Pedraza-Escudero Karen, Garibay-Nieto Nayely, Villanueva-Ortega Eréndira, López-López Carlos Omar, Galindo-Díaz Rebeca, Gallardo-Rodríguez Adán Germán, Queipo-García Gloria Eugenia, Ruíz-Barranco Alejandra, Garcés-Hernández María José, León-Hernández Mireya, Laresgoiti-Servitje Estibalitz
Pediatric Obesity Clinic at Child Wellness Unit, Hospital General de México "Dr. Eduardo Liceaga", Mexico City, MEX.
Applied Research and Technology Institute (InIAT), Universidad Iberoamericana, Mexico City, MEX.
Cureus. 2025 Mar 27;17(3):e81287. doi: 10.7759/cureus.81287. eCollection 2025 Mar.
Objectives When dealing with children and adolescents living with obesity, it is vital to be aware that exercise provides benefits in the prevention and control of non-communicable diseases and general well-being. The growing prevalence of childhood obesity makes it necessary to develop strategies aimed at controlling the barriers that limit the performance of exercise, which is why we designed a plan of exercise prescription through videos that could be accessible, free, and designed for exercise at home, as a complement to a multidisciplinary intervention program for lifestyle change. This study aimed to compare the effects of a video-based exercise prescription program (EPV) versus free-choice exercise (FCE) on anthropometric and metabolic indicators. Methods We conducted an open-label, randomized, controlled clinical trial. Patients aged eight to 16 years with obesity from the Child Unit of the General Hospital of Mexico were included. Forty-two participants finished the follow-up; 20 were boys, and 22 were girls. All patients were included in a multi-component program of healthy lifestyle changes and randomized to receive EPV (n=22) or FCE (n=20) for six months. Results The primary outcomes in both groups were a decrease in body mass index (BMI) (p < 0.001), a reduction in body fat mass (p < 0.001), and an increase in lean body mass (p = 0.003). Other outcomes observed were: in EPV, there was a decrease in low density lipid (LDL) (p=0.04); alanine aminotransferase (ALT) (p=0.002), aspartate aminotransferase (AST) (p=0.001) and uric acid (p=0.003) and an increase in high density lipid (HDL) (p=0. 002), while in FCE there was a decrease in Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) (p=0.006), insulin (p=0.006), LDL (p=0.02), ALT (p=0.002), AST (p=0.004) and gamma-glutamyl transferase (GGT) (p=0.025). Conclusion Both EPV and FCE exercise prescription programs, as part of a multidisciplinary intervention for childhood obesity, had favorable effects on body composition and metabolic parameters.
目标 在应对肥胖的儿童和青少年时，必须认识到运动对预防和控制非传染性疾病以及总体健康有益。儿童肥胖患病率的不断上升使得有必要制定策略来克服限制运动表现的障碍，这就是为什么我们设计了一个通过视频进行运动处方的计划，这些视频可以免费获取且专为在家锻炼而设计，作为生活方式改变多学科干预计划的补充。本研究旨在比较基于视频的运动处方计划（EPV）与自由选择运动（FCE）对人体测量和代谢指标的影响。
方法 我们进行了一项开放标签、随机、对照临床试验。纳入了墨西哥总医院儿童科8至16岁的肥胖患者。42名参与者完成了随访；20名是男孩，22名是女孩。所有患者都被纳入了健康生活方式改变的多成分计划，并随机分为接受EPV（n = 22）或FCE（n = 20），为期6个月。
结果 两组的主要结果都是体重指数（BMI）下降（p < 0.001）、体脂量减少（p < 0.001）以及瘦体重增加（p = 0.003）。观察到的其他结果是：在EPV组中，低密度脂蛋白（LDL）下降（p = 0.04）；丙氨酸氨基转移酶（ALT）（p = 0.002）、天冬氨酸氨基转移酶（AST）（p = 0.001）和尿酸（p = 0.003）下降，高密度脂蛋白（HDL）增加（p = 0.002），而在FCE组中，胰岛素抵抗稳态模型评估（HOMA-IR）（p = 0.006）、胰岛素（p = 0.006）、LDL（p = 0.02）、ALT（p = 0.002）、AST（p = 0.004）和γ-谷氨酰转移酶（GGT）（p = 0.025）下降。
结论 作为儿童肥胖多学科干预的一部分，EPV和FCE运动处方计划对身体成分和代谢参数都有有利影响。
