Aerobic training performed at ventilatory threshold improves liver enzymes and lipid profile related to non-alcoholic fatty liver disease in adolescents with obesity

Lira, Camila Tc de; Santos, Marcos Am Dos; Gomes, Priscyla Praxedes; Fidelix, Yara Lucy; Santos, Ana Co Dos; Tenório, Thiago; Lofrano-Prado, Mara Cristina; Prado, Wagner Luiz do

doi:10.1177/0260106017720350

Cited by 22 publications

(18 citation statements)

References 43 publications

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“…Of the 1495 articles screened after duplicates were removed, 55 met our inclusion criteria (eTable 1 in Supplement 1). Figure 1 illustrates the identification, screening, and inclusion process. The Cohen κ statistic for interrater reliability was 0.84 (95% CI, 0.72 to 0.96).…”

Section: Resultsmentioning

confidence: 99%

Exercise and Insulin Resistance Markers in Children and Adolescents With Excess Weight

García-Hermoso,

López-Gil,

Izquierdo

et al. 2023

JAMA Pediatr

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ImportanceAlthough benefits have been reported for most exercise modalities, the most effective exercise approaches for reducing insulin resistance in children and adolescents with excess weight and the optimal exercise dose remain unknown.ObjectiveTo compare exercise training modalities and their association with changes in insulin resistance markers among children and adolescents with excess weight and to establish the optimal exercise dose.Data SourcesFor this systematic review and network meta-analysis, 6 electronic databases (PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Scopus, Web of Science, and CINAHL) were searched for studies from inception to April 1, 2023.Study SelectionRandomized clinical trials (ie, randomized controlled trials and randomized trials without a control group) were included if they reported outcomes associated with aerobic training, resistance training, high-intensity interval training (HIIT), or a combination of these interventions.Data Extraction and SynthesisData extraction for this systematic review was conducted following a network meta-analysis extension of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guideline. Effect sizes were calculated as the mean difference (MD) with 95% CI using random-effects inverse-variance models with the Hartung-Knapp-Sidik-Jonkman method. The hierarchy of competing interventions was defined using the surface under the cumulative ranking curve. The Cochrane Risk-of-Bias tool, version 2 (RoB2), was used to independently assess the risk of bias of the included studies. The certainty of evidence in consistent networks was assessed using the Grading of Recommendation, Assessment, Development and Evaluation approach. The study protocol was prospectively registered with PROSPERO. Data analyses were conducted between May and June 2023.Main Outcomes and MeasuresThe primary outcomes were fasting glucose, insulin, and homeostatic model assessment for insulin resistance (HOMA-IR).ResultsThis analysis included 55 studies with a total of 3051 children and adolescents (mean [SD] age, 13.5 [2.3] years; 1537 girls [50.4%] and 1514 boys [49.6%]). Exercise was associated with reductions in fasting insulin (MD, −4.38 μU/mL [95% CI, −5.94 to −2.82 μU/mL]) and HOMA-IR (MD, –0.87 [95% CI, –1.20 to –0.53]). A nonlinear association in both markers was observed, with a required minimal exercise dosage of approximately 900 to 1200 metabolic equivalent of task minutes per week, especially in children and adolescents with insulin resistance at baseline. Combination HIIT and resistance training and concurrent training were the most effective approaches for reducing insulin resistance markers. On average, the certainty of evidence varied from low to moderate.Conclusions and RelevanceThese findings underscore the role of exercise interventions in enhancing insulin resistance markers among children and adolescents with overweight and obesity. It is advisable to include resistance exercises alongside aerobic and HIIT programs for a minimum of two to three 60-minute sessions per week.

