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Corien Peeters, Hannah Marchand, Heather Tulloch, Ron J. Sigal, Gary S. Goldfield, Stasia Hadjiyannakis and Glen P. Kenny

Background:

Purpose was to examine experiences of obese youth aged 14 to 18 years during their participation in the Healthy Eating, Aerobic, and Resistance Exercise in Youth (HEARTY) randomized controlled exercise trial.

Methods:

A longitudinal qualitative approach was used to investigate youths’ experiences across time points in the trial: 3-weeks (run-in phase; n = 44, 52% males), 3-months (midpoint; n = 25), and 6-months (end of intervention; n = 24). Participants completed telephone interviews on perceived exercise facilitators, barriers, outcomes, and program preferences. Responses were subject to content analyses and are reported as frequencies.

Results:

Participants joined the trial initially to lose weight, but focused more on fitness over time. Exercise behavior was influenced by a sense of achieving results, and by family and peers (ie, supportive comments, transportation). At 6-months, the most commonly perceived changes were improved fitness (50%) and appearance (46%). Suggested changes to the HEARTY trial included initial guidance by a trainer, and more varied and group-based activity.

Conclusions:

Exercise facilitators, barriers and perceived changes in an exercise trial are reported. Access to a gym, initial direction by a trainer, variety, and group-based activities were reported as desired components of an exercise intervention. Findings also point to the importance of involving family and peer supports.

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Mindy Millard-Stafford, Jeffrey S. Becasen, Michael W. Beets, Allison J. Nihiser, Sarah M. Lee and Janet E. Fulton

A systematic review of literature was conducted to examine the association between changes in health-related fitness (e.g., aerobic capacity and muscular strength/endurance) and chronic disease risk factors in overweight and/or obese youth. Studies published from 2000–2010 were included if the physical activity intervention was a randomized controlled trial and reported changes in fitness and health outcomes by direction and significance (p < .05) of the effect. Aerobic capacity improved in 91% and muscular fitness improved in 82% of measures reported. Nearly all studies (32 of 33) reported improvement in at least one fitness test. Changes in outcomes related to adiposity, cardiovascular, musculoskeletal, metabolic, and mental/emotional health improved in 60%, 32%, 53%, 41%, and 33% of comparisons studied, respectively. In conclusion, overweight and obese youth can improve physical fitness across a variety of test measures. When fitness improves, beneficial health effects are observed in some, but not all chronic disease risk factors.

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Antonio García-Hermoso, Mairena Sánchez-López and Vicente Martínez-Vizcaíno

The purpose of this meta-analysis of randomized trials was to determine the effectiveness of aerobic plus resistance exercise interventions on body composition related to variables in overweight and obese youth. A computerized search was made of 7 databases. The analysis was restricted to randomized controlled trials that examined the effect of aerobic and resistance exercise on body composition (body weight, body mass index, fat mass, fat-free mass, and waist circumference) in obese youth. Two independent reviewers screened studies and extracted data. Weighted mean differences (WMD) and 95% confidence intervals were calculated. Nine studies were selected for meta-analysis as they fulfilled the inclusion criteria (n = 365). Aerobic plus resistance exercise interventions (8–24 weeks duration) produced a decrease in body weight (WMD=-3.31 kg), body mass index (WMD=-1.05 kg/m2), and fat mass (WMD=-1.93% and 5.05 kg), but changes in fatfree mass and waist circumference were not observed. These changes were accentuated through programs of at least 60 min of exercise per session, generating greater reductions in body weight (WMD=-4.11 kg), fat mass (WMD=-4.07%), and increase in fat-free mass (WMD = 2.45 kg). This meta-analysis provides insight into the effectiveness of short-term aerobic plus resistance exercise interventions for decreasing body weight, body mass index, and fat mass in pediatric obesity.

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Bernard Gutin and Scott Owens

The purposes of this article were to (1): review recent studies of relations between physical activity and cardiometabolic biomarkers of youths (2); highlight areas in which additional research is needed; and (3) make recommendations for preventive interventions. Observational studies show that youths who engage in high amounts of moderate-vigorous physical activity display a more favorable cardiometabolic biomarker profile than youths who engage in lesser amounts of moderate-vigorous physical activity. Intervention studies in obese youths show that favorable changes in biomarkers are produced by moderate-vigorous physical activity doses of 150–180 min/week. However, for nonobese youths, intervention studies suggest that such doses are not effective; higher moderate-vigorous physical activity doses of approximately 300 min/week seem necessary. Continuing a physically active lifestyle from childhood into the adult years will enable people to maintain less end-organ damage and lower rates of morbidity and mortality from cardiovascular disease and type 2 diabetes.

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José Castro-Piñero, Carmen Padilla-Moledo, Francisco B. Ortega, Diego Moliner-Urdiales, Xiaofen Keating and Jonatan R. Ruiz

Background:

We examined the association of cardiorespiratory fitness and fatness with health complaints and health risk behaviors in 691 (323 girls) Spanish children aged 6 to 17.9.

Methods:

Health complaints and health risk behaviors were self-reported using items of the Health Behavior in School-aged Children questionnaire. Weight and height were measured and body mass index was computed. Cardiorespiratory fitness was measured by the 20-m shuttle-run test, and youth categorized as fit/unfit.

