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Raedeke TD, Hayes M. Feasibility of Project Mentor: A Mentoring Program Based on Self-Determination Theory for Adolescents Classified as Overweight. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2024; 95:157-170. [PMID: 37036401 DOI: 10.1080/02701367.2023.2167912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 12/14/2022] [Indexed: 06/19/2023]
Abstract
Purpose: This study examined the feasibility of Project Mentor, a mentoring program based on self-determination theory (SDT) for youth classified as overweight or obese. Methods: In Study 1, youth (N = 23) ranging from 12-18 years of age were randomly assigned to a mentoring intervention or wait-list control condition. Study 2 served as a replication sample and consisted of N = 38 youth who participated in the mentoring program. As part of a process evaluation, attendance and exercise heart rate were monitored to assess whether participants exercised at a moderate-to-vigorous level as intended. Mentees also rated whether mentors created a need-supportive environment. For outcome evaluation, basic need satisfaction, behavioral regulation, fitness, and body composition were assessed at pre, post, and follow-up. Results: Across both studies, participants attended over 80% of the exercise sessions and exercised at a moderate to vigorous intensity level. Mentees also perceived that mentors created a need-supportive environment. Post-test and follow-up basic need scores were higher than baseline values and autonomous motivation increased for mentoring program participants. Effect sizes were generally moderate to large in magnitude based on partial eta-squared and Cohen d. Aerobic fitness (i.e., Vo2peak) showed a moderate to large increase at post-test that was partially maintained at follow-up. Body composition changes were nonsignificant and small in magnitude. Participants in the wait-list control reported showed small changes or decreases across SDT related constructs, fitness, and body composition across both studies. Conclusions: Results across both studies support the feasibility of a mentoring program focused on CARE (competence, autonomy, relatedness, and enjoyment).
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Greule C, Sudeck G, Thiel A, Kastner L, Janßen P, Nieß A, Rapp F, Junne F, Krauß I. Correlates of physical activity enjoyment in children and adolescents for a new perspective on the treatment of overweight: A systematic literature review. Obes Rev 2024; 25:e13655. [PMID: 37987113 DOI: 10.1111/obr.13655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/13/2023] [Accepted: 10/03/2023] [Indexed: 11/22/2023]
Abstract
The purpose of this systematic literature review was to systematically compile the state of knowledge on correlates of physical activity enjoyment in children and adolescents to influence the perspective of future physical activity promotion approaches especially for children and adolescents affected by overweight or obesity. The electronic database search was executed in the five databases PubMed, PsychINFO, SPORTDiscus, Web of Science, and BISp-SURF, from inception to December 6, 2021. A semi-quantitative method was used for summarizing the resulted correlates. For final analysis, 85 studies comprising 48,144 children and adolescents were included. Fifty-seven variables could be coded for their relationship with physical activity enjoyment. Of these, 12 psychological variables, for example, the basic psychological needs, task orientation, or self-efficacy; six interpersonal variables, for example, peer/group acceptance, parental support, and autonomy support; and one behavioral variable, the higher self-reported physical activity, are consistent positively associated to physical activity enjoyment. A scientifically based overview could be extracted for the promotion of physical activity enjoyment in children and adolescents. There is a gap in literature focusing the perception of physical activity enjoyment in the subgroup of children and adolescents affected by overweight or obesity. Therefore, recommendations were made to enable the development of further innovative research approaches in this population.
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Affiliation(s)
- Constanze Greule
- Department of Sports Medicine, University Hospital of Tübingen, Tübingen, Germany
- Institute of Sports Science, Eberhard Karls University of Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Gorden Sudeck
- Institute of Sports Science, Eberhard Karls University of Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University of Tübingen, Tübingen, Germany
- LEAD Graduate School and Research Network, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Ansgar Thiel
- Institute of Sports Science, Eberhard Karls University of Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University of Tübingen, Tübingen, Germany
- LEAD Graduate School and Research Network, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Lydia Kastner
- Institute of Sports Science, Eberhard Karls University of Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University of Tübingen, Tübingen, Germany
- LEAD Graduate School and Research Network, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Pia Janßen
- Department of Sports Medicine, University Hospital of Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Andreas Nieß
- Department of Sports Medicine, University Hospital of Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Felicitas Rapp
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Ulm, Ulm University, Ulm, Germany
| | - Florian Junne
- Department of Psychosomatic Medicine and Psychotherapy, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Inga Krauß
- Department of Sports Medicine, University Hospital of Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University of Tübingen, Tübingen, Germany
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Zuo C, Ma X, Yang Y, Cui Y, Ye C. School-based high-intensity interval exercise program in children with overweight induce a greater improvements in body composition and physical fitness than moderate-intensity continuous exercise. BMC Public Health 2023; 23:2210. [PMID: 37946224 PMCID: PMC10633982 DOI: 10.1186/s12889-023-17149-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 11/03/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND High-intensity interval running exercise (HIIE) is emerging as a time-efficient exercise modality for improving body composition and fitness in comparison with moderate-intensity continuous aerobic exercise (MICE); however, existing evidence is still unclear in children with overweight and thus we compared the effects of HIIE and MICE on body composition, muscular, and cardiorespiratory fitness in children with overweight. METHODS In this randomized study, 40 male children with overweight aged 7-10 years were divided into an 8-week exercise regime: (1) HIIE group [n = 20; 2 sets of 15 × 20s at 85-95% maximal aerobic speed (MAS) separated by 15 × 20s recovery at 50% MAS, 3 days per week] and (2) MICE group [n = 20; 30 min at 60-70% MAS, 3 days per week]. Body composition, muscular and cardiorespiratory fitness were assessed before and after the 8-week intervention at similar times and conditions of the day. RESULTS Following the 8-week HIIE protocol, weight, BMI, and fat mass decreased significantly (weight: - 1.4% vs. 0.2%, p < 0.05; BMI: - 3.1% vs. - 0.7%, p < 0.05; fat mass: - 7.7% vs. - 1.6%, p < 0.01) as compared with MICE; while the VO2peak and MAS increased significantly in both groups, the increase in HIIE group was significantly greater than that of MICE group (VO2peak: 10.3% vs. 3.5%, p < 0.01; MAS:7.7% vs. 4.5%, p < 0.05). Although significant improvements in muscular fitness were observed in HIIE and MICE groups [counter movement jump (CMJ): 7.8% vs. 5.4%; sprinting ability: - 3.7% vs. - 1.7%], no significant differences were seen between them (p > 0.05). CONCLUSION Our findings suggested that school-based HIIE intervention was highly in improving body composition and cardiorespiratory fitness of children with overweight than the MICE regime; however, MICE still provided improvements over time that were just not to the same magnitude of HIIE.
