Effects of a family-based lifestyle intervention plus supervised exercise training on abdominal fat depots in children with overweight or obesity: a secondary analysis of a nonrandomized clinical trial

Importance Excess abdominal fat is a major determinant in the development of insulin resistance and other metabolic disorders. Increased visceral adipose tissue (VAT) seems to precede the development of insulin resistance and is therefore a prime target of childhood lifestyle interventions aimed at...

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Autores: Cadenas-Sánchez, Cristina, Cabeza Laguna, Rafael, Idoate, Fernando, Osés Recalde, Maddi, Medrano Echeverría, María, Villanueva Larre, Arantxa, Arenaza Etxeberría, Lide, Sanz Muñoz, Aritz, Ortega, Francisco B., Ruiz, Jonatan R., Labayen Goñi, Idoia
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:España
Institución:Universidad Pública de Navarra
Repositorio:Academica-e. Repositorio Institucional de la Universidad Pública de Navarra
OAI Identifier:oai:academica-e.unavarra.es:2454/45194
Acceso en línea:https://hdl.handle.net/2454/45194
Access Level:acceso abierto
Palabra clave:Exercise
Abdominal fat
Overweight children
Obese children
Diabetes prevention
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dc.title.none.fl_str_mv Effects of a family-based lifestyle intervention plus supervised exercise training on abdominal fat depots in children with overweight or obesity: a secondary analysis of a nonrandomized clinical trial
title Effects of a family-based lifestyle intervention plus supervised exercise training on abdominal fat depots in children with overweight or obesity: a secondary analysis of a nonrandomized clinical trial
spellingShingle Effects of a family-based lifestyle intervention plus supervised exercise training on abdominal fat depots in children with overweight or obesity: a secondary analysis of a nonrandomized clinical trial
Cadenas-Sánchez, Cristina
Exercise
Abdominal fat
Overweight children
Obese children
Diabetes prevention
title_short Effects of a family-based lifestyle intervention plus supervised exercise training on abdominal fat depots in children with overweight or obesity: a secondary analysis of a nonrandomized clinical trial
title_full Effects of a family-based lifestyle intervention plus supervised exercise training on abdominal fat depots in children with overweight or obesity: a secondary analysis of a nonrandomized clinical trial
title_fullStr Effects of a family-based lifestyle intervention plus supervised exercise training on abdominal fat depots in children with overweight or obesity: a secondary analysis of a nonrandomized clinical trial
title_full_unstemmed Effects of a family-based lifestyle intervention plus supervised exercise training on abdominal fat depots in children with overweight or obesity: a secondary analysis of a nonrandomized clinical trial
title_sort Effects of a family-based lifestyle intervention plus supervised exercise training on abdominal fat depots in children with overweight or obesity: a secondary analysis of a nonrandomized clinical trial
dc.creator.none.fl_str_mv Cadenas-Sánchez, Cristina
Cabeza Laguna, Rafael
Idoate, Fernando
Osés Recalde, Maddi
Medrano Echeverría, María
Villanueva Larre, Arantxa
Arenaza Etxeberría, Lide
Sanz Muñoz, Aritz
Ortega, Francisco B.
Ruiz, Jonatan R.
Labayen Goñi, Idoia
author Cadenas-Sánchez, Cristina
author_facet Cadenas-Sánchez, Cristina
Cabeza Laguna, Rafael
Idoate, Fernando
Osés Recalde, Maddi
Medrano Echeverría, María
Villanueva Larre, Arantxa
Arenaza Etxeberría, Lide
Sanz Muñoz, Aritz
Ortega, Francisco B.
Ruiz, Jonatan R.
Labayen Goñi, Idoia
author_role author
author2 Cabeza Laguna, Rafael
Idoate, Fernando
Osés Recalde, Maddi
Medrano Echeverría, María
Villanueva Larre, Arantxa
Arenaza Etxeberría, Lide
Sanz Muñoz, Aritz
Ortega, Francisco B.
Ruiz, Jonatan R.
