Follow up exercise studies in paediatric obesity: implications for long term effectiveness

Role of diet and exercise in aging, Alzheimer's disease, and other chronic diseases

Alzheimer's disease (AD) is a progressive neurodegenerative disease, characterized by memory loss and multiple cognitive impairments. Genetic mutations cause a small proportion (1-2%) of early-onset AD, with mutations in amyloid precursor protein (APP), presenilin 1 (PS1) and presenilin 2 (PS2). Major contributing factors of late-onset AD are ApoE4 genotype, traumatic brain injury, diabetes, obesity, hypertension, cardiovascular conditions, in addition to lifestyle factors, such as unhealthy diet and lack of physical exercise. Disease progression can be delayed and/or prevented to a greater extent by adopting healthy lifestyle with balanced and antioxidant enriched diet and daily exercise. The interaction and interplay of diet, exercise, age, and pharmacological interventions holds a crucial role in the progression, pathogenesis and management of AD and its comorbidities, including diabetes, obesity, hypertension and cardiovascular conditions. Antioxidant enriched diet contributes to brain health, glucose control, weight management, and cardiovascular well-being. Regular exercise removes toxins including free radicals and enhances insulin sensitivity, and supports cardiovascular function. In the current article, we discussed, the role of diet, and exercise in aging, AD and other conditions including diabetes, obesity, hypertension, cardiovascular conditions. This article also highlights the impact of medication, socioeconomic and lifestyle factors, and pharmacological interventions. These aspects were discussed in different races and ethnic groups in Texas, and the US.

Effectiveness of school-based health promotion interventions prioritized by stakeholders from health and education sectors: A systematic review and meta-analysis

Childhood obesity and associated modifiable risk factors exert significant burden on the health care system. The goal of this systematic review and meta-analysis was to examine the effectiveness of school-based intervention types perceived by Canadian stakeholders in health and education as feasible, acceptable and sustainable in terms of improving physical activity (PA), fruit and vegetable intake, and body weight. We searched multiple databases for studies that evaluated school-based interventions to prevent obesity and associated risk factors (i.e., unhealthy diet, physical inactivity, sedentary behaviour) in children aged 4–18 years from January 1, 2012 to January 28, 2020. From 10,871 identified records, we included 83 and 80 studies in our systematic review and meta-analysis, respectively. Comprehensive School Health (CSH) and interventions which focused on modifications to school nutrition policies showed statistically significant positive effects on fruit intake of 0.13 (95% CI: 0.04, 0.23) and 0.30 (95% CI: 0.1, 0.51) servings per day, respectively. No intervention types showed statistically significant effect on vegetable intake. CSH, modifications to physical education (PE) curriculum, and multicomponent interventions showed statistically significant difference in BMI of −0.26 (95% CI: −0.40, −0.12), −0.16 (95% CI: −0.3, −0.02), and −0.18 (95% CI: −0.29, −0.07), respectively. CSH interventions showed positive effect on step-count per day, but no other types of interventions showed significant effect on any of PA outcome measures. Thus, the results of this systematic review and meta-analysis suggest that decision-makers should carefully consider CSH, multicomponent interventions, modifications to PE curricula and school nutrition policies to prevent childhood obesity.

Prevention and treatment of childhood and adolescent obesity: a systematic review of meta-analyses

BACKGROUND

The goal of this systematic review is to synthesize the published meta-analyses assessing the role of nutritional, behavioral and physical activity factors/interventions on the prevention or treatment of pediatric and adolescent obesity.

METHODS

An online search was conducted in PubMed (end-of-search: September 30, 2015); English-language meta-analyses pooling observational and/or interventional studies examining weight-related indices on children and adolescents were included.