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Affiliation(s)
- Chongwen Zuo
- Air Force Medical Center of Chinese PLA, Beijing, 100142, China
- School of Kinesiology and Health, Capital University of Physical Education and Sports, Beijing, 100191, China
| | - Xiaoyan Ma
- Key Laboratory of Smart Grid of Ministry of Education, Tianjin University, Tianjin, 300072, China
| | - Yuan Yang
- Beihang University, Beijing, 100191, China
| | - Yupeng Cui
- School of Kinesiology and Health, Capital University of Physical Education and Sports, Beijing, 100191, China
| | - Chaoqun Ye
- Air Force Medical Center of Chinese PLA, Beijing, 100142, China.
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Nguyen ST, Fujita N, Oshima T, Nishihira M, Ohno H, Yoneda M, Urakawa S. Effects of long-term childhood exercise and detraining on lipid accumulation in metabolic-related organs. PLoS One 2022; 17:e0270330. [PMID: 35749411 PMCID: PMC9231767 DOI: 10.1371/journal.pone.0270330] [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: 02/28/2022] [Accepted: 06/09/2022] [Indexed: 11/25/2022] Open
Abstract
The preventive effects of regular exercise on obesity-related health problems are carried over to the non-exercise detraining period, even when physical activity decreases with aging. However, it remains unknown whether regular childhood exercises can be carried over to adulthood. Therefore, this study aimed to investigate the effects of long-term childhood exercise and detraining on lipid accumulation in organs to prevent obesity in adulthood. Four-week-old male Otsuka Long-Evans Tokushima Fatty (OLETF) rats were used as obese animals. OLETF rats were allocated into sedentary and exercise groups: exercise from 4- to 12-week-old and detraining from 12- to 20-week-old. At 12-week-old immediately after the exercise period, regular exercise completely inhibited hyperphagia, obesity, enlarged pancreatic islets, lipid accumulation and lobular inflammation in the liver, hypertrophied adipocytes in the white adipose tissue (WAT), and brown adipose tissue (BAT) whitening in OLETF rats. Additionally, exercise attenuated the decrease in the ratio of muscle wet weight to body weight associated with obesity. Decreased food consumption was maintained during the detraining period, which inhibited obesity and diabetes at 20-week-old after the detraining period. Histologically, childhood exercise inhibited the enlargement of pancreatic islets after the detraining period. In addition, inhibition of lipid accumulation was completely maintained in the WAT and BAT after the detraining period. However, the effectiveness was only partially successful in lipid accumulation and inflammation in the liver. The ratio of muscle wet weight to body weight was maintained after detraining. In conclusion, early long-term regular exercise effectively prevents obesity and diabetes in childhood, and its effectiveness can be tracked later in life. The present study suggests the importance of exercise during childhood and adolescence to inhibit hyperphagia-induced lipid accumulation in metabolic-related organs in adulthood despite exercise cessation.
