Is an Exercise Intervention the only way to Reduce Visceral Fat without Reducing Fat-free Mass in Children and Adolescents?

Objectives: To maintain proper development, it is recommended that children/adolescents focus more on increasing physical activity than dietary restriction when treating obesity. In other words, adults are better able to tolerate the reductions in fat-free body mass that often occur when trying to lose fat mass. In contrast, children and adolescents should avoid losses in fat-free mass in order to ensure proper development. Therefore, when trying to reduce visceral fat in children via a negative energy balance (i.e., exercise with or without calorie restriction), it is necessary to set desirable conditions in order to minimize the loss of fat-free mass. To determine whether this is possible, we reviewed literature discussing the relationship between changes in visceral fat obtained by abdominal imaging and changes in total body fat and fat-free mass after exercise training with and without calorie restriction in children and adolescents.Methods: Literature review.Results and Conclusions: Previous work found no reduction in fat-free mass in the exercise interventions in which there was no dietary-induced calorie restriction. This supports the idea that reducing visceral fat by increasing physical activity is the preferred strategy over dietary restriction in children and adolescents. Although factors such as the type (e.g. aerobic and/or resistance) of exercise and the amount (i.e. energy expenditure) of exercise will likely have an effect on the magnitude of change in intra-abdominal visceral fat, the quantity of each that is needed without reducing fat-free mass is currently unknown.

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Effects of Exercise Interventions on Weight, Body Mass Index, Lean Body Mass and Accumulated Visceral Fat in Overweight and Obese Individuals: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18052635 ◽

2021 ◽

Vol 18 (5) ◽

pp. 2635

Author(s):

Hyun Suk Lee ◽

Junga Lee

Keyword(s):

Body Mass Index ◽

Randomized Controlled Trials ◽

Lean Body Mass ◽

Body Mass ◽

Visceral Fat ◽

Exercise Intervention ◽

Meta Analysis ◽

Controlled Trials ◽

Exercise Interventions ◽

Randomized Controlled

(1) Background: Exercise interventions for overweight and obese individuals help reduce accumulated visceral fat, which is an indicator of cardiometabolic risk, but the effectiveness of these interventions is controversial. The purpose of this meta-analysis was to investigate the effectiveness of exercise interventions in overweight and obese individuals in order to reduce weight, body mass index (BMI), and accumulated visceral fat, and increase lean body mass. (2) Methods: Databases were used to select eligible studies for this meta-analysis. Randomized controlled trials with control and experimental groups were included. The degrees of effectiveness of the exercise interventions were computed to assess the benefits on reducing weight, BMI, and accumulated visceral fat, and increasing lean body mass. (3) Results: Sixteen studies were included in this meta-analysis. Participation in exercise interventions reduced weight (d = −0.58 (95% confidence interval (CI), −0.84–−0.31; p < 0.001; k = 9)), BMI (d = −0.50 (95% CI, −0.78–−0.21; p < 0.001; k = 7)), and accumulated visceral fat (d = −1.08 (95% CI, −1.60–−0.57; p < 0.001; k = 5)), but did not significantly increase lean body mass (d = 0.26 (95% CI, −0.11–0.63; p = 0.17; k = 6)). The average exercise intervention for overweight and obese individuals was of moderate to vigorous intensity, 4 times per week, 50 min per session, and 22 weeks duration. (4) Conclusions: Participating in exercise interventions has favorable effects on weight, BMI, and accumulated visceral fat. Further studies considering different modalities, intensities, durations, and measurements of fatness need to be conducted.

