The long-term interdisciplinary therapy with AT+RT protocol was more effective in significantly improving noninvasive biomarkers of NAFLD that are associated with the highest risk of disease progression in the pediatric population.

The purpose of this study was to determine whether aerobic plus resistance training (AT + RT) is more effective than aerobic training (AT) at reducing inflammatory markers and cardiovascular risk in obese adolescents. A total of 139 obese adolescents were enrolled, aged 15-19 years, body mass index (BMI) ≥ 95th percentile and participated in 1 year of interdisciplinary intervention. They were randomised into two groups: AT (n = 55), AT + RT (n = 61). Blood samples were collected to analyse glycaemia, insulin, the lipid profile, leptin and adiponectin concentrations. Insulin resistance was measured by homeostasis model assessment of insulin resistance index (HOMA-IR). The AT + RT group showed better results with regard to decreased body fat mass, low-density lipoprotein concentration (LDL-c) levels, subcutaneous and visceral fat and increased body lean mass. Indeed, a reduction of hyperleptinaemia and an increase in adiponectin concentrations, promoting an improvement in the leptin/adiponectin ratio, was observed. Important clinical parameters were improved in both types of exercise; however, AT + RT was more effective in improving the visceral adiposity, metabolic profile and inflammatory markers than AT alone, suggesting clinical applications for the control of intra-abdominal obesity and cardiovascular risk in the paediatric population.

To determine the most effective periodization model for strength and hypertrophy is an important step for strength and conditioning professionals. The aim of this study was to compare the effects of linear (LP) and daily undulating periodized (DUP) resistance training on body composition and maximal strength levels. Forty men aged 21.5 +/- 8.3 and with a minimum 1-year strength training experience were assigned to an LP (n = 20) or DUP group (n = 20). Subjects were tested for maximal strength in bench press, leg press 45 degrees, and arm curl (1 repetition maximum [RM]) at baseline (T1), after 8 weeks (T2), and after 12 weeks of training (T3). Increases of 18.2 and 25.08% in bench press 1 RM were observed for LP and DUP groups in T3 compared with T1, respectively (p < or = 0.05). In leg press 45 degrees , LP group exhibited an increase of 24.71% and DUP of 40.61% at T3 compared with T1. Additionally, DUP showed an increase of 12.23% at T2 compared with T1 and 25.48% at T3 compared with T2. For the arm curl exercise, LP group increased 14.15% and DUP 23.53% at T3 when compared with T1. An increase of 20% was also found at T2 when compared with T1, for DUP. Although the DUP group increased strength the most in all exercises, no statistical differences were found between groups. In conclusion, undulating periodized strength training induced higher increases in maximal strength than the linear model in strength-trained men. For maximizing strength increases, daily intensity and volume variations were more effective than weekly variations.

The aims of the present study were to compare the effects of two periodization models on metabolic syndrome risk factors in obese adolescents and verify whether the angiotensin‐converting enzyme (ACE) genotype is important in establishing these effects. A total of 32 postpuberty obese adolescents were submitted to aerobic training (AT) and resistance training (RT) for 14 weeks. The subjects were divided into linear periodization (LP, n = 16) or daily undulating periodization (DUP, n = 16). Body composition, visceral and subcutaneous fat, glycemia, insulinemia, homeostasis model assessment of insulin resistance (HOMA‐IR), lipid profiles, blood pressure, maximal oxygen consumption (VO2max), resting metabolic rate (RMR), muscular endurance were analyzed at baseline and after intervention. Both groups demonstrated a significant reduction in body mass, BMI, body fat, visceral and subcutaneous fat, total and low‐density lipoprotein cholesterol, blood pressure and an increase in fat‐free mass, VO2max, and muscular endurance. However, only DUP promoted a reduction in insulin concentrations and HOMA‐IR. It is important to emphasize that there was no statics difference between LP and DUP groups; however, it appears that there may be bigger changes in the DUP than LP group in some of the metabolic syndrome risk factors in obese adolescents with regard to the effect size (ES). Both periodization models presented a large effect on muscular endurance. Despite the limitation of sample size, our results suggested that the ACE genotype may influence the functional and metabolic characteristics of obese adolescents and may be considered in the future strategies for massive obesity control.