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Affiliation(s)
- Son Tien Nguyen
- Department of Musculoskeletal Functional Research and Regeneration, Graduate School of Biomedicine and Health Sciences, Hiroshima University, Kasumi, Minami-ku, Hiroshima, Japan
| | - Naoto Fujita
- Department of Musculoskeletal Functional Research and Regeneration, Graduate School of Biomedicine and Health Sciences, Hiroshima University, Kasumi, Minami-ku, Hiroshima, Japan
- * E-mail:
| | - Takaya Oshima
- Department of Musculoskeletal Functional Research and Regeneration, Graduate School of Biomedicine and Health Sciences, Hiroshima University, Kasumi, Minami-ku, Hiroshima, Japan
| | - Misuzu Nishihira
- Department of Musculoskeletal Functional Research and Regeneration, Graduate School of Biomedicine and Health Sciences, Hiroshima University, Kasumi, Minami-ku, Hiroshima, Japan
| | - Haruya Ohno
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi, Minami-ku, Hiroshima, Japan
| | - Masayasu Yoneda
- Department of Preventive Medicine for Diabetes and Lifestyle-Related Diseases, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi, Minami-ku, Hiroshima, Japan
| | - Susumu Urakawa
- Department of Musculoskeletal Functional Research and Regeneration, Graduate School of Biomedicine and Health Sciences, Hiroshima University, Kasumi, Minami-ku, Hiroshima, Japan
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Meng C, Yucheng T, Shu L, Yu Z. Effects of school-based high-intensity interval training on body composition, cardiorespiratory fitness and cardiometabolic markers in adolescent boys with obesity: a randomized controlled trial. BMC Pediatr 2022; 22:112. [PMID: 35232402 PMCID: PMC8886768 DOI: 10.1186/s12887-021-03079-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 12/17/2021] [Indexed: 12/31/2022] Open
Abstract
Background With accumulating evidence suggesting that CVD has its origins in childhood obesity. The purpose of this study was to determine the effect of a real-world school-based high-intensity interval training intervention on body composition, cardiorespiratory fitness and cardiometabolic markers in obese boys aged 10 to 13 years. Methods Forty-five adolescent boys with obesity (age = 11.2 ± 0.7 years, BMI = 24.2 ± 1.0 kg/m2), were randomized to high-intensity interval training group (HIIT, n = 15), moderate-intensity continuous training group (MICT, n = 15), or a control group (CON, n = 15). The intervention groups performed three weekly exercise sessions over 12 weeks. HIIT group performed two sets of eight bouts of 15 s run at high-intensity [90 ~ 100% maximal aerobic speed (MAS)] separated by eight bouts of 15 s recovery run at low-intensity (50% MAS), MICT group performed 30 min run at moderate intensity (60 ~ 70% MAS) and CON group were instructed to continue their normal behaviors. All participants had indices of body composition, cardiorespiratory fitness (CRF) and cardiometabolic markers measured at baseline and post-intervention. Statistical differences between and within groups were determined by use of two-way analysis of variance (ANOVA) with repeated measures. Results Following the school-based training program, BMI and body fat mass decreased (BMI: − 1.8 kg/m2 vs. – 1.2 kg/m2, P < 0.01; FM: − 1.6 kg, P < 0.05 vs. -3.7 kg, P < 0.01) in HIIT and MICT group, but there was no significant difference between the two interventions; \documentclass[12pt]{minimal}
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\begin{document}$$\dot{\mathrm{V}}{\mathrm{O}}_{2\mathrm{peak}}$$\end{document}V˙O2peak both increased significantly in two intervention groups, and the increment of HIIT group was significantly greater than that of MICT (6.1 mL/kg/min vs. 3.8 mL/kg/min, P < 0.01), Visceral adipose tissue was significant decrease in HIIT group (− 53 g vs. -17 g, P < 0.01) whilst the MICT group experienced a significant decrease in body fat percentage (− 3.1 ± 1.0 kg, P < 0.01), but there were no significant difference between the two interventions. Low-density lipoprotein cholesterol decreased only in HIIT group (− 17.2%, P < 0.05). Significant decrease in the usual index of insulin resistance (HOMA-IR) occurred in HIIT and MICT groups (− 27.3 and − 28.6%, respectively; P < 0.05). Conclusions Our results demonstrated that high-intensity interval training based on running can be used to improve the physical health of obese adolescents in school. Further investigations involving a larger cohort of participants, taken from different schools, is recommended. Trial registration title Effect of High Intensity Interval Training on Obese Children and Adolescents, time 16/12/2017, IDChiCTR-IOR-17013992, websitehttp://www.chictr.org.cn
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Affiliation(s)
- Cao Meng
- Institute of Physical Education, Normal College, Shenzhen University, 3688 Nan Hai Road, Nan Shan district, Shenzhen, 518061, China. .,Institute of KEEP Collaborative Innovation, Shenzhen, 518061, China.
| | - Tang Yucheng
- Institute of Physical Education, Normal College, Shenzhen University, 3688 Nan Hai Road, Nan Shan district, Shenzhen, 518061, China.,Institute of KEEP Collaborative Innovation, Shenzhen, 518061, China
| | - Li Shu
- Institute of Physical Education, Normal College, Shenzhen University, 3688 Nan Hai Road, Nan Shan district, Shenzhen, 518061, China.,Institute of KEEP Collaborative Innovation, Shenzhen, 518061, China
| | - Zou Yu
- College of Education, Zhejiang University, Zhejiang, 310058, China
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Skogen IB, Høydal KL. Adolescents who are overweight or obese - the relevance of a social network to engaging in physical activity: a qualitative study. BMC Public Health 2021; 21:701. [PMID: 33836700 PMCID: PMC8034089 DOI: 10.1186/s12889-021-10727-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 03/29/2021] [Indexed: 11/20/2022] Open
Abstract
Background Increased level of physical activity (PA) is one of the approaches offered by school health services in Norway for the prevention and treatment of children and adolescents with overweight and obesity. Research has found that young people with overweight and obesity tend to participate in less physical activity than youth of healthier weight. They also tend to perceive several barriers to PA at the environmental, interpersonal, and individual levels. This paper explores how adolescents’, who receive follow-up of weight management in primary health care, experience barriers to and facilitators for engaging in physical activity within their social networks. Methods This is a qualitative study with an explorative design inspired by phenomenological ideas based on analysis of semi-structured interviews with 10 adolescents aged 13–18. Interviews were conducted with young people with overweight or obesity in weight-related follow-up in primary health care settings in various regions in Norway. Results The results describe the barriers to and facilitators of PA in the adolescents’ social networks. The study reveals a strong emphasis on the importance of a social network for engaging in PA. According to these adolescents’ experiences of PA in their social networks, organizing PA groups that consist of similarly young people with overweight can contribute to an increased level of PA and help modify their negative perceptions of such activity. Conclusions This study finds that young people with overweight and obesity place a strong emphasis on a social network where they feel equal to others if they are to engage in PA. The study suggests that School Health Nurses should establish a social network of adolescents in the same situation, in the form of organized activity groups for young people with overweight or obesity, rather than advice on increased participation in ordinary organized sports or individual exercising. This can facilitate an increase in the PA level among this group of young people. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10727-7.