RESULTS

Sixty-six meta-analyses corresponding to more than 900,000 children and adolescents were retrieved. The majority of meta-analyses included interventional studies most of which referred to mixed or combined interventions, including components such as diet, physical activity and sedentary behavior reduction. Discrepancies between meta-analyses on observational and interventional studies were noted. Combined interventions including physical activity and nutritional modifications seemed to represent the most effective means for tackling childhood obesity.

CONCLUSIONS

Synthesis of interventional or observational evidence may yield discrepant results. The combination of enhanced physical activity and improved nutrition emerged as a promising intervention in the fight against childhood/adolescent obesity. However, further research is needed about the most effective multidimensional prevention strategy.

The Effects of Resistance Training on Health of Children and Adolescents With Disabilities

Many parents still hesitate to encourage their children to participate in resistance training programs. This is unfortunate since recent research shows that resistance training can positively affect children's health. This narrative review aims to present an overview of the health-associated effects resistance training can provide particularly in children and adolescents with disabilities by describing its effects on muscle strength, physical function, mental health, self-concept, obesity, and injury prevention. To illustrate the variety of possible fields of application, the effects of resistance training in children and adolescents suffering from Charcot-Marie-Tooth disease, cerebral palsy, Down syndrome, Ehlers-Danlos syndrome, joint hypermobility, juvenile idiopathic arthritis, obesity, and spina bifida are discussed. Although randomized controlled trials with a sufficiently large sample size are rare, the research presented in this review indicates that this mode of training might be a potent tool to improve mental and physical health by improving muscle strength, body composition, self-concept or functionality, reducing pain or injury risk, and strengthening bone or tendons even in the most vulnerable groups of children with physical or mental disability. Furthermore, it has to be emphasized that compared with other types of treatment resistance training is considered to be without adverse effects.

Special Article: Physical Activity, Physical Fitness, and Cardiovascular Risk Factors in Childhood

In adults, physical activity and exercise training are associated with reduced cardiovascular morbidity and mortality, a reduced likelihood of developing adverse cardiovascular risk factors, and improved insulin sensitivity. In childhood, participation in appropriate physical activity may prevent the development of cardiovascular risk factors in the future and complement treatment of existing cardiovascular risk factors, including hypertension, dyslipidemia, and overweight. Exercise in children can also significantly improve insulin sensitivity independent of weight loss. These e fects are mediated in overweight children by increases in lean body mass relative to fat mass and associated improvements in inflammatory mediators, endothelial function, and the associated adverse hormonal milieu.

Soccer vs. running training effects in young adult men: which programme is more effective in improvement of body composition? Randomized controlled trial

The aims of this study were: 1) To determine the effects of a 12-week recreational soccer training programme and continuous endurance running on body composition of young adult men and 2) to determine which of these two programmes was more effective concerning body composition. Sixty-four participants completed the randomized controlled trial and were randomly assigned to one of three groups: a soccer training group (SOC; n=20), a running group (RUN; n=21) or a control group performing no physical training (CON; n=23). Training programmes for SOC and RUN lasted 12-week with 3 training sessions per week. Soccer sessions consisted of 60 min ordinary five-a-side, six-a-side or seven-a-side matches on a 30-45 m wide and 45-60 m long plastic grass pitch. Running sessions consisted of 60 min of continuous moderate intensity running at the same average heart rate as in SOC (~80% HR_max). All participants, regardless of group assignment, were tested for each of the following dependent variables: body weight, body height, body mass index, percent body fat, body fat mass, fat-free mass and total body water. In the SOC and RUN groups there was a significant decrease (p < 0.05) in body composition parameters from pre- to post-training values for all measures with the exception of fat-free mass and total body water. Body mass index, percent body fat and body fat mass did not differ between groups at baseline, but by week 12 were significantly lower (p < 0.05) in the SOC and RUN groups compared to CON. To conclude, recreational soccer training provides at least the same changes in body composition parameters as continuous running in young adult men when the training intensity is well matched.

