Multidisciplinary Approach to the Treatment of Obese Adolescents: Effects on Cardiovascular Risk Factors, Inflammatory Profile, and Neuroendocrine Regulation of Energy Balance

Department of Biosciences, Universidade Federal de São Paulo (UNIFESP), Rua Silva Jardim, 136 Térreo, Vila Mathias, 11015-020 Santos, SP, Brazil
International Journal of Endocrinology (Impact Factor: 1.95). 10/2013; 2013(1):541032. DOI: 10.1155/2013/541032
Source: PubMed


The prevention of obesity and health concerns related to body fat is a major challenge worldwide. The aim of this study was to investigate the role of a medically supervised, multidisciplinary approach, on reduction in the prevalence of obesity related comorbidities, inflammatory profile, and neuroendocrine regulation of energy balance in a sample of obese adolescents. A total of 97 postpuberty obese adolescents were enrolled in this study. Body composition, neuropeptides, and adipokines were analysed. The metabolic syndrome was defined by the International Diabetes Federation (IDF). The abdominal ultrasonography was performed to measure visceral, subcutaneous fat and hepatic steatosis. All measures were performed at baseline and after one year of therapy. The multidisciplinary management promoted the control of obesity reducing body fat mass. The prevalence of metabolic syndrome, asthma, nonalcoholic fatty liver disease (NAFLD), binge eating, and hyperleptinemia was reduced. An improvement in the inflammatory profile was demonstrated by an increase in anti-inflammatory adiponectin and reduction in proinflammatory adipokines, plasminogen activator inhibitor-1, interleukin-6 concentrations, and in the Lep/Adipo ratio. Moreover, a reduction in the AgRP and an increase in the alfa-MSH were noted. The multidisciplinary approach not only reduced obesity but also is efficacious in cardiovascular risk factors, inflammatory profile, and neuroendocrine regulation of energy balance.

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    • "Data supports that the interdisciplinary intervention model associated to aerobic plus resistance training was more effective in improving the visceral adiposity, inflammatory markers and metabolic profile in obese adolescents [10] [11]. In addition, Jackson and colleagues [12] find changes in the body composition as in circumferential measurements across waist, hips, and thighs compared to placebo subjects after LLLT treatment, with a total of six treatments across 2-weeks. "
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    ABSTRACT: Introduction: Obesity is one of the most important link factors to coronary artery disease development mainly due to the pro-inflammatory and pro-thrombotic states favoring atherosclerosis progression. The LLLT acts in the cellular metabolism and it is highly effective to improve inflammation. The same occur in response to different kinds of exercise. However, we have not known the associate effects using LLLT therapies with aerobic plus resistance training as strategy specifically with target at human obesity control and its comorbidities. Objective: Investigate the effects of the LLLT associated with aerobic plus resistance training on cardiometabolic risk factors in obese women. Methodology: Women aged 20-40years (BMI≥30kg/m(2)), were divided into 2 groups: Phototherapy (PHOTO) and Placebo. They were trained aerobic plus resistance exercises (in a concurrent mode), 1h, 3times/week during 16weeks. Phototherapy was applied after each exercise session for 16min, with infrared laser, wavelength 808nm, continuous output, power 100mW, and energy delivery 50J. The body composition was measured with bioimpedance. Inflammatory mark concentrations were measured using a commercially available multiplex. Results: LLLT associated with aerobic plus resistance training was effective in decrease neck (P=0.0003) and waist circumferences (P=0.02); percentual of fat (P=0.04); visceral fat area (P=0.02); HOMA-IR (P=0.0009); Leptin (P=0.03) and ICAM (P=0.03). Also, the reduction in leptin (P=0.008) and ICAM-1 (0, 05) was much more expressive in the phototherapy group in comparison to placebo group when analyzed by delta values. Conclusion: LLLT associated with concurrent exercise (aerobic plus resistance training) potentiates the exercise effects of decreasing the cardiometabolic risk factors in obese woman. These results suggest the LLLT associated with exercises as a new therapeutic tool in the control of obesity and its comorbidities for obese people, targeting to optimize the strategies to control the cardiometabolic risk factors in these populations.
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