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The Promise of Youth Resistance Training

B&G Bewegungstherapie und Gesundheitssport ◽

10.1055/a-1378-3385 ◽

2021 ◽

Vol 37 (02) ◽

pp. 47-51

Author(s):

Avery D Faigenbaum ◽

Stephan Geisler

Keyword(s):

Physical Activity ◽

Resistance Training ◽

Children And Adolescents ◽

Vigorous Physical Activity ◽

Temporal Trends ◽

Developmentally Appropriate ◽

Muscular Fitness ◽

Exercise Interventions ◽

Sport Activities ◽

Building Activities

SummaryGlobal health reports indicate that a vast majority of children and adolescents are not accumulating the recommended amount of moderate to vigorous physical activity (MVPA) daily. This decline in MVPA has coincided with troubling temporal trends in muscular fitness in modern day youth. Since a prerequisite level of muscular strength is needed to move proficiently, developmentally appropriate interventions that target neuromuscular deficits are needed to prepare girls and boys for ongoing participation in active play, exercise and sport activities. Instead of focusing exclusively on aerobic activities, the promotion of youth physical activity should recognize the shared importance of strength, skill and aerobic activities for all youth regardless of body size or physical prowess. In addition to enhancing muscular fitness and improving motor skill performance, regular participation in resistance training has been found to have a favorable influence on musculoskeletal strength, cardiometabolic function, body composition, and mental health in children and adolescents. A new mindset that recognizes the critical importance of strength-building activities early in life is needed before this generation of girls and boys becomes resistant to exercise interventions later in life.

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Energy Balance and Energy Availability During a Selection Course for Belgian Paratroopers

Military Medicine ◽

10.1093/milmed/usab140 ◽

2021 ◽

Author(s):

Patrick Mullie ◽

Pieter Maes ◽

Laurens van Veelen ◽

Damien Van Tiggelen ◽

Peter Clarys

Keyword(s):

Physical Activity ◽

Energy Balance ◽

Energy Expenditure ◽

Metabolic Rate ◽

Energy Intake ◽

Rest Metabolic Rate ◽

Negative Energy ◽

Fat Free Mass ◽

Negative Energy Balance ◽

Energy Availability

ABSTRACT Introduction Adequate energy supply is a prerequisite for optimal performances and recovery. The aims of the present study were to estimate energy balance and energy availability during a selection course for Belgian paratroopers. Methods Energy expenditure by physical activity was measured with accelerometer (ActiGraph GT3X+, ActiGraph LLC, Pensacola, FL, USA) and rest metabolic rate in Cal.d−1 with Tinsley et al.’s equation based on fat-free mass = 25.9 × fat-free mass in kg + 284. Participants had only access to the French individual combat rations of 3,600 Cal.d−1, and body fat mass was measured with quadripolar impedance (Omron BF508, Omron, Osaka, Japan). Energy availability was calculated by the formula: ([energy intake in foods and beverages] − [energy expenditure physical activity])/kg FFM−1.d−1, with FFM = fat-free mass. Results Mean (SD) age of the 35 participants was 25.1 (4.18) years, and mean (SD) percentage fat mass was 12.0% (3.82). Mean (SD) total energy expenditure, i.e., the sum of rest metabolic rate, dietary-induced thermogenesis, and physical activity, was 5,262 Cal.d−1 (621.2), with percentile 25 at 4,791 Cal.d−1 and percentile 75 at 5,647 Cal.d−1, a difference of 856 Cal.d−1. Mean daily energy intake was 3,600 Cal.d−1, giving a negative energy balance of 1,662 (621.2) Cal.d−1. Mean energy availability was 9.3 Cal.kg FFM−1.d−1. Eleven of the 35 participants performed with a negative energy balance of 2,000 Cal.d−1, and only five participants out of 35 participants performed at a less than 1,000 Cal.d−1 negative energy balance level. Conclusions Energy intake is not optimal as indicated by the negative energy balance and the low energy availability, which means that the participants to this selection course had to perform in suboptimal conditions.

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The Effects of Aerobic Versus Cognitively Demanding Exercise Interventions on Executive Functioning in School-Aged Children: A Cluster-Randomized Controlled Trial

Journal of Sport and Exercise Psychology ◽

10.1123/jsep.2020-0034 ◽

2020 ◽

pp. 1-13

Author(s):

Anna Meijer ◽

Marsh Königs ◽

Irene M.J. van der Fels ◽

Chris Visscher ◽

Roel J. Bosker ◽

...

