title: Diet, exercise, and endothelial function in obese adolescents.
abstract: OBJECTIVE
  Endothelial dysfunction is the first, although reversible, sign of atherosclerosis and is present in obese adolescents. The primary end point of this study was to investigate the influence of a multicomponent treatment on microvascular function. Additional objectives and end points were a reduced BMI SD score, improvements in body composition, exercise capacity, and cardiovascular risk factors, an increase in endothelial progenitor cells (EPCs), and a decrease in endothelial microparticles (EMPs).
  
  
  METHODS
  We used a quasi-randomized study with 2 cohorts of obese adolescents: an intervention group (n = 33; 15.4 ± 1.5 years, 24 girls and 9 boys) treated residentially with supervised diet and exercise and a usual care group (n = 28; 15.1 ± 1.2 years, 22 girls and 6 boys), treated ambulantly. Changes in body mass, body composition, cardiorespiratory fitness, microvascular endothelial function, and circulating EPCs and EMPs were evaluated after 5 months and at the end of the 10-month program.
  
  
  RESULTS
  Residential intervention decreased BMI and body fat percentage, whereas it increased exercise capacity (P < .001 after 5 and 10 months). Microvascular endothelial function also improved in the intervention group (P = .04 at 10 months; + 0.59 ± 0.20 compared with + 0.01 ± 0.12 arbitrary units). Furthermore, intervention produced a significant reduction in traditional cardiovascular risk factors, including high-sensitivity C-reactive protein (P = .012 at 10 months). EPCs were increased after 5 months (P = .01), and EMPs decreased after 10 months (P = .004).
  
  
  CONCLUSIONS
  A treatment regimen consisting of supervised diet and exercise training was effective in improving multiple adolescent obesity-related end points.
authors: Laboratory of Cellular and Molecular Cardiology and Departments of Pediatrics and Cardiovascular Diseases and Laboratory of Experimental Medicine and Pediatrics, and luc.bruyndonckx@uantwerpen.be.
authors: Luc
authors: L
authors: Bruyndonckx
authors: Laboratory of Cellular and Molecular Cardiology and Cardiovascular Diseases and.
authors: Vicky Y
authors: VY
authors: Hoymans
authors: Zeepreventorium, De Haan, Belgium.
authors: Ann
authors: A
authors: De Guchtenaere
authors: Zeepreventorium, De Haan, Belgium.
authors: Maria
authors: M
authors: Van Helvoirt
authors: Laboratory of Cellular and Molecular Cardiology and Cardiovascular Diseases and Cardiology, University Hospital Antwerp, Antwerp, Belgium;
authors: Emeline M
authors: EM
authors: Van Craenenbroeck
authors: Laboratory of Cellular and Molecular Cardiology and.
authors: Geert
authors: G
authors: Frederix
authors: Pharmacology Research Groups, Department of Translational Pathophysiological Research.
authors: Katrien
authors: K
authors: Lemmens
authors: Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Antwerp, Belgium; and.
authors: Dirk K
authors: DK
authors: Vissers
authors: Laboratory of Cellular and Molecular Cardiology and Cardiovascular Diseases and Cardiology, University Hospital Antwerp, Antwerp, Belgium;
authors: Christiaan J
authors: CJ
authors: Vrints
authors: Departments of Pediatrics and Laboratory of Experimental Medicine and Pediatrics, and.
authors: José
authors: J
authors: Ramet
authors: Laboratory of Cellular and Molecular Cardiology and Cardiovascular Diseases and Cardiology, University Hospital Antwerp, Antwerp, Belgium;
authors: Viviane M
authors: VM
authors: Conraads
mesh_terms: D000293:Adolescent; D050197:Atherosclerosis / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D015992:Body Mass Index; D002648:Child; D004038:Diet, Reducing / Q000379:methods*; D004730:Endothelium, Vascular / Q000503:physiopathology*; D015444:Exercise; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D009765:Obesity / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D011379:Prognosis; D012307:Risk Factors; D014664:Vasodilation / Q000502:physiology*; D015431:Weight Loss / Q000502:physiology*
keywords: adolescent obesity; endothelial dysfunction; endothelial microparticles; endothelial progenitor cells