title: The effect of a physical activity consultation on body mass index z-score of overweight adolescents: results from a pediatric outpatient obesity clinic.
abstract: Physical activity (PA) is recognized as having many health benefits. Despite of all the efforts, the majority of the overweight adolescents still present low levels of PA. PA consultation can be a cost-effective way of enhancing PA and improve weight status among overweight adolescents. The main aim of this study was to analyze whether adolescents attending a PA consultation in a clinical setting show more therapeutic success at 6 months, based on body mass index (BMI) z-score and waist circumference (WC), compared to those only followed by the pediatrician and nutritionist. Clinical records from 396 patients were analyzed: PA consultation (PAc) group, n = 198; standard consultation (STc) group, n = 198. Baseline differences between groups were analyzed using chi-square and independent sample t tests. Changes within groups and between groups were analyzed using paired sample t tests and independent sample t tests, respectively. Patients in both groups decreased their BMI z-score. The PAc has shown a higher decrease in the BMI z-score (PAc -0.12, p < 0.0001; STc -0.05, p < 0.0001). The WC of the PAc group has increased 2.2 cm less than the one of the STc group (p < 0.005). The difference in waist-to-height ratio between the PAc and STc groups was of 0.015 (p < 0.005), showing a trend to decrease in the PAc group (-0.005, p = 172).
  
  
  CONCLUSIONS
  Although the success of adolescent obesity management cannot be based only on BMI, a PA consultation on the top of the traditional pediatric and nutrition interventions may further improve the BMI z-score outcome at 6 months. What is Known: • Physical activity (PA) plays an important role in weight management. However, most adolescents, in particular those who are overweight, present low levels of PA. • There is no consensus whether PA counseling influences PA behavior. What is New: • A PA consultation (a structured form of PA counseling) as part of a multidisciplinary team may further be useful for weight management of overweight adolescents followed at the clinical setting, compared to the traditional approach including only the pediatric and nutrition consultations. • Waist-to-height ratio may be more suitable than waist circumference per se to track changes in abdominal adiposity among adolescents who are still growing.
authors.affiliation: Lisbon Academic Medical Centre (CAML), Lisbon, Portugal. antonioascenso@campus.ul.pt.|Pediatric Obesity Clinic, Department of Pediatrics, Hospital de Santa Maria, Lisbon, Portugal. antonioascenso@campus.ul.pt.
authors.forename: A
authors.identifier: http://orcid.org/0000-0002-8209-1676
authors.initials: A
authors.lastname: Videira-Silva
authors.affiliation: Pediatric Obesity Clinic, Department of Pediatrics, Hospital de Santa Maria, Lisbon, Portugal.|Rheumatology Research Unit, Molecular Medicine Institute, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.
authors.forename: H
authors.initials: H
authors.lastname: Fonseca
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002648:Child; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D063766:Pediatric Obesity / Q000628:therapy*; D012189:Retrospective Studies; D055105:Waist Circumference; D061217:Weight Reduction Programs / Q000379:methods*
keywords: Adolescents; Behavior change; Overweight; Physical activity consultation; Weight management