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Abdelkarim O, El-Gyar N, Shalaby AM, Aly M. The Effects of a School-Based Physical Activity Program on Physical Fitness in Egyptian Children: A Pilot Study from the DELICIOUS Project. CHILDREN (BASEL, SWITZERLAND) 2024; 11:842. [PMID: 39062291 DOI: 10.3390/children11070842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 06/28/2024] [Accepted: 07/05/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND Ensuring the physical fitness of Egyptian children is of paramount importance to their overall well-being, given the unique socio-cultural and educational barriers they face that may hinder their active participation. As part of the DELICIOUS project, the "Be Fit Program" aims to increase the level of physical fitness among Egyptian school-aged children. This study explores the effectiveness of a structured, six-week physical activity (PA) program in improving various facets of physical fitness in children, including body composition, speed, coordination, muscular strength, and cardiovascular endurance. With the increasing prevalence of sedentary lifestyles, such efforts are imperative to improve overall health outcomes. METHODS A cohort of 125 children, aged 8.50 to 12.25 y (mean age 10.19 ± 1.03 y), participated in the study. Their body composition, speed, coordination, strength, and aerobic fitness were assessed before and after the Be Fit Program using the revised International Physical Performance Test Profile. Paired t-tests were used to detect changes between the pre- and post-tests. RESULTS Following the six-week intervention, statistical analyses revealed significant improvements in coordination and lower body strength (p < 0.01). Aerobic endurance showed marginal improvements, approaching statistical significance (p = 0.06). Conversely, there were no statistically significant changes in body composition, speed, or upper body strength (p > 0.05). CONCLUSIONS The study confirms that tailored, non-competitive physical activities can positively influence specific fitness components in Egyptian children. However, achieving holistic improvements across all targeted fitness domains may require further strategic adjustments or a longer program duration. This pilot study underscores the importance of culturally tailored, school-based PA programs and highlights the continued need for research and program refinement to comprehensively improve children's fitness in the Egyptian context.
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Affiliation(s)
- Osama Abdelkarim
- Faculty of Physical Education, Assiut University, Assiut 71515, Egypt
| | - Noha El-Gyar
- Department of Pediatric, Faculty of Medicine, Assiut University, Assiut 71515, Egypt
| | - Amira M Shalaby
- Department of Pediatric, Faculty of Medicine, Assiut University, Assiut 71515, Egypt
| | - Mohamed Aly
- Faculty of Physical Education, Assiut University, Assiut 71515, Egypt
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Cardiovascular endurance and psychosocial health predict short- and long-term BMI-SDS reduction: results from the CHILT III program. Eur J Pediatr 2023; 182:2225-2234. [PMID: 36867234 PMCID: PMC9982786 DOI: 10.1007/s00431-023-04876-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 02/09/2023] [Accepted: 02/11/2023] [Indexed: 03/04/2023]
Abstract
This longitudinal study analyzes data from the Children's Health Interventional Trial (CHILT) III, an 11-month juvenile multicomponent weight management program. The objective is to identify predictors of changes in body mass index standard deviation scores (BMI-SDS), so as to further enable the advancement of existing interventions with sustained impact. This study's sample consists of 237 children and adolescents with obesity (8-17 years, 54% girls) participating in the CHILT III program between 2003 and 2021. Anthropometrics, demographics, relative cardiovascular endurance (W/kg), and psychosocial health (i.e., physical self-concept and self-worth) were assessed at program entry ([Formula: see text]), end ([Formula: see text]), and one-year follow-up ([Formula: see text]; n = 83). From [Formula: see text] to [Formula: see text], the mean BMI-SDS was reduced by -0.16 ± 0.26 units (p < 0.001). Media use and cardiovascular endurance at baseline and improvements in endurance and self-worth over the course of the program predicted changes in BMI-SDS (adj. R2 = 0.22, p < 0.001). From [Formula: see text] to [Formula: see text], mean BMI-SDS increased ([Formula: see text], p = 0.005). Changes in BMI-SDS from [Formula: see text] to [Formula: see text] were associated with parental education, improvements in cardiovascular endurance and physical self-concept, and BMI-SDS, media use, physical self-concept, and endurance level at program end (adj. R2 = 0.39, p < 0.001). Conclusions: This study highlights the need for comprehensive, sustainable weight management approaches, in order to sustain the initial treatment benefits. In this context, improvements in cardiovascular endurance and psychosocial health could be essential strategies to pursue in practice, as they significantly predicted reductions in BMI-SDS - both pre- to post-intervention and at follow-up. TRIAL REGISTRATION DRKS00026785; date of registration: 13.10.202, retrospectively registered. WHAT IS KNOWN • Childhood obesity is associated with the onset of noncommunicable diseases, many of which are likely to carry into adulthood. Thus, effective weight management strategies for affected children and their families are vital. However, achieving lasting positive health outcomes with multidisciplinary weight management programs remains challenging. WHAT IS NEW • According to this study, short- and longer-term BMI-SDS reductions are associated to cardiovascular endurance and psychosocial health. These factors should therefore be given even greater consideration in weight management strategies, as they may be important not only in themselves but also for long-term weight loss (maintenance).