What is the effect of resistance training on the strength, body composition and psychosocial status of overweight and obese children and adolescents? A Systematic review and meta-analysis

BACKGROUND

Overweight and obese children and adolescents face many physical and psychosocial hardships. Resistance training is a modality of exercise which allows this at-risk group to excel and therefore has the potential to positively affect not only their physical but also psychosocial health.

OBJECTIVE

To systematically review and meta-analyse the peer-reviewed literature to determine the effect of resistance training on the strength, body composition and psychosocial status of overweight and/or obese children and/or adolescents.

DATA SOURCES

Relevant databases (MEDLINE, Embase, Scopus, Web of Science, SPORTDiscus, CINAHL, PsycINFO, Cochrane library, ProQuest) were searched up to and including 30 January 2013.

STUDY SELECTION

Included studies (n = 40, from the 2,247 identified) were randomised controlled trials (RCTs), non-randomised controlled trials (NRCTs) and uncontrolled trials (UCTs) which had run an exercise intervention, with a resistance training component, for overweight and/or obese children and/or adolescents, and which had examined the effect of resistance training on either strength, body composition or psychosocial outcomes.

STUDY APPRAISAL AND SYNTHESIS METHODS

Studies were initially critically appraised for risk of bias by the lead author, following which both co-authors critically appraised five randomly selected studies to assess reliability.

RESULTS

Randomised controlled trials and NRCTs were analysed separately from UCTs. To determine the overall intervention effect for each outcome variable for each study design group, standardised mean differences were calculated with each individual study/data set weighted by the inverse of the pooled variance. The overall intervention effect reported for RCTs and NRCTs was relative to the control group whereas the effect reported for UCTs shows an overall post-intervention effect. Subgroup analyses, which determined whether the overall intervention effect was influenced by intervention type, training volume, age, sex, risk of bias or study design (for RCT/NRCT group only), were run using the same summary measure. Typically, resistance training had very small to small effects on body composition and moderate to large effects on strength in favour of the intervention. However, the magnitude and direction of the effect of resistance training on psychological outcomes are still unclear given the limited number of studies which looked at psychosocial outcomes and the inconclusive results shown by this review. Uncontrolled trials typically showed larger intervention effects than RCTs and NRCTs; however, these results may be greatly influenced by maturational changes rather than the intervention itself.

LIMITATIONS

The included studies employed a number of different exercise intervention types (e.g. resistance training, resistance plus aerobic training etc.) that ranged from 6 to 52 weeks in duration. Studies also employed a number of different methodologies to assess similar outcome measures (e.g. dual energy X-ray absorptiometry versus skinfolds to assess body composition; one-repetition maximum testing versus hand grip strength to assess strength). However, by completing subgroup analyses and using a standardised summary measure these limitations have been accounted for.

CONCLUSION

While the effect of resistance training on the body composition and strength of overweight and obese children and adolescents is clear, given the paucity of conclusive data more studies are needed to fully understand the effect of resistance training on the psychosocial status of this population.

The effects of resistance exercise training on body composition and strength in obese prepubertal children

OBJECTIVE

To assess the effects of resistance exercise training on body composition and muscular strength in obese prepubertal children.

DESIGN

Study participants, who were between the ages of 8 and 12 years, met Tanner I (stage) criteria, had a body mass index ≥ 95th percentile for age and sex, were randomized to either high-repetition, moderate-intensity resistance training (n = 12) or to the non-intervention control group (n = 7) for 12 weeks. Exercise training was performed twice a week for 75 minutes per session. Body composition was assessed using dual energy x-ray absorptiometry and muscular strength was evaluated using a 1-repetition-maximum test.

