Effect of a Physical Activity Consultation in the Management of Adolescent Overweight (the PAC-MAnO project): study rationale, design and methods

Antonio Videira-Silva, Luís Sardinha, Helena Fonseca, Antonio Videira-Silva, Luís Sardinha, Helena Fonseca

Abstract

Background: Adolescent overweight is a major public health concern, as it is associated with several short-run and long-run adverse health outcomes. Inappropriate health behaviours may be at the front of this epidemic. There is widespread need for new strategies that may positively influence dietary and physical activity behaviours. This trial (NCT02941770) was designed to investigate the impact of a physical activity consultation, based on motivational interview technique, on physical activity behaviour and weight status among overweight adolescents followed at a tertiary paediatric care centre.

Methods/design: This is an ongoing non-randomised controlled clinical trial with a 6-month duration and follow-up at month 12. It is expected to be concluded in December 2018. Adolescents (n=129) aged 12-18 with a body mass index ≥p85 are recruited and allocated into three groups: (1) control group: standard care (paediatric and nutrition consultations, n=43); (2) experimental group I: standard care plus physical activity consultation (n=43); and (3) experimental group II: exposure to two sessions/week of structured physical exercise, in addition to the standard care plus physical activity consultations (n=43). Sample size was calculated according to power analysis. Participants undergo a set of socioeconomic, anthropometric, body composition, clinical and behavioural (dietary and physical activity) assessments.

Discussion: Adolescence is a critical period for the acquisition of a healthy lifestyle. The promotion of an active lifestyle may influence adolescents' weight status and further prevent multiple comorbidities. The findings of our study will provide further understanding on the impact of a physical activity consultation on physical activity behaviour and weight reduction/maintenance among overweight adolescents.

Trial registration number: NCT02941770.

Keywords: adolescent health; exercise physiology; obesity; physiology.

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Expected results of the study. BMI, body mass index.
Figure 2
Figure 2
Participant timeline and procedures.

