Relation between plasma antioxidant vitamin levels, adiposity and cardio-metabolic profile in adolescents: Effects of a multidisciplinary obesity programme

Background & aims In vivo and in vitro evidence suggests that antioxidant vitamins and carotenoids may be key factors in the treatment and prevention of obesity and obesity-associated disorders. Hence, the objective of the present study was to determine the relationship between plasma lipid-soluble antioxidant vitamin and carotenoid levels and adiposity and cardio-metabolic risk markers in overweight and obese adolescents participating in a multidisciplinary weight loss programme. Methods A therapeutic programme was conducted with 103 adolescents aged 12–17 years old and diagnosed with overweight or obesity. Plasma concentrations of a-tocopherol, retinol, ß-carotene and lycopene, anthropometric indicators of general and central adiposity, blood pressure and biochemical parameters were analysed at baseline and at 2 and 6 months of treatment. Results Lipid-corrected retinol (P < 0.05), ß-carotene (P = 0.001) and a-tocopherol (P < 0.001) plasma levels increased significantly, whereas lipid-corrected lycopene levels remained unaltered during the treatment. Anthropometric indicators of adiposity (P < 0.001), blood pressure (P < 0.01) and biochemical parameters (P < 0.05) decreased significantly, whereas fat free mass increased significantly (P < 0.001). These clinical and biochemical improvements were related to changes in plasma lipid-corrected antioxidant vitamin and carotenoid levels. The adolescents who experienced the greatest weight loss also showed the largest decrease in anthropometric indicators of adiposity and biochemical parameters and the highest increase in fat free mass. Weight loss in these adolescents was related to an increase in plasma levels of lipid-corrected a-tocopherol (P = 0.001), ß-carotene (P = 0.034) and lycopene (P = 0.019). Conclusions Plasma lipid-soluble antioxidant vitamin and carotenoid levels are associated with reduced adiposity, greater weight loss and an improved cardio-metabolic profile in overweight and obese adolescents

Efecto del incremento de la actividad física sobre la condición física en un grupo de adolescentes con sobrepeso y/u obesidad

This study evaluated the effect of increased physical activity (PA) to achieve PA recommendations according to the World Health Organization for improving health in a group of 42 adolescents (28 girls) with overweight / obesity (BMI = 29.37 ± 4.5 Kg / m²). The 12 weeks treatment consisted in the prescription and follow-up of the PA guidelines divided in two phases: intensive (weekly follow-up) and extensive (fortnightly follow-up). PA level was assessed using the Physician-based Assessment and Counseling questionnaire and the Physical Fitness using upper body isometric strength test, lower body explosive strength test and cardiorespiratory fitness test, all from the ALPHA battery fitness tests. After treatment, a significant improvement was observed (p &lt;0.05) in cardiorespiratory fitness. In conclusion, this study shows that increasing PA practice and meeting the weekly recommendations of 300 minutes of moderate-vigorous PA, the adolescents’ group improved their cardiorespiratory fitness.Se analiza el efecto del incremento de actividad física (AF) para conseguir el cumplimiento de recomendaciones de AF para la mejora de la salud &nbsp;según la Organización Mundial de la Salud&nbsp; en un grupo de 42 adolescentes (28 chicas) con sobrepeso/obesidad (IMC=29.37±4.5 Kg/m²). El tratamiento de 12 semanas de duración consistió en la prescripción y seguimiento de AF en dos fases: intensiva (seguimiento semanal) y extensiva (seguimiento quincenal). El nivel de AF se valoró mediante el cuestionario Physician-based Assessment and Counseling &nbsp;y&nbsp; la condición física &nbsp;mediante pruebas de fuerza isométrica del tren superior, fuerza explosiva de piernas y capacidad cardiorrespiratoria de la batería ALPHA. Tras el tratamiento se observa una mejora significativa (p&lt;0,05) en capacidad cardiorrespiratoria. En conclusión, se muestra que incrementando la práctica de AF y cumpliendo las recomendaciones semanales de 300 minutos de AF moderada-vigorosa los adolescentes mejoraron su capacidad cardiorrespiratoria

Determinants of longitudinal changes in cardiometabolic risk in adolescents with overweight/obesity: the EVASYON study

