Influence of Acute Physical Activity on Stress Reactivity in Obese and Normal Weight Children: A Randomized Controlled Trial

Can Acute Exercise Lower Cardiovascular Stress Reactivity? Findings from a Scoping Review

Exaggerated cardiovascular reactivity to and delayed recovery from stress increase the risk of cardiovascular diseases in the future. While exercise training has been shown to attenuate stress-induced cardiovascular reactivity and enhance recovery from stress, the effects with acute exercise are less characterized. The aim of this scoping review was to explore the range and characteristics of published evidence regarding acute exercise on cardiovascular reactivity and stress recovery. The secondary objective was to highlight research gaps and implications for future research. A total of 36 articles met the review inclusion/exclusion criteria, involving 1200 participants from various age groups, fitness and health status. Blood pressure (BP) reactivity was the most measured outcome, followed by heart rate (HR) reactivity, and to some extent, heart rate variability. Overall, acute exercise particularly of the moderate-intensity aerobic type effectively reduced stress-induced BP reactivity in the general population. The effects on HR reactivity and cardiovascular recovery were inconclusive. Further research would be recommended to establish if other forms of exercise intensity or type are equally beneficial to lower exaggerated cardiovascular responses to stress. Despite methodological differences and limitations, the available evidence supports the therapeutic potential of acute exercise in addressing the ill effects of stress on cardiovascular health.

Cortisol Reactivity to a Digital Version of Trier Social Stress Test and Eating Behavior in Non-Overweight and Overweight Adolescents: A Pilot Study

(1) Background: In the present pilot study, we examined the response of cortisol to a digital version of the Trier Social Stress Test (TSST) and corresponding eating preferences in non-overweight and overweight adolescents. (2) Methods: The experimental study group included 35 adolescents aged 15.7 ± 0.5 years (16 boys and 19 girls). The participants were split into two groups: non-overweight (N = 24) and overweight (N = 11), according to the Body Mass Index (BMI). We induced acute stress in all participants, using a digital version of the Trier Social Stress Test (TSST), with three different digital tasks. We measured salivary cortisol before the test (T0), during the stress induction by digital tasks (T5, T10, T15), and 25 min after the stress test (T40). The Health Behavior in School-Aged Children Questionnaire (HBSC) was administered to assess the influence of stress on eating behavior: the consumption of fruit, vegetables, sweets, and soft drinks and the frequency of snacks. (3) Results: Among the entire group of adolescents, we observed a significant difference between the sexes in terms of cortisol response, girls being predominantly hyperreactive (13 girls compared to 5 boys, p = 0.03). In overweight adolescents, the cortisol reactivity was lower in boys and higher in girls (p = 0.05). The overweight hyperreactive adolescents, as compared to the hyporeactive ones, had a higher frequency of daily consumption of sweets (25% vs. 0%) and soft drink (25% vs. 0). (4) Conclusions: The individual patterns of cortisol reactivity to laboratory-induced stress could be associated with an increased risk of unhealthy eating behavior in adolescents.

Cortisol Reactivity to a Digital Version of Trier Social Stress Test and Eating Behavior in Non-Overweight and Overweight Adolescents: A Pilot Study

(1) Background: In the present pilot study, we examined the response of cortisol to a digital version of the Trier Social Stress Test (TSST) and corresponding eating preferences in non-overweight and overweight adolescents. (2) Methods: The experimental study group included 35 adolescents aged 15.7 ± 0.5 years (16 boys and 19 girls). The participants were split into two groups: non-overweight (N = 24) and overweight (N = 11), according to the Body Mass Index (BMI). We induced acute stress in all participants, using a digital version of the Trier Social Stress Test (TSST), with three different digital tasks. We measured salivary cortisol before the test (T0), during the stress induction by digital tasks (T5, T10, T15), and 25 min after the stress test (T40). The Health Behavior in School-Aged Children Questionnaire (HBSC) was administered to assess the influence of stress on eating behavior: the consumption of fruit, vegetables, sweets, and soft drinks and the frequency of snacks. (3) Results: Among the entire group of adolescents, we observed a significant difference between the sexes in terms of cortisol response, girls being predominantly hyperreactive (13 girls compared to 5 boys, p = 0.03). In overweight adolescents, the cortisol reactivity was lower in boys and higher in girls (p = 0.05). The overweight hyperreactive adolescents, as compared to the hyporeactive ones, had a higher frequency of daily consumption of sweets (25% vs. 0%) and soft drink (25% vs. 0). (4) Conclusions: The individual patterns of cortisol reactivity to laboratory-induced stress could be associated with an increased risk of unhealthy eating behavior in adolescents.

