapy-specific guidelines. This scoping review aims to explore existing literature, critically appraising and synthesising findings to guide physiotherapists in the evidence-based management of childhood overweight/obesity. METHOD A scoping review was conducted, including literature up to May 2020. A review protocol exists on Open Science Framework at https://osf.io/fap8g/. Four databases were accessed including PubMed, Embase, CINAHL, Medline via OVID, with grey literature searched through google via "file:pdf". A descriptive synthesis was undertaken to explore the impact of existing interventions and their efficacy. RESULTS From the initial capture of 1871 articles, 263 intervention-based articles were included. Interventions included qualitative focused physical activity, quantitative focused physical activity and multicomponent interventions. Various outcome measures were utilised including health-, performance- and behaviour-related outcomes. The general trend for physiotherapy involvement with children who are obese appears to favour: 1) multicomponent interventions, implementing more than one component with environmental modification and parental involvement and 2) quantitative physical activity interventions, focusing on the quantity of bodily movement. These approaches most consistently demonstrated desirable changes across behavioural and health-related outcome measures for multicomponent and quantitative physical activity interventions respectively. CONCLUSION When managing children with obesity, physiotherapists should consider multicomponent approaches and increasing the quantity of physical activity, given consistent improvements in various obesity-related outcomes. Such approaches are well suited to the scope of physiotherapists and their expertise in physical activity prescription for the management of childhood obesity. Future research should examine the effect of motor skill interventions and consider the role of environmental modification/parental involvement as factors contributing to intervention success.
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Affiliation(s)
- Kim Truong
- Faculty of Health Sciences and Medicine, Bond Institute of Health and Sport, Bond University, Gold Coast, Queensland, Australia
| | - Sandra Park
- Faculty of Health Sciences and Medicine, Bond Institute of Health and Sport, Bond University, Gold Coast, Queensland, Australia
| | - Margarita D. Tsiros
- UniSA Allied Health and Human Performance, Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, South Australia, Australia
| | - Nikki Milne
- Faculty of Health Sciences and Medicine, Bond Institute of Health and Sport, Bond University, Gold Coast, Queensland, Australia
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Brand C, de Lucena Martins CM, Dias AF, Fochesatto CF, García-Hermoso A, Honório R, Mota J, Gaya ACA, Gaya AR. Multicomponent intervention effect on cardiometabolic risk factors among overweight/obese Brazilian children: a mediation analysis. SPORT SCIENCES FOR HEALTH 2021. [DOI: 10.1007/s11332-020-00666-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Khammassi M, Isacco L, Pereira B, Damaso AR, Matlosz P, Maruszczak K, Weghuber D, Dutheil F, Duclos M, Boirie Y, Julian V, Thivel D. Cardiometabolic efficacy of multidisciplinary weight loss interventions is not altered in adolescents with obesity initially diagnosed or with a persistent metabolic syndrome. Nutr Res 2021; 86:79-87. [PMID: 33551258 DOI: 10.1016/j.nutres.2020.12.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 11/25/2020] [Accepted: 12/01/2020] [Indexed: 10/22/2022]
Abstract
The efficacy of weight loss interventions might be affected by the metabolic profile of adolescents with obesity. In this study, we hypothesized that the initial diagnosis of the MS, or its persistence after an intervention, will not reduce the efficacy of a 16-week multidisciplinary weight loss program. Ninety two adolescents (12-15 years; 62 girls) with obesity completed baseline anthropometric and body composition evaluation (DXA). Lipid profile, insulinemia, glycaemia and blood pressure were measured and metabolic syndrome (MS) diagnosed. The adolescents then followed a 4-month inpatient multidisciplinary weight-management program. All measurements were performed before (T0) and after 4 months of intervention (T1). Body weight, body mass index (BMI) and percentage of fat mass (%FM) decreased significantly between T0 and T1 (P< .001), with no difference in fat-free mass (kg). All metabolic variables (except blood pressure) were improved. 47.6% of the whole sample presented with MS at baseline against 35.7% at T1. Body weight (P = 0.006), BMI (P = 0.0261), %FM (P = 0.0211), hip circumference (= 0.0131), BMI percentile (P = 0.0319), and diastolic blood pressure (P = 0.0365) showed a time x group interaction and their deltas (variations between T0 and T1) were significantly different between adolescents with and without MS at baseline. There was no significant difference between adolescents with persistent and nonpersistent MS except for ΔBMI percentile that deceased significantly more in the nonpersistent group (P = 0.0115). According to our results, the efficacy of weight loss interventions is not reduced in adolescents initially diagnosed with MS or different between those who present a persistent or nonpersistent MS after the intervention.
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Affiliation(s)
- Marwa Khammassi
- Clermont Auvergne University, EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont-Ferrand, France; Research Unit, Sportive Performance and Physical Rehabilitation, High Institute of Sports and Physical Education of Kef, University of Jendouba, Kef, Tunisia, Faculty of Science of Bizerte, University of Carthage, 7021 Zarzouna, Bizerte, Tunisia.
| | - Laurie Isacco
- Clermont Auvergne University, EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont-Ferrand, France.
| | - Bruno Pereira
- Clermont-Ferrand University Hospital, Biostatistics unit (DRCI), Clermont-Ferrand, France.
| | - Ana Raimunda Damaso
- Paulista Medicine School, Universidade Federal de São Paulo (UNIFESP), Rua Botucatu, 862-Vila Clementino, São Paulo, SP 04020-050, Brazil.
| | - Piotr Matlosz
- Institute of Physical Culture Sciences, Medical College, University of Rzeszów, 35-959 Rzeszów, Poland.
| | - Katharina Maruszczak
- Department of Pediatrics, Obesity Research Unit, Paracelsus Medical University, Salzburg, Austria..
| | - Daniel Weghuber
- Department of Pediatrics, Obesity Research Unit, Paracelsus Medical University, Salzburg, Austria..
| | - Frederic Dutheil
- Departement de Médecine du travail, Clermont-Ferrand University Hospital, G. Montpied Hospital, Clermont-Ferrand, France; Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, France; University Clermont 1, UFR Medicine, Clermont-Ferrand, France.
| | - Martine Duclos
- University Clermont 1, UFR Medicine, Clermont-Ferrand, France; Department of Sport Medicine and Functional Explorations, Clermont-Ferrand University Hospital, G. Montpied Hospital, Clermont-Ferrand, France; INRA, UMR 1019, Clermont-Ferrand, France; CRNH-Auvergne, Clermont-Ferrand, France.
| | - Yves Boirie
- University Clermont 1, UFR Medicine, Clermont-Ferrand, France; INRA, UMR 1019, Clermont-Ferrand, France; CRNH-Auvergne, Clermont-Ferrand, France; Department of Human Nutrition, Clermont-Ferrand University Hospital, G. Montpied Hospital, Clermont-Ferrand, France.
| | - Valérie Julian
- University Clermont 1, UFR Medicine, Clermont-Ferrand, France; Department of Sport Medicine and Functional Explorations, Clermont-Ferrand University Hospital, G. Montpied Hospital, Clermont-Ferrand, France; INRA, UMR 1019, Clermont-Ferrand, France; CRNH-Auvergne, Clermont-Ferrand, France.
| | - David Thivel
- Clermont Auvergne University, EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont-Ferrand, France; CRNH-Auvergne, Clermont-Ferrand, France.
