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Promoting physical activity among overweight and obese children: Effects of a family-based lifestyle intervention on physical activity and metabolic markers
Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background Overweight and obesity in childhood is associated with physical, psychological and social consequences. Physical inactivity is regarded as one of the main factors that have contributed to the increase in childhood obesity through out the world. Overweight and obesity as well as physical activity level are shown to track from childhood to adolescence and adulthood, thereby influencing not only the current health status but also long-term health. The general purpose of this thesis was to evaluate the effect of a 2-year family-based lifestyle intervention on physical activity and metabolic health among children with overweight and obesity.

Methods Children with overweight or obesity living in northern Sweden were recruited to the study. In total 105 children, mean age 10.5 years (SD±1.09), were randomized into either an intervention or a control group. The intervention group was offered as a 2-year family-based lifestyle intervention; the 1st year consisted of 14 group sessions and during the 2nd year the intervention was web-based. The control group did not participate in any intervention sessions, but performed all measurements. Physical activity was measured in all children using SenseWear Pro2 Armband (SWA) during 4 consecutive days before, in the middle and after the intervention, data regarding anthropometrics and blood values were collected in the same periods. Twenty-two of the children wore SWA during 14 days before the intervention in order to validate energy expenditure (EE) estimated by SWA against EE measured with double labelled water.

Results The SWA, together with software version 5.1, proved to be a valid device to accurately estimate EE at group level of overweight and obese children. There were no statistically significant differences between the groups neither before nor after the intervention regarding physical activity and screen-time. All children significantly decreased their time being active ≥3 METs during the study period. After the study period, significantly fewer in the control group achieved the national physical activity recommendation, and they had significantly increased their screen-time. However, these changes were not seen within the intervention group. The intervention group had a significantly lower apolipoprotein B/A1 compared to the control group at 1-year measurement; no other significant differences were found regarding metabolic markers. No statistical difference was found between the groups regarding body mass index after the 2-year study period.

Conclusion Even though a comprehensive program, the 2-year family-based lifestyle intervention had limited effects on physical activity and metabolic health in overweight and obese children. SWA is a device that can be used in future studies to measure energy expenditure among free-living overweight or obese children.

Place, publisher, year, edition, pages
Umeå: Institutionen för Kostvetenskap , 2010. , 64 p.
Keyword [en]
intervention: children: overweight: obestiy: physical activity
National Category
Food Science Physiotherapy
Research subject
Physiotherapy; Food and Nutrition
Identifiers
URN: urn:nbn:se:umu:diva-37511ISBN: 978-91-7459-102-6 (print)OAI: oai:DiVA.org:umu-37511DiVA: diva2:361058
Public defence
2010-12-10, Hörsal C, Samhällsvetarhuset, Umeå Universitet, Umeå, 13:00 (Swedish)
Opponent
Supervisors
Projects
SELFH
Available from: 2010-11-19 Created: 2010-11-05 Last updated: 2011-01-26Bibliographically approved
List of papers
1. Validity of an armband measuring energy expenditure in overweight and obese children
Open this publication in new window or tab >>Validity of an armband measuring energy expenditure in overweight and obese children
2010 (English)In: Medicine & Science in Sports & Exercise, ISSN 0195-9131, E-ISSN 1530-0315, Vol. 42, no 6, 1154-1161 p.Article in journal (Refereed) Published
Abstract [en]

Purpose: To examine the ability of the SenseWear Pro2 Armband (SWA) to accurately assess energy expenditure in free-living overweight or obese children during a two-week period, by comparison with energy expenditure measured using the doubly labeled water (DLW) method. A second aim was to examine which software version, Innerview Professional 5.1 or Sensewear Professional 6.0, are the most appropriate for use together with SWA in overweight and obese children.

Method: A random sample of 22 healthy, overweight or obese children (11 girls and 11 boys) aged 8-11 years was recruited from an ongoing intervention study. Energy expenditure in free-living conditions was simultaneously assessed with the SWA and DLW methods during a 14-day period. All data from the SWA were analyzed using InnerView Professional software versions 5.1 (SWA 5.1) and 6.1 (SWA 6.1).

Results: An accurate estimation in energy expenditure was obtained when SWA 5.1 was used, showing a non-statistically significant difference corresponding to 17 (1200) kJ[middle dot]d-1 compared with the energy expenditure measured using the DLW method. However, when SWA 6.1 was used a statistically significant (18%) underestimation of energy expenditure was obtained, corresponding to 1962 (1034) kJ[middle dot]d-1 compared with the DLW method.

Conclusion: The SWA together with software version 5.1, but not 6.1, is a valid method for accurately measuring energy expenditure at group level of free-living overweight and obese children.

