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

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dc.contributor.authorCadenas-Sánchez, Cristina
dc.contributor.authorCabeza Laguna, Rafael
dc.contributor.authorIdoate, Fernando
dc.contributor.authorOsés Recalde, Maddi
dc.contributor.authorMedrano Echeverría, María
dc.contributor.authorVillanueva Larre, Arantxa
dc.contributor.authorArenaza Etxeberría, Lide
dc.contributor.authorSanz Muñoz, Aritz
dc.contributor.authorOrtega, Francisco B.
dc.contributor.authorRuiz, Jonatan R.
dc.contributor.authorLabayen Goñi, Idoia
dc.contributor.departmentCiencias de la Saludes_ES
dc.contributor.departmentIngeniería Eléctrica, Electrónica y de Comunicaciónes_ES
dc.contributor.departmentInstitute on Innovation and Sustainable Development in Food Chain - ISFOODen
dc.contributor.departmentInstitute of Smart Cities - ISCen
dc.contributor.departmentOsasun Zientziakeu
dc.contributor.departmentIngeniaritza Elektrikoa, Elektronikoaren eta Telekomunikazio Ingeniaritzareneu
dc.date.accessioned2023-04-25T09:05:51Z
dc.date.available2023-04-25T09:05:51Z
dc.date.issued2022
dc.date.updated2023-04-25T08:54:29Z
dc.description.abstractImportance 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.en
dc.description.sponsorshipThis study was supported by grant PI13/01335 from the Spanish Ministry of Health’s Fondos de Investigación Sanitaria del Instituto de Salud Carlos III; by grant DEP2016-78377 from the Spanish Ministry of the Economy Industry and Competitiveness; by European Regional Development Funds (ERDF) Una Manera de Hacer Europa; by grant 0011-1365-2019-000085 from the Regional Government of Navarra’s Department of Economic Development (cofunded by ERDF 2014-2020 for Navarra); by grant 47/2021 from the Government of Navarra’s Department of Health; by grant FJC2018-037925-I from the Spanish Ministry of Science and Innovation (Dr Cadenas-Sanchez); by Marie Sklodowska Curie grant agreement 101028929 from the European Union’s Horizon 2020 Research and Innovation Programme (Dr Cadenas-Sanchez); by grant BES-2017-080770 from the Spanish Ministry of the Economy Industry and Competitiveness (Dr Osés); by grants PRE_2016_1_0057, PRE_2017_2_0224, PRE_2018_2_0057, and PRE_2019_2_0004 from the Education Department of the Government of the Basque Country (Dr Arenaza); and by grant SOMM17/6107/UGR from the University of Granada Plan Propio de Investigación 2021 Excellence actions: Unit of Excellence on Exercise, Nutrition and Health and the Junta de Andalucía, Consejería de Conocimiento, Investigación y Universidades, ERDF.en
dc.format.mimetypeapplication/pdfen
dc.identifier.citationCadenas-Sanchez, C., Cabeza, R., Idoate, F., Osés, M., Medrano, M., Villanueva, A., Arenaza, L., Sanz, A., Ortega, F. B., Ruiz, J. R., & Labayen, I. (2022). 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. JAMA Network Open, 5(11), e2243864. https://doi.org/10.1001/jamanetworkopen.2022.43864en
dc.identifier.doi10.1001/jamanetworkopen.2022.43864
dc.identifier.issn2574-3805
dc.identifier.urihttps://academica-e.unavarra.es/handle/2454/45194
dc.language.isoengen
dc.publisherAmerican Medical Associationen
dc.relation.ispartofJAMA Network Open, 2022; 5(11), 1-14en
dc.relation.projectIDinfo:eu-repo/grantAgreement/European Commission/Horizon 2020 Framework Programme/101028929/
dc.relation.projectIDinfo:eu-repo/grantAgreement/MINECO//PI13%2F01335/ES/
dc.relation.projectIDinfo:eu-repo/grantAgreement/AEI/Plan Estatal de Investigación Científica y Técnica y de Innovación 2013-2016/DEP2016-78377/
dc.relation.projectIDinfo:eu-repo/grantAgreement/AEI/Plan Estatal de Investigación Científica y Técnica y de Innovación 2013-2016/FJC2018-037925-I/
dc.relation.projectIDinfo:eu-repo/grantAgreement/AEI/Plan Estatal de Investigación Científica y Técnica y de Innovación 2013-2016/BES-2017-080770/
dc.relation.projectIDinfo:eu-repo/grantAgreement/Gobierno de Navarra//0011-1365-2019-000085/
dc.relation.projectIDinfo:eu-repo/grantAgreement/Gobierno de Navarra//47%2F2021/
dc.relation.publisherversionhttps://doi.org/10.1001/jamanetworkopen.2022.43864
dc.rightsThis is an open access article distributed under the terms of the CC-BY License.en
dc.rights.accessRightsinfo:eu-repo/semantics/openAccess
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectExerciseen
dc.subjectAbdominal faten
dc.subjectOverweight childrenen
dc.subjectObese childrenen
dc.subjectDiabetes preventionen
dc.titleEffects 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 trialen
dc.typeinfo:eu-repo/semantics/article
dc.type.versioninfo:eu-repo/semantics/publishedVersion
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