Longitudinal Factor Analysis Reveals a Distinct Clustering of Cardiometabolic Improvements During Intensive, Short-Term Dietary and Exercise Intervention in Obese Children and Adolescents

Abstract Due to the growth of the epidemic of obesity and the association of obesity with both short-term and long-term medical complications, many professional organizations have recommended performing laboratory testing as part of the initial evaluation of overweight and obese children and adolescents. We report on the results of laboratory testing performed on 110 patients (mean age 14.0 years, range 8–20 years) referred to our weight management program between 2011 and 2013. Our results showed mild abnormalities in levels of cholesterol, glucose, liver enzymes, and thyroid stimulating hormone (TSH) in fewer than 5% of patients for each test and no changes in management based on these results for any of the patients. We call for re-consideration of the recommendations for laboratory testing in children and adolescents being evaluated and treated for overweight and obesity.

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Effectiveness of exercise intervention on improving fundamental movement skills and motor coordination in overweight/obese children and adolescents: A systematic review

Journal of Science and Medicine in Sport ◽

10.1016/j.jsams.2017.07.001 ◽

2018 ◽

Vol 21 (1) ◽

pp. 89-102 ◽

Cited By ~ 23

Author(s):

Ahreum Han ◽

Allan Fu ◽

Stephen Cobley ◽

Ross H. Sanders

Keyword(s):

Systematic Review ◽

Children And Adolescents ◽

Motor Coordination ◽

Exercise Intervention ◽

Obese Children ◽

Movement Skills ◽

Fundamental Movement Skills

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A short-term diet and exercise intervention ameliorates inflammation and markers of metabolic health in overweight/obese children

AJP Endocrinology and Metabolism ◽

10.1152/ajpendo.00190.2012 ◽

2012 ◽

Vol 303 (4) ◽

pp. E542-E550 ◽

Cited By ~ 34

Author(s):

Ali Izadpanah ◽

R. James Barnard ◽

Anna Jane E. Almeda ◽

Gayle C. Baldwin ◽

Sydney A. Bridges ◽

...

Keyword(s):

Exercise Intervention ◽

Lifestyle Modification ◽

Metabolic Health ◽

Obese Children ◽

Short Term ◽

Serum Samples ◽

High Fiber ◽

Clinical Biomarkers ◽

Exercise Regimen ◽

Diet And Exercise

The present study was designed to examine the effects of short-term diet and exercise on markers of metabolic health, serum-stimulated production of inflammatory biomarkers from cultured monocytes and adipocytes, and serum lipomics. Twenty-one overweight/obese children (9 boys and 12 girls, age 13.0 ± 0.5 yr, BMI 33.0 ± 1.8 kg/m2) were placed on a 2-wk ad libitum, high-fiber, low-fat diet and daily exercise regimen. Fasting serum samples were taken pre- and postintervention for determination of cytokines, metabolic risk markers, and lipomics. Monocytes and adipocytes were incubated with pre- and postintervention serum to investigate changes in cytokine secretion. Correlative associations were calculated, followed by hierarchical clustering to determine relationships between fatty acid (FA) species and clinical biomarkers. Despite remaining overweight/obese, interleukin (IL)-6, IL-8, TNFα, PAI-1, resistin, amylin, leptin, insulin, and IL-1ra decreased and adiponectin increased. Culture studies indicated decreases in monocyte secretion of IL-6, TNFα, and IL-1β and adipocyte secretion of IL-6. Lipomic analysis revealed a decrease in total lipids and decreases in saturated FAs and an increase in 18:1/18:0. In general, Pearson's correlations revealed that inflammatory markers are negatively associated with a cluster of polyunsaturated FAs and positively correlated with several saturated FAs. These results indicate significant modification of multiple indices of metabolic health with short-term rigorous lifestyle modification in overweight/obese children prior to obesity reversal.

