Challenge! Health Promotion/Obesity Prevention Mentorship Model Among Urban, Black Adolescents Impact of Weight Loss on Physical Function with Changes in Strength, Muscle Mass, and Muscle Fat Infiltration in Overweight to Moderately Obese Older Adults: A Randomized Clinical Trial Two years of school-based intervention program could improve the physical fitness among Ecuadorian adolescents at health risk: subgroups analysis from a cluster-randomized trial Exercise in obese pregnant women: positive impacts and current perceptions Motivational interviewing and cognitive behaviour therapy in the treatment of adolescent overweight and obesity: study design and methodology. A family-centered lifestyle intervention to improve body composition and bone mass in overweight and obese children 6 through 8 years: a randomized controlled trial study protocol A Multilevel Analysis of Neighbourhood Built and Social Environments and Adult Self-Reported Physical Activity and Body Mass Index in Ottawa, Canada Obese children playing towards an active lifestyle. The effect of a 3-month moderate-intensity physical activity program on body composition in overweight and obese African American college females Effects of interactive video game cycling on overweight and obese adolescent health. The Nutrition and Enjoyable Activity for Teen Girls (NEAT girls) randomized controlled trial for adolescent girls from disadvantaged secondary schools: rationale, study protocol, and baseline results Impact of readiness to change behavior on the effects of a multidisciplinary intervention in obese Brazilian children and adolescents Exercise training normalizes vascular dysfunction and improves central adiposity in obese adolescents. Long-term effects of an inpatient weight-loss program in obese children and the role of genetic predisposition-rationale and design of the LOGIC-trial The association of physical activity and physical fitness with pre-adolescent obesity: an observational study in Metromanila, Philippines. Effect of a prenatal lifestyle intervention on physical activity level in late pregnancy and the first year postpartum Does school-based physical activity decrease overweight and obesity in children aged 6–9 years? A two-year non-randomized longitudinal intervention study in the Czech Republic Aerobic training suppresses exercise-induced lipid peroxidation and inflammation in overweight/obese adolescent girls. Obesity in children. Part 2: Prevention and management Relative Contribution of Physical Activity, Sedentary Behaviors, and Dietary Habits to the Prevalence of Obesity among Kuwaiti Adolescents Healthy Eating, Aerobic and Resistance Training in Youth (HEARTY): study rationale, design and methods. Physiological and behavioural outcomes of a randomised controlled trial of a cognitive behavioural lifestyle intervention for overweight and obese adolescents. A school-based physical activity program to improve health and fitness in children aged 6–13 years ("Kinder-Sportstudie KISS"): study design of a randomized controlled trial [ISRCTN15360785] Diet, Exercise, and Endothelial Function in Obese Adolescents
OBJECTIVES : The objective of this study was to evaluate a 12-session home/community-based health promotion/obesity prevention program ( Challenge ! ) on changes in BMI status , body composition , physical activity , and diet . METHODS : A total of 235 black adolescents ( aged 11–16 years ; 38 % overweight/obese ) were recruited from low-income urban communities . Baseline measures included weight , height , body composition , physical activity ( PA ) , and diet . PA was measured by 7-day play-equivalent physical activity ( ≥1800 activity counts per minute ) . Participants were r and omly assigned to health promotion/obesity prevention that is anchored in social cognitive theory and motivational interviewing and was delivered by college-aged black mentors or to control . Postintervention ( 11 months ) and delayed follow-up ( 24 months ) evaluations were conducted . Longitudinal analyses used multilevel models with r and om intercepts and generalized estimating equations , controlling for baseline age/gender . Stratified analyses examined baseline BMI category . RESULTS : Retention was 76 % over 2 years ; overweight/obese status declined 5 % among intervention adolescents and increased 11 % among control adolescents . Among overweight/obese youth , the intervention reduced total percentage of body fat and fat mass and increased fat-free mass at delayed follow-up and increased play-equivalent physical activity at postintervention but not at delayed follow-up . Intervention adolescents declined significantly more in snack/dessert consumption than control adolescents at both follow-up evaluations . CONCLUSIONS : At postintervention , there were intervention effects on diet and PA but not BMI category or body composition . At delayed follow-up , dietary changes were sustained and the intervention prevented an increase in BMI category . Body composition was improved for overweight/obese youth . Changes in body composition follow changes in diet and PA and may not be detected immediately after intervention Purpose . Evaluate the effects of weight loss on muscle mass and area , muscle fat infiltration , strength , and their association with physical function . Methods . Thirty-six overweight to moderately obese , sedentary older adults were r and omized into either a physical activity plus weight loss ( PA+WL ) or physical activity plus successful aging health education ( PA+SA ) program . Measurements included body composition by dual-energy X-ray absorptiometry , computerized tomography , knee extensor strength , and short physical performance battery ( SPPB ) . Results . At 6 months , PA+WL lost greater thigh fat and muscle area compared to PA+SA . PA+WL lost 12.4 % strength ; PA+SA lost 1.0 % . Muscle fat infiltration decreased significantly in PA+WL and PA+SA . Thigh fat area decreased 6-fold in comparison to lean area in PA+WL . Change in total SPPB score was strongly inversely correlated with change in fat but not with change in lean or strength . Conclusion . Weight loss result ed in additional improvements in function over exercise alone , primarily due to loss of body fat Background Adolescents with overweight and poor physical fitness have an increased likelihood of developing cardiovascular diseases during adulthood . In Ecuador , a health promotion program improved the muscular strength