title: Impact of significant weight loss on maximal oxygen uptake in obese children and adolescents.
abstract: BACKGROUND
  The prevalence of pediatric obesity has increased over the past few decades in all ethnic, gender, and age groups. The treatment of obesity, especially in children with moderate to severe conditions, is difficult. In this study, we examined the impact of significant weight loss as a result of participation in a multi-disciplinary weight management program on maximal oxygen uptake (VO2max) in obese children and adolescents.
  
  
  METHODS
  Eleven obese children and adolescents (7 to 14 years of age; mean age, 12.3 +/- 1.9 years) were enrolled in a weight management program at the Children's Hospital of New Orleans. The treatment program included a high-protein, very low-calorie diet (VLCD; protein intake, 1.5 to 2.0 g/kg of ideal body weight per day; and 800 kcal/d). Diets were supplemented with extra fluid, minerals, and vitamins. All subjects attended weekly 2-hour clinic sessions. During these sessions, they received nutrition instruction, participated in a moderate-intensity, progressive exercise program, and learned behavior-modification techniques. Weight, height, body mass index ([BMI]; wt/ht2), and VO2max by indirect calorimetry were obtained at enrollment and at the end of 10 weeks of treatment.
  
  
  RESULTS
  There was a significant decrease in body weight after 10 weeks. The BMI decreased significantly from 34.1 +/- 4.8 on entry to 29.4 +/- 3.5 (mean +/- SD; P < 0.0001). Despite the significant weight loss, VO2max increased significantly (P < 0.001) from entry (19.2 +/- 3.0 mL/kg/min) to completion of 10 weeks (22.4 +/- 5.8 mL/kg/min). However, absolute VO2max L/min was unchanged.
  
  
  CONCLUSIONS
  We conclude that relative VO2max mL/kg/min is significantly improved in obese youth after significant weight loss with a VLCD and moderate-intensity, progressive exercise. However, because absolute VO2max L/min was unchanged, this improvement seems to result from the reduction in total body weight as opposed to the effect of the moderate-intensity exercise intervention.
authors.affiliation: Department of Pediatrics, Louisiana State University School of Medicine, New Orleans 70112-2822, USA. msothe@LSUHSC.edu
authors.forename: M S
authors.initials: MS
authors.lastname: Sothern
authors.forename: M
authors.initials: M
authors.lastname: Loftin
authors.forename: U
authors.initials: U
authors.lastname: Blecker
authors.forename: J N
authors.initials: JN
authors.lastname: Udall
mesh_terms: D000293:Adolescent; D002648:Child; D004044:Dietary Proteins / Q000008:administration & dosage; D002149:Energy Intake; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000178:diet therapy / Q000378:metabolism*; D010101:Oxygen Consumption; D015431:Weight Loss
chemical_list: D004044:Dietary Proteins