We investigated which determinants (socioeconomic, early life factors, body composition changes, fitness changes and/or physical activity changes) best predicted longitudinal outcomes in cardiometabolic risk profile (Z-score change) in adolescents with OW/OB who underwent a 13-month multidisciplinary lifestyle intervention. A total of 165 adolescents (13-16 y; 46% boys) from the EVASYON study were included. Socioeconomic variables and early life factors were obtained from the medical records. Body composition was assessed using anthropometry. Fitness and physical activity were measured with field-based tests and questionnaires. Cardiometabolic risk factors (fasting glucose, HDL cholesterol, triglycerides, blood pressure and waist circumference) were derived from standard methods in the hospital. Body weight changes, sex and mother''s education were selected in the stepwise process as the most important determinants of changes in cardiometabolic risk profile (R2 = 0.26, p = 0.002; R2 = 0.14, p = 0.013; and R2 = 0.14, p = 0.017, respectively). Both boys and girls showed a lower cardiometabolic risk score with the reduction in body weight (r = 0.535, p = 0.009 and r = 0.506, p = 0.005, respectively). There was no interaction between sex and body weight change (p = 0.614). In conclusion, the simple measure of changes in body weight should be considered to track changes in cardiometabolic risk profile in adolescents with OW/OB

Television watching, videogames, and excess of body fat in Spanish adolescents: the AVENA study

Abstract OBJECTIVE: We assessed the individual association of sedentary behaviors with the risk of overweight and excess body fat (overfat) in adolescents. METHODS: A representative sample (1960 subjects, 1012 males, age 13-18.5 y) of Spanish adolescents was studied within the framework of the Alimentación y Valoración del Estado Nutricional de los Adolescentes (AVENA) study. Television (TV) watching, videogame and computer usage, doing homework, and the way students got to school, physical activity, and socioeconomic status were analyzed. Anthropometrics were measured to describe overweight (International Obesity Task Force cutoffs for body mass index) and overfat (body fat percentage >85th percentile). RESULTS: When all subjects were considered as an entire group, the overweight risk increased by 15.8% (P < 0.05) per increasing hour of TV watching. The overweight risks decreased by 32.5% in females, 22% per increasing year of age, and 12.5% by increasing socioeconomic status by 1 U (all Ps < 0.05). The obesity risks decreased with age by 17.8% per year in males and 27.1% in females (both Ps < 0.05). The overfat risks increased by 26.8% and 9.4% per increasing hour of TV and weekend videogame usage, respectively (both Ps < 0.05). In males, the overfat risk increased by 21.5% per increasing hour in weekend videogame usage (P < 0.05). Each hour of TV use increased the overfat risks by 22% in males and 28.3% in females (both Ps < 0.05). CONCLUSIONS: Time spent watching TV increased the risk of overweight and obesity in Spanish adolescents, but the effect was influenced by age, sex, and socioeconomic status. Moreover, an excess of body fat was more directly explained by the time spent watching TV and playing videogames during the weekend.Peer Reviewe

Diet quality index as a predictor of treatment efficacy in overweight and obese adolescents: The EVASYON study

Background & aim: A diet quality index (DQI) is a tool that provides an overall score of an individual''s dietary intake when assessing compliance with food-based dietary guidelines. A number of DQIs have emerged, albeit their associations with health-related outcomes are debated. The aim of the present study was to assess whether adherence to dietary intervention, and the overall quality of the diet, can predict body composition changes. Methods: To this purpose, overweight/obese adolescents (n = 117, aged: 13–16 years; 51 males, 66 females) were recruited into a multi-component (diet, physical activity and psychological support) family-based group treatment programme. We measured the adolescents’ compliance and body composition at baseline and after 2 months (intensive phase) and 13 months (extensive phase) of follow-up. Also, at baseline, after 6 months, and at the end of follow-up we calculated the DQI. Results: Global compliance with the dietary intervention was 37.4% during the intensive phase, and 14.3% during the extensive phase. Physical activity compliance was 94.1% at 2-months and 34.7% at 13months and psychological support compliance were growing over the intervention period (10.3% intensive phase and 45.3% during extensive phase). Adolescents complying with the meal frequency criteria at the end of the extensive phase had greater reductions in FMI z-scores than those did not complying (Cohen''s d = 0.53). A statistically significant association was observed with the diet quality index. DQI-A variation explained 98.1% of BMI z-score changes and 95.1% of FMI changes. Conclusions: We conclude that assessment of changes in diet quality could be a useful tool in predicting body composition changes in obese adolescents involved in a diet and physical activity intervention programme backed-up by psychological and family support