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Julian V, Isacco L, Khammassi M, Fillon A, Miguet M, Dutheil F, Courteix D, Zak M, Bicki J, Głuszek S, Duclos M, Boirie Y, Pereira B, Thivel D. Appetite Control Might not Be Improved after Weight Loss in Adolescents with Obesity, Despite Non-Persistent Metabolic Syndrome. Nutrients 2020; 12:E3885. [PMID: 33353174 PMCID: PMC7766326 DOI: 10.3390/nu12123885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/16/2020] [Accepted: 12/17/2020] [Indexed: 11/19/2022] Open
Abstract
The aim of this study was to evaluate the effect of a multidisciplinary weight loss intervention on energy intake and appetite sensations in adolescents with obesity, depending on the initial diagnosis or persistence of the metabolic syndrome. Ninety-two adolescents with obesity (12-15 years) followed a 16-week multidisciplinary weight loss intervention. Anthropometric and body composition characteristics, metabolic profile, ad libitum daily energy intake, and appetite sensations were assessed before and after the intervention. The presence of metabolic syndrome (MS) was determined at baseline (MS vs. non-MS) and after the program (persistent vs. non-persistent). While the intervention was effective in inducing weight loss (body weight T0: 87.1 ± 14.9 vs. T1: 81.2 ± 13.0 kg; p < 0.001) and body composition improvements in both adolescents with and without MS, energy intake (p = 0.07), hunger (p = 0.008), and prospective food consumption (p = 0.03) increased, while fullness decreased (p = 0.04) in both groups. Energy intake and appetite were not improved in non-persistent MS after the program and remained significantly higher among non-persistent adolescents compared with initially non-MS adolescents. To conclude, appetite control seems impaired in obese adolescents, irrespective of being affected by MS or not, whereas the treatment of MS in this population might fail to effectively preclude the adolescents from potential post-intervention compensatory food intake and subsequent weight regain.
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Affiliation(s)
- Valérie Julian
- Department of Sport Medicine and Functional Explorations, Clermont-Ferrand University Hospital, G. Montpied Hospital, 63000 Clermont-Ferrand, France; (V.J.); (M.D.)
- UFR Medicine, Clermont Auvergne University, 63000 Clermont-Ferrand, France;
| | - Laurie Isacco
- EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont Auvergne University, 63000 Clermont-Ferrand, France; (L.I.); (M.K.); (A.F.); (M.M.); (D.C.)
| | - Marwa Khammassi
- EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont Auvergne University, 63000 Clermont-Ferrand, France; (L.I.); (M.K.); (A.F.); (M.M.); (D.C.)
| | - Alicia Fillon
- EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont Auvergne University, 63000 Clermont-Ferrand, France; (L.I.); (M.K.); (A.F.); (M.M.); (D.C.)
| | - Maud Miguet
- EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont Auvergne University, 63000 Clermont-Ferrand, France; (L.I.); (M.K.); (A.F.); (M.M.); (D.C.)
| | - Frederic Dutheil
- Departement de Médecine du travail, Clermont-Ferrand University Hospital, G. Montpied Hospital, 63000 Clermont-Ferrand, France;
- CNRS, LaPSCo, Physiological and Psychosocial Stress, Clermont Auvergne University, 63000 Clermont-Ferrand, France
| | - Daniel Courteix
- EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont Auvergne University, 63000 Clermont-Ferrand, France; (L.I.); (M.K.); (A.F.); (M.M.); (D.C.)
| | - Marek Zak
- Collegium Medicum, Jan Kochanowski University, Zeromskiego 5, 25-369 Kielce, Poland; (M.Z.); (J.B.); (S.G.)
| | - Jacek Bicki
- Collegium Medicum, Jan Kochanowski University, Zeromskiego 5, 25-369 Kielce, Poland; (M.Z.); (J.B.); (S.G.)
| | - Stanisław Głuszek
- Collegium Medicum, Jan Kochanowski University, Zeromskiego 5, 25-369 Kielce, Poland; (M.Z.); (J.B.); (S.G.)
| | - Martine Duclos
- Department of Sport Medicine and Functional Explorations, Clermont-Ferrand University Hospital, G. Montpied Hospital, 63000 Clermont-Ferrand, France; (V.J.); (M.D.)
- UFR Medicine, Clermont Auvergne University, 63000 Clermont-Ferrand, France;
- INRA, UMR 1019, 63000 Clermont-Ferrand, France
- CRNH-Auvergne, 63000 Clermont-Ferrand, France
| | - Yves Boirie
- UFR Medicine, Clermont Auvergne University, 63000 Clermont-Ferrand, France;
- INRA, UMR 1019, 63000 Clermont-Ferrand, France
- CRNH-Auvergne, 63000 Clermont-Ferrand, France
- Department of Human Nutrition, Clermont-Ferrand University Hospital, G. Montpied Hospital, 63000 Clermont-Ferrand, France
| | - Bruno Pereira
- Clermont-Ferrand University Hospital, Biostatistics unit (DRCI), 63000 Clermont-Ferrand, France;
| | - David Thivel
- EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont Auvergne University, 63000 Clermont-Ferrand, France; (L.I.); (M.K.); (A.F.); (M.M.); (D.C.)
