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

Physical Activity, Body Composition, and Fitness Variables in Adolescents After Periods of Mandatory, Promoted or Nonmandatory, Nonpromoted Use of Step Tracker Mobile Apps: Randomized Controlled Trial

BACKGROUND

It is not known whether an intervention made mandatory as a physical education (PE) class assignment and aimed at promoting physical activity (PA) in adolescents can create a healthy walking habit, which would allow further improvements to be achieved after the mandatory and promoted intervention has been completed.

OBJECTIVE

The aims of this study were to (1) investigate whether, after a period of using a step tracker mobile app made mandatory and promoted as a PE class assignment, adolescents continue to use it when its use is no longer mandatory and promoted; (2) determine whether there are changes in the PA level, body composition, and fitness of adolescents when the use of the app is mandatory and promoted and when it is neither mandatory nor promoted; and (3) analyze whether the covariates maturity status, gender, and specific app used can have an influence.

METHODS

A total of 357 students in compulsory secondary education (age: mean 13.92, SD 1.91 y) participated in the study. A randomized controlled trial was conducted consisting of 2 consecutive 10-week interventions. Participants' PA level, body composition, and fitness were measured at baseline (T1), after 10 weeks of mandatory and promoted app use (T2), and after 10 weeks of nonmandatory and nonpromoted app use (T3). Each participant in the experimental group (EG) used 1 of 4 selected step tracker mobile apps after school hours.

RESULTS

The results showed that when the use of the apps was neither mandatory nor promoted as a PE class assignment, only a few adolescents (18/216, 8.3%) continued the walking practice. After the mandatory and promoted intervention period (T1 vs T2), a decrease in the sum of 3 skinfolds (mean difference [MD] 1.679; P=.02) as well as improvements in the PA level (MD -0.170; P<.001), maximal oxygen uptake (MD -1.006; P<.001), countermovement jump test (MD -1.337; P=.04), curl-up test (MD -3.791; P<.001), and push-up test (MD -1.920; P<.001) in the EG were recorded. However, the changes between T1 and T2 were significantly greater in the EG than in the control group only in the PA level and curl-up test. Thus, when comparing the measurements taken between T1 and T3, no significant changes in body composition (P=.07) or fitness (P=.84) were observed between the EG and the control group. The covariates maturity status, gender, and specific app used showed a significant effect in most of the analyses performed.

CONCLUSIONS

A period of mandatory and promoted use of step tracker mobile apps benefited the variables of body composition and fitness in adolescents but did not create a healthy walking habit in this population; therefore, when the use of these apps ceased to be mandatory and promoted, the effects obtained disappeared.

TRIAL REGISTRATION

ClinicalTrials.gov NCT06164041; https://clinicaltrials.gov/study/NCT06164041.

The effects of exercise on FGF21 in adults: a systematic review and meta-analysis

Background

Fibroblast growth factor 21 (FGF21) is a key hormone factor that regulates glucose and lipid homeostasis. Exercise may regulate its effects and affect disease states. Therefore, we sought to determine how exercise affects FGF21 concentrations in adults.

Methods

The review was registered in the International Prospective Systematic Review (PROSPERO, CRD42023471163). The Cochrane Library, PubMed, and Web of Science databases were searched for studies through July 2023. Studies that assessed the effects of exercise training on FGF21 concentration in adults were included. The random effect model, data with standardized mean difference (SMD), and 95% confidence intervals (CI) were used to evaluate the pooled effect size of exercise training on FGF21. The risk of heterogeneity and bias were evaluated. A total of 12 studies involving 401 participants were included.

Results

The total effect size was 0.3 (95% CI [-0.3-0.89], p = 0.33) when comparing participants who exercised to those who were sedentary. However, subgroup analysis indicated that concurrent exercise and a duration ≥10 weeks significantly decreased FGF21 concentrations with an effect size of -0.38 (95% CI [-0.74--0.01], p < 0.05) and -0.38 (95% CI [-0.63--0.13], p < 0.01), respectively.

