The prevalence of paediatric obesity has increased over the last two decades and with it, an increased diagnosis of lifestyle-related diseases in children and adolescents. High intensity interval training has recently been explored as an alternate to traditional aerobic exercise in adults with chronic disease and has potential to induce rapid reversal of subclinical disease markers in obese children and adolescents. High intensity interval training has recently been explored as an alternate to traditional aerobic exercise in adults with chronic disease and has potential to induce rapid reversal of subclinical disease markers in obese children and adolescents. Goal: The primary aim of this randomised controlled trial is to evaluate the effectiveness of a high intensity interval training intervention on myocardial function, vascular function and visceral adipose tissue in obese children and adolescents at baseline, three and twelve months. Method: Multi-centre randomised controlled trial of 100 obese children and adolescents in the cities of Trondheim (Norway) and Brisbane (Australia). Participants will be randomised to (1) high intensity interval training, (2) moderate intensity continuous training or (3) nutrition advise. Participants will partake in supervised exercise training and/or nutrition consultations for 3 months. Measurements for all study endpoints will occur at baseline, 3 months (post intervention) and 12 months (follow up). Scientific Significance : This randomised controlled trial will general substantial information regarding the effects of exercise intensity on paediatric obesity, specifically the cardio-metabolic health of this at-risk population. It is expected that communication of results will allow for more robust and realistic guidelines regarding exercise prescription in this population to be formed while outlining the benefits of high intensity interval training on subclinical markers of disease.
Worldwide, childhood overweight and obesity rates are approximately 10%, this high incidence attributed to a physically inactive lifestyle and inappropriate nutrition. Early cohort studies illustrated that fifty per cent of obese children became obese adults and consequently had an higher risk for metabolic syndrome than obese adults who were not obese as children. Both female and male overweight children and adolescents had a 30% increase in all cause mortality. The increases in risk of death were independent of adult body mass index. Systematic reviews suggest that lifestyle and exercise interventions in obese children and adolescents can lead to improvements in anthropometric and cardio-metabolic outcomes, but these are not inclusive of several important outcomes such as myocardial and vascular function or visceral adipose tissue.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
100
Twelve weeks of 2-3 supervised training sessions each week.
Twelve weeks of 2-3 supervised training sessions each week.
healthy food choices, portion sizes and regular mealtimes
University of Queensland
Brisbane, Australia
St Olavs Hospital
Trondheim, Norway
Peak systolic tissue velocity
systolic tissue Doppler velocity assessed during resting and stress echocardiography
Time frame: 12 weeks
Subcutaneous and total abdominal adipose tissue
Assessed using MRI
Time frame: 12 weeks, 12 months
Cardiorespiratory fitness (VO2peak)
Assessed using a maximal treadmill test
Time frame: 12 weeks, 12 months
Body composition
Assessed using DXA (UQ), BodPod (NTNU)
Time frame: 12 weeks, 12 months
Blood biochemistry
Analysed for lipids, glucose, insulin, inflammatory makers, satiety hormones, oxidative stress
Time frame: 12 weeks, 12 months
Physical activity
Assessed through 7 day accelerometry
Time frame: 12 weeks, 12 months
Dietary analysis
Assessed through a three-day food record
Time frame: 12 weeks, 12 months
Myocardial structure and cardiac adipose tissue (UQ)
Assessed through cardiac MRI; participants \> 12 years only
Time frame: 12 weeks
Arterial stiffness
Assessed through pulse wave velocity and pulse wave analysis
Time frame: 12 weeks, 12 months
Autonomic function
Assessed through heart rate variability and heart rate recovery
Time frame: 12 weeks, 12 months
Quality of life
Assessed through the Paediatric Quality of Life Inventory
Time frame: 12 weeks, 12 months
Visceral adipose tissue
assessed by magnetic resonance imaging (MRI)
Time frame: 12 weeks, 12 months
Vascular function
Assessed through flow mediated dilation procedure
Time frame: 12 weeks, 12 months
Peak systolic tissue velocity
systolic tissue Doppler velocity assessed during resting and stress echocardiography
Time frame: 12 months
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