OBJECTIVE:To investigate the effect of short term energy restriction combined with physical activity on serum concentrations of Interleukin-6 (IL-6) in obese children and adolescents. DESIGN: Longitudinal intervention study of 3.8 -5 MJ daily with exercise. SUBJECTS: Forty-nine white obese children and adolescents (31 girls, age 11.9 AE 1.8 y; 18 boys, age 11.6 AE 1.7 y). MEASUREMENTS: Indexes of obesity, IL-6, leptin, estradiol, systolic and diastolic blood pressure, heart rate at baseline and after 3 weeks. RESULTS: All determined parameters decreased significiantly during the 3 week program (IL-6: 3.9 AE 4.7 vs 2.0 AE 2.2 pg=ml; P < 0.05). Body mass index (BMI) fat mass, percentage fat mass (indexes of obesity), and leptin were not related to IL-6 before the program. In contrast, IL-6 concentrations correlated significantly with indexes of obesity and leptin after weight loss. IL-6 concentrations did not correlate with estradiol, systolic and diastolic blood pressure, and heart rate. Changes in IL-6 concentrations correlated significantly with changes in BMI (r ¼ 0.25, P < 0.05). CONCLUSION: An improved body composition induced by restriction of energy intake and increase in physical activity is associated with more favorable serum concentrations of IL-6 in obese children and adolescents.

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Objective-To study the eVect of a standardised training programme focusing on maintenance of fat free mass during weight reduction by energy reduction in obese children. Design-Randomised trial of physical training programme and dietary advice (group A) versus dietary advice alone (group B).Subjects-Thirty obese children and adolescents (14 group A, 16 group B) participated in the 12 week long programme; 20 children (10 group A, 10 group B) were also reassessed after one year. Measurements-Fat free mass was estimated from the resistance index, obtained by bioelectrical impedance analysis at baseline, after four, eight, and 12 weeks in all subjects, and after one year in 20 subjects. Results-The mean (SD) change in fat free mass was significantly diVerent between the two groups after 12 weeks (group A, 2.68 (3.74) kg; group B, 0.43 (1.65) kg). The change in body weight after one year was inversely correlated with the change in fat free mass after 12 weeks (r = −0.44), as assessed in the 20 subjects. Conclusions-A standardised training programme as used in this study can prevent reduction in fat free mass during weight loss in obese children. Reduction in fat free mass during weight reduction might be a risk factor for regain of weight. (Arch Dis Child 1999;81:426-428) Keywords: training programme; obesity; body composition Obesity is an ongoing problem in paediatric and adolescent health care. In previous work we identified reduction in fat free mass during rapid weight loss by energy reduction as a major factor for later regain in weight.1 Our present study aimed to: evaluate a standardised training programme for maintenance of fat free mass during weight reduction; and study the eVect of changes in fat free mass during weight reduction on the long term outcome. Resistance training has been shown to be eVective in increasing strength in children. 2There is limited information as to whether muscle growth (hypertrophy) can be induced in obese children. SubjectsThirty children consented to participate in the study and were assigned to two groups at random: group A (six boys, eight girls; mean (SD) age, 11.0 (2.5) years; mean standard deviation score for body mass index (BMI-SDS), 5.58 (2.46)) received standardised dietary advice for weight reduction by a dietitian at baseline and after four, eight, and 12 weeks of the study. In addition, subjects participated in a training programme twice weekly. Group B (seven boys, nine girls; mean age, 12.2 (2.7) years; mean BMI-SDS, 5.33 (1.79)) had the dietary intervention only. Methods BODY COMPOSITIONBody composition was estimated from bioelectrical impedance analysis. Measurements were performed at baseline and after four, eight, and 12 weeks. Total body resistance was measured by a bioelectrical impedance analyser (Akern-RJL BIA 101/S) in supine position as described previously.1 Fat free mass was estimated from the resistance index (RI), height, and age of the subject using the equations given by Shaefer et al (fat free mass (kg) = 0.15 + 0.65 × RI + 0.68 × age...

OBJECTIVE -The aim of the study was to investigate whether anthropometric and metabolic risk factors for coronary heart disease (CHD) contribute to the variation in homocysteine levels in obese children and adolescents.RESEARCH DESIGN AND METHODS -A total of 84 children and adolescents were assessed for fasting total homocysteine, methylenetetrahydrofolate reductase polymorphism (C677T mutation), folate and vitamin B 12 status, and anthropometric and metabolic risk factors for CHD.RESULTS -No significant sex differences were found for all available anthropometric and metabolic characteristics except for homocysteine, which was significantly higher in boys than in girls (7.1 vs. 6.3 µmol/l; P Ͻ 0.05). After adjustment for age and sex, homocysteine correlated significantly with BMI, fat mass, percentage of fat mass, and insulin and showed an inverse correlation with folate levels. Homocysteine did not correlate with vitamin B 12 ; total cholesterol; LDL, HDL, and VLDL; triglycerides; and glucose. BMI and fat mass correlated significantly with insulin and showed a significant inverse correlation with folate. We found no association between homocysteine and the C677T mutation. In multiple regression analyses, insulin was found to be the main correlate of homocysteine.CONCLUSIONS -Our study demonstrates for the first time that insulin is a main correlate of homocysteine in obese children and adolescents and suggests that fat mass-associated hyperinsulinism may contribute to impairment of homocysteine metabolism in childhood obesity.

Weight cycling may cause a redistribution of body fat to the upper body fat compartments. We investigated the distribution of subcutaneous adipose tissue (SAT) in 30 overweight women with a history of weight-cycling and age-matched controls (167 normal weight and 97 overweight subjects). Measurements of SAT were performed using an optical device, the Lipometer. The SAT topography describes the thicknesses of SAT layers at 15 anatomically well-defined body sites from neck to calf. The overweight women with a history of weight cycling had significantly thicker SAT layers on the upper body compared to the overweight controls, but even thinner SAT layers on their legs than the normal weight women. An android fat pattern was attributed to overweight females and, even more pronounced, to the weight cyclers. The majority of normal weight women showed a gynoid fat pattern. Using stepwise discriminant analysis, 89.0% of all weight cyclers and overweight controls could be classified correctly into the two groups. These findings show the importance of normal weight maintenance as a healthpromoting factor.