Pediatric obesity typically induces insulin resistance, often later evolving into type 2 diabetes. While exercise, enhancing insulin sensitivity, is broadly used to prevent this transition, it is unknown whether alterations in the exercise insulin response pattern occur in obese children. Therefore, we measured exercise insulin responses in 57 healthy weight (NW), 20 overweight (OW), and 56 obese (Ob) children. Blood samples were drawn before and after 30min of intermittent (2min on, 1min off) cycling at ~80% VO2max. In a smaller group (14 NW, 6 OW, 15 Ob), a high-fat meal was ingested 45 min preexercise. Baseline glycemia was similar and increased slightly and similarly in all groups during exercise. Basal insulin (pmol/L) was significantly higher in Ob vs. other groups; postexercise, insulin increased in NW (+7 ± 3) and OW (+5 ± 8), but decreased in Ob (−15 ±5, p < .0167 vs. NW). This insulin drop in Ob was disproportionately more pronounced in the half of Ob children with higher basal insulin (Ob-H). In all groups, high-fat feeding caused a rapid rise in insulin, promptly corrected by exercise. In Ob, however, insulin rose again 30 min postexercise. Our data indicates a distinct pattern of exercise-induced insulin modulation in pediatric obesity, possibly modulated by basal insulin concentrations.
Brian D. Tran, Szu-Yun Leu, Stacy Oliver, Scott Graf, Diana Vigil and Pietro Galassetti
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.
Mostafa Yaghoubi, Philip W. Fink, Wyatt H. Page, Ali Heydari and Sarah P. Shultz
affect lower extremity joint power in children’s gait . Gait Posture . 2010 ; 32 ( 2 ): 248 – 52 . PubMed ID: 20570152 doi:10.1016/j.gaitpost.2010.05.001 10.1016/j.gaitpost.2010.05.001 20570152 40. Shultz SP , Sitler MR , Tierney RT , Hillstrom HJ , Song J . Effects of pediatric obesity
Julie Masurier, Marie-Eve Mathieu, Stephanie Nicole Fearnbach, Charlotte Cardenoux, Valérie Julian, Céline Lambert, Bruno Pereira, Martine Duclos, Yves Boirie and David Thivel
recruited through pediatric consultations (Pediatric Obesity Department, Children Medical Centers, Romagnat, France and UGECAM SSR Nutrition and Obesity Ambulatory Hospital, Clermont-Ferrand, France). To be included in the study, participants had to be free of any medication that could interact with the
Olivier Rey, Jean-Marc Vallier, Caroline Nicol, Charles-Symphorien Mercier and Christophe Maïano
This study examined the effects of a five-week intervention combining vigorous interval training (VIT) with diet among twenty-four obese adolescents. Fourteen girls and ten boys (aged 14–15) schooled in a pediatric rehabilitation center participated.
The VIT intensity was targeted and remained above 80% of maximal heart rate (HR) and over six kilocalories per minute. Pre- and postintervention measures were body composition (BMI, weight, body fat percentage), physical self-perceptions (PSP), physical fitness (6-min walking distance and work) and its associated physiological responses (HRpeak and blood lactate concentration). A series of two-way analyses of variance or covariance controlling for weight loss were used to examine the changes.
Significant improvements were found in body composition, physical fitness and PSP (endurance, activity level, sport competence, global physical self-concept and appearance). In addition, boys presented higher levels of perceived strength and global physical self-concept than girls. Finally, there was a significant increase in perceived endurance, sport competence, and global physical self-concept in girls only.
This five-week VIT program combined with diet represents an effective means for improving body composition, physical fitness, and PSP in obese adolescents, the effects on PSP being larger among girls.
Jungyun Hwang, I-Min Lee, Austin M. Fernandez, Charles H. Hillman and Amy Shirong Lu
Purpose: This study examined differences in energy expenditure and bodily movement among children of different weight status during exergames that varied in mode and intensity. Methods: Fifty-seven 8- to 12-year-old children including overweight/obesity (n = 28) and normal weight (n = 29) played three 10-minute interval Xbox One exergames (Fruit Ninja, Kung-Fu, and Shape Up) categorized based on predominantly upper-, whole-, or lower-limb movement, respectively. The authors measured bodily movement through accelerometry and obtained energy expenditure and metabolic equivalent (MET) via indirect calorimetry. Results: Energy expended during gameplay was the highest in Shape Up (P < .01) and higher in Kung-Fu than Fruit Ninja (P < .01). Absolute energy expenditure was significantly higher in overweight/obese children (P < .01), but not when controlling for body mass across 3 exergames (P > .05). Based on the MET cut-points, overweight/obese children spent more time at light intensity (<3 METs) for Fruit Ninja (P < .05) and Shape Up (P < .01), but less time at vigorous intensity (≥6 METs) for Kung-Fu (P < .01) and Shape Up (P < .01). Lower-limb movements during Shape Up were less in overweight/obese children (P = .03). Conclusion: Although children in both groups expended similar energy relative to their body mass during gameplay, overweight/obese children spent more time at light intensity but less time at vigorous intensity with fewer movements especially while playing a lower limb–controlled exergame.
. Prog Cardiovasc Dis . 2014 ; 56 ( 4 ): 426 – 33 . PubMed doi:10.1016/j.pcad.2013.10.003 24438734 10.1016/j.pcad.2013.10.003 7. Schonfeld-Warden N , Warden CH . Pediatric obesity. An overview of etiology and treatment . Pediatr Clin North Am . 1997 ; 44 ( 2 ): 339 – 61 . PubMed doi:10.1016/S
Philip W. Fink, Sarah P. Shultz, Eva D’Hondt, Matthieu Lenoir and Andrew P. Hills
Pediatric obesity is considered a global epidemic, and the burden of excess mass has played an important role in the obese child’s inability to successfully perform functional movement tasks. Maintaining a stable posture is necessary for most activities of daily living; however, clinical measures
Ali Brian, Sally Taunton, Chelsee Shortt, Adam Pennell and Ryan Sacko
-8749.2009.03337.x Fairclough , S.J. , Boddy , L.M. , Hackett , A.F. , & Stratton , G. ( 2009 ). Associations between children’s socioeconomic status, weight status, and sex, with screen-based sedentary behaviours and sport participation . International Journal of Pediatric Obesity, 4 ( 4 ), 299 – 305
Jade L. Morris, Andy Daly-Smith, Margaret A. Defeyter, Jim McKenna, Steve Zwolinsky, Scott Lloyd, Melissa Fothergill and Pamela L. Graham
-based obesity treatment, then and now: twenty-five years of pediatric obesity treatment . Health Psychol . 2007 ; 26 ( 4 ): 381 – 91 . PubMed ID: 17605557 doi:10.1037/0278-618.104.22.1681 10.1037/0278-622.214.171.1241 17605557 16. Epstein LH , Wrotniak BH . Future directions for pediatric obesity treatment