Shalitin S, Ashkenazi-Hoffnung L, Yackobovitch-Gavan M, Nagelberg N, Karni Y, Hershkovitz E, Loewenthal N, Shtaif B, Gat-Yablonski G, Phillip M
The Jesse Z. and Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, and Felsenstein Medical Research Center, 14 Kaplan Street, IL-49202 Petah Tikva, Israel.
Horm Res. 2009;72(5):287-301. doi: 10.1159/000245931. Epub 2009 Oct 19.
To compare the short- and long-term effects of intervention programs on body weight and cardiometabolic risk factors.
162 obese children (6-11 years) were randomly assigned to three 12-week interventions with a 9-month follow-up period: exercise (E): 90 min moderate exercise 3 days/week (n = 52); diet (D): balanced hypocaloric diet, weekly meetings with dietician (n = 55), and diet + exercise (D+E) (n = 55). Changes in anthropometric variables, cardiometabolic profile and psychological outcome were assessed.
At 12 weeks BMI-SDS, cardiometabolic profiles, and psychological score improved in all groups. The decrease in BMI-SDS was greater in D and D+E compared with E (p < 0.001), without a significant difference between the first two groups. Waist circumference and LDL cholesterol decreased more in D+E compared with E (p = 0.026 and p = 0.038, respectively). The increase in adiponectin was greater in D and D+E compared with E (p = 0.004). Anthropometric and cardiometabolic variables regressed without significant differences between groups after 9 months. However, BMI-SDS, body fat percentage and LDL cholesterol were lower compared to baseline.
Diet alone or combined with exercise are the most effective short-term interventions for weight loss and improved cardiometabolic profiles, without a difference between them. In the long term, obese children need the long-term support of maintenance approaches.
比较干预项目对体重和心脏代谢危险因素的短期及长期影响。
162名肥胖儿童(6 - 11岁)被随机分配到三种为期12周的干预措施中,并进行为期9个月的随访:运动(E组):每周3天,每次90分钟中等强度运动(n = 52);饮食(D组):均衡低热量饮食,每周与营养师会面(n = 55);饮食 + 运动(D + E组)(n = 55)。评估人体测量学变量、心脏代谢状况和心理结果的变化。
12周时,所有组的BMI-SDS、心脏代谢状况和心理评分均有所改善。与E组相比,D组和D + E组的BMI-SDS下降幅度更大(p < 0.001),前两组之间无显著差异。与E组相比,D + E组的腰围和低密度脂蛋白胆固醇下降更多(分别为p = 0.026和p = 0.038)。与E组相比,D组和D + E组的脂联素增加幅度更大(p = 0.004)。9个月后,各人体测量学和心脏代谢变量回归,组间无显著差异。然而,BMI-SDS、体脂百分比和低密度脂蛋白胆固醇均低于基线水平。
单独饮食或饮食与运动相结合是减肥和改善心脏代谢状况最有效的短期干预措施,两者之间无差异。从长期来看,肥胖儿童需要维持措施的长期支持。