Conclusion

Concurrent exercise and longer duration may be more efficient way to decrease FGF21 concentrations in adults with metabolic disorder.

Comparison of Metabolic Risk Factors Based on the Type of Physical Activity in Korean Adolescents: Results from a Nationwide Population-Based Survey

BACKGROUND

Physical activity (PA) is associated with a favorable metabolic risk profile in adults. However, its role in adolescents remains unclear. In this study, using data (2019-2021) from the 8th Korea National Health and Nutrition Examination Survey, we investigated the optimal exercise type for preventing metabolic complications in adolescents.

METHODS

A total of 1,222 eligible adolescent participants (12-18-year-old) were divided into four groups as follows: aerobic exercise (AE), resistance exercise (RE), combined aerobic and resistance exercise (CE), and no exercise (NE). Daily PA was assessed using the international PA questionnaire. Blood samples were collected to measure lipid, glucose, and insulin levels. Additionally, the homeostasis model assessment for insulin resistance (HOMA-IR) and triglyceride-glucose (TyG) indices were measured. Multivariate regression analysis was used to compare the metabolic risk factors across the PA groups before and after propensity score matching (PSM) adjustment for confounding variables.

RESULTS

The CE group exhibited improved fasting glucose levels, lower TyG index, reduced white blood cell count, and higher high-density lipoprotein (HDL) cholesterol levels than the NE group. The RE group exhibited lower mean blood pressure, triglyceride, fasting insulin, HOMA-IR, TyG index and a reduced risk of metabolic syndrome than the NE group. The AE group had higher total and HDL cholesterol levels. In detailed comparison of the AE and RE groups, the RE group consistently exhibited favorable metabolic parameters, including lower blood pressure and total and low-density cholesterol levels, which persisted after PSM.

CONCLUSION

These findings highlight the positive effects of PA on cardiovascular risk factors in adolescents. Thus, RE may have a more favorable metabolic effect than AE. Further studies are needed to validate the benefits of exercise according to the exercise type.

Effects of different exercise types on visceral fat in young individuals with obesity aged 6-24 years old: A systematic review and meta-analysis

Introduction: The prevalence of pediatric obesity remains high all over the world. Various exercise interventions have been applied to decrease the visceral fat in young individuals with obesity. But the evidence remains controversial on the effect of the exercise on visceral fat. Moreover, it is unclear which type of the exercise is the most effective for young individuals with overweight or obesity to reduce visceral fat. Objective: The objective of this review and meta-analysis is to evaluate and compare the effectiveness of different exercise interventions on visceral fat in young individuals with overweight or obesity. Methods: Four databases consisting of PubMed, Web of Science, EBSCO, and Cochrane Library were searched prior to May 2022. Fifteen studies with a total of 30 data points involving 1,134 participants were included in this meta-analysis. And the interventions were limited to 4 exercise types [i.e., aerobic exercise (AE), resistance exercise (RE), aerobic exercise combined with resistance exercise (CE), and high-intensity interval training (HIIT)]. Data Synthesis: The results showed that AE (Standardized Mean Difference = -0.32; 95% CI = -0.50 to -0.13; p = 0.0007; I² = 37%) and HIIT (SMD = -0.59; 95% CI = -0.87 to -0.31; p < 0.0001; I² = 0%) had a significant reduction effect on visceral fat. And the effect of HIIT seemed better than AE. However, RE (SMD = -0.58; 95% CI = -1.34 to 0.17; p = 0.13; I² = 76%) and CE (SMD = -0.21; 95% CI = -0.81 to 0.38; p = 0.48; I² = 63%) had a non-significant effect on visceral fat decline. Additionally, compared with the control group, exercise interventions had a significant effect on reducing visceral fat in adolescents (SMD = -0.54; 95% CI = -0.82 to -0.26; p = 0.0001; I² = 64%) and young adults (SMD = -0.42; 95% CI = -0.69 to -0.15; p = 0.003; I² = 0%) rather than children (SMD = -0.15; 95% CI = -0.32 to 0.02; p = 0.08; I² = 0%). And the gender-based subgroup analysis indicated that the effectiveness of the exercise on the reduction of visceral fat was more significant in males (SMD = -1.27; 95% CI = -1.67 to -0.87; p < 0.00001; I² = 0%) than that in females (SMD = -0.31; 95% CI = -0.48 to -0.14; p = 0.0004; I² = 0%). Conclusion: This review and meta-analysis demonstrates that exercise interventions are efficient to decrease visceral fat in adolescents (12-18 years old) and young adults (18-24 years old). Among different exercise types, AE and HIIT are helpful for young individuals with overweight or obesity to reduce visceral fat and HIIT appears to be the most effective exercise intervention. In addition, the effect of exercise interventions on the consumption of visceral fat is more significant in males than that in females. Systematic Review Registration: [http://www.crd.york.ac.uk/PROSPERO], identifier [CRD42022310878].