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Affiliation(s)
- Ingeborg B Skogen
- Faculty of Arts and Physical Education, Department of Physical Education, Volda University College, Volda, Norway.
| | - Kjetil L Høydal
- Faculty of Arts and Physical Education, Department of Physical Education, Volda University College, Volda, Norway
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7
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Dias KA, Ingul CB, Tjønna AE, Keating SE, Gomersall SR, Follestad T, Hosseini MS, Hollekim-Strand SM, Ro TB, Haram M, Huuse EM, Davies PSW, Cain PA, Leong GM, Coombes JS. Effect of High-Intensity Interval Training on Fitness, Fat Mass and Cardiometabolic Biomarkers in Children with Obesity: A Randomised Controlled Trial. Sports Med 2018; 48:733-746. [PMID: 28853029 DOI: 10.1007/s40279-017-0777-0] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Paediatric obesity significantly increases the risk of developing cardiometabolic diseases across the lifespan. Increasing cardiorespiratory fitness (CRF) could mitigate this risk. High-intensity interval training (HIIT) improves CRF in clinical adult populations but the evidence in paediatric obesity is inconsistent. OBJECTIVES The objectives of this study were to determine the efficacy of a 12-week, HIIT intervention for increasing CRF and reducing adiposity in children with obesity. METHODS Children with obesity (n = 99, 7-16 years old) were randomised into a 12-week intervention as follows: (1) HIIT [n = 33, 4 × 4-min bouts at 85-95% maximum heart rate (HRmax), interspersed with 3 min of active recovery at 50-70% HRmax, 3 times/week] and nutrition advice; (2) moderate-intensity continuous training (MICT) [n = 32, 44 min at 60-70% HRmax, 3 times/week] and nutrition advice; and (3) nutrition advice only (nutrition) [n = 34]. CRF was quantified through a maximal exercise test ([Formula: see text]) while adiposity was assessed using magnetic resonance imaging (MRI), dual-energy X-ray absorptiometry (DXA) and air-displacement plethysmography. RESULTS HIIT stimulated significant increases in relative [Formula: see text] compared with MICT (+3.6 mL/kg/min, 95% CI 1.1-6.0, P = 0.004) and the nutrition intervention (+5.4 mL/kg/min, 95% CI 2.9-7.9, P = 0.001). However, the intervention had no significant effect on visceral and subcutaneous adipose tissue, whole body composition or cardiometabolic biomarkers (P > 0.05). CONCLUSION A 12-week, HIIT intervention was highly effective in increasing cardiorespiratory fitness when compared with MICT and nutrition interventions. While there were no concomitant reductions in adiposity or blood biomarkers, the cardiometabolic health benefit conferred through increased CRF should be noted. CLINICAL TRIALS REGISTRATION NUMBER Clinicaltrials.gov; NCT01991106.
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Affiliation(s)
- Katrin A Dias
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Brisbane, QLD, 4072, Australia
| | - Charlotte B Ingul
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.,Helse Midt-Norge RHF, Strandvegen 1, Stjørdal, Norway
| | - Arnt E Tjønna
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Shelley E Keating
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Brisbane, QLD, 4072, Australia
| | - Sjaan R Gomersall
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Brisbane, QLD, Australia
| | - Turid Follestad
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Mansoureh S Hosseini
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Siri M Hollekim-Strand
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Torstein B Ro
- Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Pediatrics, St. Olav's University Hospital, Trondheim, Norway
| | - Margrete Haram
- Department of Radiology and Nuclear Medicine, Trondheim University Hospital, Trondheim, Norway
| | - Else Marie Huuse
- Department of Radiology and Nuclear Medicine, Trondheim University Hospital, Trondheim, Norway
| | - Peter S W Davies
- Children's Nutrition Research Centre, The University of Queensland, Brisbane, QLD, Australia
| | - Peter A Cain
- Heart Care Partners, The Wesley Hospital, Brisbane, QLD, Australia
| | - Gary M Leong
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia.,Department of Paediatric Endocrinology, Lady Cilento Children's Hospital, Brisbane, QLD, Australia
| | - Jeff S Coombes
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Brisbane, QLD, 4072, Australia.
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Dias KA, Coombes JS, Green DJ, Gomersall SR, Keating SE, Tjonna AE, Hollekim-Strand SM, Hosseini MS, Ro TB, Haram M, Huuse EM, Davies PSW, Cain PA, Leong GM, Ingul CB. Effects of exercise intensity and nutrition advice on myocardial function in obese children and adolescents: a multicentre randomised controlled trial study protocol. BMJ Open 2016; 6:e010929. [PMID: 27044585 PMCID: PMC4823457 DOI: 10.1136/bmjopen-2015-010929] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION The prevalence of paediatric obesity is increasing, and with it, lifestyle-related diseases in children and adolescents. High-intensity interval training (HIIT) has recently been explored as an alternate to traditional moderate-intensity continuous training (MICT) in adults with chronic disease and has been shown to induce a rapid reversal of subclinical disease markers in obese children and adolescents. The primary aim of this study is to compare the effects of HIIT with MICT on myocardial function in obese children and adolescents. METHODS AND ANALYSIS Multicentre randomised controlled trial of 100 obese children and adolescents in the cities of Trondheim (Norway) and Brisbane (Australia). The trial will examine the efficacy of HIIT to improve cardiometabolic outcomes in obese children and adolescents. Participants will be randomised to (1) HIIT and nutrition advice, (2) MICT and nutrition advice or (3) nutrition advice. Participants will partake in supervised exercise training and/or nutrition sessions for 3 months. Measurements for study end points will occur at baseline, 3 months (postintervention) and 12 months (follow-up). The primary end point is myocardial function (peak systolic tissue velocity). Secondary end points include vascular function (flow-mediated dilation assessment), quantity of visceral and subcutaneous adipose tissue, myocardial structure and function, body composition, cardiorespiratory fitness, autonomic function, blood biochemistry, physical activity and nutrition. Lean, healthy children and adolescents will complete measurements for all study end points at one time point for comparative cross-sectional analyses. ETHICS AND DISSEMINATION This randomised controlled trial will generate substantial information regarding the effects of exercise intensity on paediatric obesity, specifically the cardiometabolic health of this at-risk population. It is expected that communication of results will allow for the development of more effective evidence-based exercise prescription guidelines in this population while investigating the benefits of HIIT on subclinical markers of disease. TRIAL REGISTRATION NUMBER NCT01991106.