- CRNH-Auvergne, 63000 Clermont-Ferrand, France
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A multidisciplinary weight loss intervention in obese adolescents with and without sleep-disordered breathing improves cardiometabolic health, whether SDB was normalized or not. Sleep Med 2020; 75:225-235. [PMID: 32861060 DOI: 10.1016/j.sleep.2020.06.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 06/20/2020] [Accepted: 06/23/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Pediatric obesity and sleep-disordered breathing (SDB) are strongly associated, and both promote metabolic impairments. However, the effects of a lifestyle intervention on the overall metabolic syndrome (MetS) are unknown. The objectives were i) to evaluate the effects of a lifestyle intervention on cardiometabolic risk (CMR), assessed with a dichotomous (MetS) and a continuous (MetScoreFM) instrument, in obese adolescents with and without SDB and ii) to compare the post-intervention cardiometabolic responses between adolescents with persistent (apnea-hypopnea index; AHI≥2) or normalized-SDB (AHI<2). METHODS Seventy-six adolescents with obesity recruited from two specialized institutions underwent a 9-12month diet and exercise intervention. Sleep and SDB (AHI≥2) were studied by polysomnography. Anthropometric parameters, fat mass (FM), glucose, insulin, lipid and leptin profiles, blood pressure (BP), MetScoreFM and MetS were assessed pre- and post-intervention. We performed comparisons between Non-SDB and SDB groups and between Normalized-SDB and Persistent-SDB subgroups. RESULTS Fifty participants completed the study. Pre-intervention, twenty youth had SDB (40%) with higher insulin concentrations and systolic BP than Non-SDB participants (p < 0.01), for a similar degree of obesity. Post-intervention, MetScoreFM (p < 0.001) and MetS prevalence (p < 0.05) were decreased in both groups. Eleven participants (55%) normalized SDB along with a decrease in insulin concentrations and BP (p < 0.05). Triglycerides, total cholesterol and LDL-cholesterol concentrations (p < 0.01) improved equally in the Normalized and Persistent-SDB subgroups. CONCLUSION SDB was associated with lower insulin sensitivity and higher BP but did not affect the lipid profile. A diet and exercise lifestyle intervention is effective in decreasing the CMR whether or not SDB was normalized in obese adolescents.
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Impact of Recreational Sports Activities on Metabolic Syndrome Components in Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:ijerph17010143. [PMID: 31878170 PMCID: PMC6981663 DOI: 10.3390/ijerph17010143] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 12/21/2019] [Accepted: 12/23/2019] [Indexed: 01/19/2023]
Abstract
We investigated the impact of a sports activities program on metabolic syndrome (MetS) components and pre-MetS among adolescents. Blood samples, blood pressure, weight, height, body mass index, waist circumference, body fat percentage, frequency of food consumption, daily time in moderate-to-vigorous physical activity (MVPA), and sedentary behavior (SB) of 92 male adolescents aged 14-18 years (16.07 ± 0.93) were evaluated. From this initial sample, 36 participants (39.1%) were diagnosed with pre-MetS or MetS and were invited to participate in the intervention program. Twelve individuals diagnosed with pre-MetS or MetS agreed to participate in a recreational sports activities program lasting 14 weeks. The pre- and post-sport program comparison showed a reduction in total cholesterol, low-density lipoprotein, and non-high-density lipoprotein (HDL), and an increase in HDL and MVPA time in the intervention group. Sports activities accounted for 42% of the MVPA daily recommendation, and at the end of the intervention period, only seven subjects maintained a positive diagnosis for pre-MetS or MetS. This study showed that recreational sports activities had a significant impact on the lipid profile.
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Effect of a multicomponent intervention in components of metabolic syndrome: a study with overweight/obese low-income school-aged children. SPORT SCIENCES FOR HEALTH 2019. [DOI: 10.1007/s11332-019-00590-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Kawabe H, Azegami T, Takeda A, Kanda T, Saito I, Saruta T, Hirose H. Features of and preventive measures against hypertension in the young. Hypertens Res 2019; 42:935-948. [PMID: 30894695 PMCID: PMC8075862 DOI: 10.1038/s41440-019-0229-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 01/06/2019] [Accepted: 01/09/2019] [Indexed: 12/14/2022]
Abstract
The Japanese hypertension guidelines report that essential hypertension is detected in 1–3% of upper elementary and high school students during blood pressure (BP) screenings. Hypertension in these age groups is an emerging public health concern mainly attributed to the rising rate of pediatric obesity. Considering the existence of BP tracking phenomenon, early preventive education and instruction are necessary, especially for male students with moderately elevated BP showing a tendency toward obesity, despite the low prevalence of hypertension in high school students. Students with a positive family history of hypertension and those born with low birth weight need the same measures. Lifestyle habits, such as increased alcohol intake, dramatically change once students begin university; thus, early education and instruction regarding the factors influencing BP are necessary. In particular, for male students with higher BP during high school, caution regarding increased body weight is required irrespective of their level of obesity. Young adults aged <40 years should be educated about the association between body weight and hypertension. Particular caution surrounding lifestyle habits, including drinking and smoking, is warranted in male hypertensive subjects because hypertension at a young age is strongly associated with obesity. BP monitoring and the management of obesity should be considered efficient approaches to the detection and treatment of hypertension. For the lifetime prevention of hypertension, it is essential to be aware of one’s health status and learn about healthy lifestyles beginning in childhood. BP measurement may be an appropriate means to achieve this goal.
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Affiliation(s)
- Hiroshi Kawabe
- Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
| | - Tatsuhiko Azegami
- Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.,Health Center, Keio University, Kanagawa, Japan
| | - Ayano Takeda
- Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.,Health Center, Keio University, Kanagawa, Japan
| | - Takeshi Kanda
- Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Ikuo Saito
- Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Takao Saruta
- Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Hiroshi Hirose
- Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.,Health Center, Keio University, Kanagawa, Japan
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De Giuseppe R, Di Napoli I, Porri D, Cena H. Pediatric Obesity and Eating Disorders Symptoms: The Role of the Multidisciplinary Treatment. A Systematic Review. Front Pediatr 2019; 7:123. [PMID: 31024868 PMCID: PMC6463004 DOI: 10.3389/fped.2019.00123] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 03/12/2019] [Indexed: 12/22/2022] Open
Abstract
The prevalence of obesity in children/adolescents has increased worldwide during the past 30 years, becoming a significant public health concern; prevention, and management of pediatric obesity onset is one of the most critical public health goals for both industrialized and developing countries. Pediatric obesity has been identified as a risk factor for various psychopathologies, including eating disorders (ED). Although it has been demonstrated that a comprehensive multidisciplinary treatment (MT), with small steps and practical approaches to lifestyle change, can be an effective treatment for children and adolescents with obesity, to the best of our knowledge, this is the first systematic review investigating the effect of MT on the development, progression or decrease of ED symptoms (EDS) in this target population. PubMed and Web of Science databases were searched (last search on 18 February 2019) according to a predetermined search strategy, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guidelines and Statement. Original studies published in English examining the effect of MT on pediatric overweight/obesity, paying particularly attention at the development of EDS, were eligible for inclusion. Seven hundred and forty-four records have been identified; nine articles with study quality ranging from weak to moderate have been included. MTs were heterogeneous in nature including length, number, frequency and type of sessions, parent-involvement and use of technology, besides several psychometric questionnaires were used to screen for EDS, since there are no standardized criteria. In 3 studies there was a significant decrease in external and emotional eating and in four studies a significant increase in restraint eating post MT. Two studies found a significant decrease of binge eating symptoms and other two studies showed an improvement of self-perception, weight, and shape concern. A statistical significant decrease in BMI, BMIz, BMISDS, and adjusted BMI was observed after all MTs, except one. A narrative summary of the evidences reported highlighted the positive impact of MT on the EDS. Moreover, since weight loss post MTs was not necessarily related to EDS, clinicians should also look for the presence of EDS and treat them accordingly.
