Open Access
Effects of a family-based lifestyle intervention plus supervised exercise training on abdominal fat depots in children with overweight or obesity: a secondary analysis of a nonrandomized clinical trial
(American Medical Association, 2022) Cadenas-Sánchez, Cristina; Cabeza Laguna, Rafael; Idoate, Fernando; Osés Recalde, Maddi; Medrano Echeverría, María; Villanueva Larre, Arantxa; Arenaza Etxeberría, Lide; Sanz Muñoz, Aritz; Ortega, Francisco B.; Ruiz, Jonatan R.; Labayen Goñi, Idoia; Ciencias de la Salud; Ingeniería Eléctrica, Electrónica y de Comunicación; Institute on Innovation and Sustainable Development in Food Chain - ISFOOD; Institute of Smart Cities - ISC; Osasun Zientziak; Ingeniaritza Elektrikoa, Elektronikoaren eta Telekomunikazio Ingeniaritzaren
Importance Excess abdominal fat is a major determinant in the development of insulin resistance and other metabolic disorders. Increased visceral adipose tissue (VAT) seems to precede the development of insulin resistance and is therefore a prime target of childhood lifestyle interventions aimed at preventing diabetes. OBJECTIVES To examine the effect of added exercise to a family-based lifestyle intervention program designed to reduce VAT plus subcutaneous (ASAT), intermuscular (IMAAT), and pancreatic (PAT) adipose tissue in children with overweight or obesity and to explore the effect of changes in VAT on insulin resistance. DESIGN, SETTING, AND PARTICIPANTS This 2-group, parallel-design clinical trial was conducted in Vitoria-Gasteiz, Spain. A total of 116 children with overweight or obesity participated and were assigned to a 22-week family-based lifestyle program (control group [n = 57]) or the same program plus an exercise intervention (exercise group [n = 59]). Data were collected between September 1, 2014, and June 30, 2017, and imaging processing for fat depot assessments and data analysis were performed between May 1, 2019, and February 12, 2021. INTERVENTIONS The compared interventions consisted of a family-based lifestyle and psychoeducation program (two 90-minute sessions per month) and the same program plus supervised exercise (three 90-minute sessions per week). MAIN OUTCOMES AND MEASURES The primary outcome of this study was the change in VAT between baseline and 22 weeks as estimated by magnetic resonance imaging. The secondary outcomes were changes in ASAT, IMAAT, and PAT. The effect of changes in VAT area on insulin resistance was also recorded. RESULTS The 116 participants included in the analysis (62 girls [53.4%]) had a mean (SD) age of 10.6 (1.1) years, and 67 (57.8%) presented with obesity. Significantly greater reductions were recorded for the exercise group in terms of reduction in VAT (−18.1% vs −8.5% for the control group; P = .004), ASAT (−9.9% vs −3.0%; P = .001), and IMAAT (−6.0% vs −2.6%; P = .02) fat fractions compared with the control group. Changes in VAT explained 87.6% of the improvement seen in insulin resistance (β = −0.102 [95% CI, −0.230 to −0.002]). CONCLUSIONS AND RELEVANCE These findings suggest that the addition of exercise to a lifestyle intervention program substantially enhanced the positive effects on abdominal fat depots in children with overweight or obesity. In addition, the reduction in VAT seemed to largely mediate the improvement of insulin sensitivity. These results highlight the importance of including exercise as part of lifestyle therapies aimed at treating childhood obesity and preventing the development of type 2 diabetes.
Open Access
Prevention of diabetes in overweight/obese children through a family based intervention program including supervised exercise (PREDIKID project): study protocol for a randomized controlled trial
(BioMed Central, 2017) Arenaza Etxeberría, Lide; Medrano Echeverría, María; Amasene, María; Rodríguez Vigil, Beatriz; Díez, Ignacio; Graña, Manuel; Tobalina, Ignacio; Maiz, Edurne; Arteche, Edurne; Larrarte, Eider; Huybrechts, Inge; Davis, Catherine L.; Ruiz, Jonatan R.; Ortega, Francisco B.; Margareto, Javier; Labayen Goñi, Idoia; Ciencias de la Salud; Osasun Zientziak
Background: The global pandemic of obesity has led to an increased risk for prediabetes and type-2 diabetes (T2D). The aims of the current project are: (1) to evaluate the effect of a 22-week family based intervention program, including supervised exercise, on insulin resistance syndrome (IRS) risk in children with a high risk of developing T2D and (2) to identify the profile of microRNA in circulating exosomes and in peripheral blood mononuclear cells in children with a high risk of developing T2D and its response to a multidisciplinary intervention program including exercise. Methods: A total of 84 children, aged 8–12 years, with a high risk of T2D will be included and randomly assigned to control (N = 42) or intervention (N = 42) groups. The control group will receive a family based lifestyle education and psycho-educational program (2 days/month), while the intervention group will attend the same lifestyle education and psycho-educational program plus the exercise program (3 days/week, 90 min per session including warm-up, moderate to vigorous aerobic activities, and strength exercises). The following measurements will be evaluated at baseline prior to randomization and after the intervention: fasting insulin, glucose and hemoglobin A1c; body composition (dual-energy X-ray absorptiometry); ectopic fat (magnetic resonance imaging); microRNA expression in circulating exosomes and in peripheral blood mononuclear cells (MiSeq; Illumina); cardiorespiratory fitness (cardiopulmonary exercise testing); dietary habits and physical activity (accelerometry). Discussion: Prevention and identification of children with a high risk of developing T2D could help to improve their cardiovascular health and to reduce the comorbidities associated with obesity.