Concurrent Training Promotes Greater Gains on Body Composition and Components of Physical Fitness Than Single-Mode Training (Endurance or Resistance) in Youth With Obesity

The prevalence of obesity in the pediatric population has become a major public health issue. Indeed, the dramatic increase of this epidemic causes multiple and harmful consequences, Physical activity, particularly physical exercise, remains to be the cornerstone of interventions against childhood obesity. Given the conflicting findings with reference to the relevant literature addressing the effects of exercise on adiposity and physical fitness outcomes in obese children and adolescents, the effect of duration-matched concurrent training (CT) [50% resistance (RT) and 50% high-intensity-interval-training (HIIT)] on body composition and physical fitness in obese youth remains to be elucidated. Thus, the purpose of this study was to examine the effects of 9-weeks of CT compared to RT or HIIT alone, on body composition and selected physical fitness components in healthy sedentary obese youth. Out of 73 participants, only 37; [14 males and 23 females; age 13.4 ± 0.9 years; body-mass-index (BMI): 31.2 ± 4.8 kg·m-2] were eligible and randomized into three groups: HIIT (n = 12): 3-4 sets×12 runs at 80–110% peak velocity, with 10-s passive recovery between bouts; RT (n = 12): 6 exercises; 3–4 sets × 10 repetition maximum (RM) and CT (n = 13): 50% serial completion of RT and HIIT. CT promoted significant greater gains compared to HIIT and RT on body composition (p &lt; 0.01, d = large), 6-min-walking test distance (6 MWT-distance) and on 6 MWT-VO2max (p &lt; 0.03, d = large). In addition, CT showed substantially greater improvements than HIIT in the medicine ball throw test (20.2 vs. 13.6%, p &lt; 0.04, d = large). On the other hand, RT exhibited significantly greater gains in relative hand grip strength (p &lt; 0.03, d = large) and CMJ (p &lt; 0.01, d = large) than HIIT and CT. CT promoted greater benefits for fat, body mass loss and cardiorespiratory fitness than HIIT or RT modalities. This study provides important information for practitioners and therapists on the application of effective exercise regimes with obese youth to induce significant and beneficial body composition changes. The applied CT program and the respective programming parameters in terms of exercise intensity and volume can be used by practitioners as an effective exercise treatment to fight the pandemic overweight and obesity in youth.

Effects of Caloric Restriction and Rope-Skipping Exercise on Cardiometabolic Health: A Pilot Randomized Controlled Trial in Young Adults

