Exercise is a key component of a family-based lifestyle intervention program aimed at helping children lose fat, according to a secondary analysis of a nonrandomized controlled trial.
During the 22-week program, overweight or obese children whose families participated in a lifestyle intervention program with supervised exercise training saw an 18.1% reduction in visceral adipose tissue (VAT) compared to a reduction 8.5% for those in the basic lifestyle program (P =0.004), reported Cristina Cadenas-Sanchez, PhD, of the University of Granada in Spain, and colleagues.
Children on the exercise program also saw significantly greater reductions in abdominal subcutaneous adipose tissue (-9.9% vs -3.0%, P=0.001) and intermuscular adipose tissue fat fractions (-6, 0% vs -2.6%, P=0.02) compared to controls, they noted in JAMA Network Open.
In addition, the number of responders in terms of VAT area (73.5% vs. 36.5%) and reduction in fat fraction (81.6% vs. 38.5%) was 40% greater in the exercise vs. control group (P<0.001).
The reductions in VAT are likely the driving force responsible for the 87.6% of the observed improvement in insulin resistance (β -0.102, 95% CI -0.230 to -0.002), highlighting “the importance of guide therapies against childhood obesity for this fat deposit”, Cadenas -Sánchez and team wrote.
“Insulin resistance is a problem that could be reversed with a substantial loss of VAT, and the present work highlights that exercise-induced reduction in VAT could mediate a reduction in insulin resistance,” they explained. “This result should help protect against the development of type 2 diabetes.”
The only outcome that did not differ significantly between the two groups was the fat fraction of pancreatic adipose tissue.
Cadenas-Sánchez and colleagues said that the current Endocrine Society pediatric clinical practice guidelines recommend these types of weight-management interventions, but also stress the need for whole-family involvement, noting that exercise should be incorporated as a key component of a comprehensive program involving diet, nutrition, and behavioral interventions.
For this secondary analysis, 116 overweight or obese children aged 8 to 12 years (mean age 10.6) from Vitoria-Gasteiz, Spain, were assigned to a 22-week family lifestyle program (n=57) or to the same program plus an exercise intervention (n = 59).
The program consisted of two 45-minute sessions per month, in which healthy eating, physical activity, and adequate sleep hygiene were promoted. It also incorporated a psychoeducational component consisting of two 45-minute sessions per month, in which the children were taught emotional coping and well-being skills. The exercise program consisted of 90 minutes of supervised and monitored physical training 3 times per week. Parents attended classes with their children.
Changes in fat mass and other metabolic parameters were collected using MRI, anthropometric and fitness assessments, and fasting blood samples.
At baseline, 57.8% of children were obese. During the 22-week program, the median attendance rate for the family-based psychoeducation and lifestyle program was 85% for children and 83% for parents, while the median adherence to supervised training in the group exercise was 72%.
Two exercise-related adverse events occurred, including knee and ankle pain.
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Kristen Monaco is a staff writer, focusing on endocrinology, psychiatry and nephrology news. Based in the New York City office, she has been with the firm since 2015.
Disclosures
This study was supported by several grants, including from the Health Research Funds of the Carlos III Health Institute of the Spanish Ministry of Health.
Cadenas-Sanchez and co-authors did not report disclosures.
Source: news.google.com