Pediatric obesity is considered one of the most important public health problems worldwide due to its high prevalence and associated comorbidities. Physical exercise has been shown to have an important role in the treatment of obesity and associated cardiometabolic dysfunction. Small-sided soccer games (SSSG) have been explored as a promising way of increasing physical exercise due to its benefits on cardiometabolic health and high degree of enjoyment, which favors long-term adherence. The objective of this research is to determine the effects of a 16-week high-intensity SSSG-based exercise intervention on cardiometabolic risk factors, physical fitness, adherence to 24-hour movement patterns, enjoyment and adherence to the intervention in adolescents with metabolic dysfunction and compare them to the effects of a traditional soccer intervention. The investigators hypothesize that high-intensity SSSG are more effective in improving the obesity-related cardiometabolic risk profile in adolescents with cardiometabolic dysfunction compared to traditional soccer training. A parallel 3-arm randomized controlled trial will be conducted in adolescents with overweight and metabolic dysfunction between 11 and 15 years of age. The inclusion criteria are: (i) age between 11-15 years at the time of intervention start; (ii) overweight or obesity (BMI\> 85th percentile); (iii) Abdominal obesity ≥90th percentile as assessed by waist circumference or a waist-to-height ratio ≥ 0.5; (iv) willing to participate in the study regardless of possible group allocation; (v) informed consent given by participant and legal representatives. Exclusion criteria: (i) health condition not compatible with participation in physical exercise; (ii) history of recent musculoskeletal injury hindering exercise participation; (iii) concurrent participation in a structured weight loss or exercise program. Those eligible to participate in the study will be randomly assigned to one of three groups: i) SSSG group, ii) traditional soccer play group (TSG), or, iii) non-exercise intervention control group (CG). Participants in both exercise intervention groups will undergo a 16-week intervention. The SSSG group will participate in a high-intensity small-sided soccer games training, while the TSG will undergo a technical and tactical skills training program and traditional soccer training. The CG participants will continue with regular school physical education classes without any additional intervention. Before and after the intervention, all participants will be assessed for cardiometabolic and hepatic biochemical markers, physical fitness, anthropometry and body composition, blood pressure, objective daily physical activity and sleep quality, and perceived enjoyment of participation in SSSG and TSG. The primary outcomes of the study will be waist circumference and cardiorespiratory fitness. The study protocol was approved by the Ethics Committee of the Faculty of Sport of the University of Porto and by the Scientific Ethics Committee of the Adventist University of Chile.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
51
Physical exercise intervention
Physical exercise intervention
Faculty of Sport of the University of Porto
Porto, Portugal
Waist circumference
Anthropometric measurement of abdominal obesity; cm
Time frame: 16 weeks
Cardiorespiratory fitness
1-mile walk/run test; minutes to run 1 mile
Time frame: 16 weeks
Variation in fasting blood glucose concentration (mg/dL)
Variation in fasting blood glucose concentration after 16 weeks of intervention. Blood samples will be obtained from each subject early in the morning by venipuncture from the antecubital vein, following a 10-h overnight fast.
Time frame: 16 weeks
Variation in serum insulin concentration (mU/L)
Variation in serum insulin concentration after 16 weeks of intervention. Blood samples will be obtained from each subject early in the morning by venipuncture from the antecubital vein, following a 10-h overnight fast.
Time frame: 16 weeks
Variation in HOMA-IR
Variation in HOMA-IR after 16 weeks of intervention. Blood samples will be obtained from each subject early in the morning by venipuncture from the antecubital vein, following a 10-h overnight fast.
Time frame: 16 weeks
Variation in glycosylated hemoglobin concentration (mg/dL)
Variation in Glycosylated hemoglobin concentration after 16 weeks of intervention. Blood samples will be obtained from each subject early in the morning by venipuncture from the antecubital vein, following a 10-h overnight fast.
Time frame: 16 weeks
Variation in high-density lipoprotein cholesterol concentration (mg/dL)
Variation in High-density lipoprotein cholesterol concentration after 16 weeks of intervention. Blood samples will be obtained from each subject early in the morning by venipuncture from the antecubital vein, following a 10-h overnight fast.
Time frame: 16 weeks
Variation in low-density lipoprotein cholesterol concentration (mg/dL)
Variation in low-density lipoprotein cholesterol concentration after 16 weeks of intervention. Blood samples will be obtained from each subject early in the morning by venipuncture from the antecubital vein, following a 10-h overnight fast.
Time frame: 16 weeks
Variation in total cholesterol concentration (mg/dL)
Variation in total cholesterol concentration after 16 weeks of intervention. Blood samples will be obtained from each subject early in the morning by venipuncture from the antecubital vein, following a 10-h overnight fast.
Time frame: 16 weeks
Variation in blood triglycerides concentration (mg/dL)
Variation in blood triglycerides concentration after 16 weeks of intervention. Blood samples will be obtained from each subject early in the morning by venipuncture from the antecubital vein, following a 10-h overnight fast.
Time frame: 16 weeks
Variation in blood Alanine aminotransferase concentration (U/L)
Variation in blood Alanine aminotransferase concentration after 16 weeks of intervention. Blood samples will be obtained from each subject early in the morning by venipuncture from the antecubital vein, following a 10-h overnight fast.
Time frame: 16 weeks
Variation in blood Aspartate aminotransferase concentration (U/L)
Variation in blood Aspartate aminotransferase concentration after 16 weeks of intervention. Blood samples will be obtained from each subject early in the morning by venipuncture from the antecubital vein, following a 10-h overnight fast.
Time frame: 16 weeks
Variation in blood Gamma glutamyl transferase concentration (U/L)
Variation in blood Gamma glutamyl transferase concentration after 16 weeks of intervention. Blood samples will be obtained from each subject early in the morning by venipuncture from the antecubital vein, following a 10-h overnight fast.
Time frame: 16 weeks
6-minute walk test
Distance covered walking in 6 minutes.
Time frame: 16 weeks
Hand grip strength
Hand grip strength test measured with a digital hand dynamometer
Time frame: 16 weeks
Lower limb strength
Assessed by Horizontal jump test.
Time frame: 16 weeks
Body composition
Assessed by the electrical bioimpedance method
Time frame: 16 weeks
Body mass index
Weight and height will be combined to report BMI in kg/m\^2
Time frame: 16 weeks
Neck circumference
Assessed by anthropometric techniques
Time frame: 16 weeks
Blood Pressure (mmHg)
Systolic and diastolic blood pressure measured with digital sphygmomanometer
Time frame: 16 weeks
Physical activity
Physical activity will be assessed objectively with a triaxial accelerometer used 24h/d during 7 consecutive days.
Time frame: 16 weeks
Sleep quality
Sleep quality will be assessed objectively with a triaxial accelerometer used 24h/d during 7 consecutive days.
Time frame: 16 weeks
Perceived enjoyment of physical activity
Assessed by the Physical Activity Enjoyment Scale questionnaire (PACES). Raw scores are transformed into a scale from 16 to 80. Higher scores correspond to higher perceived enjoyment.
Time frame: 16 weeks
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