ABSTRACT. Background. Obesity has become the most common pediatric chronic disease in the modern era. Early prevention and treatment of childhood and adolescent obesity is mandated. Surprisingly, however, only a minor fraction of obese children participate in weight reduction interventions, and the longer-term effects of these weight-reduction interventions among children have not been elucidated.Objective. To examine prospectively the short-and long-term effects of a 3-month, combined dietary-behavioral-physical activity intervention on anthropometric measures, body composition, dietary and leisure-time habits, fitness, and lipid profiles among obese children.Methods. In this randomized prospective study, 24 obese subjects completed the 3-month intervention and were compared with 22 obese, age-and gender-matched, control subjects.Results. At 3 months, there were significant differences in changes in body weight (؊2.8 ؎ 2.3 kg vs 1.2 ؎ 2.2 kg), BMI (؊1.7 ؎ 1.1 kg/m 2 vs ؊0.2 ؎ 1.0 kg/m 2 ), body fat percentage (from skinfold tests; ؊3.3 ؎ 2.6% vs 1.4 ؎ 4.7%), serum total cholesterol level (؊24.6 ؎ 15.1 mg/dL vs 0.8 ؎ 18.7 mg/dL), low-density lipoprotein cholesterol level (؊23.3 ؎ 15.2 mg/dL vs ؊3.7 ؎ 17.3 mg/dL), and fitness (215 ؎ 107 seconds vs 50 ؎ 116 seconds) in the intervention group versus the control group. After a 1-year follow-up period, there were significant differences between the intervention group (n ‫؍‬ 20) and the control group (n ‫؍‬ 20) in body weight (0.6 ؎ 6.0 kg vs 5.3 ؎ 2.7 kg), BMI (؊1.7 ؎ 2.3 kg/m 2 vs 0.6 ؎ 0.9 kg/m 2 ), and body fat percentage. There was a significant increase in leisure-time physical activity among the intervention participants, compared with a decrease among the control subjects.Conclusions. Our data demonstrate the short-and longer-term beneficial effects of a combined dietary-behavioral-physical activity intervention among obese children. These results highlight the importance of multidisciplinary programs for the treatment of childhood obesity and emphasize their encouraging long-term effects. Pediatrics 2005;115:e443-e449. URL: www.pediatrics.org/cgi/doi/10.1542/peds.2004-2172; obesity, multidisciplinary treatment, childhood, exercise.ABBREVIATIONS. LDL, low-density lipoprotein; TG, triglyceride; HDL, high-density lipoprotein.C hildhood obesity has reached epidemic proportions worldwide, despite major efforts to promote weight reduction. The mechanisms responsible for the increasing prevalence of childhood obesity are not understood completely, but lifestyle changes associated with increased caloric intake and decreased energy expenditure play probably critical roles. 1,2 Childhood obesity is associated with increased risk of hyperlipidemia, hypertension, insulin resistance, diabetes mellitus, and arteriosclerosis later in life. 3,4 In addition, long-term follow-up results indicate that obese children and adolescents tend to become obese adults. 5 Moreover, adults who were obese children have increased morbidity and mortality rates independent of their adult weig...

In March 2004 a group of 65 physicians and other health professionals representing nine countries on four continents convened in Israel to discuss the widespread public health crisis in childhood obesity. Their aim was to explore the available evidence and develop a consensus on the way forward. The process was rigorous, although time and resources did not permit the development of formal evidence-based guidelines. In the months before meeting, participants were allocated to seven groups covering prevalence, causes, risks, prevention, diagnosis, treatment, and psychology. Through electronic communication each group selected the key issues for their area, searched the literature, and developed a draft document. Over the 3-d meeting, these papers were debated and finalized by each group before presenting to the full group for further discussion and agreement. In developing a consensus statement, this international group has presented the evidence, developed recommendations, and provided a platform aimed toward future corrective action and ongoing debate in the international community.

The purpose of this study was to examine the effect of the Ramadan fast on performance capacities, dietary habits, and the daily behavioral patterns in adolescent (14-16-year-old) soccer players. Nineteen male players performed a series of fitness tests before and at the end of Ramadan fast. Caloric intake, physical activity pattern and sleep habits were evaluated during the week before the Ramadan fast and during the last week of the Ramadan fast. The fast resulted in a significant reduction in aerobic capacity [3,000 m run time (mean +/- SD): 812.8 +/- 73.3 s vs. 819.9 +/- 73.4 s, P < 0.001], speed endurance (Sum 6 x 40 m run time: 46.36 +/- 1.36 s vs. 46.73 +/- 1.31 s, P < 0.001, and performance decrement: 9.0 +/- 1.5% vs. 9.5 +/- 1.7%, P < 0.05), and jumping performance (44.8 +/- 4.5 cm vs. 44.0 +/- 4.5 cm, P < 0.05), but had no significant effect on sprint performance (7.38 +/- 0.25 s vs. 7.40 +/- 0.26 s, P = 0.20) or agility (4 x 10 m shuttle run time: 9.53 +/- 0.35 s vs. 9.55 +/- 0.37 s, P = 0.26). Daily intense physical activity was significantly reduced during Ramadan (6.4 +/- 0.2 h/week vs. 4.5 +/- 0.1 h/week, P < 0.005). There were no significant differences in total caloric intake (3,012 +/- 412 kcal/day vs. 3240 +/- 348 kcal/day, P = 0.39) or total daily sleeping hours (8.6 +/- 0.7 h/day vs. 8.6 +/- 0.5 h/day, P = 0.80) between Ramadan and a regular month. The results indicate that Ramadan fasting can lead to a significant decrease in athletic performance capacities. The decrease in performance does not necessarily relate to changes in caloric intake and sleeping hours during the fast.