Keyword(s):

Physical Activity ◽

Randomized Controlled Trial ◽

Executive Functioning ◽

Exercise Intervention ◽

Controlled Trial ◽

Vigorous Physical Activity ◽

Verbal Working Memory ◽

Control Group ◽

Exercise Interventions ◽

Randomized Controlled

The authors performed a clustered randomized controlled trial to investigate the effects of an aerobic and a cognitively demanding exercise intervention on executive functions in primary-school-age children compared with the regular physical education program (N = 856). They hypothesized that both exercise interventions would facilitate executive functioning, with stronger effects for the cognitively demanding exercise group. The interventions were provided four times per week for 14 weeks. Linear mixed models were conducted on posttest neurocognitive function measures with baseline level as covariate. No differences were found between the exercise interventions and the control group for any of the measures. Independently of group, dose of moderate to vigorous physical activity was positively related to verbal working memory and attention abilities. This study showed that physical exercise interventions did not enhance executive functioning in children. Exposure to moderate to vigorous physical activity is a crucial aspect of the relationship between physical activity and executive functioning.

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Using the Stages of Change Model to Increase the Adoption of Physical Activity among Community Participants

American Journal of Health Promotion ◽

10.4278/0890-1171-6.6.424 ◽

1992 ◽

Vol 6 (6) ◽

pp. 424-429 ◽

Cited By ~ 282

Author(s):

Bess H. Marcus ◽

Stephen W. Banspach ◽

R. Craig Lefebvre ◽

Joseph S. Rossi ◽

Richard A. Carleton ◽

...

Keyword(s):

Physical Activity ◽

Stages Of Change ◽

Intervention Program ◽

Exercise Intervention ◽

Change Model ◽

Resource Manual ◽

Exercise Interventions ◽

Stages Of Change Model ◽

And Gender ◽

Media Channels

Purpose. This study examined the use of the stages of change model to design an exercise intervention for community volunteers. Design. The “Imagine Action” campaign was a community-wide event incorporating the involvement of local worksites and community agencies. Community members registering for the campaign were enrolled in a six-week intervention program designed to encourage participation in physical activity. Subjects. Six hundred and ten adults aged 18 to 82 years old enrolled in the program. Seventy-seven percent of the participants were female and the average age was 41.8 years (SD = 13.8). Setting. The campaign was conducted in a city with a population of approximately 72,000 and was promoted throughout community worksites, area schools, organizations, and local media channels. Measures. One question designed to assess current stage of exercise adoption was included on the campaign registration form as were questions about subject name, address, telephone number, birthdate, and gender. Intervention. The intervention included written materials designed to encourage participants to initiate or increase physical activity, a resource manual describing activity options in the community, and weekly “fun walks” and “activity nights.” Results. A Stuart-Maxwell test for correlated proportions revealed that subjects were significantly more active after the six-week intervention. Sixty-two percent of participants in Contemplation became more active while 61 % in Preparation became more active. Conclusions. Most participants increased their stage of exercise adoption during the six-week intervention. This study provides preliminary support for use of the stages of change model in designing exercise interventions.

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Aerobic Exercise Interventions for Patients in Opioid Maintenance Treatment: A Systematic Review

Substance Abuse Research and Treatment ◽

10.1177/1178221820918885 ◽

2020 ◽

Vol 14 ◽

pp. 117822182091888

Author(s):

Danielle E Jake-Schoffman ◽

Meredith S Berry ◽

Marissa L Donahue ◽

Demetra D Christou ◽

Jesse Dallery ◽

...

Keyword(s):