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Affiliation(s)
- Rachele De Giuseppe
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Ilaria Di Napoli
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Debora Porri
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Hellas Cena
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy.,Clinical Nutrition and Dietetics Service, Unit of Internal Medicine and Endocrinology, ICS Maugeri IRCCS, University of Pavia, Pavia, Italy
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Miguet M, Masurier J, Chaput JP, Pereira B, Lambert C, Dâmaso AR, Courteix D, Duclos M, Boirie Y, Thivel D. Cognitive restriction accentuates the increased energy intake response to a 10-month multidisciplinary weight loss program in adolescents with obesity. Appetite 2018; 134:125-134. [PMID: 30576727 DOI: 10.1016/j.appet.2018.12.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 11/19/2018] [Accepted: 12/13/2018] [Indexed: 01/09/2023]
Abstract
BACKGROUND Multidisciplinary interventions have shown some merits in weight reduction strategies in youth, however, their impact on subsequent daily energy intake remains largely unknown. The aim of the present study was to evaluate the nutritional responses to a 10-month multidisciplinary intervention among adolescents with obesity, in relation to their eating behavior characteristics. METHODS Thirty-five adolescents (mean age: 13.4 ± 1.2 years) with obesity took part in a 10-month residential multidisciplinary weight loss program. Anthropometric measurements, body composition (dual-energy X-ray absorptiometry), 24-h ad libitum energy intake (weighted), eating behaviors (Dutch Eating Behavior Questionnaire) and appetite sensations (Visual Analogue Scales) were assessed on three occasions: at their arrival in the institution (T0), after 5 months (T1), and at the end of the 10-month program (T2). RESULTS The mean weight loss reached 11% of the adolescents' initial body weight, with an important inter-individual variability (-25% to +3% of their initial body weight). Results revealed sex differences change, with boys showing a higher decrease in fat mass percent and increase in fat-free mass compared with girls. Weight loss was accompanied by a significant decrease in emotional (-8.3%, p < 0.05) and external (-14.8%, p < 0.001) eating scores and a significant increase in 24-h ad libitum energy intake (+246 kcal, p < 0.001). The observed subsequent increased 24-h ad libitum energy intake at T2 compared to T0 was significantly higher in cognitively restrained eaters (+492 kcal) compared to unrestrained eaters (+115 kcal, p = 0,015). Dietary restraint score at baseline was inversely correlated with the percentage of weight loss (r = -0.44, p = 0.010). CONCLUSION A 10-month multidisciplinary weight loss intervention induced an increase in 24-h ad libitum energy intake compared to baseline, especially in cognitively restrained eaters. Moreover, initially cognitively restrained eaters tended to lose less body weight compared to unrestrained ones. These findings suggest that cognitive restriction may be a useful eating behavior characteristic to consider as a screening tool for identifying adverse responders to weight loss interventions in youth.
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Affiliation(s)
- M Miguet
- Clermont Auvergne University, EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont-Ferrand, France.
| | - J Masurier
- UGECAM Nutrition Obesity Ambulatory Hospital, Clermont-Ferrand, France
| | - J P Chaput
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - B Pereira
- Clermont-Ferrand University Hospital, Biostatistics Unit (DRCI), Clermont-Ferrand, France
| | - C Lambert
- Clermont-Ferrand University Hospital, Biostatistics Unit (DRCI), Clermont-Ferrand, France
| | - A R Dâmaso
- Post Graduate Program of Nutrition, Paulista Medicine School, Universidade Federal de São Paulo (UNIFESP), Rua Botucatu, 862-Vila Clementino, São Paulo, SP 04020-050, Brazil
| | - D Courteix
- Clermont Auvergne University, EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont-Ferrand, France; CRNH-Auvergne, Clermont-Ferrand, France
| | - M Duclos
- CRNH-Auvergne, Clermont-Ferrand, France; Department of Sport Medicine and Functional Explorations, Clermont-Ferrand University Hospital, G. Montpied Hospital, Clermont-Ferrand, France; INRA, UMR 1019, Clermont-Ferrand, France; University Clermont 1, UFR Medicine, Clermont-Ferrand, France
| | - Y Boirie
- CRNH-Auvergne, Clermont-Ferrand, France; INRA, UMR 1019, Clermont-Ferrand, France; University Clermont 1, UFR Medicine, Clermont-Ferrand, France; Department of Human Nutrition, Clermont-Ferrand University Hospital, G. Montpied Hospital, Clermont-Ferrand, France
| | - D Thivel
- Clermont Auvergne University, EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont-Ferrand, France; CRNH-Auvergne, Clermont-Ferrand, France
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Building a response criterion for pediatric multidisciplinary obesity intervention success based on combined benefits. Eur J Pediatr 2018; 177:1-12. [PMID: 29556792 DOI: 10.1007/s00431-018-3115-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 02/09/2018] [Indexed: 10/17/2022]
Abstract
UNLABELLED To propose a response criterion for analyzing the intervention success by verifying patient outcomes after a multidisciplinary obesity treatment program in Brazilian children and adolescents. Obese children and adolescents (n = 103) completed a 16-week multidisciplinary intervention (IG) and were compared to the control group (CG) (n = 66). A cluster of parameters (e.g. total domain of HRQoL; BMI z-score; cardiorespiratory fitness; body mass; waist circumference; fat mass; lean mass) were measured pre and post-intervention, and the sum of the median percentage variation and the percentile 25 and 75 were used from IG and CG to determine the responsiveness to the program. We are proposing four ranges in which children and adolescents may be classified after the intervention: (1) CG percentile 50 values or lower are considered non-responsive to the intervention, (2) values greater than CG percentile 50 but lower than IG percentile 50 are considered slightly responsive, (3) values greater than IG percentile 50 but lower than IG percentile 75 were considered as moderately responsive, and (4) values greater than IG percentile 75 were considered very responsive. CONCLUSIONS This criterion may serve as a complementary tool that can be employed to monitor the response to this model of multidisciplinary intervention. What is Known: • The effectiveness of multidisciplinary obesity interventions is usually determined by comparing changes in selected outcomes in the intervention versus versus control group. • There is no consensus about what should be assessed before and after the intervention program, which makes difficult to compare different programs and to determine their rate of responsiveness. What is New: • This study proposes a response criteria to pediatric obesity interventions following a similar model compared to ours based on key variables that presents low cost and high applicability in different settings.