The aim of this study is to investigate the effects of calorie restriction (CR), rope-skipping (RS) exercise, and their joint effects on cardiometabolic health in young adults. An 8-week randomized trial was conducted on 46 undergraduates aged 19–21 y from South China. The participants were randomized into the following three groups: Calorie restriction (CR) group (n = 14), Rope-skipping (RS) group (n = 14), and CR plus RS (CR–RS) group (n = 12). At both allocation and the end of the intervention, data on anthropometry, serum metabolic, and inflammatory markers were collected. A total of 40 participants completed the intervention and were included in the analysis. After the 8-week intervention, the participants from the CR group and the CR–RS group reduced in body weight (−1.1 ± 1.7 kg, −1.3 ± 2.0 kg), body mass index (−0.4 ± 0.6 kg/m², −0.5 ± 0.7 kg/m²), body fat percentage (−1.2 ± 1.6%, −1.7 ± 1.8%), and body fat mass (−1.1 kg (−2.2, −0.3), −1.1 kg (−2.5, −0.4)) compared to the baseline (p < 0.05 or p = 0.051). For metabolic and inflammatory factors, the participants in the CR–RS group showed significant decreases in low density lipoprotein cholesterol (−0.40 mmol/L) and interleukin-8 (−0.73 mmol/L). While all the above markers showed no significant difference among the groups after intervention, in the subgroup of overweight/obese participants (n = 23), the CR–RS group had significantly lower blood pressure, fasting insulin, homeostatic model assessment of insulin resistance, tumor necrosis factor-α, and interleukin-8 levels than the CR or RS groups (p < 0.05). In conclusion, both CR and CR–RS could reduce weight and improve body composition in young adults. More importantly, in those with overweight or obesity, CR–RS intervention might be superior to either CR or RS in improving cardiometabolic health.

Effects of 2 Methods of Combined Training on Cardiometabolic Risk Factors in Adolescents: A Randomized Controlled Trial

PURPOSE

To analyze the effects of 2 combined training methods on the cardiometabolic risk factors in adolescents.

METHODS

A total of 76 adolescents (16.1 [1.1] y, n = 44 female) were randomized into groups of moderate-intensity continuous training combined with resistance training (MICT + RT), high-intensity interval training combined with resistance training (HIIT + RT), or control. The training sessions were performed twice weekly for 12 weeks. The outcomes evaluated included body fat percentage, waist circumference, fasting blood glucose, fasting insulin, total cholesterol, triglycerides, low-density lipoprotein, high-density lipoprotein, glycated hemoglobin, insulin resistance index, blood pressure, peak oxygen consumption (VO2peak), and cardiometabolic risk Z score.

RESULTS

The intervention groups presented a significant reduction in the cardiometabolic risk Z score after 12 weeks of the combined exercise program. In relation to the cardiometabolic risk Z score between groups, the HIIT + RT group presented a significant intervention effect when compared with the control group (Cohen d = 0.23; P < .05). Significant intervention effects were found when comparing the MICT + RT and control groups for body fat percentage, high-density lipoprotein, and VO2peak. Between the HIIT + RT and control groups, significant intervention effects were found for body fat percentage, blood pressure, and VO2peak. There were not significant differences between the HIIT + RT and MICT + RT groups.

CONCLUSION

Twelve weeks of HIIT + RT and MICT + RT were effective in significantly reducing the cardiometabolic risk in these adolescents.

Comparative Effectiveness of High-Intensity Interval Training and Moderate-Intensity Continuous Training for Cardiometabolic Risk Factors and Cardiorespiratory Fitness in Childhood Obesity: A Meta-Analysis of Randomized Controlled Trials

Purpose: The main objective of this meta-analysis was to compare the effectiveness of high-intensity interval training (HIIT) and of moderate-intensity continuous training (MICT) on cardiometabolic health in childhood obesity and determine whether HIIT is a superior form of training in managing obese children's metabolic health.

Methods: Relevant studies published in PubMed, Web of Science, Embase, the Cochrane Library, EBSCO, and CNKI were searched, restricted to those published from inception to 1 October 2019. Only randomized controlled trials (RCTs) depicting the effect of HIIT on childhood obesity were included.