Excessive TV viewing and cardiovascular disease risk factors in adolescents. The AVENA cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Excessive television (TV) viewing might play an important role in the development of cardiovascular disease (CVD). The aim of this study was to examine the independent associations between TV viewing and CVD risk factors in adolescents.</p> <p>Methods</p> <p>A sample of 425 adolescents, aged 13- to 18.5-year-old, was included in this study. Body mass index (BMI), waist circumference (WC), glucose, total cholesterol, triglycerides, HDL-cholesterol, LDL-cholesterol, apolipoprotein (apo) A-1, apo B-100, and lipoprotein(a) levels were determined. A composite CVD risk score was computed based on age-, sex-, sexual maturation- and race-standardized triglycerides, HDL-cholesterol, LDL-cholesterol and glucose. TV viewing was self-reported.</p> <p>Results</p> <p>Two hundred and twenty-five adolescents (53%) who spent >3 hrs/day watching TV were considered as the "high TV viewing" group. Ninety-nine adolescents (23%) from the total sample were classified as overweight according to International age- and sex-specific BMI values. The high TV viewing group had significantly less favorable values of HDL-cholesterol, glucose, apo A1 and CVD score, independent of age, sex, sexual maturation, race and weight status. There was a significant interaction effect of TV viewing × weight status (P = 0.002) on WC, and the negative influence of TV viewing on WC persisted in the overweight group (P = 0.031) but was attenuated in non-overweight adolescents (P > 0.05).</p> <p>Conclusion</p> <p>Excessive TV viewing seems to be related to an unfavorable CVD risk factors profile in adolescence. Reducing TV viewing in overweight adolescents might be beneficial to decrease abdominal body fat.</p

Efectos de los programas de intervención enfocados al tratamiento del sobrepeso/obesidad infantil y adolescente

El objetivo del presente estudio fue realizar una revisión sistemática de la efectividad de los programas de intervención basados en actividad física (AF) y control dietético sobre el sobrepeso y/u obesidad en población infantil y adolescente. La búsqueda bibliográfica fue realizada en bases de datos electrónicas abarcando el período comprendido entre el 1 de julio de 2006 y el 30 de abril de 2012. Del total de 1.696 estudios encontrados inicialmente, se incluyeron 28 artículos que describieron 23 programas de AF y orientación alimentaria destinados a niños y adolescentes con sobrepeso/obesidad. Diecisiete programas fueron dirigidos a niños y adolescentes y 6 fueron diseñados específicamente para adolescentes. En 10 de los estudios, la condición física (CF) fue adicionalmente valorada. Los resultados parecen señalar que la AF asociada con orientación nutricional produce efectos positivos en la reducción del peso e índice de masa corporal (IMC). Resaltamos la necesidad de diseñar programas específicos para adolescentes, así como valorar objetivamente la eficacia de dichos programas a largo plazo en poblaciones de niños y adolescentes con sobrepeso/obesidad

Interplay between weight loss and gut microbiota composition in overweight adolescents

10 pages.-- PMID: 19390523 [PubMed].-- Printed version published Oct 2009.-- EVASYON Study Group.The aim of this study was to determine the influence of an obesity treatment program on the gut microbiota and body weight of overweight adolescents. Thirty-six adolescents (13–15 years), classified as overweight according to the International Obesity Task Force BMI criteria, were submitted to a calorie-restricted diet (10–40%) and increased physical activity (15–23 kcal/kg body weight/week) program over 10 weeks. Gut bacterial groups were analyzed by quantitative real-time PCR before and after the intervention. A group of subjects (n = 23) experienced >4.0 kg weight loss and showed significant BMI (P = 0.030) and BMI z-score (P = 0.035) reductions after the intervention, while the other group (n = 13) showed <2.0 kg weight loss. No significant differences in dietary intake were found between both groups. In the whole adolescent population, the intervention led to increased Bacteroides fragilis group (P = 0.001) and Lactobacillus group (P = 0.030) counts, and to decreased Clostridium coccoides group (P = 0.028), Bifidobacterium longum (P = 0.031), and Bifidobacterium adolescentis (P = 0.044) counts. In the high weight–loss group, B. fragilis group and Lactobacillus group counts also increased (P = 0.001 and P = 0.007, respectively), whereas C. coccoides group and B. longum counts decreased (P = 0.001 and P = 0.044, respectively) after the intervention. Total bacteria, B. fragilis group and Clostridium leptum group, and Bifidobacterium catenulatum group counts were significantly higher (P < 0.001–0.036) while levels of C. coccoides group, Lactobacillus group, Bifidobacterium, Bifidobacterium breve, and Bifidobacterium bifidum were significantly lower (P < 0.001–0.008) in the high weight–loss group than in the low weight–loss group before and after the intervention. These findings indicate that calorie restriction and physical activity have an impact on gut microbiota composition related to body weight loss, which also seem to be influenced by the individual's microbiota.Peer reviewe