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Effects of an intensive short-term diet and exercise intervention: comparison between normal-weight and obese children

AJP Regulatory Integrative and Comparative Physiology ◽

10.1152/ajpregu.00131.2013 ◽

2013 ◽

Vol 305 (5) ◽

pp. R552-R557 ◽

Cited By ~ 18

Author(s):

Christian K. Roberts ◽

Ali Izadpanah ◽

Siddhartha S. Angadi ◽

R. James Barnard

Keyword(s):

Weight Loss ◽

Lifestyle Intervention ◽

Intervention Program ◽

Exercise Intervention ◽

Serum Insulin ◽

Normal Weight ◽

Model Assessment ◽

Obese Children ◽

Short Term ◽

Phenotypic Changes

Lifestyle intervention programs currently emphasize weight loss secondary to obesity as the primary determinant of phenotypic changes. We examined whether the effects of a short-term lifestyle intervention program differ in normal-weight versus overweight/obese children. Nineteen overweight/obese (O; BMI = 33.6 ± 1.9 kg/m2) and 14 normal-weight (N; BMI = 19.9 ± 1.5 kg/m2) children participated in a 2-wk program consisting of an ad libitum high-fiber, low-fat diet and daily exercise (2–2.5 h). Fasting serum samples were taken pre- and postintervention for determination of lipids, glucose homeostasis, inflammatory cytokines, and adipokines. Only the O group lost weight (3.9%) but remained overweight/obese (32.3 ± 1.9 kg/m2). Both groups exhibited significant intervention-induced decreases ( P < 0.05) in serum insulin (N: 52.5% vs. O: 28.1%; between groups, P = 0.38), homeostatic model assessment for insulin resistance (N: 53.1% vs. O: 28.4%, P = 0.43), leptin (N: 69.3% vs. O: 44.1%, P = 0.10), amylin (N: 28.7% vs. O: 26.1%, P = 0.80), resistin (N: 40.0% vs. O: 35.1%, P = 0.99), plasminogen activator-inhibitor-1 (N: 30.8% vs. O: 25.6%, P = 0.59), IL-6 (N: 58.8% vs. O: 48.5%, P = 0.78), IL-8 (N: 46.0% vs. O: 42.2%, P = 0.49), and TNFα (N: 45.8% vs. O: 40.8%, P = 0.99). No associations between indices of weight change and phenotypic changes were noted. A short-term, intensive lifestyle modification program is effective in ameliorating metabolic risk factors in N and O children. These results suggest that obesity per se was not the primary driver of the phenotypes noted and that dietary intake and physical inactivity induce the phenotypic abnormalities. These data may have implications for the weight loss-independent management of cardiometabolic risk in pediatric populations.

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Physical Exercise Improves Heart-Rate Variability in Obese Children and Adolescents: A Systematic Review

Sustainability ◽

10.3390/su13052946 ◽

2021 ◽

Vol 13 (5) ◽

pp. 2946

Author(s):

Santos Villafaina ◽

Juan Pedro Fuentes-García ◽

Juan Luis Leon-Llamas ◽

Daniel Collado-Mateo

Keyword(s):

Systematic Review ◽

Heart Rate ◽

Heart Rate Variability ◽

Physical Exercise ◽

Children And Adolescents ◽

Cardiovascular Health ◽

Exercise Intervention ◽

Negative Impact ◽

Obese Children ◽

Exercise Interventions

Background: Childhood obesity has negative impact on heart-rate variability (HRV) and, thereby, on the cardiovascular health of children and adolescents. Thus, physical-exercise interventions were proposed to increase HRV. The present systematic review aims to provide an up-to-date analysis of research on the effect of physical-exercise interventions on HRV in obese children and adolescents. Methods: An electronic search of the literature was performed, and 10 articles were included. PRISMA guideline methodology was employed. Results: Physical-exercise interventions predominantly involved aerobic training; however, alternative training programs, including judo or recreational soccer, were found. The duration of intervention ranged from 6 to 24 weeks, with a training frequency of between 2 and 7 times per week. The duration of sessions typically ranged from 40 to 60 min. Conclusions: Results of the included articles indicated that physical-exercise intervention increased the HRV and thereby the autonomic modulation of obese children and adolescents. This is significant, as HRV is associated with cardiovascular health. Such physical-exercise interventions are crucial to reduce weight and improve cardiovascular health in children and adolescents, thereby achieving a sustainable future.