Effects of a novel mobile health intervention compared to a multi-component behaviour changing program on body mass index, physical capacities and stress parameters in adolescents with obesity: a randomized controlled trial

Background

Less than 2% of overweight children and adolescents in Switzerland can participate in multi-component behaviour changing interventions (BCI), due to costs and lack of time. Stress often hinders positive health outcomes in youth with obesity. Digital health interventions, with fewer on-site visits, promise health care access in remote regions; however, evidence for their effectiveness is scarce.

Methods

This randomized controlled not blinded trial (1:1) was conducted in a childhood obesity center in Switzerland. Forty-one youth aged 10–18 years with body mass index (BMI) > P.90 with risk factors or co-morbidities or BMI > P.97 were recruited. During 5.5 months, the PathMate2 group (PM) received daily conversational agent counselling via mobile app, combined with standardized counselling (4 on-site visits). Controls (CON) participated in a BCI (7 on-site visits). We compared the outcomes of both groups after 5.5 (T1) and 12 (T2) months. Primary outcome was reduction in BMI-SDS (BMI standard deviation score: BMI adjusted for age and sex). Secondary outcomes were changes in body fat and muscle mass (bioelectrical impedance analysis), waist-to-height ratio, physical capacities (modified Dordel-Koch-Test), blood pressure and pulse. Additionally, we hypothesized that less stressed children would lose more weight. Thus, children performed biofeedback relaxation exercises while stress parameters (plasma cortisol, stress questionnaires) were evaluated.

Results

At intervention start median BMI-SDS of all patients (18 PM, 13 CON) was 2.61 (obesity > + 2SD). BMI-SDS decreased significantly in CON at T1, but not at T2, and did not decrease in PM during the study. Muscle mass, strength and agility improved significantly in both groups at T2; only PM reduced significantly their body fat at T1 and T2. Average daily PM app usage rate was 71.5%. Cortisol serum levels decreased significantly after biofeedback but with no association between stress parameters and BMI-SDS. No side effects were observed.

Conclusions

Equally to BCI, PathMate2 intervention resulted in significant and lasting improvements of physical capacities and body composition, but not in sustained BMI-SDS decrease. This youth-appealing mobile health intervention provides an interesting approach for youth with obesity who have limited access to health care. Biofeedback reduces acute stress and could be an innovative adjunct to usual care.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12887-021-02781-2.

Impact of self-determination theory in a physiotherapeutic training : A pilot-study on motivation for movement of obese adolescents

Background

This study determined to what extent the underpinning of physiotherapeutic interventions with the evidence-based motivational psychological concept of the self-determination theory (SDT) by Ryan and Deci can increase motivation and enjoyment of movement in obese adolescents.

Methods

In this study 12 obese adolescents aged 14–18 years were offered a targeted group-specific sports program including a home exercise program of 8 weeks. The group leaders were trained in the SDT and supported to integrate motivational aspects. A SDT-based questionnaire by Kohake and Lehnert was used to evaluate motivational interventions.

Results

In total, seven (58%) patients finished the study. In the before-after comparison there were little changes in motivation. Results showed that contrary to expectations the motivation of the obese adolescents to move and to participate in the study was generally high. In the study, more internalized forms of motivation dominated, the highest quality form of motivation.

Conclusion

Digital technologies could be a successful way to further increase motivation and compliance of our target group. This MotiMove study is a basis for future research programs and empower physiotherapists and movement experts to develop and implement training programs for obese adolescents and children.

Supplementary Information

The online version of this article (10.1007/s00508-021-01849-4) contains supplementary material, which is available to authorized users.