and speed-agility , and reduced the decline of the moderate-to-vigorous physical activity of adolescents after 28 months . We performed a sub-group analysis to assess the differential effect of this intervention in overweight and low-fit adolescents . Methods We performed a cluster-r and omized pair matched trial in schools located in Cuenca – Ecuador . In total 20 schools ( clusters ) were pair matched , and 1440 adolescents of grade 8 and 9 ( mean age of 12.3 and 13.3 years respectively ) participated in the trial . For the purpose s of the subgroup analysis , the adolescents were classified into groups according to their weight status ( body mass index ) and aerobic capacity ( scores in the 20 m shuttle run and FITNESSGRAM st and ards ) at baseline . Primary outcomes included physical fitness ( vertical jump , speed shuttle run ) and physical activity ( proportion of students achieving over 60 min of moderate – to-vigorous physical activity/day ) . For these primary outcomes , we stratified analysis by weight ( underweight , normal BMI and overweight/obese ) and fitness ( fit and low fitness ) groups . Mixed linear regression models were used to assess the intervention effect . Results The prevalence of overweight/obesity , underweight and poor  physical  fitness  was 20.3 % , 5.8 % and 84.8 % respectively . A higher intervention effect was observed for speed shuttle run in overweight ( β = −1.85 s , P = 0.04 ) adolescents compared to underweight ( β = −1.66 s , P = 0.5 ) or normal weight ( β = −0.35 s , P = 0.6 ) peers . The intervention effect on vertical jump was higher in adolescents with poor physical fitness ( β = 3.71 cm , P = 0.005 ) compared to their fit peers ( β = 1.28 cm , P = 0.4 ) . The proportion of students achieving over 60 min of moderate-to-vigorous physical activity/day was not significantly different according to weight or fitness status . Conclusion Comprehensive school-based interventions that aim to improve diet and physical activity could improve speed and strength aspects of physical fitness in low-fit and overweight/obese adolescents . Trial registration Clinical trials.gov identifier NCT01004367 . Registered October 28 , 2009 Overweight and obesity have significant implication s during pregnancy and childbirth . The objective of this review was to provide a comprehensive overview of the effect of physical activity on pregnancy outcomes , the change of  physical activity during pregnancy , and women ’s perception of being physically active during pregnancy , with a particular focus on women who are overweight or obese . Many studies have investigated the beneficial effect of exercise during pregnancy , including reduced risk of gestational diabetes , preeclampsia , and operative birth , in addition to improved cardiovascular function , overall fitness , psychological well-being , and mood stability . Benefits for the infant include reduced risks of prematurity and improved fetal growth , although there is more limited information about longer-term health benefits for both women and infants . The existing literature examining physical activity patterns during pregnancy has generally focused on women of all body mass index categories , consistently indicating a reduction in activity over the course of pregnancy . However , the available literature evaluating physical activity during pregnancy among women who are overweight or obese is more limited and contradictory . A number of studies identified barriers preventing women from being active during pregnancy , including pregnancy symptoms , lack of time , access to child care , and concerns about their safety and that of their unborn baby . Conversely , significant enablers included positive psychological feelings , family influence , and receiving advice from health professionals . Very few studies have provided insights about perceptions of being active during pregnancy in the overweight and obese population . There is a need for a detailed description of physical activity patterns during pregnancy in women who are overweight or obese , and more r and omized trials evaluating exercise interventions for women who are overweight or obese , with a focus on clinical outcomes BACKGROUND Despite the high prevalence and negative physical and psychosocial consequences of overweight and obesity in adolescents , very little research has evaluated treatment in this population . Consequently , clinicians working with overweight and obese adolescents have little empirical research on which to base their practise . Cognitive behavioural therapy has demonstrated efficacy in promoting behaviour change in many treatment resistant disorders . Motivational interviewing has been used to increase motivation for change and improve treatment outcomes . In this paper we describe the rationale and design of a r and omised controlled trial testing the efficacy of motivational interviewing and cognitive behaviour therapy in the treatment of overweight and obese adolescents . METHODS Participants took part in a  motivational interview or a st and ard semi-structured assessment interview and were then r and omly allocated to a cognitive behavioural intervention or a wait-list control condition . The cognitive behavioural intervention , the CHOOSE HEALTH Program , consisted of 13 individual treatment sessions ( 12 face-to-face , 1 phone call ) followed by 9 maintenance sessions ( 7 phone calls , 2 face-to-face ) . Assessment s were conducted prior to participation , after the treatment phase and after the maintenance phase of intervention . Improvement in body composition was the primary outcome ; secondary outcomes included improved cardiovascular fitness , eating and physical activity habits , family and psychosocial functioning . CONCLUSION Despite the demonstrated effectiveness of motivational interviewing and cognitive behavioural therapy in the long-term management of many treatment resistant disorders , these approaches have been under-utilised in adolescent overweight and obesity treatment . This study provides baseline data and a thorough review of the study design and treatment approach to allow for the assessment of the efficacy of motivational interviewing and cognitive behavioural therapy in the treatment of adolescent overweight and obesity . Data obtained in this study will also provide much needed information about the behavioural and psychosocial factors associated with adolescent overweight and obesity