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      Effects of physical exercise and nutritional guidance on metabolic syndrome in obese adolescents Translated title: Efeito do exercício físico e da orientação nutricional na síndrome metabólica em adolescentes obesos

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          Abstract

          OBJECTIVES: To analyze the effects of physical exercise and nutritional guidance on body composition, physical fitness, lipid profile and insulin resistance among obese adolescents with and without metabolic syndrome. METHODS: Sixty-four obese adolescents (26 boys), 10-16 years of age, were divided into two groups: with metabolic syndrome (n=29) and without metabolic syndrome (n=35). They were classified as having metabolic syndrome if they met three or more criteria for age and sex according to the Adult Treatment Panel III (ATP III). Blood pressure, waist circumference, maximum oxygen uptake (VO2peak), blood glucose, blood insulin, homeostatic model assessment (HOMA-IR), quantitative insulin sensitivity check index (QUICKI) and lipid profile were assessed at baseline and after 12 weeks of intervention. Both groups participated in 12 weeks of physical education and two nutritional guidance sessions. Each physical education session consisted of 50 min indoor cycling, 50 min of walking/running and 20 min of stretching, three times a week. RESULTS: Fifty-five participants (with metabolic syndrome=25; without metabolic syndrome=30) completed the treatment. After 12 weeks, both groups showed reductions in body weight, BMI z-score, waist circumference, fat mass and triglycerides; and increases in height, HDL-C and VO2peak (p<0.05). In addition, the group with metabolic syndrome presented reduced systolic blood pressure and increased insulin sensitivity (p<0.05). The risk factors for metabolic syndrome decreased by 72%. CONCLUSION: Following the multidisciplinary intervention, the risk factors decreased, with improvements in physical fitness and metabolic profile. The multidisciplinary intervention was effective in reducing metabolic syndrome.

          Translated abstract

          OBJETIVOS: Analisar os efeitos de exercícios físicos (EF) e orientação nutricional (ON) sobre a composição corporal, aptidão física, perfil lipídico e resistência insulínica em adolescentes obesos com e sem síndrome metabólica (SM). MÉTODOS: 64 obesos (26 meninos), com idade entre 10 a 16 anos, divididos em dois grupos: com SM (n=29) e sem SM (n=35). Utilizou-se como critério de classificação de SM a presença de três ou mais critérios para idade e sexo de acordo com Adult Treatment Panel III (ATP III). Mensuraram-se antes e após 12 semanas de intervenção: pressão arterial, circunferência abdominal, consumo máximo de oxigênio (VO2pico), glicemia, insulinemia, Homeostatic Metabolic Assessments (HOMA-IR), Quantitative Insulin Sensitivity Check Index (QUICKI) e perfil lipídico. Os dois grupos participaram de 12 semanas de EF e duas sessões de ON. Cada sessão de EF consistiu em 50 minutos de ciclismo indoor, 50 minutos de caminhada e 20 minutos de alongamento, três vezes por semana. RESULTADOS: 55 sujeitos (com SM=25; sem SM=30) completaram o tratamento. Após 12 semanas, houve diminuição na massa corporal, IMC escore-z, circunferência abdominal, massa gorda, TG e aumento na estatura, HDL-C e VO2pico, em ambos os grupos. Além disso, houve uma redução na pressão arterial sistólica, aumento na sensibilidade à insulina (p<0,05) no grupo com SM. Os fatores de risco para SM diminuíram em 72%. CONCLUSÃO: Após a intervenção multidisciplinar, houve uma redução nos fatores de risco, melhorando a aptidão física e perfil metabólico. A intervenção multidisciplinar foi efetiva para redução da SM.

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          Waist circumference percentiles in nationally representative samples of African-American, European-American, and Mexican-American children and adolescents.

          To describe and provide estimates of the distribution of waist circumference (WC) according to percentiles in African-, European-, and Mexican-American children, and to test for group differences at different percentiles. Cross-sectional data from the Third National Health and Nutrition Examination Survey (NHANES III) were examined. The sample evaluated included 9713 nonpregnant persons 2 to 18 years of age with measured values of WCs. Age-, sex-, and ethnicity-specific percentiles were estimated via percentile regression. WC measurements increased in a monotonic fashion across ages but at nonconstant rates and in a manner that varied across age and sex. At higher percentiles of the distribution, estimates of WC differ between Mexican-American (MA) and European-American (EA) and between African-American (AA) and European-American (EA), and, in some cases, exceeded the adult cutoff value for obesity-related disease risk at as early as 13 years of age. Age-, sex-, and ethnicity-specific WC percentiles are available for US children and adolescents and can be used as an assessment tool that could impact public health recommendations. Results suggest concern with respect to high WC values among certain ethnic groups.
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            Normal growth and techniques of growth assessment.

            J M Tanner (1986)
            The shape of the human growth curve is described and illustrated. Growth studies may be longitudinal, cross-sectional, mixed longitudinal or linked-longitudinal; each has advantages and disadvantages, and each requires appropriate statistical methods for handling the data. Standards for height and height velocity for use in a clinical setting wherein follow-up over several years is presumed are described and illustrated. Such standards have to take into account tempo of growth at ages over nine years. Cross-sectionally derived standards do not do this and are not suitable for clinical use. The techniques of measurement of height, sitting height and skinfolds are described and illustrated. Growth and development during puberty is described; there are changes in body composition as well as in body size and shape. Standards for pubertal stages of breasts, pubic hair and genitalia are given and emphasis is laid on the great variation in both the timing and the duration of these pubertal changes. Measurement of developmental age is discussed. The Greulich-Pyle and Tanner-Whitehouse methods for skeletal age are described. These methods can be used for predicting adult height which is useful both in diagnosis and in following the effects of treatment. In diagnosis the predicted adult height is compared to the range of expected heights in the children of the particular pair of parents concerned (the so-called 'target' range of heights) to see if smallness is simply due to delay. Change in Tanner-Whitehouse predicted height occurs on successful treatment of, for example, growth hormone deficient short stature, and is thus a guide to the success of treatment. Standards are also given for height of children from age two to nine inclusive, with allowance for height of their parents.
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              Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man

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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                rbfis
                Brazilian Journal of Physical Therapy
                Braz. J. Phys. Ther.
                Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia (São Carlos )
                1809-9246
                February 2009
                : 13
                : 1
                : 73-81
                Affiliations
                [1 ] Universidade Federal do Paraná Brazil
                [2 ] Universidade Federal do Paraná Brazil
                Article
                S1413-35552009000100005
                10.1590/S1413-35552009005000009
                bb89ed03-4bb5-41c8-856f-0e699b9af23c

                http://creativecommons.org/licenses/by/4.0/

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                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=1413-3555&lng=en
                Categories
                ORTHOPEDICS
                REHABILITATION

                Orthopedics,Physiotherapy
                cardiovascular diseases,physical exercise,obesity,doenças cardiovasculares,exercício físico,obesidade

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