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Grünberg L, Eisenburger N, Ferrari N, Friesen D, Haas F, Klaudius M, Schmidt L, Joisten C. Secular Trend of Self-Concept in the Context of Childhood Obesity-Data from the CHILT III Programme, Cologne. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10010127. [PMID: 36670677 PMCID: PMC9856785 DOI: 10.3390/children10010127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/05/2023] [Accepted: 01/06/2023] [Indexed: 01/11/2023]
Abstract
Juvenile obesity is associated with a lower self-concept. Given the continued prevalence of obesity, we examined the secular trend of body mass index standard deviation score (BMI-SDS) and self-concept in participants of a German weight management programme (n = 242, 53.3% female, mean age 12.5 ± 2.1 years, mean BMI-SDS 2.45 ± 0.46) over a period of 15 years. Anthropometric data, physical fitness (watt/kg), and demographic data were assessed. The years 2005 to 2020 were grouped into six sections containing a mean of n = 40 participants. The questionnaire for the assessment of self and competence in children (FSK-K) was used to assess the following domains: "scholastic competence", "social competence", "physical appearance", "global self-worth", and "behavioural conduct". No significant between-group differences in self-assessment across self-concept domains were found. In all time periods, heavier children assigned the lowest rating to physical appearance. Social competence increased with higher physical fitness. Even though no negative trend in the self-concept of children with obesity was found in this cohort, the findings confirmed an association between juvenile overweight/obesity and lower physical self-concept, and between a better social competence and increasing physical fitness. Accompanying psychosocial care, therefore, rightly remains an important pillar of obesity therapy.
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Affiliation(s)
- Lisa Grünberg
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany
- Correspondence:
| | - Nina Eisenburger
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany
| | - Nina Ferrari
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany
- Cologne Center for Prevention in Childhood and Youth, Heart Center Cologne, University Hospital of Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - David Friesen
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany
| | - Fabiola Haas
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany
| | - Marlen Klaudius
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany
| | - Lisa Schmidt
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany
| | - Christine Joisten
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany
- Cologne Center for Prevention in Childhood and Youth, Heart Center Cologne, University Hospital of Cologne, Kerpener Str. 62, 50937 Cologne, Germany
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Fraemke A, Ferrari N, Friesen D, Haas F, Klaudius M, Mahabir E, Schmidt L, Joisten C. HOMA Index, Vitamin D Levels, Body Composition and Cardiorespiratory Fitness in Juvenile Obesity: Data from the CHILT III Programme, Cologne. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042442. [PMID: 35206632 PMCID: PMC8872273 DOI: 10.3390/ijerph19042442] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/16/2022] [Accepted: 02/18/2022] [Indexed: 12/22/2022]
Abstract
Juvenile obesity is associated with insulin resistance, among other comorbidities. In the pathogenesis of insulin-resistance-related diseases, including obesity and diabetes, Vitamin D deficiency is very common. Therefore, the relationship between insulin resistance, body composition, vitamin D level, and cardiorespiratory fitness in obese children and youth were analyzed based on the Children's Health InterventionaL Trial III project, Germany. Data on vitamin D levels and homeostatic model assessment (HOMA) indices were available from 147 participants (52.4% female; 90.5% obese; 12.3 ± 2.3 years, BMI: 30.5 ± 5.2 kg/m2, BMI standard deviation score (BMI-SDS): 2.52 ± 0.46). Vitamin D levels correlated negatively with the HOMA index, BMI, BMI-SDS, abdominal circumference, and body fat percentage but positively with relative cardiorespiratory fitness (p < 0.05 in each case). In the backward stepwise linear regression analysis, body fat (in kg; β = 0.403) and vitamin D levels (β = -0.154) explained 21.0% of the variance in the HOMA index. In summary, increased body fat and lower vitamin D levels are associated with increased HOMA indices in overweight and obese children and adolescents. In order to prevent potential negative consequences, including the development of manifest Type 2 diabetes, a healthy lifestyle with a vitamin-D-enriched diet and more time spent outdoors should be promoted.