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Affiliation(s)
- Katrin A Dias
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Brisbane, Queensland, Australia
| | - Jeff S Coombes
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Brisbane, Queensland, Australia
| | - Daniel J Green
- School of Sport Science, Exercise and Health, The University of Western Australia, Perth, Western Australia, Australia
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Sjaan R Gomersall
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Brisbane, Queensland, Australia
| | - Shelley E Keating
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Brisbane, Queensland, Australia
| | - Arnt Erik Tjonna
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Siri Marte Hollekim-Strand
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Mansoureh Sadat Hosseini
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Torstein Baade Ro
- Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Pediatrics, St. Olav's University Hospital, Trondheim, Norway
| | - Margrete Haram
- Department of Radiology, Trondheim University Hospital, Trondheim, Norway
| | - Else Marie Huuse
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Peter S W Davies
- Children's Nutrition Research Centre, The University of Queensland, Brisbane, Queensland, Australia
- Queensland Children's Medical Research Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - Peter A Cain
- Heart Care Partners, The Wesley Hospital, Brisbane, Queensland, Australia
| | - Gary M Leong
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland, Australia
- Department of Paediatric Endocrinology, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia
| | - Charlotte B Ingul
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
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Olaya-Contreras P, Ocampo DC, Ladekjær Larsen E. Perceptions and Practices of Physical Activity Among Colombian Overweight/Obese Schoolchildren. Glob Qual Nurs Res 2016; 3:2333393616681392. [PMID: 28462352 PMCID: PMC5342281 DOI: 10.1177/2333393616681392] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 10/17/2016] [Accepted: 10/25/2016] [Indexed: 11/15/2022] Open
Abstract
The purpose of this study was to explore the contexts that shape obese children's engagement in physical activity (PA) focusing on children's perceptions. The qualitative design consisted of non-participant observations, and unstructured and semi-structured focus group and individual interviews. Data were analyzed by use of conventional content analysis. Participants were overweight/obese children from a public school in Colombia. The findings show that the main context where PA took place was during physical education (PE) classes at school and in the children's neighborhoods. The participants perceived the PE classes to be too competitive and demotivating. PA taking place outside school was associated with fun, but occurred only on an infrequent basis and was challenged by living in insecure neighborhoods. Adapting a health promotion approach that emphasizes participation and social environments might motivate obese children to become physically active at school as well as during leisure time.
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Affiliation(s)
- Patricia Olaya-Contreras
- Unit for Health Promotion Research, University of Southern Denmark, Esbjerg, Denmark
- Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
| | | | - Eva Ladekjær Larsen
- Unit for Health Promotion Research, University of Southern Denmark, Esbjerg, Denmark
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Marques A, Minderico C, Martins S, Palmeira A, Ekelund U, Sardinha LB. Cross-sectional and prospective associations between moderate to vigorous physical activity and sedentary time with adiposity in children. Int J Obes (Lond) 2015; 40:28-33. [PMID: 26303349 DOI: 10.1038/ijo.2015.168] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Revised: 07/06/2015] [Accepted: 08/13/2015] [Indexed: 11/09/2022]
Abstract
BACKGROUND Physical activity (PA) and sedentary time (SED) have both been suggested as potential risk factors for adiposity in children. However, there is paucity of data examining the temporal associations between these variables. OBJECTIVE This study aimed to analyze the cross-sectional and prospective associations between PA, SED and body composition in children. METHODS A total of 510 children (age at baseline 10.1±0.8, age at follow-up 11.8±0.9) from six Portuguese schools from the Oeiras Municipality participated in this study. PA and SED were measured by accelerometry and trunk fat mass (TFM) and body fat mass (BFM) were measured by dual energy X-ray absorptiometry. Fat mass index (FMI) was calculated as BFM divided by height squared. Several regression models adjusted for age, sex, maturity status, follow-up duration, baseline levels of the outcome variable and SED or moderate to vigorous PA (MVPA) were performed. RESULTS MVPA (min per day) was cross-sectionally inversely associated with adiposity indexes (FMI, TFM and BFM). Adiposity indexes were inversely associated with time in MVPA. In prospective analyses, MVPA was associated with a lower levels of FMI (β=-0.37, 95% confidence interval (CI): -0.49 to -0.26, P<0.001), TFM (β=-0.20, 95% CI: -0.29 to -0.10, P<0.001) and BFM (β=-0.37, 95% CI: -0.49 to -0.26, P<0.001). When the model was adjusted for age, sex, maturity status and for baseline levels of the outcome variables MVPA remained a significant predictor of lower adiposity indexes (FMI: β=-0.09, 95% CI: -0.16 to -0.01, P<0.05; TFM: β=-0.08, 95% CI: -0.15 to -0.01, P<0.05; BFM: β=-0.07, 95% CI: -0.15 to 0.00, P<0.05). Adiposity was not associated with MVPA when modeled as the exposure in prospective analyses. SED was not related with adiposity indexes, except for the relationship with FMI. CONCLUSIONS In cross-sectional and prospective analyses, MVPA is associated with lower adiposity independent of covariates and SED. Results suggest that promoting MVPA is important for preventing gain in adiposity in healthy children.
