ABSTRACT. Background. Obesity has become the most common pediatric chronic disease in the modern era. Early prevention and treatment of childhood and adolescent obesity is mandated. Surprisingly, however, only a minor fraction of obese children participate in weight reduction interventions, and the longer-term effects of these weight-reduction interventions among children have not been elucidated.Objective. To examine prospectively the short-and long-term effects of a 3-month, combined dietary-behavioral-physical activity intervention on anthropometric measures, body composition, dietary and leisure-time habits, fitness, and lipid profiles among obese children.Methods. In this randomized prospective study, 24 obese subjects completed the 3-month intervention and were compared with 22 obese, age-and gender-matched, control subjects.Results. At 3 months, there were significant differences in changes in body weight (؊2.8 ؎ 2.3 kg vs 1.2 ؎ 2.2 kg), BMI (؊1.7 ؎ 1.1 kg/m 2 vs ؊0.2 ؎ 1.0 kg/m 2 ), body fat percentage (from skinfold tests; ؊3.3 ؎ 2.6% vs 1.4 ؎ 4.7%), serum total cholesterol level (؊24.6 ؎ 15.1 mg/dL vs 0.8 ؎ 18.7 mg/dL), low-density lipoprotein cholesterol level (؊23.3 ؎ 15.2 mg/dL vs ؊3.7 ؎ 17.3 mg/dL), and fitness (215 ؎ 107 seconds vs 50 ؎ 116 seconds) in the intervention group versus the control group. After a 1-year follow-up period, there were significant differences between the intervention group (n ‫؍‬ 20) and the control group (n ‫؍‬ 20) in body weight (0.6 ؎ 6.0 kg vs 5.3 ؎ 2.7 kg), BMI (؊1.7 ؎ 2.3 kg/m 2 vs 0.6 ؎ 0.9 kg/m 2 ), and body fat percentage. There was a significant increase in leisure-time physical activity among the intervention participants, compared with a decrease among the control subjects.Conclusions. Our data demonstrate the short-and longer-term beneficial effects of a combined dietary-behavioral-physical activity intervention among obese children. These results highlight the importance of multidisciplinary programs for the treatment of childhood obesity and emphasize their encouraging long-term effects. Pediatrics 2005;115:e443-e449. URL: www.pediatrics.org/cgi/doi/10.1542/peds.2004-2172; obesity, multidisciplinary treatment, childhood, exercise.ABBREVIATIONS. LDL, low-density lipoprotein; TG, triglyceride; HDL, high-density lipoprotein.C hildhood obesity has reached epidemic proportions worldwide, despite major efforts to promote weight reduction. The mechanisms responsible for the increasing prevalence of childhood obesity are not understood completely, but lifestyle changes associated with increased caloric intake and decreased energy expenditure play probably critical roles. 1,2 Childhood obesity is associated with increased risk of hyperlipidemia, hypertension, insulin resistance, diabetes mellitus, and arteriosclerosis later in life. 3,4 In addition, long-term follow-up results indicate that obese children and adolescents tend to become obese adults. 5 Moreover, adults who were obese children have increased morbidity and mortality rates independent of their adult weig...

ObjectiveThe aim of the present study was to determine physical activity (PA) and nutrition knowledge and preferences in low socio-economic status kindergarten children.MethodsFollowing height and weight measurement, 795 low socio-economic status kindergarten children (age 3.8-6.8 y.o) completed a photo-pair knowledge and preferences food and exercise questionnaire.ResultsNo difference was found between nutrition and PA knowledge scores (52.3 ± 0.9 versus 52.6 ± 0.8%, respectively). There was no difference between the nutrition knowledge and preference score (52.3 ± 0.9 versus 50.9 ± 0.9%, respectively). PA preference was significantly higher than knowledge (56.9 ± 1.5 versus 52.6 ± 0.8%, respectively; p < 0.0001). Significant correlations were found between nutrition knowledge and preferences (r = 0.55, p < 0.0001), physical activity knowledge and preferences (r = 0.46, p < 0.0001), and nutrition and PA preferences (r = 0.46, p < 0.001). Nutrition preference scores were significantly lower in overweight compared to normal weight kindergartners 48.1 ± 1.7 versus 52.0 ± 1.0%; p < 0.05). PA knowledge and preference scores were significantly higher among male compared to the female kindergartners (p < 0.001 for both).ConclusionOur data demonstrate diversities in physical activity and nutrition knowledge and preferences among low socio-economic status kindergarten children. These findings may be important for the development of health promotion programs in low socioeconomic kindergarten children.

Exercise leads to increases in circulating levels of peripheral blood mononuclear cells (PBMCs) and to a simultaneous, seemingly paradoxical increase in both pro- and anti-inflammatory mediators. Whether this is paralleled by changes in gene expression within the circulating population of PBMCs is not fully understood. Fifteen healthy men (18-30 yr old) performed 30 min of constant work rate cycle ergometry (approximately 80% peak O2 uptake). Blood samples were obtained preexercise (Pre), end-exercise (End-Ex), and 60 min into recovery (Recovery), and gene expression was measured using microarray analysis (Affymetrix GeneChips). Significant differential gene expression was defined with a posterior probability of differential expression of 0.99 and a Bayesian P value of 0.005. Significant changes were observed from Pre to End-Ex in 311 genes, from End-Ex to Recovery in 552 genes, and from Pre to Recovery in 293 genes. Pre to End-Ex upregulation of PBMC genes related to stress and inflammation [e.g., heat shock protein 70 (3.70-fold) and dual-specificity phosphatase-1 (4.45-fold)] was followed by a return of these genes to baseline by Recovery. The gene for interleukin-1 receptor antagonist (an anti-inflammatory mediator) increased between End-Ex and Recovery (1.52-fold). Chemokine genes associated with inflammatory diseases [macrophage inflammatory protein-1alpha (1.84-fold) and -1beta (2.88-fold), and regulation-on-activation, normal T cell expressed and secreted (1.34-fold)] were upregulated but returned to baseline by Recovery. Exercise also upregulated growth and repair genes such as epiregulin (3.50-fold), platelet-derived growth factor (1.55-fold), and hypoxia-inducible factor-I (2.40-fold). A single bout of heavy exercise substantially alters PBMC gene expression characterized in many cases by a brisk activation and deactivation of genes associated with stress, inflammation, and tissue repair.