Brain, Appetite, Teens, and Exercise
- Conditions
- Energy BalanceAppetitive BehaviorObesity
- Interventions
- Behavioral: Exercise InterventionBehavioral: Newsletter
- Registration Number
- NCT03783390
- Lead Sponsor
- Children's Mercy Hospital Kansas City
- Brief Summary
The long-term goal is to develop effective, evidence-based lifestyle interventions to prevent and treat childhood obesity and related co-morbidities. The short-term goal, and the purpose of this application, is to quantify appetite and neural mechanisms of food reward in overweight/obese (OW/OB) sedentary youth and to quantify changes following the implementation of a physical activity intervention. The central hypothesis is that appetite becomes dysregulated at low levels of physical activity via neural reward pathways, and appetite control will improve following a long-term exercise intervention. The investigators consider this project a pilot study designed to generate data to be used for future external funding opportunities, demonstrate collaboration between researchers, and test the feasibility of the protocols.
- Detailed Description
Specific Aim 1: To identify associations between neural, psychological, and hormonal appetite control pathways using subjective and objective measures of appetite and neurocognitive assessments of reward pre-intervention.
Hypothesis 1: There will be significant cross-modulation of appetite across neural (brain activation), psychological (subjective hunger), and hormonal pathways (satiety biomarkers), though the temporal relationship between each in response to feeding is unknown.
Specific Aim 2: To assess the effectiveness of a physical activity intervention on eating behavior in adolescents; OW/OB inactive adolescents will be randomly assigned to a 3-month exercise intervention (Exercise +Newsletter), or a control condition (Newsletter).
Hypothesis 2a: Those exposed to the exercise intervention will have greater improvements (compared to control group) in appetite (subjective self-reported hunger and palatability responses, and, objectively, satiety and appetite hormones glucose, insulin, ghrelin, and leptin, and calories consumed during ad libitum meal).
Hypothesis 2B. Compared to pre-intervention, OB/OW youth in the exercise group will show decreased reward activation in regions of the brain when making decisions about appetizing foods compared to post-intervention when hungry and when fed. In self-control regions, compared to pre-intervention, the investigators will observe increased activity in both hungry and fed conditions.
At the end of the proposed study, it is the expectation that the investigators will have collected important preliminary data regarding how long-term structured exercise acts upon appetite and neural mechanisms related to food reward in adolescents. Findings are key not only to interventions targeting OW/OB youth, but also to public policy and health recommendations for the importance of physical activity in children.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 19
Not provided
- BMI <85th percentile for age and sex
- Weight not stable
- Age <14 or >17
- On meds that may alter metabolism
- Active (>20 min/day exercise)
- Not at risk for T2D, according to American Diabetes Association (ADA) criteria (see above)
- Not willing to participate in an exercise program
- Not willing to provide permission/assent
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Exercise Intervention/Newsletter Exercise Intervention After completion of the initial fMRI session the participant will be randomly assigned to intervention for 3 months and then complete another round of assessments described as above (except for the orientation session). Exercise Intervention/Newsletter Newsletter After completion of the initial fMRI session the participant will be randomly assigned to intervention for 3 months and then complete another round of assessments described as above (except for the orientation session).
- Primary Outcome Measures
Name Time Method Assess the effectiveness of a physical activity intervention on eating behavior- subjective responses 12 monthts To assess the effectiveness of a physical activity intervention on eating behavior in adolescents; OW/OB inactive adolescents will be randomly assigned to a 3-month exercise intervention (Exercise +Newsletter), or a control condition (Newsletter).
Those exposed to the exercise intervention will have greater improvements (compared to control group) in appetite (subjective self-reported hunger responses).
- Secondary Outcome Measures
Name Time Method Assess the effectiveness of a physical activity intervention on eating behavior- subjective responses 12 monthts To assess the effectiveness of a physical activity intervention on eating behavior in adolescents; OW/OB inactive adolescents will be randomly assigned to a 3-month exercise intervention (Exercise +Newsletter), or a control condition (Newsletter).
Those exposed to the exercise intervention will have greater improvements (compared to control group) in appetite (subjective self-reported hunger responses).Assess the effectiveness of a physical activity intervention on eating behavior- biological responses 12 monthts To assess the effectiveness of a physical activity intervention on eating behavior in adolescents; OW/OB inactive adolescents will be randomly assigned to a 3-month exercise intervention (Exercise +Newsletter), or a control condition (Newsletter).
Those exposed to the exercise intervention will have greater improvements (compared to control group) in appetite hormones ghrelin, and leptin.Assess changes in structural and functional MRI in response to an exercise intervention- reward and control 12 months Assess changes in structural and functional MRI pre- to post- intervention in sedentary youth at risk for type 2 diabetes.
Compared to pre-intervention, youth in the exercise group will show de-creased activation in reward regions (orbitofrontal cortex, ventral striatum) when making food/activity choices; increased activation in control regions (dorsolateral PFC, inferior frontal gyrus) during food/activity choices.Assess changes in structural and functional MRI in response to an exercise intervention- prefrontal and hippocampal volume 12 months Assess changes in structural and functional MRI pre- to post- intervention in sedentary youth at risk for type 2 diabetes.
Youth randomized to the exercise intervention will exhibit increases in prefrontal and hippocampal volume compared to controls.
Trial Locations
- Locations (1)
Children's Mercy Kansas City
🇺🇸Kansas City, Missouri, United States