Labayen Goñi, Idoia
author2_role author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Ciencias de la Salud
Ingeniería Eléctrica, Electrónica y de Comunicación
Institute on Innovation and Sustainable Development in Food Chain - ISFOOD
Institute of Smart Cities - ISC
Osasun Zientziak
Ingeniaritza Elektrikoa, Elektronikoaren eta Telekomunikazio Ingeniaritzaren
dc.subject.none.fl_str_mv Exercise
Abdominal fat
Overweight children
Obese children
Diabetes prevention
topic Exercise
Abdominal fat
Overweight children
Obese children
Diabetes prevention
description Importance Excess abdominal fat is a major determinant in the development of insulin resistance and other metabolic disorders. Increased visceral adipose tissue (VAT) seems to precede the development of insulin resistance and is therefore a prime target of childhood lifestyle interventions aimed at preventing diabetes. OBJECTIVES To examine the effect of added exercise to a family-based lifestyle intervention program designed to reduce VAT plus subcutaneous (ASAT), intermuscular (IMAAT), and pancreatic (PAT) adipose tissue in children with overweight or obesity and to explore the effect of changes in VAT on insulin resistance. DESIGN, SETTING, AND PARTICIPANTS This 2-group, parallel-design clinical trial was conducted in Vitoria-Gasteiz, Spain. A total of 116 children with overweight or obesity participated and were assigned to a 22-week family-based lifestyle program (control group [n = 57]) or the same program plus an exercise intervention (exercise group [n = 59]). Data were collected between September 1, 2014, and June 30, 2017, and imaging processing for fat depot assessments and data analysis were performed between May 1, 2019, and February 12, 2021. INTERVENTIONS The compared interventions consisted of a family-based lifestyle and psychoeducation program (two 90-minute sessions per month) and the same program plus supervised exercise (three 90-minute sessions per week). MAIN OUTCOMES AND MEASURES The primary outcome of this study was the change in VAT between baseline and 22 weeks as estimated by magnetic resonance imaging. The secondary outcomes were changes in ASAT, IMAAT, and PAT. The effect of changes in VAT area on insulin resistance was also recorded. RESULTS The 116 participants included in the analysis (62 girls [53.4%]) had a mean (SD) age of 10.6 (1.1) years, and 67 (57.8%) presented with obesity. Significantly greater reductions were recorded for the exercise group in terms of reduction in VAT (−18.1% vs −8.5% for the control group; P = .004), ASAT (−9.9% vs −3.0%; P = .001), and IMAAT (−6.0% vs −2.6%; P = .02) fat fractions compared with the control group. Changes in VAT explained 87.6% of the improvement seen in insulin resistance (β = −0.102 [95% CI, −0.230 to −0.002]). CONCLUSIONS AND RELEVANCE These findings suggest that the addition of exercise to a lifestyle intervention program substantially enhanced the positive effects on abdominal fat depots in children with overweight or obesity. In addition, the reduction in VAT seemed to largely mediate the improvement of insulin sensitivity. These results highlight the importance of including exercise as part of lifestyle therapies aimed at treating childhood obesity and preventing the development of type 2 diabetes.
publishDate 2022
dc.date.none.fl_str_mv 2022
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2454/45194
url https://hdl.handle.net/2454/45194
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv info:eu-repo/grantAgreement/European Commission/Horizon 2020 Framework Programme/101028929
info:eu-repo/grantAgreement/MINECO//PI13%2F01335
info:eu-repo/grantAgreement/AEI/Plan Estatal de Investigación Científica y Técnica y de Innovación 2013-2016/DEP2016-78377
info:eu-repo/grantAgreement/AEI/Plan Estatal de Investigación Científica y Técnica y de Innovación 2013-2016/FJC2018-037925-I
info:eu-repo/grantAgreement/AEI/Plan Estatal de Investigación Científica y Técnica y de Innovación 2013-2016/BES-2017-080770
info:eu-repo/grantAgreement/Gobierno de Navarra//0011-1365-2019-000085
info:eu-repo/grantAgreement/Gobierno de Navarra//47%2F2021
dc.rights.none.fl_str_mv This is an open access article distributed under the terms of the CC-BY License.
https://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv This is an open access article distributed under the terms of the CC-BY License.
https://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv American Medical Association
publisher.none.fl_str_mv American Medical Association
dc.source.none.fl_str_mv reponame:Academica-e. Repositorio Institucional de la Universidad Pública de Navarra
instname:Universidad Pública de Navarra
instname_str Universidad Pública de Navarra
reponame_str Academica-e. Repositorio Institucional de la Universidad Pública de Navarra
collection Academica-e. Repositorio Institucional de la Universidad Pública de Navarra