Background Childhood obesity gives rise to health complications including impaired musculoskeletal development that associates with increased risk of fractures . Prevention and treatment programs should focus on nutrition education , increasing physical activity ( PA ) , reducing sedentary behaviours , and should monitor bone mass as a component of body composition . To ensure lifestyle changes are sustained in the home environment , programs need to be family-centered . To date , no study has reported on a family-centered lifestyle intervention for obese children that aims to not only ameliorate adiposity , but also support increases in bone and lean muscle mass . Furthermore , it is unknown if programs of such nature can also favorably change eating and activity behaviors . The aim of this study is to determine the effects of a 1 y family-centered lifestyle intervention , focused on both nutrient dense foods including increased intakes of milk and alternatives , plus total and weight-bearing PA , on body composition and bone mass in overweight or obese children . Methods / design The study design is a r and omized controlled trial for overweight or obese children ( 6–8 y ) . Participants are r and omized to control , st and ard treatment ( StTx ) or modified treatment ( ModTx ) . This study is family-centred and includes individualized counselling sessions on nutrition , PA and sedentary behaviors occurring 4 weeks after baseline for 5 months , then at the end of month 8 . The  control group receives counselling at the end of the study . All groups are measured at baseline and every 3 months for the primary outcome of changes in body mass index Z-scores . At each visit blood is drawn and children complete a research er-administered behavior question naire and muscle function testing . Changes from baseline to 12 months in body fat ( % and mass ) , waist circumference , lean body mass , bone ( mineral content , mineral density , size and volumetric density ) , dietary intake , self-reported PA and sedentary behaviour are examined . Discussion This family-centered theory-based study permits for biochemical and physiological assessment s. This trial will assess the effectiveness of the intervention at changing lifestyle behaviours by decreasing adiposity while enhancing lean and bone mass . If successful , the intervention proposed offers new insights for the management or treatment of childhood obesity . Trial registration Clinical Trials.gov , NCT01290016 Canadian research examining the combined effects of social and built environments on  physical activity ( PA ) and obesity is limited . The purpose of this study was to determine the relationships among built and social environments and  PA and overweight/obesity in 85 Ottawa neighbourhoods .  Self-reported PA , height and weight were collected from 3,883 adults using the International PA Question naire from the 2003–2007 sample s of the Rapid Risk Factor Surveillance System . Data on neighbourhood characteristics were obtained from the Ottawa Neighbourhood Study ; a large study of neighbourhoods and health in Ottawa .  Two-level binomial logistic regression models stratified by sex were used to examine the relationships of environmental and individual variables with PA and overweight/obesity while using survey weights . Results identified that approximately half of the adults were insufficiently active or overweight/obese . Multilevel models identified that for every additional convenience store , men were two times more likely to be physically active ( OR = 2.08 , 95 % CI : 1.72 , 2.43 ) and with every additional specialty food store women were almost two times more likely to be overweight or obese ( OR = 1.77 , 95 % CI : 1.33 , 2.20 ) . Higher green space was associated with a reduced likelihood of PA  ( OR = 0.93 , 95 % CI : 0.86 , 0.99 ) and increased odds of overweight and obesity in men ( OR = 1.10 , 95 % CI : 1.01 , 1.19 ) , and decreased odds of overweight/obesity in women ( OR = 0.66 , 95 % CI : 0.44 , 0.89 ) . In men , neighbourhood socioeconomic scores , voting rates and sense of community belonging were all significantly associated with overweight/obesity . Intraclass coefficients were low , but identified that the majority of neighbourhood variation in outcomes was explained by the models . Findings identified that green space , food l and scapes and social cohesiveness may play different roles on  PA  and overweight/obesity in men and women and future prospect i ve studies are needed AIM To determine whether five months of guided active play in overweight or obese children and adolescents under multi-disciplinary management for weight reduction leads to increased physical activity levels in leisure time , as well as changes in aerobic fitness and body composition . METHODS Sixty overweight or obese children and adolescents were r and omly assigned to an intervention or control group . All participants received dietary advice and were encouraged to increase physical activity level . The intervention group additionally participated in 60-minute guided active play/physical activity twice a week for 5 months . Physical activity was recorded ; aerobic fitness and body composition were measured at inclusion and after cessation of intervention . RESULTS Physical activity level during weekend days was significantly higher for the intervention group compared with the controls after 5 months intervention ( p=0.04 ) . The mean reduction in percentage of body fat was 1.8 % ( 95%CI : 0.6 , 3.1 ) in the intervention group ( p=0.04 ) and not significant among the controls ( 0.9 [ -0.9 , 2.7 ] ) . There was no change in aerobic fitness . CONCLUSION Five months of guided active play was associated with increased physical activity levels during weekend days and reduced body fat , although weakly , in overweight and obese children and adolescents participating in multi-disciplinary weight reduction programmes Summary This study evaluated body composition outcomes following a 3-month exercise program for overweight/obese Black women .  