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Effects of a psychological intervention on the quality of life of obese adolescents under a multidisciplinary treatment. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2017. [DOI: 10.1016/j.jpedp.2016.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Freitas CRM, Gunnarsdottir T, Fidelix YL, Tenório TRS, Lofrano-Prado MC, Hill JO, Prado WL. Effects of a psychological intervention on the quality of life of obese adolescents under a multidisciplinary treatment. J Pediatr (Rio J) 2017; 93:185-191. [PMID: 27821251 DOI: 10.1016/j.jped.2016.05.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 05/11/2016] [Accepted: 05/24/2016] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE To investigate the effects of multidisciplinary treatment with and without psychological counseling on obese adolescents' self-reported quality of life. METHODS Seventy-six obese adolescents (15.87±1.53 y) were allocated into psychological counseling group (PCG; n=36) or control group (CG; n=40) for 12 weeks. All participants received the same supervised exercise training, nutritional and clinical counseling. Participants in PCG also received psychological counseling. QOL was measured before and after 12 weeks of intervention by Generic Questionnaire for the Evaluation of Quality of Life (SF-36). RESULTS The dropout rate was higher in GC (22.5%) when compared with PCG (0.0%) (p<0.001). After 12 weeks, participants from PCG presents lower body weight, relative fat mass and higher free fat mass (p<0.001 for all) compared to GC. QOL improved among adolescents from both groups (p<0.05), however, a better QOL was reported from those adolescents enrolled in PCG. CONCLUSION The inclusion of a psychological counseling component in multidisciplinary treatment for adolescent obesity appears to provide benefits observed for improved QOL as compared with treatment without psychological counseling.
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Affiliation(s)
- Camila R M Freitas
- Universidade de Pernambuco, Programa de Pós-Graduação em Educação de Física, Recife, PE, Brazil
| | | | - Yara L Fidelix
- Universidade de Pernambuco, Programa de Pós-Graduação em Educação de Física, Recife, PE, Brazil
| | - Thiago R S Tenório
- Universidade de Pernambuco, Programa de Pós-Graduação em Educação de Física, Recife, PE, Brazil; Instituto Federal de Educação, Ciência e Tecnologia do Sertão Pernambucano, Serra Talhada, PE, Brazil
| | | | - James O Hill
- University of Colorado, Anschutz Center for Health & Wellness, Denver, United States
| | - Wagner L Prado
- Universidade Federal de São Paulo (UNIFESP), Departamento de Ciências do Movimento Humano, Santos, SP, Brazil.
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MENDES AA, IEKER ASD, CASTRO TFD, AVELAR A, NARDO JÚNIOR N. Multidisciplinary programs for obesity treatment in Brazil: A systematic review. REV NUTR 2016. [DOI: 10.1590/1678-98652016000600011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
ABSTRACT This study aimed to conduct a systematic review of publications addressing the multidisciplinary treatment of obesity in Brazil and analyze their main results. A search was conducted in the databases SciELO, Lilacs, and Pubmed/Medline using the following search terms: 'obesidade', 'intervenção', 'tratamento', 'Brasil', for the search in Portuguese, and 'obesity', 'intervention', 'treatment', 'Brazil', for the search in English. Based on these terms, the following combination of words was used: 'Intervenção multiprofissional da obesidade', 'tratamento multidisciplinar da obesidade, tratamento multiprofissional da obesidade' and 'multidisciplinary obesity intervention', 'multidisciplinary obesity treatment', 'Multiprofessional obesity treatment'. Inclusion criteria were as follows: original studies carried out in Brazil involving human beings and that reported an intervention including two or more health care professionals. Articles published between January 2005 and July 2015 were analyzed independently by two reviewers. At the end of the analysis, out of 355 articles initially selected, 26 met all inclusion criteria. The following results were found: 23 studies involved children and adolescents and 03 involved adults 20-60 years of age. It was also found that the 26 studies analyzed had an impact on anthropometric parameters, 10 on physical fitness parameters, 16 on biochemical parameters, 10 on the reduction in comorbidities, 6 on nutritional parameters, and 4 on the psychological/social aspects. Based on evidence presented in the studies reviewed, it can be said that the multidisciplinary treatment for obesity greatly contributed to the reduction in the anthropometric indicators, especially BMI and the biochemical, social, and psychological parameters. Thus, these findings demonstrate that there is a need to expand the range of this type of treatment since it has proven to be effective in the fight against obesity and its comorbidities.
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Zhang Y, Mei S, Yang R, Chen L, Gao H, Li L. Effects of lifestyle intervention using patient-centered cognitive behavioral therapy among patients with cardio-metabolic syndrome: a randomized, controlled trial. BMC Cardiovasc Disord 2016; 16:227. [PMID: 27863480 PMCID: PMC5116154 DOI: 10.1186/s12872-016-0398-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 11/07/2016] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Cardio-metabolic syndrome (CMS) is a highly prevalent condition. There is an urgent need to identify effective and integrated multi-disciplinary approaches that can reduce risk factors for CMS. METHODS Sixty-two patients with a history of CMS were randomized 1:1 into two groups: a standard information -only group (control), or a self-regulated lifestyle waist circumference (patient-centered cognitive behavioral therapy) intervention group. A pretest and posttest, controlled, experimental design was used. Outcomes were measured at the baseline (week 0) and at the end of intervention (week 12). Comparisons were drawn between groups and over time. RESULTS The mean (standard deviation) age of the subjects was 48.6 (5.8) years ranging from 32 to 63, and 56.9% of the participants were female. Both groups showed no significant differences in Demographic variables and the metabolic syndrome indicators at baseline. While the control group only showed modest improvement after 12 weeks, compared to baseline, the intervention group demonstrated significant improvement from baseline. This study controlled for patients' demographics and baseline characteristics when assessing the effects of intervention. After adjusting for age, education and baseline level, the experimental group and the control group were statistically significant different in the following post-treatment outcomes: WC (F = 35.96, P < 0.001), TG (F = 18.93, P < 0.001), RSBP (F = 33.89, P < 0.001) and SF-36(F = 157.93, P < 0.001). The results showed patients' age and education were not strong predictors of patients' outcome (including WC, TG, RSBP and SF-36). CONCLUSIONS Lifestyle intervention on patient-centered cognitive behavioral therapy can improve the physical and mental health conditions among individuals reporting a history of cardio-metabolic syndrome, and possibly provided preliminary benefits for the treatment of CMS. TRIAL REGISTRATION Chinese Clinical Trial Register #, ChiCTR15006148 .