RESULTS

Exercise-group participants attended 98% of the 24 total sessions and showed a significant increase in body weight (57.6± 13.5 vs 59.6± 14.1 kg), height (144.9± 9 vs 146.6± 10.4 cm), lean body mass (32.6± 6.8 vs 34.0± 7.0 kg), lean body mass index (lean body mass in kg/height2; 15.3± 1.6 vs 15.6± 1.5 kg/m2), arm strength (28.4± 5.8 vs 31.2± 6.0 kg), and leg strength (89.4± 31.7 vs 113.4± 34 2 kg) from baseline measures (P < 0.05). Control group participants also showed significant increases in weight, height, and lean body mass from baseline measures (P < 0.05) but not in arm or leg strength. When the changes in participant body composition and muscular strength were compared between the exercise and control groups, significant differences were found in leg lean mass and leg strength (P < 0.05). There were no changes in percent body fat and fat mass index [FM/height2(kg/m2)] in either group.

CONCLUSION

Resistance training increases leg lean mass and leg strength in obese prepubertal youth and may have a positive effect on overall physical activity and health.

A review of randomized controlled trials of aerobic exercise training on fitness and cardiometabolic risk factors in obese adolescents

Aerobic training is the most prescribed exercise modality for the management of pediatric obesity. There is strong evidence that it decreases waist circumference, percent body fat and visceral fat, increases cardiorespiratory fitness, and decreases blood pressure in obese adolescents. However, the independent effects of aerobic exercise training on other cardiometabolic risk factors (ie, insulin resistance markers, plasma lipid levels, and inflammatory markers) are limited and yield inconsistent findings. Our article reviews randomized controlled trials evaluating the effects of aerobic exercise training on body composition, fitness, lipid levels, and insulin resistance in obese adolescents (aged 13-18 years) and outlines future research directions for this population.

Top 10 practical lessons learned from physical activity interventions in overweight and obese children and adolescents

Physical activity (PA) interventions targeting overweight and obese children and adolescents have shown only modest success, and dropout is an area of concern. Proper design and implementation of a PA intervention is critical for maximizing adherence and thus increasing the overall health benefits from PA participation. We propose practical advice based on our collective clinical trial experience with support from the literature on best practices related to PA interventions in overweight and obese children and adolescents. The top 10 lessons learned are (i) PA setting–context is important; (ii) choice of fitness trainer matters; (iii) physical activities should be varied and fun; (iv) the role of the parent–guardian should be considered; (v) individual physical and psychosocial characteristics should be accounted for; (vi) realistic goals should be set; (vii) regular reminders should be offered; (viii) a multidisciplinary approach should be taken; (ix) barriers should be identified early and a plan to overcome them developed; and (x) the right message should be communicated: specifically, what's in it for them? The recommendations in this paper can be used in other pediatric PA programs, physical education settings, and public health programs, with the hope of decreasing attrition and increasing the benefits of PA participation to promote health in children and adolescents.

Leptin, adiponectin, and short-term and long-term weight loss after a lifestyle intervention in obese children

OBJECTIVE

In overweight children, high leptin levels are independently associated with higher risk for cardiovascular disease, whereas adiponectin seems to be protective against type 2 diabetes and atherosclerosis. The study examines the predictive value of leptin for weight loss after a 4- to 6-wk inpatient therapy and again after 1 y; as well as the association among weight loss, leptin, and adiponectin levels and changes in cardiometabolic risk factors after therapy.

METHODS

Body mass index (BMI), blood pressure, Tanner stage, and cardiometabolic risk factors were studied in 402 children (59.2% females, 13.9 ± 2.3 y, BMI 33.8 ± 5.7 kg/m(2)) before and after a 4-to 6-wk inpatient intervention (exercise, diet, and behavioral therapy) and BMI 1 y later (n = 206).

RESULTS

BMI was reduced from 33.8 ± 5.7 to 30.5 ± 5.1 kg/m(2) (P < 0.001) during the lifestyle intervention and remained unchanged after 1 y. Baseline BMI was positively associated with leptin (r = 0.60; P < 0.001) and cardiometabolic risk factors (blood pressure, high-density lipoprotein [HDL] cholesterol, triglycerides). Baseline leptin was associated with BMI and triglycerides (r = 0.39; P < 0.001), baseline adiponectin with HDL-cholesterol (r = 0.40; P < 0.001). Baseline BMI explained 40.7% of the variance in weight loss during therapy. The combination of BMI, sex, and leptin explained 50.4% of the variance. Neither BMI nor leptin predicted weight changes over the long term.