Shifts in clostridia, bacteroides and immunoglobulin-coating fecal bacteria associated with weight loss in obese adolescents

10 pages, 4 tables, 3 figures.-- Online version published 9 December 2008[Objective]: To evaluate the effects of a multidisciplinary obesity treatment programme on fecal microbiota composition and immunoglobulin-coating bacteria in overweight and obese adolescents and their relationship to weight loss.[Design]: Longitudinal intervention study based on both a calorie-restricted diet (calorie reduction=10–40%) and increased physical activity (calorie expenditure=15–23 kcal/kg body weight per week) for 10 weeks.[Participants]: Thirty-nine overweight and obese adolescents (BMI mean 33.1 range 23.7–50.4; age mean 14.8 range, 13.0–16.0).[Measurements]: BMI, BMI z-scores and plasma biochemical parameters were measured before and after the intervention. Fecal microbiota was analyzed by fluorescent in situ hybridization. Immunoglobulin-coating bacteria were detected using fluorescent-labelled F(ab')2 antihuman IgA, IgG and IgM.[Results]: Reductions in Clostridium histolyticum and E. rectale-C. coccoides proportions significantly correlated with weight and BMI z-score reductions in the whole adolescent population. Proportions of C. histolyticum, C. lituseburense and E. rectale-C. coccoides dropped significantly whereas those of the Bacteroides-Prevotella group increased after the intervention in those adolescents who lost more than 4 kg. Total fecal energy was almost significantly reduced in the same group of adolescents but not in the group that lost less than 2.5 kg. IgA-coating bacterial proportions also decreased significantly in participants who lost more than 6 kg after the intervention, paralleled to reductions in C. histolyticum and E. rectale-C. coccoides populations. E. rectale-C. coccoides proportions also correlated with weight loss and BMI z-score reduction in participants whose weight loss exceeded 4 kg.[Conclusions]: Specific gut bacteria and an associated IgA response were related to body weight changes in adolescents under lifestyle intervention. These results suggest interactions between diet, gut microbiota and host metabolism and immunity in obesity.This work was supported by grants AGL2005- 05788-C02-01 from the Spanish Ministry of Education (MEC) and AP 002/07 from Consejería de Sanidad (Valencia, Spain). The EVASYON study was supported by grants from Spanish Ministry of Health (PI051574).Peer reviewe

Selective alterations within executive functions in adolescents with excess weight

Increasing evidence underscores overlapping neurobiological pathways to addiction and obesity. In both conditions, reward processing of preferred stimuli is enhanced, whereas the executive control system that would normally regulate reward-driven responses is altered. This abnormal interaction can be greater in adolescence, a period characterized by relative immaturity of executive control systems coupled with the relative maturity of reward processing systems. The aim of this study is to explore neuropsychological performance of adolescents with excess weight (n = 27, BMI range 24-51kg/m 2) vs. normal-weight adolescents (n = 34, BMI range 17-24kg/m 2) on a comprehensive battery of executive functioning tests, including measures of working memory (letter-number sequencing), reasoning (similarities), planning (zoo map), response inhibition (five-digit test (FDT)-interference and Stroop), flexibility (FDT-switching and trail-making test (TMT)), self-regulation (revised-strategy application test (R-SAT)), and decision-making (Iowa gambling task (IGT)). We also aimed to explore personality traits of impulsivity and sensitivity to reward. Independent sample t-and Z Kolmogorov-Smirnov tests showed significant differences between groups on indexes of inhibition, flexibility, and decision-making (excess-weight participants performed poorer than controls), but not on tests of working memory, planning, and reasoning, nor on personality measures. Moreover, regression models showed a significant association between BMI and flexibility performance. These results are indicative of selective alterations of particular components of executive functions in overweight adolescents.This study has been funded by grants from the Spanish Ministry of Health (Fondo de Investigaciones Sanitarias, grant 05/2369), and the Andalusian Service of Health (Servicio Andaluz de Salud, grant PI-0416/2008Peer Reviewe