Results:

Unfit youth were more likely to report health complaints sometime (OR: 2.556, 95% CI: 1.299–5.031; and OR: 1.997, 95% CI: 1.162–3.433, respectively) and health risk behaviors such as drinking alcohol sometime (OR: 5.142, 95% CI: 1.214–21.783; and OR: 2.413, 95% CI: 1.484–3.923) than their fit counterparts. Overweight-obese youth were more likely to report health complaints (OR: 1.732, 95% CI: 1.019–2.945; and OR: 1.983, 95% CI: 1.083–3.629, respectively). The analysis of the combined influence of fitness and fatness revealed that fit youth had lower health complaints index than the fat-unfit and unfat-unfit groups (all P < .05).

Conclusions:

Low fitness and overweight-obesity increased the risk of having health complaints in youth, yet high levels of cardiorespiratory fitness might overcome deleterious effects of overweight-obesity on health complaints.

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James Dollman, Rebecca Stanley and Andrew Wilson

Valid measurement of youth physical activity is important and self-report methods provide convenient assessments at the population level. There is evidence that the validity of physical activity self-report varies by weight category. The aim of this study was to assess the validity of the 3-Day Physical Activity Recall (3DPAR), separately between normal weight and overweight/obese Australian youth. Accelerometer-derived physical activity variables were compared with 3DPAR variables in 155 (77 females) 11- to 14-year-olds from Adelaide, South Australia. In the whole sample, validity coefficients for self-reported moderate and moderate to vigorous physical activity were modest (rs = 0.12-0.31) and similar across gender and weight status categories. Validity coefficients for self-reported vigorous physical activity were much stronger (rs = 0.59-0.73) among overweight/obese than among normal weight participants. The validity of the 3DPAR in this study was low in the whole sample but varied according to physical activity intensity and the weight status of the child. Specifically, the 3DPAR may be appropriate for describing vigorous intensity physical activity among overweight and obese youth.

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Samuel G. Wittekind, Nicholas M. Edwards, Philip R. Khoury, Connie E. McCoy, Lawrence M. Dolan, Thomas R. Kimball and Elaine M. Urbina

Background: We aimed to (1) compare a subjective and objective measure of habitual physical activity (PA), (2) determine the association of PA and cardiovascular risk factors, and (3) test the hypothesis that PA is an independent determinant of target organ damage in youth. Methods: Cross-sectional analysis of youth with and without type 2 diabetes [mean age = 22 (3.9) y]. PA was measured with International Physical Activity Questionnaire and Actical accelerometer. Target organ damage was assessed with echocardiography and peripheral arterial testing. Subjects were stratified into tertiles of total PA, and differences were tested by analysis of variance and χ2 tests. General linear models tested for independent associations. Results: The correlation between International Physical Activity Questionnaire and accelerometry was weak (r = .23, P = .0003). Less active subjects had worse cardiovascular risk profiles and target organ damage, including stiffer arteries (P < .01). These outcome differences did not reach statistical significance when adjusted for covariates, such as lipid levels and glycemic control. Conclusion: Survey assessment of PA is complicated by inaccurate reporting. There is a strong association of habitual PA with cardiovascular risk factor clustering. PA may exert its beneficial effect on arterial stiffness in obese youth through improved glycemic control.

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Julian A. Reed, Andrea L. Maslow, Savannah Long and Morgan Hughey

Object:

Increased importance on academic achievement has resulted in many school districts focusing on improved academic performance leading to reductions in physical education time. The purpose was to examine the effects of 45 minutes of daily physical education on the cognitive ability, fitness performance and body composition of African American elementary and middle school youth.

Methods:

Participants completing the informed consent in grades 2nd to 8th were included in the study. A pre/posttest design was used with repeated measures analysis of variance. Experimental and control school participants were pretested on the cognitive measures (ie, Fluid Intelligence and Perceptual Speed) and FitnessgramR physical fitness test items (eg, aerobic capacity, muscular strength and muscular endurance, body composition) in September 2009 and posttested in May 2010.

Results:

Experimental elementary and middle school participants observed significantly greater improvements compared with control elementary and middle school participants on 7 of 16 fitness and body composition measures and on 8 of 26 cognitive measures. These fitness, body composition, and cognitive improvement differences were more noticeable among elementary and middle school females.

Conclusions:

Providing 45 minutes of daily physical education can perhaps increase cognitive ability while increasing fitness and decreasing the prevalence of overweight and obese youth.

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Heather Hayes Betz, Joey C. Eisenmann, Kelly R. Laurson, Katrina D. DuBose, Mathew J. Reeves, Joseph J. Carlson and Karin A. Pfeiffer

Purpose: The objective of this study was to examine the independent and combined association of physical activity and body mass index (BMI) with blood pressure in youth. Methods: Youth aged 8–18 years from the 2003–2006 National Health and Nutrition Examination Survey (NHANES) with BMI, blood pressure, and physical activity (accelerometer) were included in the analyses. A total of 2585 subjects (1303 males; 47% of all 8- to 18-year-olds) met these criteria. Results: Obese youth had a systolic blood pressure that was 8 mm Hg higher than normal weight youth. A significant interaction between BMI and physical activity on blood pressure was found (P < .001), and group differences among the BMI/activity groups showed that the 3 obese groups and the overweight/least active group had significantly higher systolic blood pressure than the normal weight/active group across all analyses. The overweight/least active and normal weight/least active groups had significantly higher diastolic blood pressure than the normal weight/active group as well. Conclusions: This study showed a significant independent and combined association of BMI and physical activity with blood pressure in youth. Interventions need to focus on the reduction of fatness/BMI as a way to reduce the cardiovascular risk in youth.

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YoonMyung Kim

) ( 5 , 55 ), in children and adolescents. It is also well established that obese children and adolescents are more likely to remain obese as adults ( 66 ). Furthermore, tracking for such health outcomes from childhood into adulthood is more predominant in overweight and obese youth than their lean