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Affiliation(s)
- Ying Zhang
- Department of Children and Adolescent Health Care, School of Public Health, Jilin University, #1163 Xinmin Street, Changchun, 130021 People’s Republic of China
- Department of Education, The First Affiliated Hospital, Jinzhou Medical University, Jinzhou, China
| | - Songli Mei
- Department of Children and Adolescent Health Care, School of Public Health, Jilin University, #1163 Xinmin Street, Changchun, 130021 People’s Republic of China
| | - Rui Yang
- Department of Internal Medicine, The First Affiliated Hospital, Jinzhou Medical University, Jinzhou, China
| | - Ling Chen
- Department of Internal Medicine, The First Affiliated Hospital, Jinzhou Medical University, Jinzhou, China
| | - Hang Gao
- Department of Internal Medicine, The First Affiliated Hospital, Jinzhou Medical University, Jinzhou, China
| | - Li Li
- Faculty of Humanity Management, Jinzhou Medical University, Jinzhou, China
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Effect of water- versus land-based exercise training as a component of a multidisciplinary intervention program for overweight and obese adolescents. Physiol Behav 2016; 165:365-73. [DOI: 10.1016/j.physbeh.2016.08.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 08/01/2016] [Accepted: 08/17/2016] [Indexed: 11/19/2022]
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Martínez-Momblán MA, Gómez C, Santos A, Porta N, Esteve J, Úbeda I, Halperin I, Campillo B, Guillaumet M, Webb SM, Resmini E. A specific nursing educational program in patients with Cushing's syndrome. Endocrine 2016; 53:199-209. [PMID: 26400845 DOI: 10.1007/s12020-015-0737-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Accepted: 09/04/2015] [Indexed: 11/28/2022]
Abstract
Cushing's syndrome (CS) is a rare endocrine disease, due to cortisol hypersecretion. CS patients have comorbidities, often still present after biochemical cure. Specific nursing healthcare programs to address this disease and achieve improved health related quality of life (HRQoL) are lacking. Thus, an educational nursing intervention, through the development and promotion of specific educational tools, appears to be justified. The objective of this study is to assess the effectiveness of an educational nursing program in CS patients on HRQoL, clinical parameters, level of pain and physical activity, patterns of rest, and use of health resources. A prospective, randomized study was conducted in two reference hospitals for CS. Sixty-one patients (mean age 47 ± 12.7 years, 83.6 % females) were enrolled and divided into 2 groups: an "intervention" group where educational sessions were performed over 9 months and a "control" group, without these sessions. Specific questionnaires were used at the beginning and end of the study. After educational sessions, the intervention group had a better score in the CushingQoL questionnaire (p < 0.01), reduced level of pain (p < 0.05), improved physical activity (p < 0.01) and healthy lifestyle (p < 0.001) compared to the control group. A correlation between the CushingQoL score and reduced pain (r = 0.46, p < 0.05), improved physical activity (r = 0.89, p < 0.01), and sleep (r = 0.53, p = 0.01) was observed. This educational nursing program improved physical activity, healthy lifestyle, better sleep patterns, and reduced pain in CS patients, influencing HRQoL and reducing consumption of health resources. Moreover, the brief nature of the program suggests it as a good candidate to be used in CS patients.
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Affiliation(s)
- M Antonia Martínez-Momblán
- University School of Nursing, Hospital Sant Pau, Barcelona, Spain
- Universitat Autónoma de Barcelona (UAB), 08193, Bellaterra (Cerdanyola del Vallès), Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBER-ER), Unit 747, ISCIII, Madrid, Spain
| | - Carmen Gómez
- Intensive Care Department, Hospital Sant Pau, Barcelona, Spain
| | - Alicia Santos
- Universitat Autónoma de Barcelona (UAB), 08193, Bellaterra (Cerdanyola del Vallès), Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBER-ER), Unit 747, ISCIII, Madrid, Spain
- Endocrinology/Medicine Department, Hospital de Sant Pau, IIB Sant Pau, C. S. Antoni Maria Claret n.167, 08025, Barcelona, Spain
| | - Nuria Porta
- Department of Statistics and Operations Research, Universitat Politècnica de Catalunya (UPC), Barcelona, Spain
| | - Julia Esteve
- University School of Nursing, Hospital Sant Pau, Barcelona, Spain
- Universitat Autónoma de Barcelona (UAB), 08193, Bellaterra (Cerdanyola del Vallès), Spain
| | - Inmaculada Úbeda
- Department of Nursing, Universitat de Barcelona (UB), Barcelona, Spain
| | - Irene Halperin
- Department Endocrinology, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
| | - Beatriz Campillo
- University School of Nursing, Hospital Sant Pau, Barcelona, Spain
- Universitat Autónoma de Barcelona (UAB), 08193, Bellaterra (Cerdanyola del Vallès), Spain
| | - Montserrat Guillaumet
- University School of Nursing, Hospital Sant Pau, Barcelona, Spain
- Universitat Autónoma de Barcelona (UAB), 08193, Bellaterra (Cerdanyola del Vallès), Spain
| | - Susan M Webb
- Universitat Autónoma de Barcelona (UAB), 08193, Bellaterra (Cerdanyola del Vallès), Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBER-ER), Unit 747, ISCIII, Madrid, Spain
- Endocrinology/Medicine Department, Hospital de Sant Pau, IIB Sant Pau, C. S. Antoni Maria Claret n.167, 08025, Barcelona, Spain
| | - Eugenia Resmini
- Universitat Autónoma de Barcelona (UAB), 08193, Bellaterra (Cerdanyola del Vallès), Spain.
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBER-ER), Unit 747, ISCIII, Madrid, Spain.
- Endocrinology/Medicine Department, Hospital de Sant Pau, IIB Sant Pau, C. S. Antoni Maria Claret n.167, 08025, Barcelona, Spain.