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Affiliation(s)
- Annika Fraemke
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, Am Sportpark Müngersdorf 6, German Sport University Cologne, 50933 Cologne, Germany; (N.F.); (D.F.); (F.H.); (M.K.); (L.S.); (C.J.)
- Correspondence:
| | - Nina Ferrari
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, Am Sportpark Müngersdorf 6, German Sport University Cologne, 50933 Cologne, Germany; (N.F.); (D.F.); (F.H.); (M.K.); (L.S.); (C.J.)
- Cologne Center for Prevention in Childhood and Youth/Heart Center Cologne, University Hospital of Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - David Friesen
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, Am Sportpark Müngersdorf 6, German Sport University Cologne, 50933 Cologne, Germany; (N.F.); (D.F.); (F.H.); (M.K.); (L.S.); (C.J.)
| | - Fabiola Haas
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, Am Sportpark Müngersdorf 6, German Sport University Cologne, 50933 Cologne, Germany; (N.F.); (D.F.); (F.H.); (M.K.); (L.S.); (C.J.)
| | - Marlen Klaudius
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, Am Sportpark Müngersdorf 6, German Sport University Cologne, 50933 Cologne, Germany; (N.F.); (D.F.); (F.H.); (M.K.); (L.S.); (C.J.)
| | - Esther Mahabir
- Comparative Medicine, Center for Molecular Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Robert-Koch-Str. 21, 50931 Cologne, Germany;
| | - Lisa Schmidt
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, Am Sportpark Müngersdorf 6, German Sport University Cologne, 50933 Cologne, Germany; (N.F.); (D.F.); (F.H.); (M.K.); (L.S.); (C.J.)
| | - Christine Joisten
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, Am Sportpark Müngersdorf 6, German Sport University Cologne, 50933 Cologne, Germany; (N.F.); (D.F.); (F.H.); (M.K.); (L.S.); (C.J.)
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Sack C, Ferrari N, Friesen D, Haas F, Klaudius M, Schmidt L, Torbahn G, Wulff H, Joisten C. Health Risks of Sarcopenic Obesity in Overweight Children and Adolescents: Data from the CHILT III Programme (Cologne). J Clin Med 2022; 11:jcm11010277. [PMID: 35012017 PMCID: PMC8746104 DOI: 10.3390/jcm11010277] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 12/25/2021] [Accepted: 01/04/2022] [Indexed: 02/07/2023] Open
Abstract
Sarcopenic obesity is increasingly found in youth, but its health consequences remain unclear. Therefore, we studied the prevalence of sarcopenia and its association with cardiometabolic risk factors as well as muscular and cardiorespiratory fitness using data from the German Children’s Health InterventionaL Trial (CHILT III) programme. In addition to anthropometric data and blood pressure, muscle and fat mass were determined with bioelectrical impedance analysis. Sarcopenia was classified via muscle-to-fat ratio. A fasting blood sample was taken, muscular fitness was determined using the standing long jump, and cardiorespiratory fitness was determined using bicycle ergometry. Of the 119 obese participants included in the analysis (47.1% female, mean age 12.2 years), 83 (69.7%) had sarcopenia. Affected individuals had higher gamma-glutamyl transferase, higher glutamate pyruvate transaminase, higher high-sensitivity C-reactive protein, higher diastolic blood pressure, and lower muscular and cardiorespiratory fitness (each p < 0.05) compared to participants who were ‘only’ obese. No differences were found in other parameters. In our study, sarcopenic obesity was associated with various disorders in children and adolescents. However, the clinical value must be tested with larger samples and reference populations to develop a unique definition and appropriate methods in terms of identification but also related preventive or therapeutic approaches.
