Uwe Blecker

The health benefits of physical activity in children and adolescents : implications for chronic disease prevention

Abstract Clinical, epidemiological and basic research evidence clearly supports the inclusion of regular physical activity as a tool for the prevention of chronic disease and the enhancement of overall health. In children, activities of a moderate intensity may enhance overall health, and assist in preventing chronic disease in at-risk youth. The numerous health benefits of regular exercise are dependent on the type, intensity and volume of activity pursued by the individual. These benefits include reduction of low density lipoproteins while increasing high density lipoprotein; improvement of glucose metabolism in patients with type II diabetes; improved strength, self esteem and body image; and reduction in the occurrence of back injuries. In addition, a progressive, moderate-intensity exercise program will not adversely effect the immune system and may have a beneficial effect on the interleukin-2/natural killer cell system. Furthermore, by decreasing sedentary behaviors and, thus, increasing daily physical activity, individuals may experience many stress-reducing benefits, which may enhance the immune system. Conclusion Moderate intensity exercise of a non-structured nature seems to facilitate most of the disease prevention goals and health promoting benefits. With new guidelines promoting a less intense and more time-efficient approach to regular physical activity, it is hoped that an upward trend in the physical activity patterns, and specifically children at risk for chronic disease, will develop in the near future.

Safety, Feasibility, and Efficacy of a Resistance Training Program In Preadolescent Obese Children

BACKGROUND Safe and effective exercise programs are needed to prevent and treat chronic diseases in childhood. In particular, preadolescent obese children should participate in activities that are specific to their special needs. Resistance or strength training has been prescribed for adult obese persons. Research is limited concerning the use of resistance training in programs that treat obese preadolescents. METHODS Nineteen treatment subjects (7-12 years of age) were enrolled in a 10-week weight management program which included diet, behavior modification, and aerobic and flexibility exercises. Forty-eight control subjects (7-12 years of age) participated in the diet, behavior modification program, and a thrice-a-week walking program. The efficacy of the overall weight management program was examined by anthropometry at 10 weeks and 1 year. RESULTS Fifteen treatment subjects completed the 10-week program (retention rate, 78.9%). Thereafter compliance decreased by approximately 33% for the long-term study. Seventeen control subjects completed the program (retention rate, 35%). Weight, percent of ideal body weight, and body mass index were reduced significantly at 10 weeks (P<0.0001) and did not increase significantly at 1-year follow-up in both treatment and control groups. Height increased significantly at 1 year in both treatment and control subjects. In the treatment subjects, percent fat decreased significantly (P<0.001), whereas fat-free mass did not change significantly (P>0.05). CONCLUSIONS A resistance-training program may be included safely in a multidisciplinary weight management program for obese preadolescent male and female children. The addition of specific exercise regimes such as resistance training may improve program retention especially in severely obese youth.

Hepatic Insulin Clearance Increases after Weight Loss in Obese Children and Adolescents

BACKGROUND Obesity is a rapidly increasing health problem among US youth. Hyperinsulinemia is associated with obesity and has been found to be a contributory factor for the development of cardiovascular disease in the obese. It has been suggested that hyperinsulinemia of obesity is a result of increased insulin secretion caused by insulin resistance. However, it has been shown in adults that decreased hepatic insulin clearance (HIC) is the primary cause of hyperinsulinemia in this population. METHODS We studied 15 obese children and adolescents (11 F, 4 M; 8.6 to 18.1 years) before and 10 weeks after their enrollment in a multidisciplinary weight reduction program, which included a protein-sparing modified fast, a moderate intensity progressive exercise program, and a behavior-modification intervention. RESULTS All patients lost weight (P < 0.05). Measurements of immunoreactive insulin (IRI) and C-peptide reactivity (CPR) were performed before the program and at 10 weeks. IRI levels dropped significantly, whereas CPR levels did not change. CPR/IRI molar ratios, considered an indirect estimation of HIC, rose significantly after weight loss. CONCLUSIONS Our data suggest that hyperinsulinemia seen in obese children and adolescents is caused by decreased HIC. The cause for this decrease remains unknown, but it is reversible upon weight loss.

The effect of protein-sparing modified fast in obese children with insulin dependent MODY-type diabetes mellitus. 422

The effect of protein-sparing modified fast in obese children with insulin dependent MODY-type diabetes mellitus. 422

Age as a Factor in Long Term Program Retention and Weight Maintenance in Obese Children and Adolescents |[dagger]| 698

Research indicates that prevention of adult obesity may be accomplished through the treatment of prediatric obesity. However, it is unclear whether treatment should begin during the early or later childhood years. We examined the one-year program retention and weight maintenance of 139 obese children(M=63, F=76; Age=12.11±2.6 yrs.; Range=7.1-17.6 yrs.) enrolled in a multidisciplinary pediatric weight management program. The one-year program consisted of a protein-sparing modified fast diet, followed by a balanced hypocaloric diet, nutrition education, behavior modification, and a moderate-intensity (45-55% VO2max), progressive exercise program. Measures of height, weight, percent of ideal body weight (%IBW), and body mass index (BMI) were obtained at baseline, ten weeks and one year. For statistical analysis, subjects were blocked by age as follows: 7-8 yrs., 9-10 yrs., 11-12 yrs., and 13+ yrs. A repeated measures one way analysis of variance indicated the the results in the table (%IBW, mean±S.D;*Baseline to 10 weeks and baseline to 1 year. 10 weeks to 1 year = N.S.).

Modified food starches in baby foods

Modified food starches were developed as a stabilizer, providing desirable consistency, texture, and storage ability. They are used primarily in strained and junior foods and, to a minor extent, in infant formulas. However, despite the fact that there is an increasing tendency to introduce solid foods to infants at a very early age, there is few long-term studies to delineate the effect of starch feeding on the growth of young infants.Modified food starches used by the food industry for infants and young children are of concern and there is an urgent need for additional data regarding their bioavailability, effect on nutrient absorption, intestinal changes, and toxic, mutagenic, and carcinogenic effects. Therefore, the inclusion of modified food starches should be used prudently and sparingly.

Serum lipid profiles in pediatric patients enrolled in a multidisciplinary weight reduction program: differences between White and African-American children. † 578

Serum lipid profiles in pediatric patients enrolled in a multidisciplinary weight reduction program: differences between White and African-American children. † 578

Protein Sparing Modified Fast Versus Dexfenfluramine Hydrochloride(Redux®) as a Treatment for Childhood Obesity in Male Adolescents 580

Protein Sparing Modified Fast Versus Dexfenfluramine Hydrochloride(Redux®) as a Treatment for Childhood Obesity in Male Adolescents 580

Male and female serum lipid profiles in pediatric patients enrolled in a multidisciplinary weight reduction program. † 579

Male and female serum lipid profiles in pediatric patients enrolled in a multidisciplinary weight reduction program. † 579