Open Access
Effects of exercise on hepatic steatosis in children: role of fitness
(2019) Medrano Echeverría, María; Labayen Goñi, Idoia; Ciencias de la Salud; Osasun Zientziak
Los objetivos principales de esta Tesis Doctoral Internacional fueron: I) examinar si la capacidad cardiorrespiratoria se relaciona con la concentración plasmática de enzimas hepáticas en adolescentes europeos independientemente de la circunferencia de cintura, y testar si tener una mayor capacidad cardiorrespiratoria está asociada con un mejor perfil de enzimas hepáticas en aquellos adolescentes con una mayor circunferencia de cintura; II) explorar la asociación de los componentes de la condición física y la actividad física con el porcentaje de grasa hepática, las concentraciones plasmáticas de enzimas hepáticas, la resistencia a la insulina y el riesgo cardiometabólico en niñas y niños con sobrepeso u obesidad; III) analizar sistemáticamente el efecto del ejercicio físico supervisado en el porcentaje de grasa hepática y en la prevalencia de esteatosis hepática en niños y adolescentes; investigar el diseño de ejercicio más apropiado en términos de tipo, intensidad, volumen y frecuencia, para el manejo de la esteatosis hepática pediátrica; y explorar si existe una asociación entre las mejorar de la capacidad cardiorrespiratoria y la fuerza muscular con la reducción del porcentaje de grasa hepática en jóvenes; IV) determinar si un programa de intervención multicomponente de 22 semanas de duración, basado en educación familiar en estilos de vida saludable y psicoeducación que incluya además ejercicio físico supervisado, es más efectivo reduciendo el porcentaje de grasa hepática que solamente el programa educativo en niñas y niños con sobrepeso u obesidad; y V) analizar la variabilidad interindividual y comparar la prevalencia de respondedores en relación con el porcentaje de grasa hepática, la adiposidad total y abdominal y las concentraciones plasmáticas de gamma-glutamil-transferasa en los niñas y niños participantes en una intervención basada en educación familiar en estilos de vida saludable y psicoeducación de 22 semanas de duración, que incluya o no ejercicio físico.
Open Access
Parents' diet quality and physical activity are associated with lifestyle in spanish children and adolescents: the PASOS study
(MDPI, 2023) Monserrat-Mesquida, Margalida; Ródenas-Munar, Marina; Gómez, Santiago F.; Wärnberg, Julia; Medrano Echeverría, María; González Gross, Marcela; Gusi, Narcís; Aznar, Susana; Marín-Cascales, Elena; González Valeiro, Miguel A.; Serra-Majem, Lluis; Pulgar, Susana; Segú, Marta; Fitó, Montserrat; Según, Genís; Benavente-Marín, Juan C.; Labayen Goñi, Idoia; Zapico, Augusto G.; Sánchez-Gómez, Jesús; Jiménez-Zazo, Fabio; Alcaraz, Pedro E.; Sevilla-Sánchez, Marta; Herrera-Ramos, Estefanía; Schröder, Helmut; Tur, Josep A.; Bouzas, Cristina; Ciencias de la Salud; Osasun Zientziak; Institute on Innovation and Sustainable Development in Food Chain - ISFOOD
Background: Non-communicable chronic diseases are associated with a low-quality diet, low physical activity, and sedentary behavior. Objective: To assess how parents’ diet and physical activity habits were associated with their offsprings’ lifestyles. Study design: A cross-sectional analysis of 8–16-year-old children and adolescents (n = 2539; 51.9% girls) was carried out within the frame of the first edition of the Physical Activity, Sedentarism, Lifestyles, and Obesity in Spanish Youth study (PASOS-2019). Data on adherence to the Mediterranean Diet (MedDiet), daily moderate–vigorous physical activity (MVPA), and screen time per day (television, computer, video games, and mobile phone) were collected from children and adolescents, and data on parents’ diet quality and physical activity were compiled. Logistic regression models were used to assess the association between parents’ lifestyles and those of children and adolescents. Results: High diet quality of parents was associated with higher adherence to the MedDiet of children and adolescents, as well as high consumption of fruit, vegetables, fish, nuts, and legumes. The high physical activity level of parents was associated with the low consumption of fast foods, sweets, and candies in children and adolescents. Children with high levels of physical activity were those whose parents showed better diet quality and physical activity levels. Conclusions: Parents’ high diet quality and physical activity were associated with healthy lifestyles, higher adherence to the MedDiet, and physical activity of their offspring, mainly in adolescents.

Medrano Echeverría, María

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