Physical Activity ◽

Aerobic Exercise ◽

Maintenance Treatment ◽

Exercise Intervention ◽

Adjunctive Treatment ◽

Bibliographic Databases ◽

Opioid Use ◽

Opioid Maintenance Treatment ◽

Exercise Interventions ◽

Supervised Exercise

Background: Opioid maintenance treatment (OMT) is the standard for treatment of opioid use disorder, but some individuals on OMT experience disrupted sleep, heightened sensitivity to pain, and continued relapse to non-medical opioid use. An adjunctive treatment that has potential to address these shortcomings of OMT is aerobic exercise. Objective: The aim of the present review was to identify and evaluate components of aerobic exercise interventions targeting OMT patients. Methods: For this PROSPERO-registered review (ID CRD42020139626), studies were identified via electronic bibliographic databases, funded research ( NIH RePORTER) and clinical trials databases ( ClinicalTrials.gov), and reference sections of relevant manuscripts. Studies that evaluated the effects of an aerobic exercise intervention using a comparison condition or pretest-posttest design in adult OMT patients were included. Results: Of 2971 unique records, three primary studies and one supplemental manuscript comprised the final sample. All studies were randomized trials involving supervised exercise interventions enrolling small samples of middle-aged OMT patients. Exercise interventions included a variety of aerobic and non-aerobic activities (e.g. flexibility exercises), and none controlled the dose of aerobic exercise. Few studies used objective measures of physical activity or cardiorespiratory fitness and there were no significant effects of adjunctive exercise on substance use outcomes, but tests of the latter were likely underpowered. Conclusions: Though early in the accumulation of evidence, interventions targeting aerobic exercise for OMT patients appear feasible, acceptable to patients, and beneficial. Longer-term studies that employ larger samples, include assessments of behavioral and biological mechanisms of change, more rigorous measurement of physical activity, and controlled doses of aerobic activity are warranted.

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Role of physical activity in the treatment of nonalcoholic fatty liver disease in children and adolescents

Applied Physiology Nutrition and Metabolism ◽

10.1139/apnm-2012-0503 ◽

2013 ◽

Vol 38 (8) ◽

pp. 805-812 ◽

Cited By ~ 3

Author(s):

Anthony R. Deldin ◽

SoJung Lee

Keyword(s):

Physical Activity ◽

Insulin Resistance ◽

Liver Disease ◽

Children And Adolescents ◽

Calorie Restriction ◽

Fatty Liver Disease ◽

Liver Fat ◽

Obese Children ◽

Nonalcoholic Fatty Liver

Currently, nonalcoholic fatty liver disease (NAFLD) is the most frequent liver abnormality observed in obese children and adolescents. A strong body of evidence suggests that increased liver fat is significantly associated with visceral adiposity, metabolic syndrome, and insulin resistance in obese children and adolescents. Diet and exercise are generally recommended to treat obese youth with NAFLD as they do not carry side effects and confer multiple cardiometabolic benefits. Studies in adult populations report a beneficial effect of regular physical activity on reducing liver fat. In children and adolescents, available data show that weight loss induced by increasing physical activity and calorie restriction is beneficial to reduce liver fat and associated health risk factors such as insulin resistance and dyslipidemia. Currently, evidence regarding the independent effects of regular exercise alone (e.g., without calorie restriction) on NAFLD are unclear. Additionally, there is no data regarding the optimal exercise regimen (e.g., type, dose, intensity) that should be prescribed for reducing NAFLD in children and adolescents. The purpose of this review is to examine the role of physical activity on NAFLD in children and adolescents.

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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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Evaluation of non-invasive arterial stiffness parameters and their relationship with physical activity, anthropometric indices and lipid profiles in healthy middle-aged adults: results of the PERSIAN cohort study

10.22541/au.160960295.57089074/v1 ◽

2021 ◽

Author(s):

Mohammad Nosrati-Oskouie ◽

Sajjad Arefinia ◽

Saeed Eslami Hasan Abadi ◽

Abdolreza Norouzy ◽

Hamed Khedmatgozar ◽

...

Keyword(s):