CONCLUSIONS

Overweight children maintained a substantial amount of weight loss after participation in a short-term inpatient lifestyle intervention. Baseline BMI was positively associated with weight reduction during the intervention, whereas baseline leptin had only a minor predictive value.

Exercise intervention in childhood obesity: a randomized controlled trial comparing hospital-versus home-based groups

OBJECTIVE

The aim of this study was to compare the effect of a hospital clinic group- versus home-based combined exercise-diet program for the treatment of childhood obesity.

METHODS

One hundred ten overweight/obese Spanish children and adolescents (6-16 years) in 2 intervention groups (hospital clinic group-based [n = 45] and home-based [n = 41]) and a sex-age-matched control group (n = 24) were randomly assigned to participate in a 6-month combined exercise (aerobic and resistance training) and Mediterranean diet program. Anthropometric values (including body weight, height, body mass index, BMI-Z score, and waist circumference) were measured pre- and postintervention for all the participants. Percentage body fat was also determined with a body fat analyzer (TANITA TBF-410 M).

RESULTS

Our study showed a significant reduction in percentage body fat and body mass index Z-score among both intervention-group participants (4%, 0.16, hospital clinic group-based; 4.4%, 0.23, home-based; P < .0001). There was also a significant reduction in waist circumference in the home-based group (4.4 cm; P = .019). Attendance rates at intervention sessions were equivalent for both intervention groups (P = .805).

CONCLUSIONS

The study findings indicate that a simple home-based combined exercise and Mediterranean diet program may be effective among overweight and obese children and adolescents, because it improves body composition, is feasible and can be adopted on a large scale without substantial expenses.

Estimating travel reduction associated with the use of telemedicine by patients and healthcare professionals: proposal for quantitative synthesis in a systematic review

Background

A major benefit offered by telemedicine is the avoidance of travel, by patients, their carers and health care professionals. Unfortunately, there is very little published information about the extent of avoided travel. We propose to undertake a systematic review of literature which reports credible data on the reductions in travel associated with the use of telemedicine.

Method

The conventional approach to quantitative synthesis of the results from multiple studies is to conduct a meta analysis. However, too much heterogeneity exists between available studies to allow a meaningful meta analysis of the avoided travel when telemedicine is used across all possible settings. We propose instead to consider all credible evidence on avoided travel through telemedicine by fitting a linear model which takes into account the relevant factors in the circumstances of the studies performed. We propose the use of stepwise multiple regression to identify which factors are significant.

Discussion

Our proposed approach is illustrated by the example of teledermatology. In a preliminary review of the literature we found 20 studies in which the percentage of avoided travel through telemedicine could be inferred (a total of 5199 patients). The mean percentage avoided travel reported in the 12 store-and-forward studies was 43%. In the 7 real-time studies and in a single study with a hybrid technique, 70% of the patients avoided travel. A simplified model based on the modality of telemedicine employed (i.e. real-time or store and forward) explained 29% of the variance. The use of store and forward teledermatology alone was associated with 43% of avoided travel. The increase in the proportion of patients who avoided travel (25%) when real-time telemedicine was employed was significant (P = 0.014). Service planners can use this information to weigh up the costs and benefits of the two approaches.

