Effect of Different Physical Activity Training Methods on Overweight Adolescents

<p class="abstract"><strong>BACKGROUND:</strong> In view of the growing trend of obesity around the world, including in our country, and the effect of reduced physical activity in increasing the incidence of obesity and overweight in children and adolescents and limitations of families in providing transport for their children to attend exercise classes, as well as time limitations of students in taking part in these classes, accessing appropriate methods for presenting physical activity training seems essential.</p> <p class="abstract"><strong>&nbsp;&nbsp; METHODS:</strong><strong> </strong>This non-pharmacological clinical trial was performed during six months from May to November 2007 on 105 children and adolescents aged 6-18 years with obesity, randomly assigned to 3 groups of thirty-five. Nutrition and treatment behavior were the same in all groups, but physical activity training in the first group was taking part in physical activity training classes twice a week, in the second group by providing a training CD, and in the third group via face-to-face training. Before and after the intervention, anthropometric indicators were measured and recorded.</p> <p class="abstract"><strong>&nbsp;&nbsp; RESULTS:</strong> Mean body mass index (BMI) of participants in group attended physical activity training classes, and in the group undergone training with CD, after the interventions was significantly lower than that before the intervention.<strong>&nbsp;</strong></p> <p class="abstract"><strong>&nbsp;&nbsp; </strong><strong>CONCLUSION:</strong> Our findings demonstrated that training using CDs can also be effective in reducing BMI in overweight and obese children and adolescents as much as face-to-face education and participation in physical training classes. Extending such interventions can be effective at the community level.</p> <p class="abstract">&nbsp;</p><table cellspacing="0" cellpadding="0" align="left"><tbody><tr><td width="35" height="12"><br /></td></tr> <tr><td><br /></td> <td>&nbsp;</td></tr></tbody></table><p class="abstract">&nbsp;</p> <strong>Keywords:</strong> Children, adolescents, physical activity, education, obesity, treatment

Barriers to Physical Activity in a Population-based Sample of Children and Adolescents in Isfahan, Iran

Objectives: This study was conducted to explore the barriers to physical activity in a representative sample of Iranian children and adolescents.Methods: The studywas conducted in 2007 in urban and rural areas of Isfahan district in Iran. In the qualitative part,we used the grounded theory approach, including semi-structured focus group discussionsand in-depth interviews. The quantitative part comprised 600 randomly selected students.Results: The qualitative study included 34 school students (16 girls), 20 parents (11 mothers) and 11 school staff. All students disclosed that studying was a priority.They pointed to lack of safe and easy-access place for physical activity and unsupportive family as the main barriers. Lack of self-confidence and low self-worth were the two other concepts developed in this context.Parents pointed to lack of safe and easy-access place for activity followed by the priority of studying. The concepts derived from interviews with school staff included unhealthy modeling of parents, priority of studying, and inadequate public know-ledge about how to integrate physical activity in routine daily life.The quantitative survey comprised 600 students including 286 (47.8%) girls. Parents’ education level had inverse association with children’s physical activity level. Significant inverse associations of self-efficacy and physical activity levels were documented.Conclusions: Increasing the public knowledge about adopting physical activity habits in routinedaily life, informing the families and students about the benefits of physical activity to improvelearning, as well as providing safe places such as using the school facilities in non-school hoursshould be considered in planning effective preventive strategies and interventions

RESULTS OF A NON- PHARMACOLOGICAL TRIAL FOR WEIGHT LOSS OF OBESE CHILDREN-PARENTS PAIRS

Abstract &nbsp;&nbsp; BACKGROUND: Family-based interventions are the most well-established way for the treatment of childhood obesity.For being applicable and sustainable; these interventions should be assessed in different community settings. The aim of this study was to compare the effects of two methods of nutritional intervention on weight loss of of obese children-parents pairs. &nbsp;&nbsp; METHODS: This 12-week non-pharmacologic trial. With one year of follow up was conducted among 120 participants (60 pairs of obese children- parents). They were randomly assigned into two groups of equal number: one group received a diet with an energy content based on the calorie requirement for height, and the other group received dietary counseling about healthy nutrition for weight loss. &nbsp;&nbsp; RESULTS: Comparison of baseline characteristics vs. one-year follow up, showed that the mean value of body mass index decreased significantly in children, but not in their parents. In addition both groups of children had favorable changes in the mean consumption frequency of the studied food groups. The difference was not significantly different between the children in these two groups.&nbsp; &nbsp;&nbsp; CONCLUSION: This study showed that dietary counseling, consisting of simple and applicable improvement in dietary habits can be integrated to the usual diet of the family, and will result in sustainable changes. Furthermore, it confirmed the efficacy and sustainability of dietary counseling for weight control of obese children but not their parents; and emphasized on the importance of healthy lifestyle establishment, from early life rather than trying to change it during adulthood. &nbsp; &nbsp;&nbsp; Keywords: Children, Parents, Obesity, Weight loss, Dietary habits.</p