Physical Activity ◽

Arterial Stiffness ◽

Visceral Fat ◽

Augmentation Index ◽

Lipid Profiles ◽

Fat Free Mass ◽

Middle Aged ◽

Anthropometric Indices ◽

Visceral Fat Area ◽

Middle Aged Adults

Background: Arterial stiffness (AS) indicates the initial stage of cardiovascular disease (CVD), which associated with modifiable and lifestyle risk factors. We aimed to examine the association of AS with anthropometric indices, lipid profiles, and physical activity. Methods: 658 healthy middle-aged adults selected and anthropometric indices (body mass index (BMI), waist circumferences (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), neck circumferences (NC), a body shape index (ABSI), body roundness index (BRI), body-fat mass (BFM), visceral-fat, fat-free mass(FFM), lipid profiles, and PA were measured. Arterial Stiffness measured by carotid-femoral pulse wave velocity (cf-PWV) and central augmentation index (cAIx). Results: Our results show, cf-PWV positively associated with TGs (β = 0.10, p = 0.01) and in anthropometric indices corelated with, WC (β = 0.11, p = 0.02), WHR (β = 0.09, p = 0.03), WHtR (β = 0.1, p = 0.02), and BRI (β = 0.09, p = 0.04). cAIx was independently positive association with cholesterol (β = 0.08, p = 0.03), WC (β = 0.1, p = 0.03), WHR (β = 0.09, p = 0.02), ABSI (β = 0.09, p = 0.01), BRI (β = 0.08, p = 0.05), visceral-fat area (β = 0.09, p = 0.03) and BFM (β = 0.08, p = 0.04) and negatively associated with PA (β = -0.08, p = 0.03). Conclusions: WC, WHR, and BRI were associated with both cf-PWV and cAIx. TGs and WHtR associated with cf-PWV, while cAIx was associated with ABSI, so improving these indices may be helpful to prevent CVD.

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Physical activity and cardiovascular disease risk in women with polycystic ovary syndrome

10.7190/shu-thesis-00398 ◽

2021 ◽

Author(s):

◽

Amie Woodward

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Cardiovascular Health ◽

Exercise Intervention ◽

Polycystic Ovary ◽

Exercise Group ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Exercise Interventions ◽

Supervised Exercise

Background Polycystic ovary syndrome (PCOS) is a complex, heterogeneous endocrinopathy affecting metabolic, reproductive, and cardiovascular health in women. Evidence indicates that women with PCOS present with a cluster of cardiovascular disease (CVD) risk factors. Physical activity (PA) interventions have been shown to reduce various CVD risk factors in women with PCOS. Research also suggests that sedentary behaviours have a distinct deleterious effect on cardiometabolic health. Thus, increasing PA and reducing sedentary behaviour may be a worthwhile therapeutic target to improve cardiovascular health in women with PCOS. The programme of research presented in this thesis investigates the feasibility and acceptability of two PA interventions to improve markers of CVD risk in women with PCOS using both quantitative and qualitive methods. Methods A systematic review and meta-analysis of the effects of exercise interventions on CVD risk factors in women with PCOS provided an evidence base on which to design a supervised exercise intervention. A feasibility randomised controlled trial (RCT) of two physical activity interventions for women with PCOS was conducted. Participants were randomised to either a supervised exercise intervention, a lifestyle physical activity intervention (LPAG) aimed at reducing sedentary behaviours, or a control group, for 12 weeks. Semi-structured interviews were conducted with a purposive sample of participants from each group on completion of the RCT to explore the acceptability of the interventions, and barriers and facilitators to PA. Results The systematic review and meta-analysis demonstrated that moderate intensity aerobic exercise interventions of ≥three months in duration, with a frequency of three sessions/week, had favourable effects on CVD risk factors. These results informed the design of the RCT. Thirty-six women with PCOS were enrolled onto the feasibility RCT (12 per group). The recruitment rate was 56% and adherence rate to the exercise intervention was considered moderate at 53%. The retention rate was high at 89%, with only five participants lost to follow-up. Adherence to the LPAG was 100%. Two non-serious adverse events were reported in the exercise group, unrelated to trial procedures. For the secondary outcomes, trend data indicates a 14% reduction in oxidised LDL concentrations in the exercise group. In addition, the data indicates weight loss (kg) of 3.4% and 3.6% in the exercise group and the LPAG, respectively. Qualitative data from the interviews (n=11) indicated that the interventions were well received, but acceptability could be improved by providing social connectivity and implementing measures that encourage the adoption of long-term health-promoting behaviours. Conclusions iii The findings suggest that the procedures for recruitment, allocation, and outcome measurements were acceptable. However, adherence to the supervised exercise intervention was below an acceptable rate. The qualitative component provides valuable contextual data that will be crucial to addressing adherence for both the progression to a full-scale RCT, and community interventions for women with PCOS.

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