Sothern M S, Loftin M, Blecker U, Udall J N
Department of Pediatrics, Louisiana State University School of Medicine, New Orleans 70112-2822, USA.
J Investig Med. 2000 Nov;48(6):411-6.
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.
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.
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.
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.
在过去几十年中，所有种族、性别和年龄组的儿童肥胖患病率均有所上升。肥胖的治疗，尤其是对中重度肥胖儿童而言，颇具难度。在本研究中，我们考察了参与多学科体重管理项目导致显著体重减轻对肥胖儿童和青少年最大摄氧量（VO2max）的影响。
11名肥胖儿童和青少年（7至14岁；平均年龄12.3±1.9岁）参加了新奥尔良儿童医院的体重管理项目。治疗方案包括高蛋白、极低热量饮食（VLCD；蛋白质摄入量为每天每千克理想体重1.5至2.0克；800千卡/天）。饮食中补充了额外的液体、矿物质和维生素。所有受试者每周参加2小时的门诊课程。在这些课程中，他们接受营养指导，参与中等强度的渐进性运动项目，并学习行为矫正技术。在入组时和治疗10周结束时测量体重、身高、体重指数（[BMI]；体重/身高²）以及通过间接测热法测量的VO2max。
10周后体重显著下降。BMI从入组时的34.1±4.8显著降至29.4±3.5（平均值±标准差；P<0.0001）。尽管体重显著减轻，但VO2max从入组时（19.2±3.0毫升/千克/分钟）到10周结束时（22.4±5.8毫升/千克/分钟）仍显著增加（P<0.001）。然而，绝对VO2max升/分钟没有变化。
我们得出结论，采用VLCD和中等强度的渐进性运动使肥胖青少年体重显著减轻后，相对VO2max毫升/千克/分钟有显著改善。然而，由于绝对VO2max升/分钟没有变化，这种改善似乎是由于总体重的减轻，而非中等强度运动干预的效果。