A review of resistance exercise training in obese adolescents

Resistance training-also known as strength or weight training-has been well recognized by several national organizations as a safe and beneficial exercise modality for the health and well-being of children and adolescents. Resistance exercise improves muscular strength and can improve body composition (eg, increase lean body mass and decrease percent body fat) provided that a sufficient exercise stimulus is prescribed. Effects of resistance exercise training on body composition and metabolic profile are well established in obese adults, but warrant further investigation in obese youth. This article reviews the rationale for including a resistance training component with interventions geared toward overweight and obese adolescents by discussing the effects on various health measures. Shortcomings in published trials, including small, ethnic minority samples of short-duration and low-frequency exercise sessions primarily conducted in prepubertal youth (rather than postpubertal adolescents) limit the generalizability of the published literature on the effectiveness of resistance exercise in obese adolescents.

Unpacking vertical and horizontal integration: childhood overweight/obesity programs and planning, a Canadian perspective

Background

Increasingly, multiple intervention programming is being understood and implemented as a key approach to developing public health initiatives and strategies. Using socio-ecological and population health perspectives, multiple intervention programming approaches are aimed at providing coordinated and strategic comprehensive programs operating over system levels and across sectors, allowing practitioners and decision makers to take advantage of synergistic effects. These approaches also require vertical and horizontal (v/h) integration of policy and practice in order to be maximally effective.

Discussion

This paper examines v/h integration of interventions for childhood overweight/obesity prevention and reduction from a Canadian perspective. It describes the implications of v/h integration for childhood overweight and obesity prevention, with examples of interventions where v/h integration has been implemented. An application of a conceptual framework for structuring v/h integration of an overweight/obesity prevention initiative is presented. The paper concludes with a discussion of the implications of vertical/horizontal integration for policy, research, and practice related to childhood overweight and obesity prevention multiple intervention programs.

Summary

Both v/h integration across sectors and over system levels are needed to fully support multiple intervention programs of the complexity and scope required by obesity issues. V/h integration requires attention to system structures and processes. A conceptual framework is needed to support policy alignment, multi-level evaluation, and ongoing coordination of people at the front lines of practice. Using such tools to achieve integration may enhance sustainability, increase effectiveness of prevention and reduction efforts, decrease stigmatization, and lead to new ways to relate the environment to people and people to the environment for better health for children.

A meta-analysis of obesity interventions among U.S. minority children

PURPOSE

To quantitatively evaluate the efficacy of interventions designed to prevent or treat obesity among U.S. minority children using meta-analytic techniques.

METHODS

A total of 40 intervention trials involving 10,725 children aged 6-19 years were examined.

RESULTS

Interventions with more components showed a higher mean effect size than those with fewer components: among 32 controlled trials, d = .07 for one-component (n = 6); d = .08 for two-component (n = 15); d = .33 for three-component (n = 10); and d = .71 for four-component (n = 1) interventions. Interventions with parental involvement (n = 22, d = .21) and lifestyle interventions (n = 14, d = .34) showed a greater mean effect size than those without parental involvement (n = 10, d = .05) or lifestyle interventions (n = 18, d = .04), despite the fact that their 90% confidence intervals overlapped. Among uncontrolled trials (n = 8), two-component interventions (n = 5) yielded d = .86 and three-component interventions (n = 3) yielded d = .96.

CONCLUSIONS

Evidence indicates that, among U.S. minority children, obesity interventions with three or more components might be more efficacious than those using fewer components. Parental involvement, lifestyle change, culturally-based adaptation, and interactive computer programs seem to show promise in the reduction of obese minority children.

How useful are systematic reviews of child obesity interventions?

To facilitate the translation of research evidence into practice, policy makers and practitioners require practice-relevant information such as the effectiveness of interventions delivered in specific settings, by various personnel, using various intervention modalities, and descriptions of intervention costs or adverse outcomes. The aim of this study was to review the relevance of information reported in systematic reviews of child obesity interventions in terms of these requirements. A systematic search was conducted for systematic reviews of child obesity interventions published in English between 1990 and 2008. A total of 3150 citations were examined. Of the 44 eligible reviews, 16 examined prevention interventions, 18 examined treatment interventions, and 10 examined both prevention and treatment interventions. Less than 50% of prevention and treatment reviews reported the effect of interventions conducted in specific settings, the effect of interventions conducted by various personnel and the effect of those delivered via various intervention modalities. Similarly, few (4-15%) reviews reported cost or adverse event outcomes. Existing systematic reviews of childhood obesity interventions provide limited practice-relevant information. The potential for benefit from the translation of evidence into practice is therefore limited. Involving end users in systematic review development may improve the relevance of outcomes reported in systematic reviews.