VALIDATION OF THE CHILD AND ADOLESCENT INTERNATIONAL PHYSICAL ACTIVITY QUESTIONNAIRES IN IRANIAN CHILDREN AND ADOLESCENTS

Abstract &nbsp;&nbsp; BACKGROUND: With reference to the importance of physical activity during childhood and adolescence in their health promotion and prevention of chronic diseases during adulthood, it is necessary to have a reliable and valid method for evaluating physical activity level in this age group. Physical activity questionnaire child (PAQ-C) and adolescents (PAQ-A) have been designed for this purpose. This study aimed to validate these questionnaires in a representative sample of Iranian children and adolescents. &nbsp;&nbsp; METHODS: After translating the PAQ-C and PAQ-A to Persian, the face and content validities of these questionnaires were assessed by a committee of experts of different specialties including specialists in pediatrics, community medicine, social specialist and sport medicine. After minor modification of some items of the questionnaires according to the available types of physical activity and the socio-cultural conditions, the final questionnaires were prepared. Thereafter, 82 children and adolescents with 8 to 18 years of age completed the questionnaires. &nbsp;&nbsp; RESULTS: To assess the questionnaire reliability Iranian students and the validity accreditation was modified and got from the committee. A Cronbach&rsquo;s alpha of 0.894 was produced at the end of the analysis showing it has been reliable for this population. &nbsp;&nbsp; CONCLUSION: According to the results found in this survey, PAQ questionnaire can be used as a reliable and valid method for next studies; so health planning based on Iranian students&rsquo; physical activity will be possible in future. &nbsp; &nbsp;&nbsp; Keywords: Physical Activity Questionnaire, Reliability, Validity.</p

Can a Trial of Motivational Lifestyle Counseling be Effective for Controlling Childhood Obesity and the Associated Cardiometabolic Risk Factors?

This study was conducted to assess the effectiveness of a simple office-based program for encouraging healthy lifestyle on controlling childhood obesity and associated cardiometabolic risk factors. Methods: This non-randomized 24-week lifestyle modification trial was conducted among 457 obese children and adolescents, aged 2–18 years, who had at least one cardiometabolic risk factor in addition to obesity. This trial included three components of exercise, diet education and behavior modification, with all recommendations provided by a pediatrician, two general physicians and a nurse. Instead of strict inhibitory recommendations, healthier lifestyle was encouraged. Results: Overall 448 (98.04%) of enrolled children completed the trial with a mean age of 9.6 ± 2.9 years. After the trial, the mean of anthropometric measures and cardiometabolic risk factors decreased significantly, the mean high-density lipoprotein cholesterol (HDL-C) increased significantly, and the prevalence of the metabolic syndrome decreased from 20.8% to 1.8%. Triglycerides, LDL-C, diastolic blood pressure and WC had the highest decrease in all age groups, with the most prominent changes in the 14–18-year age group. By each -1SD decline in BMI and WC, risk factors had significant improvement. Conclusion: Motivational office-based counseling can be effective in treatment of childhood obesity and its associated cardio-metabolic risk factors. Such approach can be implemented in the primary health care system; and can be of special concern in low- and middle-income countries with limited human and financial resources. We suggest that expanding the roles of non-physician clinicians such as nurse practitioners can help to increase the amount of time available for such services

Association of the components of the metabolic syndrome with non- alcoholic fatty liver disease among normal-weight, overweight and obese children and adolescents

<p>Abstract</p> <p>Objectives</p> <p>This study aimed to determine the prevalence of the metabolic syndrome, abnormalities of liver enzymes and sonographic fatty liver, as well as the inter-related associations in normal weight, overweight and obese children and adolescents.</p> <p>Methods</p> <p>This cross-sectional study was conducted among a sample of 1107 students (56.1% girls), aged 6-18 years in Isfahan, Iran. In addition to physical examination, fasting blood glucose, serum lipid profile and liver enzymes were determined. Liver sonography was performed among 931 participants. These variables were compared among participants with different body mass index (BMI) categories.</p> <p>Results</p> <p>From lower to higher BMI category, alanine aminotransferase (ALT), total cholesterol, LDL-cholesterol, triglycerides and systolic blood pressure increased, and HDL-cholesterol decreased significantly. Elevated ALT, aspartate aminotransferase (AST) and alkaline phosphatase (ALP) were documented in respectively 4.1%, 6.6% and 9.8% of normal weight group. The corresponding figure was 9.5%, 9.8% and 9.1% in overweight group, and 16.9%, 14.9% and 10.8% in obese group, respectively. In all BMI categories, ALT increased significantly by increasing the number of the components of the metabolic syndrome. Odds ratio for elevated liver enzymes and sonographic fatty liver increased significantly with higher number of the components of the metabolic syndrome and higher BMI categories before and after adjustment for age.</p> <p>Conclusions</p> <p>Because of the interrelationship of biochemical and sonographic indexes of fatty liver with the components of the metabolic syndrome, and with increase in their number, it is suggested to determine the clinical impact of such association in future longitudinal studies.</p