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Affiliation(s)
- A Marques
- Centro Interdisciplinar de Estudo da Performance Humana, Faculty of Human Kinetics, Department of Sports and health, University of Lisbon, Lisbon, Portugal
| | - C Minderico
- Centro Interdisciplinar de Estudo da Performance Humana, Faculty of Human Kinetics, Department of Sports and health, University of Lisbon, Lisbon, Portugal.,Faculty of Physical Education and Sports, Lusofona University of Humanities and Technologies, Lisbon, Portugal
| | - S Martins
- Faculty of Physical Education and Sports, Lusofona University of Humanities and Technologies, Lisbon, Portugal
| | - A Palmeira
- Centro Interdisciplinar de Estudo da Performance Humana, Faculty of Human Kinetics, Department of Sports and health, University of Lisbon, Lisbon, Portugal.,Faculty of Physical Education and Sports, Lusofona University of Humanities and Technologies, Lisbon, Portugal
| | - U Ekelund
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway.,MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - L B Sardinha
- Centro Interdisciplinar de Estudo da Performance Humana, Faculty of Human Kinetics, Department of Sports and health, University of Lisbon, Lisbon, Portugal
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Deforche B, De Bourdeaudhuij I. Attentional distraction during exercise in overweight and normal-weight boys. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:3077-90. [PMID: 25782065 PMCID: PMC4377953 DOI: 10.3390/ijerph120303077] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2014] [Revised: 03/02/2015] [Accepted: 03/04/2015] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to investigate the effect of attentional distraction on field running distance and activity intensity during an exercise session in normal-weight and overweight youngsters and to investigate potential mediators. Fifty-three 12–14 yr-old boys participated twice in a 12-min running test and a 20-min exercise session, once with attentional distraction (by listerning to music) and once without distraction (counterbalanced randomised controlled design). At the end of the endurance test running distance was recorded. During the exercise session activity intensity was assessed by accelerometers. After each experiment, rate of perceived exertion (RPE) was estimated and seven questions were asked about how participants experienced the experiment. Both overweight and normal-weight boys ran further during the running test with music (p < 0.05) and this effect was mediated by a decrease in feelings of annoyance. During the exercise session with music, both overweight and normal-weight boys exercised less at low and high intensity and more at moderate and very high intensity (p < 0.01) and this effect was mediated by a decrease in RPE. We can conclude that attentional distraction has a positive effect on running distance on a field endurance test and on activity intensity during an exercise session through different mechanisms in both overweight and normal-weight boys.
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Affiliation(s)
- Benedicte Deforche
- Department of Public Health, Ghent University, De Pintelaan 185, 9000 Gent, Belgium.
- Department of Human Biometrics and Biomechanics, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussel, Belgium.
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sports Sciences, Ghent University, Watersportlaan 2, 9000 Gent, Belgium.
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Dickinson K, Place M. A Randomised Control Trial of the Impact of a Computer-Based Activity Programme upon the Fitness of Children with Autism. AUTISM RESEARCH AND TREATMENT 2014; 2014:419653. [PMID: 25400946 PMCID: PMC4220566 DOI: 10.1155/2014/419653] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Revised: 08/16/2014] [Accepted: 09/07/2014] [Indexed: 11/18/2022]
Abstract
The poor levels of fitness in children with autism are prompting concern for the children's future health. This study looked to assess if a computer-based activity programme could improve fitness levels (as reflected in cardiopulmonary function) of these children, and achieve a reduction in their body mass index. In a randomised controlled trial, 50 children with autism (of which 33 were under the age of 11 years and 39 were boys) were allocated to an intervention group which encouraged them to use the Nintendo Wii and the software package "Mario and Sonics at the Olympics" in addition to their routine physical education classes. 50 children with autism (34 under the age of 11 years and 40 being boys) acted as controls. At the end of one year, analysis of the changes in scores using analysis of covariance (ANCOVA) on the Eurofit fitness tests showed that the intervention group had made statistically significant improvement on all tests other than flexibility. These improvements were also significantly better than controls. This type of intervention appears to be an effective addition to standard fitness training in order to help children with autism improve their fitness levels.