Place, publisher, year, edition, pages
The American College of Sports Medicine, 2010
Keyword
doubly labeled water; activity monitor; physical activity; overweight children
Research subject
Food and Nutrition
Identifiers
urn:nbn:se:umu:diva-31899 (URN)10.1249/MSS.0b013e3181c84091 (DOI)000277725700015 ()
Available from: 2010-02-22 Created: 2010-02-22 Last updated: 2017-12-12Bibliographically approved
2. Effect of a 1-year lifestyle intervention on physical activity in overweight and obese children
Open this publication in new window or tab >>Effect of a 1-year lifestyle intervention on physical activity in overweight and obese children
2011 (English)In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 13, no 3, 87-96 p.Article in journal (Refereed) Published
Abstract [en]

This study evaluated the effect of a family-based multifactor intervention programme on physical activity among overweight or obese children. Children (n = 105, mean age 10.6 ± 1.07 years) with overweight or obesity were randomized into an intervention or control group. The intervention group participated in a 1-year programme aiming at lifestyle changes regarding food habits and physical activity. All children's physical activity was measured using SenseWear Armband at baseline and after 1 year. The children in both groups had a physical activity level (PAL) of 1.67 (0.27) at baseline. When comparing the intervention and control groups, no significant differences were found in physical activity outcome variables after 1 year of intervention. Contrarily to the hypotheses, both groups decreased their energy expenditure and time spent at >3 MET, and there was no change in steps and screen time after 1 year. Despite extensive efforts, the intervention showed no significant positive effect on overweight and obese children's PAL. Further studies are needed to obtain more knowledge on how to maintain or increase the PAL successfully among overweight and obese children.

Read More: http://informahealthcare.com/doi/abs/10.3109/14038196.2011.566353

Keyword
BMI, childhood, exercise, prevention
National Category
Other Social Sciences not elsewhere specified Physiotherapy
Research subject
Food and Nutrition
Identifiers
urn:nbn:se:umu:diva-37504 (URN)10.3109/14038196.2011.566353 (DOI)
Available from: 2010-11-05 Created: 2010-11-05 Last updated: 2017-12-12Bibliographically approved
3. Effects on physical activity of a 2-year lifestyle intervention in overweight and obese children
Open this publication in new window or tab >>Effects on physical activity of a 2-year lifestyle intervention in overweight and obese children
2011 (English)In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 13, no 3, 97-109 p.Article in journal (Refereed) Published
Abstract [en]

The aim was to examine the effect on physical activity of a 2-year family-based lifestyle intervention among overweight and obese Swedish children 8–12 years of age; 105 children were randomized to either intervention or control group. The intervention group was offered a 2-year lifestyle programme. Physical activity was measured using SenseWear Pro2 Armband during 4 consecutive days before and after the intervention. When comparing the intervention and control groups, no significant differences were found in the physical activity outcome variables after 2 years of intervention. However, the intervention group decreased their number of steps per day by 13%, p = 0.003 but had an unchanged screen time, whereas the control group had an unchanged number of steps but increased their screen time by 15%, p = 0.02, from baseline to 2-year measurement. There were no significant change in the intervention group, whereas significantly fewer children in the control group achieved the physical activity recommendations at 2-year measurement (88%) compared with at baseline (98%), p = 0.007. Future interventions regarding physical activity among overweight and obese children are of great importance even though the present one showed limited effects. In the continuing work, a greater effect may be received with an extended and more intense intervention regarding physical activity, focusing on reducing sedentary time rather than increasing the physical activity level.

Read More: http://informahealthcare.com/doi/abs/10.3109/14038196.2011.562540

Keyword
BMI, childhood, exercise habits, prevention
National Category
Other Social Sciences not elsewhere specified Physiotherapy
Research subject
Food and Nutrition
Identifiers
urn:nbn:se:umu:diva-37507 (URN)10.3109/14038196.2011.562540 (DOI)
Available from: 2010-11-05 Created: 2010-11-05 Last updated: 2017-12-12Bibliographically approved
4. Effects on metabolic health after a 1-year-lifestyle intervention in overweight and obese children: a randomized controlled trial
Open this publication in new window or tab >>Effects on metabolic health after a 1-year-lifestyle intervention in overweight and obese children: a randomized controlled trial
2012 (English)In: Journal of Nutrition and Metabolism, ISSN 2090-0724, E-ISSN 2090-0732, Vol. 2012, 913965Article in journal (Refereed) Published
Abstract [en]

Objective. To evaluate the effect of a family-based intervention on anthropometric and metabolic markers in overweight and obese children. Methods. Overweight or obese 8-12 years olds (n = 93) were randomized into intervention or control groups. The intervention group participated in a program aiming for lifestyle changes regarding food habits and physical activity. Anthropometric measures and venous blood samples were collected from all children at baseline and after 1 year. Results. BMI z-scores decreased in both groups, 0.22 (P = 0.002) and 0.23 (P = 0.003) in intervention and control group, respectively, during the 1-year study, but there was no difference in BMI between the groups at 1-year measurement (P = 0.338). After 1 year, there was a significant difference in waist circumference, waist/hip ratio, and apolipoprotein B/A1 ratio between intervention and control group. Conclusions. The intervention had limited effects on anthropometrics and metabolic markers, which emphasizes the need of preventing childhood overweight and obesity.

National Category
Other Social Sciences not elsewhere specified
Research subject
Food and Nutrition
Identifiers
urn:nbn:se:umu:diva-37509 (URN)10.1155/2012/913965 (DOI)2-s2.0-84873828297 (Scopus ID)
Available from: 2010-11-05 Created: 2010-11-05 Last updated: 2017-06-08Bibliographically approved

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