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22
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Management of Moderate Hypertriglyceridemia in Childhood and Adolescence. CURRENT CARDIOVASCULAR RISK REPORTS 2016. [DOI: 10.1007/s12170-016-0484-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Cavazzotto TG, Brasil MR, Oliveira VM, da Silva SR, Ronque ERV, Queiroga MR, Serassuelo Junior H. Nutritional status of children and adolescents based on body mass index: agreement between World Health Organization and International Obesity Task Force. ACTA ACUST UNITED AC 2015; 32:44-9. [PMID: 24676189 PMCID: PMC4183002 DOI: 10.1590/s0103-05822014000100008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Accepted: 09/27/2013] [Indexed: 11/21/2022]
Abstract
Objective: To investigate the agreement between two international criteria for
classification of children and adolescents nutritional status. Methods: The study included 778 girls and 863 boys aged from six to 13 years old. Body mass
and height were measured and used to calculate the body mass index. Nutritional
status was classified according to the cut-off points defined by the World Health
Organization and the International Obesity Task Force. The agreement was evaluated
using Kappa statistic and weighted Kappa. Results: In order to classify the nutritional status, the agreement between the criteria
was higher for the boys (Kappa 0.77) compared to girls (Kappa 0.61). The weighted
Kappa was also higher for boys (0.85) in comparison to girls (0.77). Kappa index
varied according to age. When the nutritional status was classified in only two
categories - appropriate (thinness + accentuated thinness + eutrophy) and
overweight (overweight + obesity + severe obesity) -, the Kappa index presented
higher values than those related to the classification in six categories. Conclusions: A substantial agreement was observed between the criteria, being higher in males
and varying according to the age.
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24
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Kavey REW. Combined dyslipidemia in childhood. J Clin Lipidol 2015; 9:S41-56. [PMID: 26343211 DOI: 10.1016/j.jacl.2015.06.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Revised: 05/21/2015] [Accepted: 06/05/2015] [Indexed: 01/19/2023]
Abstract
Combined dyslipidemia (CD) is now the predominant dyslipidemic pattern in childhood, characterized by moderate-to-severe elevation in triglycerides and non-high-density lipoprotein cholesterol (non-HDL-C), minimal elevation in low-density lipoprotein cholesterol (LDL-C), and reduced HDL-C. Nuclear magnetic resonance spectroscopy shows that the CD pattern is represented at the lipid subpopulation level as an increase in small, dense LDL and in overall LDL particle number plus a reduction in total HDL-C and large HDL particles, a highly atherogenic pattern. In youth, CD occurs almost exclusively with obesity and is highly prevalent, seen in more than 40% of obese adolescents. CD in childhood predicts pathologic evidence of atherosclerosis and vascular dysfunction in adolescence and young adulthood, and early clinical cardiovascular events in adult life. There is a tight connection between CD, visceral adiposity, insulin resistance, nonalcoholic fatty liver disease, and the metabolic syndrome, suggesting an integrated pathophysiological response to excessive weight gain. Weight loss, changes in dietary composition, and increases in physical activity have all been shown to improve CD significantly in children and adolescents in short-term studies. Most importantly, even small amounts of weight loss are associated with significant decreases in triglyceride levels and increases in HDL-C levels with improvement in lipid subpopulations. Diet change focused on limitation of simple carbohydrate intake with specific elimination of all sugar-sweetened beverages is very effective. Evidence-based recommendations for initiating diet and activity change are provided. Rarely, drug therapy is needed, and the evidence for drug treatment of CD in childhood is reviewed.
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Affiliation(s)
- Rae-Ellen W Kavey
- Department of Pediatrics, University of Rochester Medical Center, Rochester, NY, USA.
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25
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Browning MG, Bean MK, Wickham EP, Stern M, Evans RK. Cardiometabolic and Fitness Improvements in Obese Girls Who Either Gained or Lost Weight during Treatment. J Pediatr 2015; 166:1364-9. [PMID: 25890676 PMCID: PMC4446179 DOI: 10.1016/j.jpeds.2015.03.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Revised: 02/03/2015] [Accepted: 03/05/2015] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate the quality of weight change (change in fat mass vs fat-free mass [FFM]), changes in cardiorespiratory fitness (CRF), and frequencies of metabolic risk factors in adolescent females with obesity who either lost or gained weight following lifestyle treatment. STUDY DESIGN Fifty-eight girls (mean age = 13.0 ± 1.6 years; 77% black; mean body mass index = 36.5 ± 4.5 kg/m(2)) completed a 6-month lifestyle intervention combining dietary and behavioral counseling with aerobic and resistance exercise training. We examined baseline to 6-month differences in weight (kg), body composition, CRF, and frequencies of metabolic risk factors between weight loss and weight gain groups. RESULTS In the weight loss group, body weight (-4.50 ± 3.53 kg, P < .001), fat mass (-4.50 ± 2.20 kg, P < .001), and body fat percentage (-2.97% ± 1.45%, P < .001) decreased, and FFM was unchanged at 6 months. In the weight gain group, body weight (4.50 ± 2.20 kg, P < .001), fat mass (1.52 ± 3.16 kg, P < .024), and FFM (2.99 ± 2.45 kg, P < .001) increased, and body fat percentage was unchanged. Both groups improved CRF (P < .05). Frequencies of metabolic risk factors were reduced across all participants after the 6-month treatment. CONCLUSIONS Participation in a weight management program might elicit health improvements in obese adolescent females who increase weight and fat mass, provided that FFM gains are sufficient to negate increases in body fat percentage. TRIAL REGISTRATION ClinicalTrials.gov: NCT00167830.
