Department of Pediatrics, School of Medicine, University of Navarra, Pamplona, Spain.
Department of Pediatrics, Navarra Hospital Complex, Avenue Irunlarrea, 431008, Pamplona, Spain.
Nutr J. 2020 May 27;19(1):49. doi: 10.1186/s12937-020-00570-8.
The aim of this study is to describe the effects of a prolonged dietary-behavioral-physical activity intervention (24 months) on body composition in a group of adolescents with obesity.
Longitudinal study in 196 individuals with obesity (86 boys and 110 girls) aged 10.1-14.9 years that completed a prolonged combined intervention (24 months). Values for weight, height, skinfold thickness, waist circumference, BMI, body fat, fat mass index (FMI) and fat-free mass index (FFMI) were registered or calculated. A good response to treatment was reported when a BMI z-score reduction of greater than or equal to 0.5 units of the initial value occurred after 24 month of follow up.
A good response after 24 months of follow-up reached 58.2% (n = 114). In boys with obesity and BMI status improvement, weight z-score, BMI z-score, body fat, and FMI significantly decreased (p < 0.05). In girls with obesity and BMI status improvement, weight z-score, BMI z-score, waist circumference, waist z-score, body fat and FMI significantly decreased (p < 0.05). In both sexes the height and FFMI increased significantly (p < 0.05). The multiple logistic regression analysis showed that girls and younger age were associated with BMI status improvement; concurrently, the place of residence (urban or rural) and degree of obesity were not associated with BMI status improvement.
The application of long-term combined strategies in the treatment of childhood obesity seems to be effective. As BMI decreases, a reduction in fat mass is also detected, with evident sexual dimorphism, in the absence of changes in fat-free mass and, consequently, in longitudinal growing.
本研究旨在描述一项长期饮食-行为-体力活动干预(24 个月)对肥胖青少年体成分的影响。
对 196 名肥胖青少年(男 86 名,女 110 名)进行了纵向研究,年龄为 10.1-14.9 岁,完成了长期联合干预(24 个月)。记录或计算体重、身高、皮褶厚度、腰围、BMI、体脂肪、脂肪质量指数(FMI)和去脂体重指数(FFMI)。在 24 个月的随访后,BMI z 评分较初始值降低≥0.5 个单位时,报告治疗效果良好。
24 个月随访后,58.2%(n=114)的患者达到了良好的反应。在肥胖且 BMI 改善的男孩中,体重 z 评分、BMI z 评分、体脂肪和 FMI 显著降低(p<0.05)。在肥胖且 BMI 改善的女孩中,体重 z 评分、BMI z 评分、腰围、腰围 z 评分、体脂肪和 FMI 显著降低(p<0.05)。在两性中,身高和 FFMI 均显著增加(p<0.05)。多因素逻辑回归分析显示,女孩和年龄较小与 BMI 状态改善相关;同时,居住地(城市或农村)和肥胖程度与 BMI 状态改善无关。
长期联合策略在儿童肥胖症的治疗中似乎是有效的。随着 BMI 的降低,脂肪量也随之减少,存在明显的性别二态性,而去脂体重没有变化,因此在纵向生长中没有变化。