Innovative Assessments Help Elucidate Sustained Improvements in Fitness and Metabolic Health in Obese Children.

Abstract

Objective: Treatment of childhood obesity is a medical challenge and limited data are available describing successful long term interventions. This study presents a multi-disciplinary intervention that resulted in sustained physiological improvement over a one-year period.

Methods: The criterion outcome variables include cardiovascular fitness (CVF) measured by a population-specific treadmill test to predict maximal oxygen uptake (predicted VO₂ max) and the body composition (BC) variables of fat mass, non-bone lean mass and percent body fat from whole body dual energy x-ray absorptiometry (DXA) scans. Subjects were overweight and obese children (N=79) evaluated at baseline, 6 and 12 months at a University Hospital-based pediatric fitness clinic.

Results: Statistically significant improvements in non-bone lean body mass (+4.24 kg ± 5.0, p<0.0001) and predicted VO₂ max (+0.14L/min ± 0.10, p<0.0001) were seen at 6 months. These significant improvements were sustained over 12 months: body fat percentage (-2.28 ± 3.49, p<0.0001), lean mass (+6.0 kg ± 4.0, p<0.0001) and predicted VO₂ max (+0.22 L/min ± 0.19, p<0.0001). These results were observed despite increases in weight and body mass index (BMI) at 6-months (weight: +6.6 kg ± 6.93, p<0.0001; BMI: +0.37 ± 1.21, p=0.47) and 12-months (weight: +6.3 kg ± 5.8, p<0.0001; BMI: +0.91 ± 2.06, p=0.0002).

Conclusion: These results reflect the sustained effect of a multidisciplinary approach, and the value of using valid and reliable assessment methods to measure sustained physiological changes in a sample of 79 overweight and obese children.