Results: Nine RCTs involving 309 participants were included in the meta-analysis. Among the 309 participants, 158 subjects were randomized for HIIT, while the others were randomized for MICT. Significant differences were observed in the body weight (mean difference [MD] = −5.45 kg, p = 0.001), body mass index (BMI; MD = −1.661 kg/m², p = 0.0001), systolic blood pressure (SBP; MD = −3.994 mmHg, p = 0.003), and diastolic blood pressure (DBP; MD = −3.087 mmHg, p = 0.0001) in the HIIT group relative to the baseline values. Similar effects were found in the MICT group, as depicted by the significantly decreased values for body weight (MD = −4.604 kg, p = 0.0001), BMI (MD = −2.366 kg/m², p = 0.0001), SBP (MD = −3.089 mmHg, p = 0.019), and DBP (MD = −3.087 mmHg, p = 0.0001). However, no significant differences were observed in the changes in body weight, BMI, SBP, or DBP between the HIIT and MICT groups. Furthermore, our studies showed that both HIIT and MICT could significantly improve VO_2peak (HIIT, MD = 4.17 ml/kg/min, 95% CI: 3.191 to 5.163, p = 0.0001; MICT, MD = 1.704 ml/kg/min, 95% CI: 0.279 to 3.130, p = 0.019). HIIT also showed more positive effects on VO_2peak (SMD = 0.468, 95% CI: 0.040 to 0.897, p = 0.006) than MICT.

Conclusion: HIIT positively affects the cardiometabolic risk factors in childhood obesity. Similar positive effects on body composition and blood pressure were established. Moreover, HIIT can improve cardiorespiratory fitness more significantly than MICT. These findings indicate that HIIT may be an alternative and effective training method for managing childhood obesity.

PROSPERO Registration Number: CRD42018111308.

The effects of high-intensity interval training versus moderate-intensity continuous training on fat loss and cardiometabolic health in pediatric obesity: A protocol of systematic review and meta-analysis

BACKGROUND

The effects of aerobic exercise on fat loss and cardiometabolic health are well-documented, but it is unknown whether a high-intensity interval training (HIIT) elicit a greater health benefit in obese children and adolescents.

METHODS

Relevant studies in Pubmed, Web of Science, Embase, the Cochrane Library, EBSCO, and CNKI will be searched for studies with language restriction in English and Chinese, which were published from inception to December 1, 2018. Only randomized controlled trials of HIIT on pediatric obesity will be included, and observational studies, prospective cohort studies, and systematic reviews will be excluded. Two reviewers will independently screen the studies; risk of bias assessment and data extraction, and the results are inconsistent when discussed or resolved by a third reviewer. Data analysis and synthesis will be completed by the Revman 5.3 software and Stata 12.0 software. This study will be conducted by following the guideline of the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols.

CONCLUSION

This study will be conducted by previously published data, thus ethics approval is not required. This finding will be published in a related peer-reviewed journal and present it at international conferences.

PROSPERO REGISTRATION NUMBER

CRD42018111308.

Physical activity in adolescents and children and relationship to metabolic health

PURPOSE OF REVIEW

To summarize the recent developments relating to the role of physical activity in improving insulin resistance and metabolic syndrome in children and adolescents.

RECENT FINDINGS

The current literature strengthens previous findings on the relationship between physical activity and metabolic health in children; suggests a protective role for physical activity in the setting of obesity; examines population-specific findings; addresses specific effects of different modalities of physical activity in improving health; reveals potential mediators in the relationship between physical activity and metabolic health; and suggests new markers of metabolic health that could potentially be used as outcomes in future physical activity studies.

SUMMARY

Recent research generally confirms the role of physical activity in decreasing insulin resistance and metabolic syndrome in children and adolescents. However, the current literature is limited by unstandardized research methods and definitions, and also aggregation of different age groups, genders, and weight status. Future research should address these issues to offer targeted physical activity interventions.

Practical Lessons Learned from Adolescent and Parent Experiences Immediately and 12 Months following a Family-Based Healthy Lifestyle Intervention

BACKGROUND

Adolescence is a critical time to intervene and establish healthy long-term behaviors to decrease the impact of adult obesity in the future. The purpose of this study was to identify key intervention strategies and techniques for community interventions by analyzing the short-term and longer-term shared experiences of both adolescents with overweight or obesity and their parents involved in a community-based, healthy lifestyle intervention.

