Effects of physical exercises and nutritional guidance on the cardiovascular risk profile of obese children

Universidade Federal de Santa Catarina, Florianópolis, SC, Brasil.
Revista da Associação Médica Brasileira (Impact Factor: 0.93). 02/2013; 59(1):56-63. DOI: 10.1016/S2255-4823(13)70430-2
Source: PubMed


To analyze the effects of a supervised physical exercise and nutritional guidance program, conducted with a playful basis, on the cardiovascular risk profile of obese children.

Forty-four children aged between 8 and 11 years, divided into two groups, were paired by gender and age: intervention group (n = 22) and control group (n = 22). The following parameters were measured before and after the intervention: body mass, height, waist circumference, total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, fasting glucose, high-sensitive C-reactive protein, blood pressure, and carotid intima-media thickness. Both groups continued their traditional medical treatment. The case group exercised with recreational activities three times a week during 12 weeks, and participated in a weekly nutritional guidance session. The control group did not participate in the intervention described. Descriptive statistics, paired and unpaired Student's t-test, Mann-Whitney's U test, and the Wilcoxon test were used, with a significance level of p < 0.05.

32 children concluded the study (16 in each group). At the end of the study, the case group showed a significant reduction in the body mass index (BMI) (p = 0.001), total cholesterol (p = 0.001), LDL cholesterol (p = 0.001), diastolic blood pressure (p = 0.010), and average (p = 0.003) and maximum (p = 0.002) carotid intima-media thickness. The control group showed a significant increase in waist circumference (p = 0.001), blood glucose (p = 0.025), C-reactive protein (p = 0.016), a reduction of HDL cholesterol (p = 0.012) and total cholesterol (p = 0.042), and an increase in the average (p = 0.012) and maximum (p = 0.024) carotid intima-media thickness.

The program proved effective in the reduction of obesity indicators and of the intima-media thickness, a direct and early signal of atherosclerosis.

Download full-text


Available from: Jorge Mota
  • [Show abstract] [Hide abstract]
    ABSTRACT: Unlabelled: The present study aimed to investigate whether obese children improve their balance and postural performance following a 6-month-weight management program. Twenty-nine obese children aged 6-14 years were examined posturographically before and after participation in weight management program. The interactive balance system evaluated the stability index, Fourier spectral analysis, weight distribution index, and falling index. The performance was evaluated for eight positions requiring closure of eyes, standing on pillows, as well as head turns. Anthropometric measurements (e.g., weight, height, BMI, and BMI percentiles) were also determined before and after the intervention. We found significant increase in height and significant decreased in BMI percentile following the intervention program (p<.05). Pre-intervention BMI percentile was found to be correlated with stability index in most of the positions measured (e.g., normal open position=.464; p=.011). Following the intervention program, an interaction was found between BMI percentile differences (pre- versus post-interventional) and balance (stability index and F2-F4 frequencies of most standing positions). Furthermore, a correlation was found between general stability and the falling index (.446; p=.015). Regression analysis showed that only initial weight distribution index and post-intervention BMI entered the equation as predictors of post-intervention weight distribution index. Conclusion: Weight management program for childhood obesity improved stability, reduced potential vestibular stress/disturbances, and decreased falling probability of the participants. Further longitudinal studies are needed to verify the relationship between physical activity, weight loss, and reduction of subsequent injuries in obese children.
    No preview · Article · Jul 2013 · European Journal of Pediatrics
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Educative strategies need to be adopted to encourage the consumption of healthy foods and to promote physical activity in childhood and adolescence. The effects of recreational physical activity and a health-habit orientation program using an illustrated diary on the cardiovascular risk profile of overweight and obese children was investigated. The weight and height of 314 schoolchildren aged between 9 and 11 years old, in a public school in Brasilia, Federal District, Brazil, were recorded. According to the body mass index (BMI) classification proposed by the World Health Organization, 84 were overweight or obese for their age and sex. Of these children, 34 (40%) participated in the study. Students were divided into two groups matched for sex, age, BMI, percent body fat (%BF): the intervention group (IG, n = 17) and the control group (CG, n = 17). The IG underwent a program of 10 weeks of exercise with recreational activities and health-habit orientation using an illustrated diary of habits, while no such interventions were used with the CG during the study period. Before and after the intervention, the children's weight, height, BMI, %BF, waist circumference (WC), maximum oxygen intake (VO2max), total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL), triglycerides, glucose, eating habits, and physical activity level (PAL) were assessed. In analyzing the data, we used descriptive statistics and paired and unpaired t-tests, using a significance level of 0.05. For assessment of dietary habits, a questionnaire, contingency tables, and the chi-squared test were used, with <0.05 set as the significance level. After 10 weeks of intervention, the IG showed a reduction in BMI (pre: 22.2 ± 2.1 kg/m(2) versus [vs] post: 21.6 ± 2.1 kg/m(2), P < 0.01); WC (pre: 70.1 ± 6.1 cm vs post: 69.1 ± 5.8 cm, P < 0.01); %BF (pre: 29.2% ± 4.6% vs post: 28.0% ± 4.8%, P < 0.01); systolic blood pressure (P < 0.01); VO2max (P = 0.014); TC (P < 0.01); LDL (P < 0.01); triglycerides (P < 0.01); and intake of candy (P < 0.01) and soda drinks (P < 0.01), while an increase in the consumption of fruit (P < 0.01) and PAL (P < 0.01) were observed. The CG did not show any change in the health parameters assessed. The program was effective in reducing risk factors for cardiovascular disease and the use of an illustrative diary may have been the key to this result, since students were motivated to change their poor eating habits and to increase their physical activity level.
    Full-text · Article · Nov 2013 · Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: It is unclear how sedentary behavior (SED), physical activity (PA), and cardiorespiratory fitness (CRF) influence vascular structure in children of varying body size. This study examined whether associations between SED, PA, and CRF with intima-media thickness (IMT) added to that of abdominal fatness and IMT. Differences in physiological measures among waist circumference (WC) percentiles were tested. Methods: We assessed IMT of the carotid artery in 265 children aged 11 to 13 years (135 girls). Measures included IMT assessed with high-resolution ultrasonography, WC, body fat mass (BFM) from DXA, and CRF determined using a maximal cycle test. SED and PA were assessed by accelerometry. Association between IMT and CRF adjusted for PA variables, and body composition phenotypes were tested with multiple linear regression analysis. Results: CRF was related to IMT independently of moderate to vigorous PA (MVPA) and SED (P < .05). When WC was added to the model CRF was no longer associated with IMT (P > .05). Children in the higher WC group had increased mean values of BMI, BFM, WC, and IMT and lower MVPA and CRF (P < .05). Conclusion: Full modeling of SED, MVPA, CRF, and WC revealed that regional adiposity appears to have the biggest role in arterial structure of children.
    Full-text · Article · Jun 2014 · Journal of physical activity & health