Pilar De Miguel-Etayo

Body composition changes during interventions to treat overweight and obesity in children and adolescents; a descriptive review

Nutrition, physical activity and behavior-modifying techniques are widely applied components of interventions treating obesity. Our aim was to review available information on the short and long term effects of intervention treatment on body fat composition of overweight and obese children and adolescents and, to obtain a further understanding on how different body composition techniques detect longitudinal changes. In total, thirteen papers were included; seven included a multidisciplinary intervention component, five applied a combined dietary and physical activity intervention and one a physical activity intervention. Body composition techniques used included anthropometric indices, bioelectrical impedance analysis, and dual energy X-ray absorptiometry. Percentage of fat mass change was calculated in when possible. Findings suggested, no changes were observed in fat free mass after 16 weeks of nutritional intervention and the lowest decrease on fat mass percentage was obtained. However, the highest fat mass percentage with parallel increase in fat free mass, both assess by DXA was observed in a multi-component intervention applied for 20 weeks. In conclusion, more studies are needed to determine the best field body composition method to monitor changes during overweight treatment in children and adolescents.

Anthropometric indices to assess body-fat changes during a multidisciplinary obesity treatment in adolescents: EVASYON Study.

BACKGROUND & AIMS The main objectives of weight loss interventions in children and adolescents are to decrease fat mass while maintaining fat-free mass. Several methods are available to assess childhood and adolescence obesity, such as weight and height, bioelectrical impedance, skin-fold thickness measurements and other laboratory methods. The aim was to assess simple anthropometric indices as predictors of body-fat changes, using dual-energy X-ray absorptiometry measurements as reference method. METHODS Multi-intervention approach (diet, physical activity and psychological support in a family-group-based treatment) was implemented with a one-year follow-up in 13-to-16-year-old overweight or obese Spanish adolescents. A total of 83 adolescents were recruited from Granada and Zaragoza, males (n = 43) (31.6 kg/m(2)) and females (n = 40) (32.0 kg/m(2)). We measured body composition with anthropometry and dual-energy X-ray absorptiometry. All measurements were made at baseline, and after 2 and 13 months. Random coefficient regression model was used to calculate the proportion of body composition changes during follow-up that would be explained by simple body composition indices based on anthropometric measures. RESULTS After controlling for age and Tanner stage, body mass index explained 76.5% of body composition changes in males and 90.1% in females, while fat mass index (assessed by skin-folds) explained 78.9% of body composition changes in males and 84.0% of body composition changes in females. CONCLUSIONS In conclusion, we found that BMI was a good indicator of body fat composition changes in children and adolescents, although FMI assessed by anthropometry was also a good indicator.

Fitness and fatness in relation with attention capacity in European adolescents: The HELENA study

OBJECTIVES To examine the association of health-related physical fitness components and accurate measures of fatness with attention in European adolescents. DESIGN Cross-sectional study. METHODS A sub-sample of 444 adolescents from the HELENA study (14.5±1.2years) from 6 different countries participated in this study. Adolescents underwent evaluations of fitness (20m shuttle run, handgrip strength, standing long jump and 4×10m shuttle run tests), fatness (body mass index, skinfold thicknesses, bioelectrical impedance, Bod Pod and dual-energy X-ray absorptiometry) and attention (d2-test). RESULTS Higher cardiorespiratory fitness was positively associated with better attention capacity (β=0.1, p=0.03). Body mass index and fat mass index measured by Bod Pod and dual-energy X-ray absorptiometry in a subset were negatively associated with attention (β=-0.11, p=0.02; β=-0.36, p=0.02; β=-0.34, p=0.03; respectively). All models were adjusted for age, sex, family-affluence scale and mother education. When these models were additionally adjusted for cardiorespiratory fitness when fatness was the main predictor and vice versa, the associations were somewhat attenuated and were no longer statistically significant. Muscular strength, speed-agility and body fatness markers measured by bioelectrical impedance and skinfolds were not associated with attention. The fit and non-overweight adolescents presented the highest values of attention capacity whilst their unfit and overweight peers showed the lowest values of attention (47.31±2.34 vs. 33.74±4.39; p<0.01). CONCLUSIONS Our results support that both cardiorespiratory fitness and fatness are associated with attention, yet these associations are not independent. A combined effect was also observed, with fit and non-overweight adolescents showing the highest levels of attention and those unfit and overweight the lowest.

Body composition changes during a multidisciplinary treatment programme in overweight adolescents: EVASYON study

INTRODUCTION the main objectives of weight-loss interventions are to decrease fat mass while maintaining fatfree mass. OBJECTIVE our aim was to address effectiveness body composition changes in overweight adolescents assessed by different body composition methods following an obesity intervention programme. MATERIAL AND METHODS the life-style intervention was multi-disciplinary, with 13 months follow-up. Participants were 13-to-16 year-old overweight, or obese, Spanish adolescents. The adolescents (n = 156; 54.8% females) had body composition measured with anthropometry, dual-energy X-ray absorptiometry and air-displacement plethysmography. All measurements were made at baseline, and after 2- and 13-months. Repeated measures analysis of covariance to compare mean anthropometric changes over time and the Bonferroni correction were applied. Imputation of anthropometric measures was performed. RESULTS a high significant decrease in fat mass index was achieved in males after 2-and 13-months of intervention as measured by anthropometry (1.16 and 1.56 kg / m2, respectively), X-ray absorptiometry (1.51 and 1.91 kg / m2) and plethysmography (2.13 and 2.44 kg/m2). Moreover, a short and long-term maintenance of fat-and fat-free mass index was observed by X-ray absorptiometry in females (0.94 and 0.68 kg/m2). CONCLUSION our multidisciplinary approach to lifestyle intervention has a favourable impact on body fat mass and fat-free mass index as well as waist-to-height ratio, over 13 months intervention in overweight and obese adolescents.

Design and Objectives of the South American Youth/Child Cardiovascular and Environmental (SAYCARE) Study: Design and Objectives of the SAYCARE Study

The purpose of this paper is to introduce the overarching study design of the South American Youth/Child Cardiovascular and Environmental (SAYCARE) study, which is an observational multicenter feasibility study held in seven South American cities: Buenos Aires (Argentina), Lima (Peru), Medellin (Colombia), Montevideo (Uruguay), Santiago (Chile), and São Paulo and Teresina (Brazil). Children and adolescents (3‐17 years of age) were studied.