METHODS

Qualitative interviews and focus groups were conducted with teens (aged 12-16 years with a BMI above the 85th percentile) and their parents immediately following the 8-week intervention (n = 37 teens, n = 33 parents) and at 12 months follow-up (n = 23 teens, n = 20 parents). Results were analyzed thematically.

RESULTS

Both teens and parents reported high satisfaction with the program. Immediately following the 8-week intervention, teens reported enjoying participating in exercise with similar peers. Parents described inaccurate expectations from the program. After the 12-month follow-up, teens reported struggling with a cyclical pattern of health behaviors, and parents described a sense of loss following the intensive program and improved communication skills with their adolescent.

CONCLUSIONS

Several practical strategies emerged for use in future community programs for adolescents with overweight or obesity. Future programs should consider management of expectations, perceptions vs. outcomes, and the cyclical nature of behavior change in adolescents. Strategies for future health behavior change interventions with overweight adolescents should address time management, translation of knowledge into behavior change, successful implementation of practical goal-setting strategies, and increasing intrinsic motivation.

Multiple components of fitness improved among overweight and obese adolescents following a community-based lifestyle intervention

Fitness is an important component of health, and obese adolescents regularly have poor fitness. Unfortunately, few have assessed the impact of community-based lifestyle interventions on multiple components of fitness. The purpose of this study was to assess the impact of participation in a community-based intervention involving adolescents and parents on multiple components of fitness of obese adolescents. In a within-subject, waitlist controlled clinical trial with 12 months follow-up in Western Australia, participants (n = 56) completed multiple fitness measures at baseline, immediately prior to beginning an 8-week intervention and at 3, 6 and 12 months during a maintenance period. Performance on the shuttle walk was improved immediately post-intervention (increase of 42.8 m, 95% CI: 7.5, 78.2) and at 12 months post-intervention (increase of 44.6 m, 95% CI: 1.3, 87.8) compared with pre-intervention. Muscle performance of quadriceps and deltoids were improved post-intervention (increase of 1.1 (95% CI: 0.1, 2.1) kg · F and 1.0 (0.02, 2.1) kg · F, respectively) and all muscle performance measures were improved at 12 months following the intervention. There were no changes in waist circumference. A community-based lifestyle programme such as Curtin University's Activity, Food and Attitudes Program (CAFAP) may be a viable strategy for improving fitness in overweight adolescents.

Concurrent and aerobic exercise training promote similar benefits in body composition and metabolic profiles in obese adolescents

BACKGROUND

The prevalence of obesity in pediatric population is increasing at an accelerated rate in many countries, and has become a major public health concern. Physical activity, particularly exercise training, remains to be a cornerstone of pediatric obesity interventions. The purpose of our current randomized intervention trial was to compare the effects of two types of training matched for training volume, aerobic and concurrent, on body composition and metabolic profile in obese adolescents. Thus the aim of the study was compare the effects of two types of training matched for training volume, aerobic and concurrent, on body composition and metabolic profile in obese adolescents.

METHODS

32 obese adolescents participated in two randomized training groups, concurrent or aerobic, for 20 weeks (50 mins x 3 per week, supervised), and were compared to a 16-subject control group. We measured the percentage body fat (%BF, primary outcome), fat-free mass, percentage of android fat by dual energy x-ray absorptiometry, and others metabolic profiles at baseline and after interventions, and compared them between groups using the Intent-to-treat design.

RESULTS

In 20 weeks, both exercise training groups significantly reduced %BF by 2.9-3.6% as compare to no change in the control group (p = 0.042). There were also positive changes in lipid levels in exercise groups. No noticeable changes were found between aerobic and concurrent training groups.

CONCLUSIONS

The benefits of exercise in reducing body fat and metabolic risk profiles can be achieved by performing either type of training in obese adolescents.

TRIAL REGISTRATION

REGISTRATION NUMBER

RBR-4HN597.

