Effects of dietary intervention and strength training on blood lipid level in obese children

Sung, Rita Y T; Yu, Carol; Chang, S K Y; Mo, Shaocong; Woo, Kam-Sang; Lam, Christopher Wai‐Kei

doi:10.1136/adc.86.6.407

Cited by 95 publications

(103 citation statements)

References 11 publications

(3 reference statements)

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“…Randomized trials that draw the control and treatment groups from the same cohort and have resistance training as a single modality are extremely limited. All the four RCTs that addressed both adiposity and the metabolic outcomes of PRT utilized circuit training [52][53][54][55] for the delivery of the PRT, and three 52,54,55 of these studies included a dietary intervention in addition to the PRT making it impossible to ascertain the individual contribution from each component of the intervention. In the one RCT of isolated low-moderate intensity circuit training (n ¼ 32), 53 the change in adiposity was opposite to our findings, with Weltman et al reporting waist circumference significantly increased (2.4 cm) in the circuit training group compared with the control group who remained the same over a 14-week intervention.…”

Section: Discussionmentioning

confidence: 99%

The effect of high-intensity progressive resistance training on adiposity in children: a randomized controlled trial

2008

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Background: High-intensity progressive resistance training (PRT) improves adiposity and metabolic risk in adults, but has not been investigated in children within a randomized controlled trial (RCT). Objective: We hypothesized that high-intensity PRT (8 weeks, twice a week) would decrease central adiposity in children, as assessed via waist circumference. Methods Design/Setting/Participants: Concealed randomization stratified by age and gender was used to allocate rural New Zealand school students to the wait-list control or PRT group. Intervention: Participants were prescribed two sets (eight repetitions per set) of 11 exercises targeting all the major muscle groups at high intensity. Primary Outcome: Waist circumference; secondary outcomes included whole body fat, muscular fitness (one repetition maximum), cardiorespiratory fitness (peak oxygen consumption during a treadmill test), lipids, insulin sensitivity and fasting glucose. Results: Of the 78 children (32 girls and 46 boys; mean age 12.2(1.3) years), 51% were either overweight (33%) or obese (18%). High-intensity PRT significantly improved waist circumference (mean change PRT À0.8 (2.2) cm vs þ 0.5 (1.7) cm control; F ¼ 7.59, P ¼ 0.008), fat mass (mean change PRT þ 0.2 (1.4) kg vs þ 1.0 (1.2) kg control; F ¼ 6.00, P ¼ 0.017), percent body fat (mean change PRT -0.3 (1.8)% vs þ 1.2 (2.1)% control; F ¼ 9.04, P ¼ 0.004), body mass index (mean change PRT À0.01 (0.8) kg m À2 vs þ 0.4 (0.7) kg m À2 control; F ¼ 6.02, P ¼ 0.017), upper body strength (mean change PRT þ 11.6(6.1) kg vs þ 2.9(3.7) kg control; F ¼ 48.6, Po0.001) and lower body strength (mean change PRT þ 42.9(26.6) kg vs þ 28.5(26.6) kg control; F ¼ 4.72, P ¼ 0.034) compared to the control group. Waist circumference decreased the most in those with the greatest baseline relative strength (r ¼ À0.257, P ¼ 0.036), and greatest relative (r ¼ À0.400, P ¼ 0.001) and absolute (r ¼ 0.340, P ¼ 0.006) strength gains during the intervention. Conclusion: Isolated high-intensity PRT significantly improves central and whole body adiposity in association with muscle strength in normal-weight and overweight children. The clinical relevance and sustainability of these changes in adiposity should be addressed in future long-term studies.

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Section: Discussionmentioning

confidence: 99%

The effect of high-intensity progressive resistance training on adiposity in children: a randomized controlled trial

2008

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“…Of 45 potentially relevant papers considered, we excluded 32 for the following reasons: eight were conducted in mixed weight cohorts, [31][32][33][34][35][36][37] four were specifically conducted in normal weight cohorts, [38][39][40][41] six studies compared overweight subjects with normal weight control subjects, [42][43][44][45][46][47] five studies were nonrandomized trials [48][49][50][51][52] and nine studies [53][54][55][56][57][58][59][60][61] published data which were previously published, in three studies already included in this review. 51,62,63 Treatment/intervention All studies were of supervised exercise.…”