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spelling Effects of a family-based lifestyle intervention plus supervised exercise training on abdominal fat depots in children with overweight or obesity: a secondary analysis of a nonrandomized clinical trialCadenas-Sánchez, CristinaCabeza Laguna, RafaelIdoate, FernandoOsés Recalde, MaddiMedrano Echeverría, MaríaVillanueva Larre, ArantxaArenaza Etxeberría, LideSanz Muñoz, AritzOrtega, Francisco B.Ruiz, Jonatan R.Labayen Goñi, IdoiaExerciseAbdominal fatOverweight childrenObese childrenDiabetes preventionImportance Excess abdominal fat is a major determinant in the development of insulin resistance and other metabolic disorders. Increased visceral adipose tissue (VAT) seems to precede the development of insulin resistance and is therefore a prime target of childhood lifestyle interventions aimed at preventing diabetes. OBJECTIVES To examine the effect of added exercise to a family-based lifestyle intervention program designed to reduce VAT plus subcutaneous (ASAT), intermuscular (IMAAT), and pancreatic (PAT) adipose tissue in children with overweight or obesity and to explore the effect of changes in VAT on insulin resistance. DESIGN, SETTING, AND PARTICIPANTS This 2-group, parallel-design clinical trial was conducted in Vitoria-Gasteiz, Spain. A total of 116 children with overweight or obesity participated and were assigned to a 22-week family-based lifestyle program (control group [n = 57]) or the same program plus an exercise intervention (exercise group [n = 59]). Data were collected between September 1, 2014, and June 30, 2017, and imaging processing for fat depot assessments and data analysis were performed between May 1, 2019, and February 12, 2021. INTERVENTIONS The compared interventions consisted of a family-based lifestyle and psychoeducation program (two 90-minute sessions per month) and the same program plus supervised exercise (three 90-minute sessions per week). MAIN OUTCOMES AND MEASURES The primary outcome of this study was the change in VAT between baseline and 22 weeks as estimated by magnetic resonance imaging. The secondary outcomes were changes in ASAT, IMAAT, and PAT. The effect of changes in VAT area on insulin resistance was also recorded. RESULTS The 116 participants included in the analysis (62 girls [53.4%]) had a mean (SD) age of 10.6 (1.1) years, and 67 (57.8%) presented with obesity. Significantly greater reductions were recorded for the exercise group in terms of reduction in VAT (−18.1% vs −8.5% for the control group; P = .004), ASAT (−9.9% vs −3.0%; P = .001), and IMAAT (−6.0% vs −2.6%; P = .02) fat fractions compared with the control group. Changes in VAT explained 87.6% of the improvement seen in insulin resistance (β = −0.102 [95% CI, −0.230 to −0.002]). CONCLUSIONS AND RELEVANCE These findings suggest that the addition of exercise to a lifestyle intervention program substantially enhanced the positive effects on abdominal fat depots in children with overweight or obesity. In addition, the reduction in VAT seemed to largely mediate the improvement of insulin sensitivity. These results highlight the importance of including exercise as part of lifestyle therapies aimed at treating childhood obesity and preventing the development of type 2 diabetes.This study was supported by grant PI13/01335 from the Spanish Ministry of Health’s Fondos de Investigación Sanitaria del Instituto de Salud Carlos III; by grant DEP2016-78377 from the Spanish Ministry of the Economy Industry and Competitiveness; by European Regional Development Funds (ERDF) Una Manera de Hacer Europa; by grant 0011-1365-2019-000085 from the Regional Government of Navarra’s Department of Economic Development (cofunded by ERDF 2014-2020 for Navarra); by grant 47/2021 from the Government of Navarra’s Department of Health; by grant FJC2018-037925-I from the Spanish Ministry of Science and Innovation (Dr Cadenas-Sanchez); by Marie Sklodowska Curie grant agreement 101028929 from the European Union’s Horizon 2020 Research and Innovation Programme (Dr Cadenas-Sanchez); by grant BES-2017-080770 from the Spanish Ministry of the Economy Industry and Competitiveness (Dr Osés); by grants PRE_2016_1_0057, PRE_2017_2_0224, PRE_2018_2_0057, and PRE_2019_2_0004 from the Education Department of the Government of the Basque Country (Dr Arenaza); and by grant SOMM17/6107/UGR from the University of Granada Plan Propio de Investigación 2021 Excellence actions: Unit of Excellence on Exercise, Nutrition and Health and the Junta de Andalucía, Consejería de Conocimiento, Investigación y Universidades, ERDF.American Medical AssociationCiencias de la SaludIngeniería Eléctrica, Electrónica y de ComunicaciónInstitute on Innovation and Sustainable Development in Food Chain - ISFOODInstitute of Smart Cities - ISCOsasun ZientziakIngeniaritza Elektrikoa, Elektronikoaren eta Telekomunikazio Ingeniaritzaren2022info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2454/45194reponame:Academica-e. Repositorio Institucional de la Universidad Pública de Navarrainstname:Universidad Pública de NavarraInglésinfo:eu-repo/grantAgreement/European Commission/Horizon 2020 Framework Programme/101028929info:eu-repo/grantAgreement/MINECO//PI13%2F01335info:eu-repo/grantAgreement/AEI/Plan Estatal de Investigación Científica y Técnica y de Innovación 2013-2016/DEP2016-78377info:eu-repo/grantAgreement/AEI/Plan Estatal de Investigación Científica y Técnica y de Innovación 2013-2016/FJC2018-037925-Iinfo:eu-repo/grantAgreement/AEI/Plan Estatal de Investigación Científica y Técnica y de Innovación 2013-2016/BES-2017-080770info:eu-repo/grantAgreement/Gobierno de Navarra//0011-1365-2019-000085info:eu-repo/grantAgreement/Gobierno de Navarra//47%2F2021This is an open access article distributed under the terms of the CC-BY License.https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:academica-e.unavarra.es:2454/451942026-06-17T12:41:47Z
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