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Affiliation(s)
- Matthew G. Browning
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA
| | - Melanie K. Bean
- Healthy Lifestyle Center, Department of Pediatrics, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, VA
| | - Edmond P. Wickham
- Healthy Lifestyle Center, Department of Pediatrics, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, VA,Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA
| | - Marilyn Stern
- Department of Rehabilitation and Mental Health Counseling, University of South Florida, Tampa, FL
| | - Ronald K. Evans
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA,Healthy Lifestyle Center, Department of Pediatrics, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, VA
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26
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da Silva DF, Bianchini JAA, Lopera CA, Capelato DA, Hintze LJ, Nardo CCS, Ferraro ZM, Nardo Junior N. Impact of readiness to change behavior on the effects of a multidisciplinary intervention in obese Brazilian children and adolescents. Appetite 2015; 87:229-35. [DOI: 10.1016/j.appet.2014.12.221] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 12/22/2014] [Accepted: 12/23/2014] [Indexed: 11/25/2022]
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27
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Walsh SM, Palmer W, Welsh JA, Vos MB. Challenges and Successes of a Multidisciplinary Pediatric Obesity Treatment Program. Nutr Clin Pract 2014; 29:780-5. [DOI: 10.1177/0884533614551839] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Stephanie M. Walsh
- Wellness Department, Children’s Healthcare of Atlanta, Atlanta, Georgia
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Wendy Palmer
- Wellness Department, Children’s Healthcare of Atlanta, Atlanta, Georgia
| | - Jean A. Welsh
- Wellness Department, Children’s Healthcare of Atlanta, Atlanta, Georgia
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
- Nutrition and Health Sciences Program, Graduate School of Biological and Biomedical Sciences, Emory University, Atlanta, Georgia
| | - Miriam B. Vos
- Wellness Department, Children’s Healthcare of Atlanta, Atlanta, Georgia
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
- Nutrition and Health Sciences Program, Graduate School of Biological and Biomedical Sciences, Emory University, Atlanta, Georgia
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28
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Bianchini JAA, da Silva DF, Hintze LJ, Antonini VDS, Lopera CA, McNeil J, Nardo Junior N. Obese adolescents who gained/maintained or lost weight had similar body composition and cardiometabolic risk factors following a multidisciplinary intervention. J Exerc Sci Fit 2014. [DOI: 10.1016/j.jesf.2014.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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29
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Parasympathetic cardiac activity is associated with cardiorespiratory fitness in overweight and obese adolescents. Pediatr Cardiol 2014; 35:684-90. [PMID: 24272169 DOI: 10.1007/s00246-013-0838-6] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Accepted: 11/05/2013] [Indexed: 10/26/2022]
Abstract
The aim of this study was to investigate the association between cardiac parasympathetic activity and cardiorespiratory fitness, insulin, and hemodynamic profile in overweight and obese adolescent girls and boys (aged 12-16 years). Data were taken from the Multidisciplinary Obesity Treatment Program. Only post-intervention measurements are presented herein. Body composition, cardiorespiratory fitness, blood pressure, and metabolic profile (insulin and glucose profile) of adolescents were assessed. Cardiac parasympathetic activity was determined by resting heart rate variability, which was analyzed using a heart rate monitor. Greater parasympathetic cardiac activity was associated with higher levels of cardiorespiratory fitness in both girls and boys (0.375 ≤ r ≤ 0.900), while the sympathetic-vagal balance was negatively related to maximal oxygen uptake (VO2max) in girls (r = 0.478). An association between lower parasympathetic activity and insulin resistance was noted in girls (mean of R-R intervals [RRmean] and homeostasis model assessment insulin-resistance index [HOMA-IR]: r = -0.678), while greater systolic blood pressure (SBP) and lower parasympathetic activity were associated in both sexes (RRmean and SBP: r = -0.526; high frequency [HF (nu)] and SBP: r = -0.754). In conclusion, autonomic nervous system activity was associated with cardiorespiratory fitness, insulin resistance, and SBP in overweight and obese adolescents. The identification of these potential relationships assists with the establishment of future long-term exercise interventions that evaluate the improvements in parasympathetic nervous system activity, in addition to metabolic profile and cardiorespiratory fitness in overweight and obese adolescents.
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30
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Behringer M, Gruetzner S, McCourt M, Mester J. Effects of weight-bearing activities on bone mineral content and density in children and adolescents: a meta-analysis. J Bone Miner Res 2014; 29:467-78. [PMID: 23857721 DOI: 10.1002/jbmr.2036] [Citation(s) in RCA: 109] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Revised: 06/21/2013] [Accepted: 07/01/2013] [Indexed: 01/22/2023]
Abstract
Osteoporosis and associated fractures are a major health concern in Western industrialized nations. Exercise during growth is suggested to oppose the involutional bone loss later in life by increasing peak bone mass. The primary aim of the present meta-analysis was to provide a robust estimate of the effect of weight-bearing activities (WBAs) on bone mineral content (BMC) and areal bone mineral density (aBMD), during childhood and adolescence. To locate relevant studies up to June 2012, computerized searches of multiple bibliographic databases and hand searches of key journals and reference lists were performed. Results were extracted by two independent reviewers. The quality of the included trials was assessed via the Physiotherapy Evidence Database (PEDro) score. The study group effect was defined as the difference between the standardized mean change for the treatment and control groups divided by the pooled pretest SD. From 109 potentially relevant studies, only 27 met the inclusion criteria. The analyzed training programs were capable of significantly increasing BMC and aBMD during growth. However, the weighted overall effect sizes (ESs) for changes in BMC (ES 0.17; 95% confidence interval [CI], 0.05-0.29; p < 0.05) and aBMD (ES 0.26; 95% CI, 0.02-0.49) were small. Stepwise backward regression revealed that more than one-third of the observed variance (r(2) = 0.35) between subgroups of the BMC dataset could be explained by differences in the amount of habitual calcium intake per day (beta 0.54, p < 0.01) and the maturational stage (beta -0.28, p < 0.01) at baseline. No significant moderators were identified for aBMD, possibly due to the small number of trials investigating WBAs on aBMD. The results of this meta-analysis conclude that WBAs alongside high calcium intake provide a practical, relevant method to significantly improve BMC in prepubertal children, justifying the application of this exercise form as an osteoporosis prophylaxis in this stage of maturity.
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Affiliation(s)
- Michael Behringer
- Institute of Training Science and Sport Informatics, German Sport University Cologne, Cologne, Germany
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31
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Suburu J, Gu Z, Chen H, Chen W, Zhang H, Chen YQ. Fatty acid metabolism: Implications for diet, genetic variation, and disease. FOOD BIOSCI 2013; 4:1-12. [PMID: 24511462 DOI: 10.1016/j.fbio.2013.07.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Cultures across the globe, especially Western societies, are burdened by chronic diseases such as obesity, metabolic syndrome, cardiovascular disease, and cancer. Several factors, including diet, genetics, and sedentary lifestyle, are suspected culprits to the development and progression of these health maladies. Fatty acids are primary constituents of cellular physiology. Humans can acquire fatty acids by de novo synthesis from carbohydrate or protein sources or by dietary consumption. Importantly, regulation of their metabolism is critical to sustain balanced homeostasis, and perturbations of such can lead to the development of disease. Here, we review de novo and dietary fatty acid metabolism and highlight recent advances in our understanding of the relationship between dietary influences and genetic variation in fatty acid metabolism and their role in chronic diseases.
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Affiliation(s)
- Janel Suburu
- Department of Cancer Biology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Zhennan Gu
- State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Jiangnan University, Wuxi 214122, P.R. China ; Department of Cancer Biology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Haiqin Chen
- State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Jiangnan University, Wuxi 214122, P.R. China
| | - Wei Chen
- State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Jiangnan University, Wuxi 214122, P.R. China
| | - Hao Zhang
- State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Jiangnan University, Wuxi 214122, P.R. China
| | - Yong Q Chen
- State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Jiangnan University, Wuxi 214122, P.R. China ; Department of Cancer Biology, Wake Forest School of Medicine, Winston-Salem, North Carolina
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