Effects of Exercise Intensity in Obese Children and Adolescents
- Conditions
- Obesity
- Interventions
- Behavioral: Moderate intensity continuous trainingBehavioral: High intensity interval trainingDietary Supplement: Nutritional advice
- Registration Number
- NCT01991106
- Lead Sponsor
- Norwegian University of Science and Technology
- Brief Summary
The prevalence of paediatric obesity has increased over the last two decades and with it, an increased diagnosis of lifestyle-related diseases in children and adolescents. High intensity interval training has recently been explored as an alternate to traditional aerobic exercise in adults with chronic disease and has potential to induce rapid reversal of subclinical disease markers in obese children and adolescents.
High intensity interval training has recently been explored as an alternate to traditional aerobic exercise in adults with chronic disease and has potential to induce rapid reversal of subclinical disease markers in obese children and adolescents.
Goal: The primary aim of this randomised controlled trial is to evaluate the effectiveness of a high intensity interval training intervention on myocardial function, vascular function and visceral adipose tissue in obese children and adolescents at baseline, three and twelve months.
Method: Multi-centre randomised controlled trial of 100 obese children and adolescents in the cities of Trondheim (Norway) and Brisbane (Australia). Participants will be randomised to (1) high intensity interval training, (2) moderate intensity continuous training or (3) nutrition advise. Participants will partake in supervised exercise training and/or nutrition consultations for 3 months. Measurements for all study endpoints will occur at baseline, 3 months (post intervention) and 12 months (follow up).
Scientific Significance : This randomised controlled trial will general substantial information regarding the effects of exercise intensity on paediatric obesity, specifically the cardio-metabolic health of this at-risk population. It is expected that communication of results will allow for more robust and realistic guidelines regarding exercise prescription in this population to be formed while outlining the benefits of high intensity interval training on subclinical markers of disease.
- Detailed Description
Worldwide, childhood overweight and obesity rates are approximately 10%, this high incidence attributed to a physically inactive lifestyle and inappropriate nutrition. Early cohort studies illustrated that fifty per cent of obese children became obese adults and consequently had an higher risk for metabolic syndrome than obese adults who were not obese as children. Both female and male overweight children and adolescents had a 30% increase in all cause mortality. The increases in risk of death were independent of adult body mass index.
Systematic reviews suggest that lifestyle and exercise interventions in obese children and adolescents can lead to improvements in anthropometric and cardio-metabolic outcomes, but these are not inclusive of several important outcomes such as myocardial and vascular function or visceral adipose tissue.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 100
- Obese (BMI ≥ 95th percentile - age and sex specific criteria)
- Elevated blood pressure (≥ 95th percentile for systolic or diastolic values)
- Congenital heart disease
- Coronary artery disease
- Family history of hypertropic obstructive cardiomyopathy
- Any abnormality during rest or stress echocardiography which indicates it would be unsafe to participate
- Self reported kidney failure
- Any major organ transplant
- Considerable pulmonary disease including severe or poorly controlled asthma
- Smoking
- Diabetes
- Epilepsy or a history of seizures
- Orthopaedic or neurological limitations to exercise
- Diagnosed attention deficit hypersensitivity disorder
- Steroid medications
- Participation in another research study
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description High intensity interval training Nutritional advice 10-minute warm up at 60-70% of maximal heart rate (HRmax). Then walking, running or cycling at 85-95% of maximal heart rate at intervals of 4 x 4 minutes, with 3 minute active breaks (50-70% of HRmax) between intervals. A 5-minute cool down period. Moderate intensity continuous training Moderate intensity continuous training walking, running or cycling continuously at 60-70% HRmax for 44 minutes. High intensity interval training High intensity interval training 10-minute warm up at 60-70% of maximal heart rate (HRmax). Then walking, running or cycling at 85-95% of maximal heart rate at intervals of 4 x 4 minutes, with 3 minute active breaks (50-70% of HRmax) between intervals. A 5-minute cool down period. Moderate intensity continuous training Nutritional advice walking, running or cycling continuously at 60-70% HRmax for 44 minutes. nutritional advice Nutritional advice 10 individual nutrition consultations with an accredited dietitian over the 12 month period. Content of consultations will include healthy food choices, portion sizes and regular mealtimes.
- Primary Outcome Measures
Name Time Method Peak systolic tissue velocity 12 weeks systolic tissue Doppler velocity assessed during resting and stress echocardiography
- Secondary Outcome Measures
Name Time Method Subcutaneous and total abdominal adipose tissue 12 weeks, 12 months Assessed using MRI
Cardiorespiratory fitness (VO2peak) 12 weeks, 12 months Assessed using a maximal treadmill test
Body composition 12 weeks, 12 months Assessed using DXA (UQ), BodPod (NTNU)
Blood biochemistry 12 weeks, 12 months Analysed for lipids, glucose, insulin, inflammatory makers, satiety hormones, oxidative stress
Physical activity 12 weeks, 12 months Assessed through 7 day accelerometry
Dietary analysis 12 weeks, 12 months Assessed through a three-day food record
Myocardial structure and cardiac adipose tissue (UQ) 12 weeks Assessed through cardiac MRI; participants \> 12 years only
Arterial stiffness 12 weeks, 12 months Assessed through pulse wave velocity and pulse wave analysis
Autonomic function 12 weeks, 12 months Assessed through heart rate variability and heart rate recovery
Quality of life 12 weeks, 12 months Assessed through the Paediatric Quality of Life Inventory
Visceral adipose tissue 12 weeks, 12 months assessed by magnetic resonance imaging (MRI)
Vascular function 12 weeks, 12 months Assessed through flow mediated dilation procedure
Peak systolic tissue velocity 12 months systolic tissue Doppler velocity assessed during resting and stress echocardiography
Trial Locations
- Locations (2)
St Olavs Hospital
🇳🇴Trondheim, Norway
University of Queensland
🇦🇺Brisbane, Australia