Umeå University's logo

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 1^st year consisted of 14 group sessions and during the 2^nd 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.

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

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

Introduction: Physical inactivity is regarded as one of the main factors that have contributed to the rapid increase in prevalence of childhood obesity in recent decades. The aim of this study was to evaluate whether participation in a family-based multifactor intervention program could increase physical activity among overweight and obese children.

Methods: 105 children, mean age 10.5 years (SD±1.09), with overweight and obesity living in northern Sweden were recruited and randomized into an intervention or control group. The intervention group was invited to participate in a program aiming at improving lifestyle regarding food habits and physical activity. The children’s physical activity was measured during 4 days at baseline and after 1 year with SenseWear Armband.

Results: There were no statistically significant differences between the groups neither at either baseline or 1 year, regarding energy expenditure, steps/day, time being sedentary (< 3 MET), and time being active at different MET-levels. For all children, time being active ≥ 3 MET significantly decreased with 44.5 (111) min/d from baseline to 1-year. Despite the decrease in physical activity, the children were physically active ≥ 3 MET during 4.1 (1.6) h/d at 1-year.

Conclusion: Physical activity decreased with increased age among overweight and obese children, despite extensive effort of intervention. To make future interventions worthwhile it is important to consider the participant’s physical activity level before entering the study, when planning and setting up the intervention program; to comprise the participant’s individual goals regarding physical activity; and to focus specifically on decreasing time being sedentary.

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.

The aim was to investigate the validity of SenseWear Pro₂ Armband (SWA) when assessing energy expenditure of overweight and obese children. A random selection of 22 children with an isoBMI>25 were recruited from 8-11 year olds participating in an intervention study. Energy expenditure in free-living condition was assessed during 14 days by using SWA. The armband was worn 24h/d, and removed only for water activities. Total energy expenditure was measured with double labelled water (DLW) method during the same period covered by SWA. During the data collection, an updated version of the software used by SWA was released and data were analysed with both software version. The validity when using software version 5.1 (SWA_5.1) and 6.1 (SWA_6.1) was investigated by comparison with measured energy expenditure by DLW method. In total, 11 girls and 11 boys with mean age of 10.3±0.99 years and isoBMI 22.8±0.62 participated. The average wearing time of SWA was 12 days (range 7-14) and 23.3 h/day (range 18.8-24.0). There was no statistically significant difference in mean physical activity level (PAL) by SWA_5.1 compared by DLW-method. A minor non-significant underestimation of energy expenditure 0.02±1.20 MJ/day (95%CI -0.55,0.52) measured by SWA_5.1 compared with DLW-method was shown. However, the children's PAL according to SWA_6.1 was 1.37 compared with 1.68 according to DLW method. When assessed by SWA_6.1 there was a significant underestimation of energy expenditure by 1.96±1.03MJ/day (95%CI-2.42,-1.50) compared with DLW-method. The differences between SWA_5.1 andSWA_6.1 may be partly explained bya statistically significant difference in the amount of time the two software versions have registered time spent on different activity levels (MET<3, MET3-<6, MET6-<9, MET≥9). When comparing time spent on sedentary activities (MET<3) significantly less time was assessed by SWA_5.1 compared with SWA_6.1, 18±2.1 h/d and 20±2.4 h/d respectively. These differences became more apparent at higher METs. A significantly longer time spent on activities with MET≥9, was assessed by SWA_5.1 compared with SWA_6.1, 11±26 min/d and 2.5±5.3 min/d respectively. In conclusion, the SWA with software v 5.1, but not with software v 6.1, is a valid device to accurately measure energy expenditure at group level in overweight and obese children during free-living condition.

Introduction: Exercise-induced laryngeal obstruction (EILO) is a differential diagnosis for asthma and prevalent in athletes referred for exercise-induced dyspnoea. The aim of this study was to estimate the prevalence of EILO in elite cross-country skiers, known for a high prevalence of asthma.

Method: Elite cross-country skiers were invited for screening of EILO. Screening consisted of clinical assessment, questionnaires, skin prick test, spirometry, eucapnic voluntary hyperventilation test, and continuous laryngoscopy during exercise test. Current asthma was defined as physician-diagnosed asthma and use of asthma medication during the last 12 months. EILO was defined as ≥2 points at the supraglottic or glottic level during exercise at maximal effort, using a visual grade score system.

Result: A total of 89 (51% female) cross-country skiers completed the study. EILO was identified in 27% of the skiers, 83% of whom were female. All skiers with EILO had supraglottic EILO, there was no glottic EILO. Current asthma was present in 34 (38%) of the skiers, 10 (29%) of whom had concomitant EILO. In the skiers with EILO, a higher proportion reported wheeze or shortness of breath following exercise, compared to skiers without EILO. In skiers with EILO and current asthma, compared to skiers with asthma only, a higher proportion reported wheeze or shortness of breath following exercise. Asthma medication usage did not differ between these groups.

Conclusion: EILO is common in elite cross-country skiers, especially females. Asthma and EILO may co-exist, and the prevalence of respiratory symptoms is higher in skiers with both. Testing for EILO should be considered in cross-country skiers with respiratory symptoms.