#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Reduction of abdominal obesity and cardiometabolic health risks in obese adolescents in response to a short-term spa weight management program


Authors: Petr Hlavatý;  Hana Zamrazilová;  Marie Kunešová;  Lenka Dušátková;  Barbora Sedláčková;  Vojtěch Hainer
Authors place of work: Endokrinologický ústav Praha
Published in the journal: Čas. Lék. čes. 2010; 149: 537-541
Category: Original Article

Summary

Background.
Overweight and obesity is associated with metabolic and cardiovascular complications even in children and adolescents. Obesity in childhood represents a serious health problem, as an obese child frequently remains obese subject in adulthood. Obesity is also an important early risk factor for morbidity and mortality in adulthood. The aim of this study was to follow changes in selected anthropometric parameters and cardiometabolic risks in overweight and obese adolescents in response to a 4-week spa weight management program.

Methods and Results.
The studied cohort included 342 adolescents (boys, n = 121, girls, n = 221); mean age (± SD) 14.9 ± 1.4 years (range 13.0 to 17.9 years) with overweight or obesity, mean BMI (± SD) 30.1 ± 4.4 kg/m2 who underwent a 4-week spa weight management program. Anthropometric (body height and weight, waist circumference, sagittal abdominal diameter, total body fat and intra-abdominal fat), clinical (blood pressure) and biochemical (total cholesterol, HDL and LDL cholesterol, triglycerides, glucose, insulin) parameters were studied. All examinations were conducted before and after a 4-week weight management program. Statistical evaluation of the data was performed by ANOVA. The data are expressed as means ± SD. In response to treatment all subjects demonstrated significant decreases in initial body weight (-6.3 ± 2.3 %), percent of total fat (-2.7 ± 2.5 %), percent of trunk fat (-2.5 ± 1.5 %), degree of enlargement in visceral fat stores (-2.1 ± 2.8), as well as reductions in waist circumference (-4.7 ± 3.2 cm) and sagittal abdominal diameter (-1.0 ± 1.8 cm). Positive changes in lipid profile and decrease in insulin resistance as measured by HOMA-IR were also recorded together with significant reductions in both systolic and diastolic blood pressures.

Conclusions.
Short-term weight management program in adolescents led to significant reductions in body weight, trunk and visceral fat and cardiometabolic health risks.

Key words:
obesity, cardiometabolic health risks, weight management program, visceral fat, trunk fat, waist circumference, sagittal abdominal diameter, adolescents.


Zdroje

1. Daniels, S. The consequences of childhood overweight and obesity. Future Child 2006; 16: 47–67.

2. Weiss R, Dziura J, Burgert TS, et al. Obesity and the Metabolic Syndrome in Children and Adolescents. N Engl J Med 2004; 350: 2362–2374.

3. Cali AMG, Caprio S. Obesity in children and adolescents. J Clin Endocrinol Metab 2008; 93: S31–S36.

4. Serdula MK, Ivery D, Coates RJ, et al. Do obese children become obese adults? A review of the literature. Prev Med 1993; 22: 167–177.

5. Caprio S. Insulin resistance in childhood obesity. J. Pediatr. Endocrinol. Metab 2002; 15(Suppl 1): 487–492.

6. Lee JM, Okumura MJ, Davis MM, et al. Prevalence and determinants of insulin resistance among US adolescents. A population-based study. Diabetes Care 2006; 29: 2427–2432.

7. Berenson GS, Srinivasan SR, Bao W, et al. Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. N Engl J Med 1998; 338: 1650–1655.

8. Freedman DS, Dietz WH, Srinivasan SR, et al. The relation of overweight to cardiovascular risk factors among children and adolescents: the Bogalusa Heart Study. Pediatrics 1999; 103: 1175–1182.

9. Kaufman FR. Type 2 diabetes mellitus in children and youth: a new epidemic. J Pediatr Endocrinol Metab 2002; 15(Suppl 2): 737–744.

10. Bláha P, Vignerová J, Riedlová J, et al. VI. celostátní antropologický výzkum dětí a mládeže. Čes.-slov. Pediat. 2003; 58: 766–770.

11. Kunešová M, Hainer V. Životní styl a obezita v ČR. STEM/MARK a.s., 2006.

12. Reilly JJ. Diagnostic accuracy of the BMI for age in paediatrics. Int J Obes 2006; 30: 595–597.

13. Must A, Anderson SE. Body mass index in children and adolescents: considerations for population-based applications. Int J Obes 2006; 30: 590–594.

14. Lisá L, Kytnarová J, Stožický F, et al. Doporučený postup prevence a léčby dětské obezity. DMEV 2008; 3: 140–144.

15. McCarthy HD, Ellis SM, Cole TJ. Central overweight and obesity in British youth aged 11-16 years: cross sectional surveys of waist circumference. Br Med J 2003; 326: 624–627.

16. Reilly JJ, Kelly J, Wilson DC. Accuracy of simple clinical and epidemiological definitions of childhood obesity: systematic review and evidence appraisal. Obes Rev 2010 (Epub ahead of print).

17. Brook RD, Bard RL, Glazewski L, et al. Effect of short-term weight loss on the metabolic syndrome and conduit vascular endothelial function in overweight adults. Am J Cardiol 2004; 93: 1012–1016.

18. Noakes M, Clifton PM. Weight loss and plasma lipids. Curr Opin Lipidol 2000; 11: 65–70.

19. Racette SB, Weiss EP, Hickner RC, et al. Modest weight loss improves insulin action in obese African Americans. Metabolism 2005; 54: 960–965.