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Short term fasting of obese children and adolescents

Journal of Adolescent Health Care ◽

10.1016/s0197-0070(83)80460-4 ◽

1983 ◽

Vol 4 (3) ◽

pp. 222

Author(s):

P.H. Patterson ◽

G.J. Graham

Keyword(s):

Children And Adolescents ◽

Obese Children ◽

Short Term

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Exercise and BMI in Overweight and Obese Children and Adolescents: A Systematic Review and Trial Sequential Meta-Analysis

BioMed Research International ◽

10.1155/2015/704539 ◽

2015 ◽

Vol 2015 ◽

pp. 1-17 ◽

Cited By ~ 4

Author(s):

George A. Kelley ◽

Kristi S. Kelley ◽

Russell R. Pate

Keyword(s):

Children And Adolescents ◽

Exercise Intervention ◽

Average Length ◽

Meta Analysis ◽

Exercise Program ◽

Number Needed To Treat ◽

Obese Children ◽

Random Effects Models ◽

Type 1 Error ◽

Intervention Trials

Objective. Determine the effects of exercise on body mass index (BMI in kg·m−2) among overweight and obese children and adolescents.Methods. Trial sequential meta-analysis of randomized controlled exercise intervention trials ≥ 4 weeks and published up to November 11, 2014.Results. Of the 5,436 citations screened, 20 studies representing 971 boys and girls were included. Average length, frequency, and duration of training were 13 weeks, 3 times per week, for 46 minutes per session. Overall, random-effects models showed that exercise decreased BMI by 3.6% (mean: −1.08; 95% CI: −0.52 to −1.64;Q=231.4;p<0.001;I2=90.9%; 95% CI: 87.6% to 93.4%;D2=91.5%). Trial sequential meta-analysis showed that changes in BMI crossed the monitoring boundary for a type 1 error in 2010, remaining stable thereafter. The number needed to treat was 5 while the percentile improvement was 26.9. It was estimated that approximately 2.5 million overweight and obese children in the US and 22.0 million overweight and obese children worldwide could reduce their BMI by participating in a regular exercise program. Overall quality of evidence was rated as moderate.Conclusions. Exercise is associated with improvements in BMI among overweight and obese children and adolescents. This trial is registered with PROSPERO Trial Registration #CRD42015017586.

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Exercise and adiposity in overweight and obese children and adolescents: a systematic review with network meta-analysis of randomised trials

BMJ Open ◽

10.1136/bmjopen-2019-031220 ◽

2019 ◽

Vol 9 (11) ◽

pp. e031220 ◽

Cited By ~ 7

Author(s):

George A Kelley ◽

Kristi S Kelley ◽

Russell R Pate

Keyword(s):

Strength Training ◽

Children And Adolescents ◽

Body Fat ◽

Fat Mass ◽

Exercise Intervention ◽

Meta Analysis ◽

Randomised Trial ◽

Obese Children ◽

Exercise Interventions ◽

Intervention Trials

ObjectivesDetermine both the effects and hierarchy of effectiveness for exercise interventions (aerobic, strength training or both) on selected measures of adiposity (body mass index (BMI) in kg/m2, fat mass and per cent body fat) in overweight and obese children and adolescents.DesignNetwork meta-analysis of randomised exercise intervention trials.SettingAny setting where a randomised trial could be conducted.ParticipantsOverweight and obese male and/or female children and adolescents 2–18 years of age.InterventionsRandomised exercise intervention trials>4 weeks, published between 1 January 1973 and 22 August 2018, and which included direct and/or indirect evidence for aerobic, strength training or combined aerobic and strength training.Primary outcomesChanges in BMI in kg/m2, fat mass and per cent body fat.ResultsFifty-seven studies representing 127 groups (73 exercise, 54 control) and 2792 participants (1667 exercise, 1125 control) met the criteria for inclusion. Length of training (X- ± SD) averaged 14.1±6.2 weeks, frequency, 3.3±1.1 days per week and duration 42.0±21.0 min per session. Significant and clinically important reductions in BMI, fat mass and per cent body fat were observed in aerobic versus control comparisons (BMI, mean, 95% CI -1.0, 1.4 to −0.6; fat mass -2.1, –3.3 to −1.0 kg; per cent fat -1.5, –2.2 to −0.9%) and combined aerobic and strength versus control comparisons (BMI -0.7, –1.4 to −0.1; fat mass -2.5, –4.1 to −1.0 kg; per cent fat, -2.2, –3.2 to −1.2%). A significant reduction in per cent fat was also found for strength vs control comparisons (-1.3,–2.5 to −0.1%). Combined aerobic and strength training was ranked first for improving both fat mass (kg) and per cent body fat while aerobic exercise was ranked first for improving BMI.ConclusionsAerobic and combined aerobic and strength training are associated with improvements in adiposity outcomes in overweight and obese children and adolescents.PROSPERO registration numberCRD42017073103.

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