Windows of opportunity for physical activity in the prevention of obesity

Tackling increasing rates of obesity is likely to be a defining feature of health care over the next several decades. Adult obesity is a persistent and treatment-resistant problem. Consequently, an emerging theme in the literature is to commence prevention efforts earlier in the developmental time course. This view is based primarily on epidemiological data demonstrating a link between traits manifesting early during development and increased obesity risk in adulthood. Physical activity is a perennial factor in discussions of obesity prevention. However, the optimal timing and type of physical activity interventions to commence remains unclear. Critical developmental windows of plasticity may afford time-limited opportunities to shape body composition across the life course; however, physical activity has not been explicitly considered in these discussions. Although animal models suggest that physical activity commenced earlier in development has differential effects on obesity onset compared to physical activity commenced in adulthood, human research is lacking. In this conceptual review, we consider physical activity during critical developmental periods as a way to mitigate obesity risk later in life.

Lifestyle therapy for the treatment of youth with type 2 diabetes

Type 2 diabetes (T2D) in youth is a relatively novel condition facing paediatric health care providers. Few experimental trials exist to guide clinical management in this population. Supporting and prescribing modifiable lifestyle behaviours is cornerstone in the management of T2D in adults. Clinical trials in obese adolescents suggest that intensive lifestyle interventions that include both dietary changes and increased physical activity elicit clinically meaningful reductions in weight and improve cardiovascular risk profiles. Observational studies in youth with T2D suggest that better diet quality and increased physical activity are associated with better metabolic control; however, the limited experimental data available does not support these observations. Trials evaluating lifestyle monotherapy for the treatment of hyperglycaemia in youth with T2D do not exist, and the only study evaluating combined lifestyle and pharmacologic therapy did not show additional benefit over pharmacologic treatment with metformin alone. Physiological and psychosocial differences between youth and adults with T2D likely contribute to the differences in the effectiveness of lifestyle therapy for improving glycaemic control. The current review describes these topics in detail and provides recommendations for paediatric health care providers for the promotion of lifestyle therapy for the management of hyperglycaemia and cardiovascular risk factors for youth with T2DM.

The influence of sprint interval training on body composition, physical and metabolic fitness in adolescents and young adults with intellectual disability: a randomized controlled trial

OBJECTIVE

In this study we evaluated the effect of sprint interval training on metabolic and physical fitness in adolescents and young adults with intellectual disabilities when compared with continuous aerobic training and no training (control).

METHODS

Fifty-four persons with intellectual disabilities (age: 17 (3.0), body mass index: 27.7 (3.7), intelligence quotient: 59 (8.6)) were matched based on age, gender and intelligence quotient between sprint interval training (n = 17), continuous aerobic training (n = 15) and control (n = 14). Sprint interval training was composed of three blocks of 10 minutes at ventilatory threshold (blocks 1 and 3: 10 sprint bouts of 15 seconds, followed by 45 seconds relative rest; block 2: continuous training) twice a week for 15 weeks. Continuous aerobic training was composed of three blocks of 10 minutes continuous training. After eight weeks, intensity was increased to 110% of ventilatory threshold. The control group did not participate in supervised exercise training. Before and after the training period, body composition, physical and metabolic fitness were evaluated.

RESULTS

Sprint interval training showed a significant positive evolution for waist circumference, fat%, systolic blood pressure, lipid profile, fasting insulin, homeostasis model assessment of insulin resistance, peak VO2, peak Watt, ventilatory threshold, 6-minute walk distance and muscle fatigue resistance when compared with no training (P < 0.01). The sprint interval training group demonstrated significant improvements for fat%, systolic blood pressure, low-density lipoprotein, fasting insulin, peak VO2 and peak power and ventilatory threshold (P < 0.01) when compared with continuous aerobic training.

CONCLUSION

In this study we could observe that sprint interval training has stronger beneficial effects on body composition, physical fitness and metabolic fitness compared with control. Compared with continuous aerobic training, sprint interval training seems to result in better outcome.