References

    1. Ng M, Fleming T, Robinson M, et al. . Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2014;384:766–81. 10.1016/S0140-6736(14)60460-8
    1. Farpour-Lambert NJ, Baker JL, Hassapidou M, et al. . Childhood Obesity Is a Chronic Disease Demanding Specific Health Care--a Position Statement from the Childhood Obesity Task Force (COTF) of the European Association for the Study of Obesity (EASO). Obes Facts 2015;8:342–9. 10.1159/000441483
    1. Inchley J, Currie D, Jewell J, et al. . Adolescent obesity and related behaviours: trends and inequalities in the WHO European Region, 2002–2014: World Health Organization, 2017.
    1. Sardinha LB, Santos R, Vale S, et al. . Prevalence of overweight and obesity among Portuguese youth: a study in a representative sample of 10-18-year-old children and adolescents. Int J Pediatr Obes 2011;6:e124–8. 10.3109/17477166.2010.490263
    1. Adegboye AR, Andersen LB, Froberg K, et al. . Linking definition of childhood and adolescent obesity to current health outcomes. Int J Pediatr Obes 2010;5:130–42. 10.3109/17477160903111730
    1. Hannon TS, Rao G, Arslanian SA. Childhood obesity and type 2 diabetes mellitus. Pediatrics 2005;116:473–80. 10.1542/peds.2004-2536
    1. Wardle J, Cooke L. The impact of obesity on psychological well-being. Best Pract Res Clin Endocrinol Metab 2005;19:421–40. 10.1016/j.beem.2005.04.006
    1. Ebbeling CB, Pawlak DB, Ludwig DS. Childhood obesity: public-health crisis, common sense cure. Lancet 2002;360:473–82. 10.1016/S0140-6736(02)09678-2
    1. Stovitz SD, Pereira MA, Vazquez G, et al. . The interaction of childhood height and childhood BMI in the prediction of young adult BMI. Obesity 2008;16:2336–41. 10.1038/oby.2008.359
    1. Singh AS, Mulder C, Twisk JW, et al. . Tracking of childhood overweight into adulthood: a systematic review of the literature. Obes Rev 2008;9:474–88. 10.1111/j.1467-789X.2008.00475.x
    1. Frayling TM, Timpson NJ, Weedon MN, et al. . A common variant in the FTO gene is associated with body mass index and predisposes to childhood and adult obesity. Science 2007;316:889–94. 10.1126/science.1141634
    1. Dumith SC, Gigante DP, Domingues MR, et al. . Physical activity change during adolescence: a systematic review and a pooled analysis. Int J Epidemiol 2011;40:685–98. 10.1093/ije/dyq272
    1. Cooper AR, Goodman A, Page AS, et al. . Objectively measured physical activity and sedentary time in youth: the International children’s accelerometry database (ICAD). Int J Behav Nutr Phys Act 2015;12:113 10.1186/s12966-015-0274-5
    1. Mostazir M, Jeffery A, Hosking J, et al. . Evidence for energy conservation during pubertal growth. A 10-year longitudinal study (EarlyBird 71). Int J Obes 2016;40:1619–26. 10.1038/ijo.2016.158
    1. Dietz WH. Critical periods in childhood for the development of obesity. Am J Clin Nutr 1994;59:955–9. 10.1093/ajcn/59.5.955
    1. Daniels SR, Arnett DK, Eckel RH, et al. . Overweight in children and adolescents: pathophysiology, consequences, prevention, and treatment. Circulation 2005;111:1999–2012. 10.1161/01.CIR.0000161369.71722.10
    1. Marshall WA, Tanner JM. Variations in pattern of pubertal changes in girls. Arch Dis Child 1969;44:291–303. 10.1136/adc.44.235.291
    1. Crews F, He J, Hodge C. Adolescent cortical development: a critical period of vulnerability for addiction. Pharmacol Biochem Behav 2007;86:189–99. 10.1016/j.pbb.2006.12.001
    1. Bodenheimer T, Wagner EH, Grumbach K. Improving primary care for patients with chronic illness. JAMA 2002;288:1775–9. 10.1001/jama.288.14.1775
    1. Barlow SE. Expert Committee. Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics 2007;120(Suppl 4):S164–92. 10.1542/peds.2007-2329C
    1. Chae HW, Kwon YN, Rhie YJ, et al. . Effects of a structured exercise program on insulin resistance, inflammatory markers and physical fitness in obese Korean children. J Pediatr Endocrinol Metab 2010;23:1065–72. 10.1515/jpem.2010.168
    1. Penedo FJ, Dahn JR. Exercise and well-being: a review of mental and physical health benefits associated with physical activity. Curr Opin Psychiatry 2005;18:189–93. 10.1097/00001504-200503000-00013
    1. Prochaska JO, DiClemente CC. Stages of change in the modification of problem behaviors. Prog Behav Modif 1992;28:183–218.
    1. McCallum Z, Wake M, Gerner B, et al. . Outcome data from the LEAP (Live, Eat and Play) trial: a randomized controlled trial of a primary care intervention for childhood overweight/mild obesity. Int J Obes 2007;31:630–6. 10.1038/sj.ijo.0803509
    1. Henderson M, Daneman D, Huot C, et al. . The impact of exercise consultation on activity levels and metabolic markers in obese adolescents: a pilot study. Int J Pediatr Endocrinol 2010;2010:681510 10.1186/1687-9856-2010-681510
    1. Videira-Silva A, Fonseca H. The effect of a physical activity consultation on body mass index z-score of overweight adolescents: results from a pediatric outpatient obesity clinic. Eur J Pediatr 2017;176:655–60. 10.1007/s00431-017-2892-1
    1. Teixeira PJ, Silva MN, Mata J, et al. . Motivation, self-determination, and long-term weight control. Int J Behav Nutr Phys Act 2012;9:22 10.1186/1479-5868-9-22
    1. Kelishadi R, Malekahmadi M, Hashemipour M, et al. . Can a trial of motivational lifestyle counseling be effective for controlling childhood obesity and the associated cardiometabolic risk factors? Pediatr Neonatol 2012;53:90–7. 10.1016/j.pedneo.2012.01.005
    1. Boushey CJ, Harris J, Bruemmer B, et al. . Publishing nutrition research: a review of sampling, sample size, statistical analysis, and other key elements of manuscript preparation, Part 2. J Am Diet Assoc 2008;108:679–88. 10.1016/j.jada.2008.01.002
    1. Caspersen CJ, Powell KE, Christenson GM. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep 1985;100:126–31.
    1. Ortega FB, Tresaco B, Ruiz JR, et al. . Cardiorespiratory fitness and sedentary activities are associated with adiposity in adolescents. Obesity 2007;15:1589–99. 10.1038/oby.2007.188
    1. Kelishadi R, Hashemi M, Mohammadifard N, et al. . Association of changes in oxidative and proinflammatory states with changes in vascular function after a lifestyle modification trial among obese children. Clin Chem 2008;54:147–53. 10.1373/clinchem.2007.089953
    1. Ascenso A, Palmeira A, Pedro LM, et al. . Physical activity and cardiorespiratory fitness, but not sedentary behavior, are associated with carotid intima-media thickness in obese adolescents. Eur J Pediatr 2016;175:391–8. 10.1007/s00431-015-2654-x
    1. Yin Z, Moore JB, Johnson MH, et al. . The Medical College of Georgia Fitkid project: the relations between program attendance and changes in outcomes in year 1. Int J Obes 2005;29(Suppl 2):S40–5. 10.1038/sj.ijo.0803061
    1. ACSM. ACSM’s guidelines for exercise testing and prescription. 9th edn: Lippincott Williams & Wilkins, 2013.
    1. de Onis M, Lobstein T. Defining obesity risk status in the general childhood population: which cut-offs should we use? Int J Pediatr Obes 2010;5:458–60. 10.3109/17477161003615583
    1. Ford AL, Hunt LP, Cooper A, et al. . What reduction in BMI SDS is required in obese adolescents to improve body composition and cardiometabolic health? Arch Dis Child 2010;95:256–61. 10.1136/adc.2009.165340
    1. Rito AI, Carvalho MA, Ramos C, et al. . Program Obesity Zero (POZ)--a community-based intervention to address overweight primary-school children from five Portuguese municipalities. Public Health Nutr 2013;16:1043–51. 10.1017/S1368980013000244
    1. Tripp SB, Perry JT, Romney S, et al. . Providers as weight coaches: using practice guides and motivational interview to treat obesity in the pediatric office. J Pediatr Nurs 2011;26:474–9. 10.1016/j.pedn.2011.07.009
    1. Luzier J, Berlin K, Weeks J. Behavioral treatment of pediatric obesity: review and future directions. Children’s Health Care 2010;39:312–34. 10.1080/02739615.2010.516202
    1. Vandenbroeck P, Goossens J, Clemens M. Foresight tackling obesities: future choices—building the obesity system map: UK Government’s GOfS, 2007.
    1. Bemelmans WJ, Wijnhoven TM, Verschuuren M, et al. . Overview of 71 European community-based initiatives against childhood obesity starting between 2005 and 2011: general characteristics and reported effects. BMC Public Health 2014;14:758 10.1186/1471-2458-14-758
    1. Fisher EB, Fitzgibbon ML, Glasgow RE, et al. . Behavior matters. Am J Prev Med 2011;40:e15–30. 10.1016/j.amepre.2010.12.031

Source: PubMed

3
Subscribe