BMI decreased over the 3-month study despite an observed increase in body fat . Enhancements in bone marrow density and muscle density were also observed . Results show promising yet hypothesis-generating findings to explore in future research . Introduction Few studies have evaluated the relationship between aerobic physical activity ( PA ) and body composition among young adult overweight/obese African American ( AA ) women . Purpose The current study evaluated the effect of a 3-month moderate-intensity aerobic physical activity intervention for overweight and obese young adult women on bone , lean , and fat mass . Methods Participants ( n = 15 ) were a r and omly selected subset of AA female college students ( M age = 21.7 years ; M BMI = 33.3 ) enrolled in a larger PA promotion pilot study ( n = 31 ) . Study protocol required participants to engage in four 30–60-min moderate-intensity aerobic PA sessions each week . Whole body composition was measured by dual-energy X-ray absorptiometry ( DXA ) , and peripheral quantitative computed tomography ( pQCT ) was used to assess additional quantitative and qualitative assessment of the radius . Results BMI decreased over the duration of the study ( P = .034 ) , reflected by a marginal decrease in body weight ( P = .057 ) . However , unexpectedly , increases in adipose tissue measures were observed , including total body fat ( P = .041 ) , percent body fat ( P = .044 ) , trunk fat ( P = .031 ) , and percent trunk fat ( P = .041 ) . No changes in DXA-measured bone outcomes were observed ( i.e. , bone mineral density , P = .069 ; bone mineral content , P = .211 ) . Results from the pQCT assessment showed that bone marrow density increased ( P = .011 ) , but cortical density remained stable ( P = .211 ) . A marginally significant increase in muscle density ( P = .053 ) and no changes in muscle area ( P = .776 ) were observed . Conclusions A 3-month moderate-intensity PA program was associated with several promising findings , including increased bone marrow and stabilization of body weight . However , the increase in adipose tissue and trend for decreased bone mineral density were unexpected and indicate the need for future studies with larger sample s to further explore these outcomes The purpose of this study was to examine the efficacy of interactive video game stationary cycling ( GameBike ) in comparison with stationary cycling to music on adherence , energy expenditure measures , submaximal aerobic fitness , body composition , and cardiovascular disease risk markers in overweight and obese adolescents , using a r and omized controlled trial design . Thirty overweight ( with at least 1 metabolic complication ) or obese adolescents aged 12 - 17 years were stratified by gender and r and omized to video game or music condition , with 4 participants ( 2 per group ) failing to complete the twice weekly 60 min sessions of the 10-week trial . The music group had a higher rate of attendance compared with the video game group ( 92 % vs. 86 % , p < 0.05 ) . Time spent in minutes per session at vigorous intensity ( 80%-100 % of predicted peak heart rate ) ( 24.9 ± 20 min vs. 13.7 ± 12.8 min , p < 0.05 ) and average distance ( km ) pedaled per session ( 12.5 ± 2.8 km vs. 10.2 ± 2.2 km , p < 0.05 ) also favoured the music group . However , both interventions produced significant improvements in submaximal indicators of aerobic fitness as measured by a grade d cycle ergometer protocol . Also , when collapsed , the exercise modalities reduced body fat percentage and total cholesterol . The present study indicates that cycling to music was just as effective  as stationary cycling while playing video games at improving fitness , body composition , and cholesterol profiles in overweight and obese teens , and result ed in increased attendance , vigorous intensity of physical activity , and distance pedaled . Therefore , our data support the superiority of cycling to music and indicate investing in the more expensive GameBike may not be worth the cost Background Child and adolescent obesity predisposes individuals to an increased risk of morbidity and mortality from a range of lifestyle diseases . Although there is some evidence to suggest that rates of pediatric obesity have leveled off in recent years , this has not been the case among youth from low socioeconomic background s. The purpose of this paper is to report the rationale , study design and baseline findings of a school-based obesity prevention program for low-active adolescent girls from disadvantaged secondary schools . Methods / Design The Nutrition and Enjoyable Activity for Teen Girls ( NEAT Girls ) intervention will be evaluated using a group r and omized controlled trial . NEAT Girls is a 12-month multi-component school-based intervention developed in reference to Social Cognitive Theory and includes enhanced school sport sessions , interactive seminars , nutrition workshops , lunch-time physical activity ( PA ) sessions , PA and nutrition h and books , parent newsletters , pedometers for self-monitoring and text messaging for social support . The following variables were assessed at baseline and will be completed again at 12- and 24-months : adiposity , objective ly measured PA , muscular fitness , time spent in sedentary behaviors , dietary intake , PA and nutrition social-cognitive mediators , physical self-perception and global self-esteem . Statistical analyses will follow intention-to-treat principles and hypothesized mediators of PA and nutrition behavior change will be explored . Discussion NEAT Girls is an innovative intervention targeting low-active girls using evidence -based behavior change strategies and nutrition and PA messages and has the potential to prevent unhealthy weight gain and reduce the decline in physical activity and poor dietary habits associated with low socio-economic status . Few studies have reported the long-term effects of school-based obesity prevention programs and the current study has the potential to make an important contribution to the field . Trial registration Australian New Zeal and Clinical Trials Registry No : The obesity epidemic is a global challenge that requires evidence -based intervention to slow the emergence of weight-related illness in children and adolescents . Thus , effective treatments are urgently needed . This study aim ed to analyze whether there is relationship between the initial stage of readiness for behavior change ( SRBC ) and the results obtained through participation in a multidisciplinary program of obesity treatment ( MPOT ) . The study included 113 overweight or obese children and adolescents who participated in an intervention for 16 weeks , in which the categorical variable was the SRBC . The dependent variables included : anthropometric measures of body composition , hemodynamic parameters ( e.g. , blood pressure values ) , and health-related physical fitness . Although stages 1 and 2 had greater improvements in flexibility than those in stage 5 , and stage 1 had greater percentage changes in abdominal strength than those in stage 5 , children and adolescents in the highest stage had greater percentage changes for anthropometric , hemodynamic and cardiorespiratory fitness , suggesting an impact of the stage of change on the effects of a MPOT . This study suggests that SRBC plays a role in obesity treatment in Brazilian children and adolescents and warrants consideration when enrolling patients to intervention OBJECTIVES We sought to characterize the impact of obesity on vascular function in adolescents and to determine whether an exercise program reverses abnormalities in endothelial function . BACKGROUND Obesity , a major modifiable risk factor for cardiovascular disease , is epidemic in Western societies , with rapid rates of increase in the young . Atherosclerosis begins in childhood , and endothelial dysfunction is its earliest detectable manifestation . METHODS The influence of eight weeks of circuit training ( CT ) was examined in 19 obese subjects ( 14.3 + /- 1.5 years ) , using a r and omized , crossover protocol . Functional capacity and muscular strength were assessed by st and ard techniques .  Body composition was examined using anthropometric measures and dual-energy X-ray absorptiometry .  Conduit vessel endothelial function was assessed using high-resolution ultrasound and flow-mediated dilation ( FMD ) of the brachial artery . RESULTS Circuit training decreased abdominal and trunk fat and significantly improved fitness and muscular strength ( p < 0.05 ) . In the obese group , FMD was significantly impaired relative to control subjects ( n = 20 ) at entry ( 5.3 + /- 0.9 % vs. 8.9 + /- 1.5 % , p < 0.05 ) and was normalized after CT ( 8.8 + /- 0.8 % , p < 0.05 ) . CONCLUSIONS Circuit training improved functional capacity , muscular strength , and body composition in obese adolescents . Furthermore , conduit vessel function was normalized after exercise training . If vascular dysfunction is an integral component of the pathogenesis of vascular disease , this study supports the value of an exercise program in the management of obese adolescents Background The prevalence of childhood obesity has increased worldwide , which is a serious concern as obesity is associated with many negative immediate and long-term health consequences . Therefore , the treatment of overweight and obesity in children and adolescents is strongly recommended . Inpatient weight-loss programs have shown to be effective particularly regarding short-term weight-loss , whilst little is known both on the long-term effects of this treatment and the determinants of successful weight-loss and subsequent weight maintenance . The purpose of this study is to evaluate the short , middle and long-term effects of an inpatient weight-loss program for children and adolescents and to investigate the likely determinants of weight changes , whereby the primary focus lies on the potential role of differences in polymorphisms of adiposity-relevant genes . Methods / Design The study involves overweight and obese children and adolescents aged 6 to 19 years , who participate in an inpatient weight-loss program for 4 to 6 weeks . It started in 2006 and it is planned to include 1,500 participants by 2013 . The intervention focuses on diet , physical activity and behavior therapy . Measurements are taken at the start and the end of the intervention and comprise blood analyses ( DNA , lipid and glucose metabolism , adipokines and inflammatory markers ) , anthropometry ( body weight , height and waist circumference ) , blood pressure , pubertal stage , and exercise capacity . Physical activity , dietary habits , quality of life , and family background are assessed by question naires . Follow-up assessment s are performed 6 months , 1 , 2 , 5 and 10 years after the intervention : Children will complete the same question naires at all time points and visit their general practitioner for examination of anthropometric parameters , blood pressure and assessment of pubertal stage . At the 5 and 10 year follow-ups , blood parameters and exercise capacity will be additionally measured . Discussion Apart from illustrating the short , middle and long-term effects of an inpatient weight-loss program , this study will contribute to a better underst and ing of inter-individual differences in the regulation of body weight , taking into account the role of genetic predisposition and lifestyle factors . Trial Registration NCT01067157 BACKGROUND Childhood obesity has been inconsistently associated with decreased levels of physical activity and fitness . Moreover , little is known about this relationship among Filipino preteens . METHODS This cross sectional study reports the association between childhood obesity , measures of physical activity , and fitness .  Children aged 11 to 12 from r and omly selected schools from San Juan , Metromanila were included . Outcome measures were body mass index , Filipino modified Physical Activity Question naire for Older children ( F_PAQ-C ) ,  st and ing broad jump , 50 m sprint  and  20 m multistage shuttle run .  RESULTS 380 children participated in the study . Obese children had significantly lower median scores in the F_PAQ-C compared with overweight children . Overweight children had lower scores in the st and ing broad jump , 50 m sprints and predicted VO2max as compared with children with normal BMI . There were modest associations between the 50 m sprint , predicted VO2max , and F_PAQ-C. CONCLUSION Our study has showed that physical activity and fitness scores were strongly correlated with childhood obesity . If childhood physical fitness is a predictor of physical fitness in adulthood which is a risk factor in cardiovascular diseases , there is a strong possibility that the prevalence of cardiovascular disease in the Philippines will increase dramatically in the future Background Despite documented health benefits for mother and baby , physical activity (PA)-level tends to decline in pregnancy . Overweight/obese and physically inactive women are two selected groups at increased risk of pregnancy complications . Thus , efficient strategies to maintain or increase PA-level in pregnancy and the postpartum period , especially among these women , are warranted . This secondary