title: Effects of an intensive short-term diet and exercise intervention: comparison between normal-weight and obese children.
abstract: Lifestyle intervention programs currently emphasize weight loss secondary to obesity as the primary determinant of phenotypic changes. We examined whether the effects of a short-term lifestyle intervention program differ in normal-weight versus overweight/obese children. Nineteen overweight/obese (O; BMI = 33.6 ± 1.9 kg/m(2)) and 14 normal-weight (N; BMI = 19.9 ± 1.5 kg/m(2)) children participated in a 2-wk program consisting of an ad libitum high-fiber, low-fat diet and daily exercise (2-2.5 h). Fasting serum samples were taken pre- and postintervention for determination of lipids, glucose homeostasis, inflammatory cytokines, and adipokines. Only the O group lost weight (3.9%) but remained overweight/obese (32.3 ± 1.9 kg/m(2)). Both groups exhibited significant intervention-induced decreases (P < 0.05) in serum insulin (N: 52.5% vs. O: 28.1%; between groups, P = 0.38), homeostatic model assessment for insulin resistance (N: 53.1% vs. O: 28.4%, P = 0.43), leptin (N: 69.3% vs. O: 44.1%, P = 0.10), amylin (N: 28.7% vs. O: 26.1%, P = 0.80), resistin (N: 40.0% vs. O: 35.1%, P = 0.99), plasminogen activator-inhibitor-1 (N: 30.8% vs. O: 25.6%, P = 0.59), IL-6 (N: 58.8% vs. O: 48.5%, P = 0.78), IL-8 (N: 46.0% vs. O: 42.2%, P = 0.49), and TNFα (N: 45.8% vs. O: 40.8%, P = 0.99). No associations between indices of weight change and phenotypic changes were noted. A short-term, intensive lifestyle modification program is effective in ameliorating metabolic risk factors in N and O children. These results suggest that obesity per se was not the primary driver of the phenotypes noted and that dietary intake and physical inactivity induce the phenotypic abnormalities. These data may have implications for the weight loss-independent management of cardiometabolic risk in pediatric populations.
authors.affiliation: Exercise and Metabolic Disease Laboratory, Translational Section, School of Nursing, University of California Los Angeles, Los Angeles, California 90095-6918, USA. croberts@ucla.edu
authors.forename: Christian K
authors.initials: CK
authors.lastname: Roberts
authors.forename: Ali
authors.initials: A
authors.lastname: Izadpanah
authors.forename: Siddhartha S
authors.initials: SS
authors.lastname: Angadi
authors.forename: R James
authors.initials: RJ
authors.lastname: Barnard
mesh_terms: D000293:Adolescent; D001835:Body Weight; D002648:Child; D003131:Combined Modality Therapy / Q000379:methods; D004035:Diet Therapy / Q000379:methods*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood*; D008297:Male; D009765:Obesity / Q000503:physiopathology* / Q000628:therapy*; D012016:Reference Values; D040242:Risk Reduction Behavior; D016896:Treatment Outcome
chemical_list: D007328:Insulin
keywords: cytokines; metabolic; nutrition; physical activity