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Affiliation(s)
- Kathleen Dickinson
- School of Health and Life Sciences, Northumbria University, Coach Lane Campus, Newcastle Upon Tyne NE7 7XA, UK
| | - Maurice Place
- School of Health and Life Sciences, Northumbria University, Coach Lane Campus, Newcastle Upon Tyne NE7 7XA, UK
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Saavedra JM, García-Hermoso A, Escalante Y, Domínguez AM. Self-determined motivation, physical exercise and diet in obese children: A three-year follow-up study. Int J Clin Health Psychol 2014. [DOI: 10.1016/j.ijchp.2013.12.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Richmond RC, Davey Smith G, Ness AR, den Hoed M, McMahon G, Timpson NJ. Assessing causality in the association between child adiposity and physical activity levels: a Mendelian randomization analysis. PLoS Med 2014; 11:e1001618. [PMID: 24642734 PMCID: PMC3958348 DOI: 10.1371/journal.pmed.1001618] [Citation(s) in RCA: 123] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Accepted: 02/05/2014] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Cross-sectional studies have shown that objectively measured physical activity is associated with childhood adiposity, and a strong inverse dose-response association with body mass index (BMI) has been found. However, few studies have explored the extent to which this association reflects reverse causation. We aimed to determine whether childhood adiposity causally influences levels of physical activity using genetic variants reliably associated with adiposity to estimate causal effects. METHODS AND FINDINGS The Avon Longitudinal Study of Parents and Children collected data on objectively assessed activity levels of 4,296 children at age 11 y with recorded BMI and genotypic data. We used 32 established genetic correlates of BMI combined in a weighted allelic score as an instrumental variable for adiposity to estimate the causal effect of adiposity on activity. In observational analysis, a 3.3 kg/m² (one standard deviation) higher BMI was associated with 22.3 (95% CI, 17.0, 27.6) movement counts/min less total physical activity (p = 1.6×10⁻¹⁶), 2.6 (2.1, 3.1) min/d less moderate-to-vigorous-intensity activity (p = 3.7×10⁻²⁹), and 3.5 (1.5, 5.5) min/d more sedentary time (p = 5.0×10⁻⁴). In Mendelian randomization analyses, the same difference in BMI was associated with 32.4 (0.9, 63.9) movement counts/min less total physical activity (p = 0.04) (∼5.3% of the mean counts/minute), 2.8 (0.1, 5.5) min/d less moderate-to-vigorous-intensity activity (p = 0.04), and 13.2 (1.3, 25.2) min/d more sedentary time (p = 0.03). There was no strong evidence for a difference between variable estimates from observational estimates. Similar results were obtained using fat mass index. Low power and poor instrumentation of activity limited causal analysis of the influence of physical activity on BMI. CONCLUSIONS Our results suggest that increased adiposity causes a reduction in physical activity in children and support research into the targeting of BMI in efforts to increase childhood activity levels. Importantly, this does not exclude lower physical activity also leading to increased adiposity, i.e., bidirectional causation.
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Affiliation(s)
- Rebecca C. Richmond
- MRC Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - George Davey Smith
- MRC Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Andy R. Ness
- Department of Oral and Dental Science, University of Bristol, Bristol, United Kingdom
| | - Marcel den Hoed
- Molecular Epidemiology and Science for Life Laboratory, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - George McMahon
- MRC Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Nicholas J. Timpson
- MRC Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
- * E-mail:
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Berry DC, Schwartz TA, McMurray RG, Skelly AH, Neal M, Hall EG, Aimyong N, Amatuli DJ, Melkus G. The family partners for health study: a cluster randomized controlled trial for child and parent weight management. Nutr Diabetes 2014; 4:e101. [PMID: 24418827 PMCID: PMC3904082 DOI: 10.1038/nutd.2013.42] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Accepted: 11/26/2013] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE The purpose of this study was to test a two-phased nutrition and exercise education, coping skills training, and exercise intervention program for overweight or obese low-income ethnic minority 2nd to 4th grade children and their parents in rural North Carolina, USA. METHODS A cluster randomized controlled trial was carried out with 358 children (7-10 years) and a parent for each child (n=358). General linear mixed models were used to determine the effects of the intervention on weight, adiposity, health behaviors, and eating and exercise self-efficacy by examining changes in children and parents from baseline to completion of the study (18 months). RESULTS At 18 months, children in the experimental group did not have a significantly decreased body mass index (BMI) percentile (P=0.470); however, they showed a reduction in the growth rate of their triceps (P=0.001) and subscapular skinfolds (P<0.001) and an improvement in dietary knowledge (P=0.018) and drank less than one glass of soda per day (P=0.052) compared with the control group. Parents in the experimental group had decreased BMI (P=0.001), triceps (P<0.001) and subscapular skinfolds (P<0.001) and increased nutrition (P=0.003) and exercise (P<0.001) knowledge and more often drank water or unsweetened drinks (P=0.029). At 18 months, children in the experimental group did not show significant improvement in eating (P=0.956) or exercise self-efficacy (P=0.976). Experimental parents demonstrated improved socially acceptable eating self-efficacy (P=0.013); however, they did not show significant improvement in self-efficacy pertaining to emotional eating (P=0.155) and exercise (P=0.680). CONCLUSION The results suggest that inclusion of children and parents in the same intervention program is an effective way to decrease adiposity and improve nutrition behaviors in both children and parents and improve weight and eating self-efficacy in parents.