analysis examined the effect of a prenatal lifestyle-intervention on PA-level in late pregnancy and the first year postpartum , with sub analysis on initially physically active versus inactive and normal-weight versus overweight/obese women . Method The Norwegian Fit for Delivery ( NFFD ) r and omized controlled trial included healthy primiparous women with singleton pregnancies and body mass index ( BMI ) ≥19 kg/m2 assigned to an intervention group , n = 303 ( twice weekly group-exercises and dietary counseling ) or a control group , n = 303 ( st and ard prenatal care ) . The International Physical Activity Question naire short-form was used to assess PA-levels at inclusion ( mean gestational week ( GW ) 16 ) , GW 36 , and six and 12 months postpartum . Results At GW 36 , a positive intervention-effect with a significant between-group difference in total PA-level compared to time of inclusion was found for the total group ( 530 MET-min/week , p = 0.001 ) and the subgroups of normal-weight ( 533 MET-min/week , p = 0.003 ) and initially active women ( 717 MET-min/week , p<0.001 ) . Intervention-effect was dependent on exercise-adherence among overweight/obese and inactive women . Compared to time of inclusion , the intervention groups maintained total PA-level at GW 36 , while total PA-level decreased in the control groups . The PA-levels increased postpartum , but with no significant differences between the r and omization groups . Conclusion The NFFD prenatal combined lifestyle intervention had a significant effect on TPA-level in late pregnancy among women entering pregnancy normal-weight or physically active , thereby preventing the downward trend typically seen during pregnancy . Intervention-effect among overweight/obese and physically inactive women was , however , dependent on exercise-adherence . Long-term intervention-effect was not observed in the postpartum period Background Globally , efforts aim ed at the prevention of childhood obesity have led to the implementation of a range of school-based interventions . This study assessed whether augmenting physical activity ( PA ) within the school setting result ed in increased daily PA and decreased overweight/obesity levels in 6 - 9-year-old children . Methods Across the first to third primary school years , PA of 84 girls and 92 boys was objective ly monitored five times ( each for seven successive days ) using Yamax pedometer ( step counts ) and Caltrac accelerometer ( activity energy expenditure AEE - kcal/kg per day ) . Four schools were selected to participate in the research ( 2 intervention , 2 controls ) , comprising intervention ( 43 girls , 45 boys ) and control children ( 41 girls , 47 boys ) . The study was non-r and omized and the intervention schools were selected on the basis of existing PA-conducive environment . Analyses of variance ( ANOVA ) for repeated measures examined the PA programme and gender effects on the step counts and AEE . Logistic regression ( Enter method ) determined the obesity and overweight occurrence prospect over the course of implementation of the PA intervention . Results There was a significant increase of school-based PA during schooldays in intervention children ( from ≈ 1718 to ≈ 3247 steps per day ; and from 2.1 to ≈ 3.6 Kcal/Kg per day ) in comparison with the control children .  Increased school-based PA  of intervention children during schooldays contributed to them achieving > 10,500 steps and > 10.5 Kcal/Kg per school day across the 2 years of the study , and result ed in a stop of the decline in PA levels that is known to be associated with the increasing age of children .  Increased school-based PA  had also positive impact on leisure time PA of schooldays and on PA at weekends of intervention children . One year after the start of the PA intervention , the odds of being overweight or obese in the intervention children was almost three times lower than that of control children ( p < 0.005 ) , and these odds steadily decreased with the duration of the intervention . Conclusions The findings suggest that school-based PA ( Physical Education lessons , PA during short breaks and longer recesses , PA at after-school nursery ) in compatible active environments ( child-friendly gym and school playground , corridors with movement and playing around corners and for games ) has a vital role in obesity and overweight reduction among younger pupils This study aim ed to determine whether aerobic training could reduce lipid peroxidation and inflammation at rest and after maximal exhaustive exercise in overweight/obese adolescent girls . Thirty-nine adolescent girls ( 14 - 19 years old ) were classified as nonobese or overweight/obese and then r and omly assigned to either the nontrained or trained group ( 12-week multivariate aerobic training program ) . Measurements at the beginning of the experiment and at 3 months consisted of body composition , aerobic fitness ( VO2peak ) and the following blood assays : pre- and postexercise lipid peroxidation ( 15F2a-isoprostanes [ F2-Isop ] , lipid hydroperoxide [ ROOH ] , oxidized LDL [ ox-LDL ] ) and inflammation ( myeloperoxidase [ MPO ] ) markers . In the overweight/ obese group , the training program significantly increased their fat-free mass ( FFM ) and decreased their percentage of fat mass ( % FM ) and hip circumference but did not modify their VO2peak . Conversely , in the nontrained overweight/obese group , weight and % FM increased , and VO2peak decreased , during the same period . Training also prevented exercise-induced lipid peroxidation and /or inflammation in overweight/obese girls ( F2-Isop , ROOH , ox-LDL , MPO ) . In addition , in the trained overweight/obese group , exercise-induced changes in ROOH , ox-LDL and F2-Isop were correlated with improvements in anthropometric parameters ( waist-to-hip ratio , % FM and FFM ) . In conclusion aerobic training increased tolerance to exercise-induced oxidative stress in overweight/obese adolescent girls partly as a result of improved body composition # # # # Summary points In the first part of this article we described how obesity in children is measured , its prevalence , whether children should be screened , and the risk factors for and consequences of obesity.1 In this part we review the current evidence on the prevention and management of childhood obesity . # # # # Sources and selection criteria This review draws on the Foresight report , guidance from the National Institute