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Background: Paediatric hepatic steatosis is highly prevalent and closely related to type 2 diabetes. Aims: To determine whether the addition of supervised exercise to a family-based lifestyle-and psycho-educational intervention results in greater reduction of percentage hepatic fat (HF), adiposity, and cardiometabolic risk factors in children with overweight/obesity. Methods: The study subjects of this non-randomized, two-arm, parallel design, clinical trial were 116 overweight/obese children (10.6±1.1 years, 53.4% girls) living in Vitoria-Gasteiz (Spain). For 22 weeks they followed either a lifestyle-and psycho-education program (control intervention [CI], N=57), consisting of two family-based education sessions/month, or the same plus supervised exercise (intensive intervention [II], N=59) focused mainly on high-intensity aerobic workouts (3 sessions/week, 90 min/session). The primary outcome was the change in percentage HF (as measured by MRI) between baseline and the end of the intervention period. Secondary outcomes included changes in body mass index (BMI), fat mass index (FMI), abdominal fat (measured by dual-Xray-absorptiometry), blood pressure, triglycerides, high density lipoprotein, low density lipoprotein, gamma-glutammyl-transferase, glucose and insulin concentrations. Results: A total of 102 children completed the trial (N=53 and N=49 in the CI and II groups, respectively). Percentage HF decreased only in the II group (-1.20±0.31% vs. 0.04±0.30%, II and CI, respectively), regardless of baseline value and any change in adiposity (P<0.01). BMI, FMI, abdominal fat (P≤0.001) and insulin (P<0.05) were reduced in both groups. 3 Conclusions: Multicomponent intervention programs that include exercise training may help reduce, adiposity, insulin resistance and hepatic steatosis in overweight/obese children.

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BackgroundThe global pandemic of obesity has led to an increased risk for prediabetes and type-2 diabetes (T2D). The aims of the current project are: (1) to evaluate the effect of a 22-week family based intervention program, including supervised exercise, on insulin resistance syndrome (IRS) risk in children with a high risk of developing T2D and (2) to identify the profile of microRNA in circulating exosomes and in peripheral blood mononuclear cells in children with a high risk of developing T2D and its response to a multidisciplinary intervention program including exercise.MethodsA total of 84 children, aged 8–12 years, with a high risk of T2D will be included and randomly assigned to control (N = 42) or intervention (N = 42) groups. The control group will receive a family based lifestyle education and psycho-educational program (2 days/month), while the intervention group will attend the same lifestyle education and psycho-educational program plus the exercise program (3 days/week, 90 min per session including warm-up, moderate to vigorous aerobic activities, and strength exercises). The following measurements will be evaluated at baseline prior to randomization and after the intervention: fasting insulin, glucose and hemoglobin A1c; body composition (dual-energy X-ray absorptiometry); ectopic fat (magnetic resonance imaging); microRNA expression in circulating exosomes and in peripheral blood mononuclear cells (MiSeq; Illumina); cardiorespiratory fitness (cardiopulmonary exercise testing); dietary habits and physical activity (accelerometry).DiscussionPrevention and identification of children with a high risk of developing T2D could help to improve their cardiovascular health and to reduce the comorbidities associated with obesity.Trial registrationClinicalTrials.gov, ID: NCT03027726. Registered on 16 January 2017.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-017-2117-y) contains supplementary material, which is available to authorized users.