Obesity is a worldwide epidemic with a high prevalence of comorbidities, including alterations in bone mineral metabolism. The purpose of this yearlong study was to evaluate the role of 2 types of exercise training (aerobic and aerobic plus resistance exercise) on adipokines parameters and bone metabolism in adolescents who are obese. This was a clinical trial study with interdisciplinary weight loss therapy. Forty-two postpubertal adolescents who are obese were subjected to interdisciplinary weight loss therapy with physical exercise, medical monitoring, nutritional intervention, and psychological intervention. Data were collected from serum analyses of leptin, ghrelin, adiponectin, glucose, and insulin. Anthropometric measurements of body composition, bone mineral density, visceral, and subcutaneous fat were also performed. Statistical tests were applied using repeated-measures analysis of variance. Correlations were established using the Pearson test, and dependencies of variables were established using simple linear regression test. Both training types promoted reductions in body mass index, total central, visceral and subcutaneous fat, insulin concentration, and homeostasis model assessment insulin resistance (HOMA-IR) index, but only aerobic plus resistance training showed statistical improvements in the bone mineral content, adiponectin concentration, and lean tissue. Effective reduction in the visceral/subcutaneous ratio, central/peripheral ratio, and leptin concentration was observed. Insulin and the HOMA-IR index were negative predictors of bone mineral content in the combined training group. Moreover, fat distribution was a negative predictor for bone mineral density in both groups. Aerobic plus resistance training promotes a protective role in bone mineral content associated with an improvement in adiponectin and leptin concentrations, favoring the control of the inflammatory state related to obesity in adolescents. Aerobic plus resistance training combined with interdisciplinary interventions provides important strategies to approach obesity, and these strategies may contribute to clinical practice.

The complexity pathogenesis in the nonalcoholic fatty liver disease (NAFLD) involves an interplay between adipokines and neuroendocrine regulation of energy balance, including the role of neuropeptide Y (NPY)/agouti-related protein (AgRP) system. The first aim of this study was to assess the effect of long-term interdisciplinary intervention on NAFLD in obese adolescents, and the second objective was to establish the relationship between NPY/AgRP ratio and adiponectinemia. Fifty-five postpuberty obese adolescents were submitted to interdisciplinary intervention. The group was divided between subjects with and without NAFLD (n = 19 and 36, respectively). Blood samples were collected to measure glycemia, hepatic transaminases, lipid profile, insulin resistance, and sensitivity. Adiponectin, NPY, and AgRP concentrations were measured by enzyme-linked immunosorbent assay. Food intake was measured using 3-day diet records. It was observed at baseline that important clinical parameters including body weight, body mass index, visceral fat, homeostasis model assessment of insulin resistance, quantitative insulin sensitivity check index, triglycerides, very low-density lipoprotein cholesterol, and hepatic transaminases were more altered in NAFLD patients. After the intervention, these parameters, total energy, and macronutrient intake were reduced significantly in both groups. The most important finding was the positive correlation between AgRP and visceral fat in all patients and the negative correlation between NPY/AgRP and adiponectinemia only in NAFLD obese adolescents. The NAFLD patients presented more altered clinical parameters than the non-NAFLD subjects, including the negative correlation between adiponectinemia and NPY/AgRP. These results suggested that NAFLD obese adolescents presented an inflammatory profile that can influence the neuroendocrine regulation of energy balance, suggesting an additional impairment in the weight loss therapy.

No abstract

Our findings showed an important influence of diet composition in the orexigenic system, being essential consider that the excessive saturated fatty acids intake could be a determinant factor to increase nonalcoholic fatty liver disease.