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Section: Resultsmentioning

confidence: 99%

Exercise and Insulin Resistance Markers in Children and Adolescents With Excess Weight

García-Hermoso,

López-Gil,

Izquierdo

et al. 2023

JAMA Pediatr

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“…Some NAFLD markers improved in both intervention groups (high-density lipoprotein, ALT, AST), but there was no change in glucose, insulin, and insulin resistance. Hepatic fat has not been assessed [ 44 ].…”

Section: Resultsmentioning

confidence: 99%

Non-Alcoholic Fatty Liver Disease in Children

Brecelj

Orel

2021

Medicina

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Background and Objectives: The prevalence of pediatric non-alcoholic fatty liver disease is increasing. A lot of new data are published regularly. Materials and Methods: Original clinical studies, review articles, and guidelines in children were searched for and the most relevant included in this review. Results: A total of 138 retrieved papers were classified into pathogenesis, epidemiology, diagnosis, and treatment. Pathogenesis is currently explained with the “multi hit hypothesis”, with complex interactions of genetic and environmental factors which trigger inflammation in steatotic liver. The prevalence is rising. A diagnosis can be made with laboratory tests, imaging, and liver biopsy after the exclusion of other causes of liver steatosis. The mainstay of treatment is lifestyle modification consisting of dietary intervention and increased physical activity. The progression to liver cirrhosis can occur even in children. Conclusions: Non-alcoholic fatty liver disease in children is a part of a metabolic syndrome in the majority of patients. Due to its complex etiology and high prevalence, multidisciplinary teams, together with public health professionals, should be involved in its treatment.

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“…These commonly reported barriers consequently result in poor treatment adherence, low retention rates [ 5 ], and poor long-term success rates. Our prior research examining the impact of inpatient behavioral interventions on health-related outcomes among adolescents with obesity found high dropout rates ranging from 45% to 55% [ 6 , 7 , 8 , 9 , 10 , 11 ]. Other studies have found that outpatient interventions may increase program adherence [ 12 , 13 , 14 , 15 ].…”

Section: Introduction: Time For a Change?mentioning

confidence: 99%

“…Behavioral lifestyle-based interventions are the gold standard of adolescent obesity treatment [ 21 ]. In fact, we previously demonstrated that several types of in-person lifestyle interventions aiming to improve eating behavior, mental health, and physical activity levels were equally effective for inducing short-term benefits in several health-related outcomes, including quality of life in adolescents with obesity [ 6 , 7 , 8 , 9 , 10 , 11 , 22 , 23 ]. Unfortunately, the magnitude of the effects on these key outcomes was small, and the interventions appear ineffective in the long-term.…”

Section: Introduction: Time For a Change?mentioning

confidence: 99%

Development of an Extended-Reality (XR)-Based Intervention to Treat Adolescent Obesity

Malik

Prado

Lappan

et al. 2022

IJERPH

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Public health policies aimed at obesity reduction are more often directed toward adults than children. This is alarming given that rates of childhood obesity have been steadily increasing, and, if not treated early, adolescents with obesity may develop comorbidities into adulthood. Lifestyle-based interventions are the cornerstone of childhood obesity treatment. Recently, extended-reality (XR)-based interventions have been incorporated into the treatment of obesity, and parents and adolescents perceive virtual reality (VR) interventions as a promising approach to increasing physical activity levels and improving eating habits. VR is a tool that fits perfectly with contemporary adolescent culture, which is radically different from that of just two generations ago. It is plausible that an XR-based intervention for treating adolescents with obesity could have a profound influence on obesity management over the long-term. An understanding of adolescents’ preferences, wants, and needs must be considered in the development of new interventions. We suggest that VR interventions can provide a new approach to weight management for children and adolescents and provide recommendations to assess adolescents’, caregivers’, and primary care providers’ needs. These needs could then be used for the development of an XR-based intervention aimed at inducing sustained lifestyle changes in adolescents with obesity.

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Aerobic training performed at ventilatory threshold improves liver enzymes and lipid profile related to non-alcoholic fatty liver disease in adolescents with obesity

Abstract: Both high and low-intensity training improved biomarkers related to NAFLD. Thus, high-intensity training can be a safe and effective alternative to prevent and treat NAFLD in adolescents with obesity.

Cited by 22 publications

References 43 publications

Exercise and Insulin Resistance Markers in Children and Adolescents With Excess Weight

Exercise and Insulin Resistance Markers in Children and Adolescents With Excess Weight

Non-Alcoholic Fatty Liver Disease in Children

Development of an Extended-Reality (XR)-Based Intervention to Treat Adolescent Obesity

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