for Health and Clinical Excellence and the Australian National Health Medical Research Council , and Cochrane review . In April 2008 we search ed the Cochrane Library data base of review s and the Centre for Review s and Dissemination data bases using the search term “ obesity ” . We also conducted a Medline search ( ( Child$ or paediatric or pediatric or adolescent ) and ( Obes$ or overweight ) ) limited to 1 January 2005 to 6 May 2008 and “ review articles ” ; this identified 1105 articles . We read the abstract s of these articles and retrieved relevant papers . We also used articles from our own bibliographies collected over the past 10 years . The evidence to support the measurement , prevention , and management of obesity in children is still relatively weak , with few r and omised controlled trials or systematic review s. The strength of evidence is developing and the up date d Cochrane review that will be published in 2009 Background The increasing rate of obesity among Kuwaiti adolescents is associated with immediate and long term-risks to their health and well-being . Objective To up date data on the prevalence of overweight and obesity among Kuwaiti adolescents and to examine the relative contribution of selected lifestyle factors to overweight and obesity in this population . Methods The present study is part of the Arab Teens Lifestyle Study ( ATLS ) . A total of 906 adolescents ( 463 boys and 443 girls ) aged between 14 and 19 years were selected from Kuwaiti schools by a multistage stratified r and omization process . A vali date d question naire was used to collect data on  physical activity , sedentary lifestyle , and eating habits . The International Obesity Task Force ( IOTF ) cutoff values for adolescents under 18 years of age were used to define overweight and obesity . Total energy expenditure was calculated using metabolic equivalent-minutes per week . A general linear model was used to establish the proportion of the variance ( expressed in partial eta squared ) in excess weight attributable to differences in eating habits and physical activity . Results The prevalence of overweight and obesity was 50.5 % in boys and 46.5 % in girls . Among boys , moderate and vigorous activities were found to be significantly negatively associated with overweight and obesity ( p < .05 ) , whereas in girls , only those with not less than moderate activities were negatively associated with overweight and obesity ( p < .05 ) . Sedentary behaviors , time spent watching television , and time spent working on the computer were not significantly associated with obesity in either sex . Consumption of breakfast , vegetables , and fast foods ( boys and girls ) and potatoes , cakes and doughnuts , and sweets ( girls only ) was significantly associated with overweight and obesity ( p < .05 ) . In general , the partial eta square explained by physical activity was less than 3.6 % in boys compared with less than 1.0 % in girls , and eating habits explained less than 1.8 % in boys compared with 2.5 % in girls . Conclusions Physical activity explains a greater proportion of variation in body mass index than do eating habits , particularly in boys . Eating habits explain a greater proportion of variation in body mass index than does physical activity in girls . Prospect i ve studies are needed to clarify the relative effects of sedentary behaviors on overweight in adolescents PURPOSE The objective of the Healthy Eating Aerobic and Resistance Training in Youth ( HEARTY ) trial ( Clinical Trials . Gov # NCT00195858 ) was to examine the effects of resistance training , with and without aerobic training , on percent body fat in sedentary , post-pubertal overweight or obese adolescents aged 14 - 18 years . This paper describes the HEARTY study rationale , design and methods . METHODS After a 4-week supervised low-intensity exercise run-in period , 304 overweight or obese adolescents with a body mass index≥85th percentile for age and sex were r and omized to 4 groups for 22 weeks ( 5 months ) : diet+aerobic exercise , diet+resistance exercise , diet+combined aerobic and resistance exercise , or a diet only waiting-list control . All participants received dietary counseling design ed to promote healthy eating with a maximum daily energy deficit of -250 kcal . OUTCOMES The primary outcome is percent body fat measured by Magnetic Resonance Imaging . Secondary outcomes include changes in anthropometry , regional body composition , resting energy expenditure , cardiorespiratory fitness , musculoskeletal fitness , cardiometabolic risk markers , and psychological health . SUMMARY To our knowledge , HEARTY is the largest clinical trial examining effects of aerobic training , resistance training , and combined aerobic and resistance training on changes in adiposity and cardiometabolic risk markers in overweight and obese adolescents . The findings will have important clinical implication s regarding the role that resistance training should play in the management of adolescent obesity and its co-morbidities AIM This study evaluates the efficacy of the Choose Health program , a family-based cognitive behavioural lifestyle program targeting improved eating and activity habits , in improving body composition , cardiovascular fitness , eating and activity behaviours in overweight and obese adolescents . METHOD The sample comprised 29 male and 34 female overweight ( n = 15 ) or obese ( n = 48 ) adolescents aged 11.5 - 18.9 years ( M = 14.3 , SD = 1.9 ) . Participants were r and omly allocated to treatment or waitlist control conditions ; waitlist condition participants were offered treatment after 6 months .  DEXA-derived and anthropometric measures of body composition ; laboratory-based cycle ergometer and field-assessed cardiovascular fitness data ; objective and self-report physical activity measures ; and self-report measures of eating habits and 7-day weighed food diaries  were used to assess treatment outcome . Adherence to treatment protocol s was high . RESULTS Treatment result ed in significant ( p < .05 ) and sustained improvements in a range of body composition ( body fat , percent body fat , lean mass ) and anthropometric measures ( weight , BMI , BMI -for-age z-score and percentiles ) . Minimal improvements were seen in cardiovascular fitness . Similar results were obtained in completer and intention-to-treat analysis . Poor adherence to assessment protocol s limits conclusions that can be drawn from physical activity and dietary data . CONCLUSIONS Participation in the Choose Health program result ed in significant improvement in body composition . Longer-term follow up is required to determine the durability of intervention effects . Alternative approaches to the measurement of diet and physical activity may be required for adolescents Background Childhood obesity is the result of a long lasting imbalance between energy intake and energy expenditure . A major contributing factor is physical inactivity which is closely linked to bone health , cardiovascular disease risk , fitness and psychological factors . The school seems to provide an excellent setting to enhance levels of  physical activity ( PA ) .  