Effects of exercise in addition to a family-based lifestyle intervention program on hepatic fat in children with overweight
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American Diabetes Association
Hepatic steatosisChildhoodphysical activityNutritionPsychologyObesity
Publisher version: Labayen, I., Medrano, M., Arenaza, L., Maíz, E., Osés, M., Martínez-Vizcaíno, V., ... & Ortega, F. B. (2020). Effects of exercise in addition to a family-based lifestyle intervention program on hepatic fat in children with overweight. Diabetes Care, 43(2), 306-313. [https://doi.org/10.2337/dc19-0351]
SponsorshipSpanish Ministry of Health "Fondos de Investigation Sanitaria del Institute de Salud Carlos III" PI13/01335; Spanish Ministry of Industry and Competitiveness DEP2016-78377-R; EU Fondos Estructurales de la Union Europea (FEDER) funds ("Una manera de hacer Europa"); Spanish Ministry of Education, Culture and Sports FPU14/03329; Education Department of the Government of the Basque Country PRE_2016_1_0057 PRE_2017_2_0224 PRE_2018_2_0057; University of Granada Plan Propio de Investigacion 2016-Excellence actions: Unit of Excellence on Exercise and Health (UCEES); Junta de Andalucia, Consejeria de Conocimiento, Investigacion y Universidades (FEDER) SOMM17/6107/UGR
Background: Paediatric hepatic steatosis is highly prevalent and closely related to type 2 diabetes. Aims: To determine whether the addition of supervised exercise to a family-based lifestyle- and psycho-educational intervention results in greater reduction of percentage hepatic fat (HF), adiposity, and cardiometabolic risk factors in children with overweight/obesity. Methods: The study subjects of this non-randomized, two-arm, parallel design, clinical trial were 116 overweight/obese children (10.6±1.1 years, 53.4% girls) living in Vitoria-Gasteiz (Spain). For 22 weeks they followed either a lifestyle- and psycho-education program (control intervention [CI], N=57), consisting of two family-based education sessions/month, or the same plus supervised exercise (intensive intervention [II], N=59) focused mainly on high-intensity aerobic workouts (3 sessions/week, 90 min/session). The primary outcome was the change in percentage HF (as measured by MRI) between baseline and the end of the intervention period. Secondary outcomes included changes in body mass index (BMI), fat mass index (FMI), abdominal fat (measured by dual-X-ray-absorptiometry), blood pressure, triglycerides, high density lipoprotein, low density lipoprotein, gamma-glutammyl-transferase, glucose and insulin concentrations. Results: A total of 102 children completed the trial (N=53 and N=49 in the CI and II groups, respectively). Percentage HF decreased only in the II group (-1.20±0.31% vs. 0.04±0.30%, II and CI, respectively), regardless of baseline value and any change in adiposity (P<0.01). BMI, FMI, abdominal fat (P≤0.001) and insulin (P<0.05) were reduced in both groups. Conclusions: Multicomponent intervention programs that include exercise training may help reduce, adiposity, insulin resistance and hepatic steatosis in overweight/obese children.