Section: Studies Included/excludedmentioning

confidence: 99%

Efficacy of exercise for treating overweight in children and adolescents: a systematic review

2006

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Background: Overweight prevalence among children/adolescents is increasing, while adult obesity may potentially cause a decline in life expectancy. More exercise is uniformly recommended, although treatment efficacy remains unclear. Objective: To determine the efficacy of exercise alone for treating overweight in children/adolescents. Design: A systematic review and meta-analysis of randomized trials published in English were completed following multiple database searches performed on December 10, 2004. Studies of isolated or adjunctive exercise/physical activity treatment in overweight/obese children or adolescents which reported any overweight outcome were included. Literature searches identified 645 papers which were manually searched, of which 45 were considered for inclusion, of which 13 papers which reported 14 studies were included (N ¼ 481 overweight boys and girls, aged B12 years). Two reviewers independently identified relevant papers for potential inclusion and assessed methodological quality. Principal measures of effects included the mean difference (MD) (between treatment and control groups), the weighted MD (WMD), and the standardized MD (SMD). Results: Few studies were of robust design. The pooled SMD was À0.4 (À0.7, À0.1, P ¼ 0.006) for percent body fat, and À0.2 (À0.6, 0.1, P ¼ 0.07) for central obesity outcomes, whereas the pooled WMD was À2.7 kg (À6.1 kg, 0.8 kg, P ¼ 0.07) for body weight, all of which favored exercise. Pooled effects on body weight were significant and larger for studies of higher doses, whereas nonsignificant and smaller effects were seen for studies of lower doses of exercise (155-180 min/weeks vs 120-150 min/ weeks). Conclusions: Based on the small number of short-term randomized trials currently available, an aerobic exercise prescription of 155-180 min/weeks at moderate-to-high intensity is effective for reducing body fat in overweight children/adolescents, but effects on body weight and central obesity are inconclusive. Recommendations for future study designs are discussed.

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“…16 Scientific evidences collected in the last years in pediatric subjects, in opposition, support the existence of a strong relationship between PA and MS; [17][18][19][20][21] moreover, several intervention studies performed in obese children and adolescents showed the efficacy of PA programs on MS parameters. [22][23][24][25][26][27][28][29][30][31][32][33] Therefore, there is an evident discrepancy between theory and practice regarding the role given to PA in MS treatment.…”

Section: Introductionmentioning

confidence: 99%

Physical activity as the main therapeutic tool for metabolic syndrome in childhood

Brambilla¹,

Pozzobon

Pietrobelli

2010

Int J Obes

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Physical activity (PA) and diet directly influence obesity and metabolic syndrome (MS) as important determinants of body composition. Understanding how PA relates to MS in youth is of great importance, and could offer a common strategy for clinical and public health approaches to control this condition. The underlying disorder of MS is a condition of insulin resistance, and a strong relationship between PA level and insulin sensitivity is clearly ascertained. The type, duration, frequency and intensity of PA affect fuel metabolism, in particular carbohydrate and lipid oxidation. The possible modulation of metabolism because of increased fat oxidation by PA is the basis for both prevention and restoration of insulin resistance and MS in obese children. In daily clinical practice, diet followed by pharmacologic treatment are usually the approaches taken, whereas PA is often considered just a suggestion. Although diet and PA have different effects on body composition, with both contributing to fat loss, only PA increases muscle mass and thus has a direct effect on metabolic function, expressed by changes in cardiovascular risk factors. Therefore, it is important to remember their complementary but different targets in daily clinical practice, such as body weight control for diet and metabolic health for PA. In this review, we have summarized the literature on the relationship between PA and MS in pediatrics. Then, we have analyzed the possibility of using PA for MS treatment, as an alternative to drugs, by discussing the results of intervention studies, reasons for low compliance to PA, related benefits, adherence difficulties and costs. Finally, we have tried to suggest recommendations for a multiple-step PA strategy in children and adolescents at risk for MS, by considering PA as the 'key' player in treatment.

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Effects of dietary intervention and strength training on blood lipid level in obese children

Cited by 95 publications

References 11 publications

The effect of high-intensity progressive resistance training on adiposity in children: a randomized controlled trial

The effect of high-intensity progressive resistance training on adiposity in children: a randomized controlled trial

Efficacy of exercise for treating overweight in children and adolescents: a systematic review

Physical activity as the main therapeutic tool for metabolic syndrome in childhood

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