Study protocol
weight reduction
The study was approved by the Ethics Committee of the Istituto Auxologico Italiano, IRCCS, Milan, Italy (ethical committee code of approval: 2022_03_15_03; research project code: 01C212; acronym: ALPOLAROB). The study was conducted in accordance with the Declaration of Helsinki and with the 2005 Additional Protocol to the European Convention of Human Rights and Medicine concerning Biomedical Research. Before the study began, all the volunteers and their parents were fully informed of the purpose of the study and provided written informed consent. The adolescents were hospitalized for a multidisciplinary BWRP. During the first few days, all the participants underwent a physical examination including hematology, biochemistry, and urine analysis. Physical examination included assessment of anthropometric characteristics, body composition, basal metabolic rate (BMR), energy expenditure (EE), and substrate oxidation rate during submaximal exercise. Thereafter, all volunteers followed a 3-week personalized weight-management program entailing moderate energy restriction, nutritional education, and psychological counseling. Participants were randomly allocated (using sealed envelopes and a 1:1 ratio) into two groups: the COMB (n:10) and MICT groups (n:11). All the testing sessions were conducted just before the beginning (week 0, W0) and at the end of the 3-week body weight reduction program (week 3, W3).