Exercise for preventing childhood obesity

Childhood obesity is a key public health issue in the United States and around the globe in developed and developing countries. Obese children are at increased risk of acute medical illnesses and chronic diseases-in particular, osteoarthritis, diabetes mellitus, and cardiovascular disease, which can lead to poor quality of life; increased personal and financial burden to individuals, families, and society; and shortened lifespan. Physical inactivity and sedentary lifestyle are associated with being overweight in children and adults. Thus it is imperative to consider exercise and physical activity as a means to prevent and combat the childhood obesity epidemic. Familiarity with definitions of weight status in children and health outcomes like metabolic syndrome is crucial in understanding the literature on childhood obesity. Exercise and physical activity play a role in weight from the prenatal through adolescent time frame. A child's family and community impact access to adequate physical activity, and further study of these upstream issues is warranted. Recommended levels of physical activity for childhood obesity prevention are being developed.

Estratégias para prevenção da obesidade em crianças e adolescentes

Poucos estudos obtiveram resultados favoráveis na prevenção da obesidade. Teoricamente, crianças e adolescentes, se comparados aos adultos, poderiam mais facilmente prevenir o ganho excessivo de peso, pois estão crescendo e têm maior possibilidade de gastar energia em atividades de lazer. Entretanto, não se consegue superar os muitos fatores que concorrem para a crescente epidemia de obesidade e as intervenções na sua maioria abordam uma fração muito pequena dos fatores que geram a obesidade. Aspectos importantes, como o papel da indústria de alimentos, das cadeias de fast food, das propagandas, de um estilo de vida que mantêm as crianças cada vez mais sedentárias e submetidas a um hiperconsumo calórico, não têm espaço nos desenhos de estudos tradicionais. Das intervenções publicadas, as que integram a família no tratamento têm obtido melhores resultados. Estudos com elementos isolados da dieta como cálcio, proteína, fibras e índice glicêmico não têm mostrado eficácia, e embora não conclusivos, os resultados referentes à redução de bebidas com alto teor de açúcar e redução do sedentarismo são promissores.

Leptin: a potential biomarker for childhood obesity?

Leptin, a hormone made by adipocytes, is an important circulating signal for the regulation of body weight. A review of the scientific literature (PubMed Search 1994 to 2005) for studies examining the relationship among leptin, pediatric obesity and the impact of exercise intervention programmes on leptin concentrations are summarized. The potential utility of leptin as a biomarker for identifying children at risk of obesity is discussed. This literature review demonstrated that (1) leptin directly interacts with the hypothalamus for energy balance regulation; (2) the measurement of free, bound and total leptin as well as soluble leptin receptor concentration are critical for our understanding of obesity in children; and (3) leptin concentration may be an important factor for determining intervention programme responsiveness in pediatric obesity.

A Review of Childhood and Adolescent Obesity Interventions

Obesity is one of the largest health problems facing Americans. Figures produced by the National Center for Health Statistics show that in 1999-2002, 15.8% of 6-11-year-olds were overweight as were 16.1% of adolescents aged 12-19. Some have proposed that interventions in childhood may be the best place to focus efforts to reduce the growing obesity epidemic. This paper examines several of the popular intervention strategies that have been proposed for youth and assesses the potential of these interventions for meaningful public health impacts. Findings show that most childhood obesity interventions completed to date produced only meager results, creating need for more well-designed studies that are tailored to the needs of specific age, ethnic and economic groups.