20. Bihan H, Takbou K, Cohen R, et al. Impact of short-duration lifestyle intervention in collaboration with general practitioners in patients with the metabolic syndrome. Diabetes Metab 2009; 35: 185–191.

21. Kirk S, Zeller M, Claytor R, et al. The relationship of health outcomes to improvement in BMI in children and adolescents. Obes Res 2005; 13: 876–882.

22. Reinehr T, Andler W. Changes in the atherogenic risk factor profile according to degree of weight loss. Arch Dis Child 2004; 89: 419–422.

23. Sung RY, Yu CW, Chang SK, et al. Effects of dietary intervention and strength training on blood lipid level in obese children. Arch Dis Child 2002; 86: 407–410.

24. Matthews DR, Hosker JP, Rudenski AS, et al. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985; 28: 412–419

25. Ho TF. Cardiovascular risks associated with obesity in children and adolescents. Ann Med Singapore 2009; 38: 48–49.

26. Kim JA, Park HS. Association of abdominal fat distribution and cardiometabolic risk factors among obese Korean adolescents. Diabetes Metab 2008; 34: 126–130.

27. Taksali SE, Caprio S, Dziura J, et al. High visceral and low abdominal subcutaneous fat stores in the obese adolescent. A determinant of an adverse metabolic phenotype. Diabetes 2008; 57: 367–371.

28. Sampaio LR, Simões EJ, Assis AM, et al. Validity and reliability of the sagittal abdominal diameter as a predictor abdominal fat. Arq Bras Endocrinol Metabol 2007; 51: 980–986.

29. Zamboni M, Turcato E, Armellini F, et al. Sagittal abdominal diameter as a practical predictor of visceral fat. Int J Obes Relat Metab Disord 1998; 22: 655–660.

30. Brambilla P, Bedogni G, Moreno LA, et al. Crossvalidation of anthropometry against magnetic resonance imaging for the assessment of visceral and subcutaneous adipose tissue in children. Int J Obes 2006; 30: 23–30.

31. Ryo M, Maeda K, Onda T, et al. A new simple method for the measurement of visceral fat accumulation by bioelectrical impedance. Diabetes Care 2005; 28: 451–453.

32. Nagai M, Komiya H, Mori Y, et al. Development of a new method for estimating visceral fat area with multi-frequency bioelectrical impedance. Tokohu J Exp Med 2008; 214: 105–112.

33. Zamrazilová H, Hlavatý P, Dušátková L, et al. Nová jednoduchá metoda stanovení viscerálního a trunkálního tuku pomocí bioelektrické impedance: Srovnání s magnetickou rezonancí a duální rentgenovou absorpcimetrií u českých adolescentů. Čas Lék Čes 2010; 149: 417–422.

34. Irwin ML, Yasui Y, Ulrich CM, et al. Effect of exercise on total and intra-abdominal body fat in postmenopausal women: a randomized controlled trial. JAMA 2003; 289: 323–330.

35. Irving BA, Davis CK, Brock DW, et al. Effect of exercise training intensity on abdominal visceral fat and body composition. Med Sci Sports Exerc 2008; 40: 1863–1872.

36. O’Leary VB, Marchetti CM, Krishnan RK, et al. Exercise-induced reversal of insulin resistance in obese elderly is associated with reduced visceral fat. J Appl Physiol 2006; 100: 1584–1589.

37. Wabitsch M, Braun U, Heinze E, et al. Body composition in 5-18-y-old obese children and adolescents before and after weight reduction as assessed by deuterium dilution and bioelectrical impedance analysis. Am J Clin Nutr 1996, 64: 1–6.

38. Wabitsch M, Hauner H, Heinze E, et al. Body-fat distribution and changes in the atherogenic risk-factor profile in obese adolescent girls during weight reduction. Am J Clin Nutr. 1994, 60: 54–60.

39. Knöpfli BH, Radtke T, Lehmann M, et al. Effects of a multidisciplinary inpatient intervention on body composition, aerobic fitness, and quality of life in severely obese girls and boys. J Adolesc Health 2008; 42: 119–127.

40. Huelsing J, Kanafani N, Mao J, et al. Camp jump start: effects of a residential summer weight-loss camp for older children and adolescents. Pediatrics 2010; 125: 884–890.

41. Noakes M, Clifton PM. Weight loss and plasma lipids. Curr Opin Lipidol 2000; 11: 65–70.

42. Ben Ounis O, Elloumi M, Ben Chiekh I, et al. Effects of two-month physical-endurance and diet-restriction programmes on lipid profiles and insulin resistance in obese adolescent boys. Diabetes Metab 2008; 34: 595–600.

Štítky
Addictology Allergology and clinical immunology Angiology Audiology Clinical biochemistry Dermatology & STDs Paediatric gastroenterology Paediatric surgery Paediatric cardiology Paediatric neurology Paediatric ENT Paediatric psychiatry Paediatric rheumatology Diabetology Pharmacy Vascular surgery Pain management Dental Hygienist

Článok vyšiel v časopise

Journal of Czech Physicians

Najčítanejšie tento týždeň
Najčítanejšie v tomto čísle
Prihlásenie
Zabudnuté heslo

Zadajte e-mailovú adresu, s ktorou ste vytvárali účet. Budú Vám na ňu zasielané informácie k nastaveniu nového hesla.

Prihlásenie

Nemáte účet?  Registrujte sa

#ADS_BOTTOM_SCRIPTS#