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

Abstract

BackgroundAdolescent 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/DesignThis 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.DiscussionAdolescence 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 numberNCT02941770.

Life-stage factors associated with overweight severity in adolescents

“…It is crucial to investigate lifestage factors associated with overweight in order to prevent excessive BMI increase throughout this critical period for the development of obesity. 17,23,24 The main aim of this study was to investigate the influence of perinatal factors (i.e. way of delivery, birth weight) and overweight onset on overweight severity in a sample of overweight adolescents followed at a Pediatric Obesity Clinic, in order to identify the factors associated with BMI severity in this population.…”

“…Adolescence may be considered as the last critical period for the development of obesity. 17 Although the prevalence of obesity has come to a plateau in many European countries, the severity of obesity seems to increase, especially among adolescents. 18 Due to the increased obesity severity and its related comorbidities, several authors have suggested that waist circumference (WC) and waist-height ratio (WHtR) should be routinely assessed and used as measures of central adiposity.…”

The effect of a physical activity consultation in the management of adolescent excess weight: Results from a non‐randomized controlled trial

“…Nevertheless, there was even a trend for greater BMI z‐score decrease in the EGI group compared to EGII (Δ−0.19 vs. Δ−0.10, respectively). It is possible that motivational interview played a higher influence in EGI compared to EGII since a reduced contact time with health professionals could stimulate participants' autonomy as well as their perception of self‐efficacy in overcoming potential barriers to PA practice and in achieving individual goals 15 . Another possible explanation for BMI z‐score changes not being superior in the EGII at 6 months may be associated with the tailored PA counselling.…”

“…The PAC‐MAnO project is registered in Clinicaltrials.gov (NCT02941770) and the study protocol can be found elsewhere 15 …”

<p>Relationship between nonalcoholic fatty liver disease and bone mineral density in adolescents with obesity: a meta-analysis</p>

“…An epidemiological study from Portugal showed that ~3% of adolescents are obese, and 30% are overweight 16,17. In 2017, the Health Behaviour in School-Aged Children from the WHO showed that, among more than half of the European countries, the incidence of adolescent obesity rapidly increased from 2002 to 2014 18.…”