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Affiliation(s)
- Carolin Sack
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, Am Sportpark Müngersdorf 6, German Sport University Cologne, 50933 Cologne, Germany; (N.F.); (D.F.); (F.H.); (M.K.); (L.S.); (C.J.)
- Correspondence:
| | - Nina Ferrari
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, Am Sportpark Müngersdorf 6, German Sport University Cologne, 50933 Cologne, Germany; (N.F.); (D.F.); (F.H.); (M.K.); (L.S.); (C.J.)
- Cologne Center for Prevention in Childhood and Youth/Heart Center Cologne, University Hospital of Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - David Friesen
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, Am Sportpark Müngersdorf 6, German Sport University Cologne, 50933 Cologne, Germany; (N.F.); (D.F.); (F.H.); (M.K.); (L.S.); (C.J.)
| | - Fabiola Haas
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, Am Sportpark Müngersdorf 6, German Sport University Cologne, 50933 Cologne, Germany; (N.F.); (D.F.); (F.H.); (M.K.); (L.S.); (C.J.)
| | - Marlen Klaudius
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, Am Sportpark Müngersdorf 6, German Sport University Cologne, 50933 Cologne, Germany; (N.F.); (D.F.); (F.H.); (M.K.); (L.S.); (C.J.)
| | - Lisa Schmidt
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, Am Sportpark Müngersdorf 6, German Sport University Cologne, 50933 Cologne, Germany; (N.F.); (D.F.); (F.H.); (M.K.); (L.S.); (C.J.)
| | - Gabriel Torbahn
- Department of Pediatrics, Paracelsus Medical University, Breslauer Str. 201, 90471 Nuremberg, Germany;
| | - Hagen Wulff
- Department of Sport and Health Sciences, Faculty of Human Sciences, University of Potsdam, Karl-Liebknecht-Str. 24–25, 14476 Potsdam, Germany;
| | - Christine Joisten
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, Am Sportpark Müngersdorf 6, German Sport University Cologne, 50933 Cologne, Germany; (N.F.); (D.F.); (F.H.); (M.K.); (L.S.); (C.J.)
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Eisenburger N, Friesen D, Haas F, Klaudius M, Schmidt L, Vandeven S, Joisten C. Predicting Psychosocial Health of Children and Adolescents with Obesity in Germany: The Underappreciated Role of Physical Fitness. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11188. [PMID: 34769706 PMCID: PMC8583523 DOI: 10.3390/ijerph182111188] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/19/2021] [Accepted: 10/22/2021] [Indexed: 12/17/2022]
Abstract
Background: The aim of this study was to analyze the inhibitory and promotive factors of psychosocial health in the context of childhood obesity, incorporating physical fitness as an additional, potentially relevant predictor. Methods: The sample comprised cross-sectional data of 241 children and adolescents with obesity and overweight from the German Children's Health InterventionaL TriaL III program (12.5 ± 2.1 years; 51.9% girls). Demographics and lifestyle patterns were assessed via parent reports. Anthropometric data and physical fitness in relation to body weight (W/kg) were measured. Children and adolescents completed standardized questionnaires (GW-LQ-KJ, FSK-K) to assess health-related quality of life (HRQOL) and five dimensions of self-concept (scholastic, social, physical, behavioral, and self-worth). Results: Multiple linear regression analysis showed that HRQOL was significantly related to relative physical fitness (W/kg; β = 0.216, p = 0.011) as were scholastic (β = 0.228, p = 0.008) and social self-concept (β = 0.197, p = 0.023). Increasing body mass index (BMI) Z-scores, age, physical activity (hours/day), low parental educational levels, and/or migration background were negatively associated with three subdomains of self-concept (physical, behavioral, self-worth; all p < 0.05). Conclusion: The results emphasize BMI Z-scores, age, physical activity, migration background, and parents' educational level as relevant predictors of psychosocial health in the context of childhood obesity. Additionally, this study adds physical fitness as a key determinant of HRQOL and self-concept. To enable the development of more effective weight management, therapeutic strategies should therefore consider addressing these aspects and improving physical fitness in particular not only for weight loss but also to strengthen psychosocial health.
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Affiliation(s)
- Nina Eisenburger
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany; (D.F.); (F.H.); (M.K.); (L.S.); (S.V.); (C.J.)
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