However , there is insufficient data from previous school-based intervention trials on how to enhance overall PA . It is also unknown whether an intervention aim ed at increasing PA is effective in improving the children 's health . The purpose of this paper is to outline the design of a school-based r and omized , controlled trial ( RCT ) aim ing to increase overall PA and to improve fitness and health in 6- to 13-year-old children . Methods / Design 15 schools were r and omized to the intervention ( n = 9 ) or the control ( n = 6 ) group , stratified by geographic region ( urban vs. rural ) and by age ( 1st and 5th grade ) . Participation was given for all children in the intervention group since in this group the intervention was part of the normal school curriculum . The intervention during one academic year consisted of : 1 . two additional physical education classes per week given by trained physical education teachers adding up to a total of five PA classes per week , 2 . short PA breaks ( 2–5 min each ) during academic lessons , 3 . PA home work , and 4 . adaptation of recreational areas around the school . All children underwent  anthropometric measurements , blood pressure assessment , fitness testing , measurement of PA  and they filled out question naires . At least 70 % of all children agreed to blood sampling and measurements of body composition and bone mineral measurements by dual energy x-ray absorptiometry . The primary endpoints of the study after one year were an increase in total PA by accelerometry , an increase in aerobic fitness measured by the 20 m shuttle run , a decrease in percent body fat derived from skinfold measurements and an increase in quality of life as assessed by the child health question naire in the intervention group compared to the control group . Secondary outcomes were overall fitness , differences in body composition including body fat distribution , cardiovascular risk factors , psychosocial health , bone mineral content and density of femur , lumbar spine and total body and food intake . Discussion Our preliminary data suggest that the children were representative of Swiss children with respect to sex , socio-demographic status , and body mass index . Short-term results can be expected by the beginning of 2007 . We hypothesized that our intervention will lead to an increase in PA , fitness and overall health . Based on our data , we aim to provide important information regarding the influence of such an intervention on these outcome measures in school-aged children and to provide nationwide guidelines to improve PA in children BACKGROUND AND OBJECTIVES : Endothelial dysfunction is the first , although reversible , sign of atherosclerosis and is present in obese adolescents . The primary end point of this study was to investigate the influence of a multicomponent treatment on microvascular function . Additional objectives and end points were a reduced BMI SD score , improvements in body composition , exercise capacity , and cardiovascular risk factors , an increase in endothelial progenitor cells ( EPCs ) , and a decrease in endothelial microparticles ( EMPs ) . METHODS : We used a quasi-r and omized study with 2 cohorts of obese adolescents : an intervention group ( n = 33 ; 15.4 ± 1.5 years , 24 girls and 9 boys )  treated residentially with supervised diet and exercise and a usual care group ( n = 28 ; 15.1 ± 1.2 years , 22 girls and 6 boys ) , treated ambulantly . Changes in body mass , body composition , cardiorespiratory fitness , microvascular endothelial function , and circulating EPCs and EMPs were evaluated after 5 months and at the end of the 10-month program . RESULTS : Residential intervention  decreased BMI and body fat percentage , whereas it increased exercise capacity ( P < .001 after 5 and 10 months ) . Microvascular endothelial function also improved in the intervention group ( P = .04 at 10 months ; + 0.59 ± 0.20 compared with + 0.01 ± 0.12 arbitrary units ) . Furthermore , intervention produced a significant reduction in traditional cardiovascular risk factors , including high-sensitivity C-reactive protein ( P = .012 at 10 months ) . EPCs were increased after 5 months ( P = .01 ) , and EMPs decreased after 10 months ( P = .004 ) . CONCLUSIONS : A treatment regimen consisting of supervised diet and exercise training was effective in improving multiple adolescent obesity-related end points
The review was registered ( Number CRD42013004632 ) on PROSPERO , the International Prospect i ve Register of Systematic Review s. Results The results indicated that PA is associated with significant and beneficial changes in fat percentage , waist circumference , systolic blood pressure , insulin , low-density lipoprotein cholesterol , and total cholesterol , as well as with small non-significant changes in diastolic blood pressure , glucose , and high-density lipoprotein cholesterol .
Conclusion Although limited , results from controlled trials suggest that PA intervention may improve physical fitness and risk factors for cardiovascular disease in adolescents who are overweight or obese
Background The increasing prevalence of obesity in the pediatric age range has become a major concern .
Studies have investigated the role of physical activity ( PA ) to prevent obesity in this population .
However , previous review s did not focus on the effects of PA in overweight/obese adolescents on physical fitness and risk factors for cardiovascular disease altogether .
Objective The present systematic review analyzed trials investigating the effect of PA on aerobic capacity , muscle strength , body composition , hemodynamic variables , biochemical markers , and endothelial function in obese/overweight adolescents .