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Affiliation(s)
- D C Berry
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - T A Schwartz
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Biostatistics, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - R G McMurray
- School of Exercise and Sport Science and Nutrition, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - A H Skelly
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - M Neal
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - E G Hall
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - N Aimyong
- Department of Biostatistics, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - D J Amatuli
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - G Melkus
- School of Nursing, Muriel and Virginia Pless Center for Nursing Research, New York University, New York, NY, USA
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Morano M, Colella D, Rutigliano I, Fiore P, Pettoello-Mantovani M, Campanozzi A. A multi-modal training programme to improve physical activity, physical fitness and perceived physical ability in obese children. J Sports Sci 2013; 32:345-53. [DOI: 10.1080/02640414.2013.824602] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Berry DC, McMurray R, Schwartz TA, Skelly A, Sanchez M, Neal M, Hall G. Rationale, design, methodology and sample characteristics for the family partners for health study: a cluster randomized controlled study. BMC Public Health 2012; 12:250. [PMID: 22463125 PMCID: PMC3353192 DOI: 10.1186/1471-2458-12-250] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2011] [Accepted: 03/30/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Young children who are overweight are at increased risk of becoming obese and developing type 2 diabetes and cardiovascular disease later in life. Therefore, early intervention is critical. This paper describes the rationale, design, methodology, and sample characteristics of a 5-year cluster randomized controlled trial being conducted in eight elementary schools in rural North Carolina, United States. METHODS/DESIGN The first aim of the trial is to examine the effects of a two-phased intervention on weight status, adiposity, nutrition and exercise health behaviors, and self-efficacy in overweight or obese 2nd, 3 rd, and 4th grade children and their overweight or obese parents. The primary outcome in children is stabilization of BMI percentile trajectory from baseline to 18 months. The primary outcome in parents is a decrease in BMI from baseline to 18 months. Secondary outcomes for both children and parents include adiposity, nutrition and exercise health behaviors, and self-efficacy from baseline to 18 months. A secondary aim of the trial is to examine in the experimental group, the relationships between parents and children's changes in weight status, adiposity, nutrition and exercise health behaviors, and self-efficacy. An exploratory aim is to determine whether African American, Hispanic, and non-Hispanic white children and parents in the experimental group benefit differently from the intervention in weight status, adiposity, health behaviors, and self-efficacy.A total of 358 African American, non-Hispanic white, and bilingual Hispanic children with a BMI ≥ 85th percentile and 358 parents with a BMI ≥ 25 kg/m² have been inducted over 3 1/2 years and randomized by cohort to either an experimental or a wait-listed control group. The experimental group receives a 12-week intensive intervention of nutrition and exercise education, coping skills training and exercise (Phase I), 9 months of continued monthly contact (Phase II) and then 6 months (follow-up) on their own. Safety endpoints include adverse event reporting. Intention-to-treat analysis will be applied to all data. DISCUSSION Findings from this trial may lead to an effective intervention to assist children and parents to work together to improve nutrition and exercise patterns by making small lifestyle pattern changes. TRIAL REGISTRATION NCT01378806.
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Affiliation(s)
- Diane C Berry
- School of Nursing, The University of North Carolina at Chapel Hill, Campus Box 7460, Chapel Hill, NC 27599-7460, USA
| | - Robert McMurray
- School of Exercise and Sport Science, The University of North Carolina at Chapel Hill, 025 Fetzer Gymnasium, Campus Box 8700, Chapel Hill, NC 27599-8700, USA
| | - Todd A Schwartz
- School of Nursing, The University of North Carolina at Chapel Hill, Campus Box 7460, Chapel Hill, NC 27599-7460, USA
| | - Anne Skelly
- School of Nursing, The University of North Carolina at Chapel Hill, Campus Box 7460, Chapel Hill, NC 27599-7460, USA
| | - Maria Sanchez
- School of Nursing, The University of North Carolina at Chapel Hill, Campus Box 7460, Chapel Hill, NC 27599-7460, USA
| | - Madeline Neal
- School of Nursing, The University of North Carolina at Chapel Hill, Campus Box 7460, Chapel Hill, NC 27599-7460, USA
| | - Gail Hall
- School of Nursing, The University of North Carolina at Chapel Hill, Campus Box 7460, Chapel Hill, NC 27599-7460, USA
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Verloigne M, De Bourdeaudhuij I, Tanghe A, D'Hondt E, Theuwis L, Vansteenkiste M, Deforche B. Self-determined motivation towards physical activity in adolescents treated for obesity: an observational study. Int J Behav Nutr Phys Act 2011; 8:97. [PMID: 21923955 PMCID: PMC3189862 DOI: 10.1186/1479-5868-8-97] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2011] [Accepted: 09/19/2011] [Indexed: 12/04/2022] Open
Abstract
Background Within the Self-Determination Theory (SDT) framework, the first major study aim was to investigate the SDT tenets in an obese adolescent population by examining the factor structure of the Behavioural Regulation in Exercise Questionnaire-2 (BREQ-2) and by investigating associations between physical activity (PA) and motivation in obese adolescents. The second aim was to study differences in motivation according to adolescents' educational level, since lower educated obese adolescent are a sub-risk group for lower PA levels among the obese adolescents. The third aim was to investigate whether attending a residential obesity treatment program could lead to an increase in autonomous motivation towards PA and to see if the treatment effect on motivation was different in low versus high educated youth. Methods For the first study aim, the sample comprised 177 obese adolescents at the start of a 10-month multidisciplinary residential obesity treatment program (BMI = 35.9 ± 6.0 kg/m2, 15.1 ± 1.5 years, 62% girls). A subsample of 65 adolescents (stratified by educational level) were divided into low (n = 34) versus high educated (n = 31) as part of the second and third study aim. Motivation was assessed using the BREQ-2 and PA using the Flemish Physical Activity Questionnaire. Results Exploratory factor analysis showed sufficient validations with the original factor for 17 out of 19 BREQ-2 items. Significant positive correlations were found between PA and the composite score of relative autonomy (r = 0.31, p < 0.001), introjected (r = 0.23, p < 0.01), identified (r = 0.31, p < 0.001) and intrinsic regulation (r = 0.38, p < 0.001). Higher educated adolescents scored higher on the composite score of relative autonomy, introjected, identified and intrinsic regulation at the start of treatment (F = 3.68, p < 0.001). The composite score of relative autonomy, external, identified and intrinsic regulation significantly increased during treatment for all adolescents (F = 6.65, p < 0.001). Introjected regulation significantly increased for lower educated adolescents (F = 25.57, p < 0.001). Conclusions The BREQ-2 can be used in an obese adolescent population. Higher levels of autonomous motivation towards PA were related to higher PA levels. Adolescents had increases in both autonomous and controlled forms of motivation during treatment. Special attention for lower educated adolescents during treatment is needed, as they have a lower autonomous motivation at the start of treatment and an increase in introjected regulation during treatment.
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Affiliation(s)
- Maïté Verloigne
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
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