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Published on: March 7, 2019
The feasibility of a home-based moderate-intensity physical activity intervention in obese children and adolescents
Louise S Conwell1, Stewart G Trost, Luke Spence
1Department of Endocrinology and Diabetes, Royal Children's Hospital, Herston, Brisbane, Queensland, Australia. louise_conwell@health.qld.gov.au
Insights
A 10-week home-based physical activity (PA) program improved insulin sensitivity (S(I)) in obese youth. This feasible intervention increased daily steps without changing BMI-SDS, suggesting a potential strategy for metabolic health.
Area of Science:
- Pediatrics
- Metabolic Health
- Exercise Science
Background:
- Childhood obesity is a growing concern, linked to insulin resistance and metabolic dysfunction.
- Early intervention is crucial to mitigate long-term health risks associated with obesity in young people.
Purpose of the Study:
- To assess the feasibility of a 10-week home-based physical activity (PA) program for obese children and adolescents.
- To evaluate changes in insulin sensitivity (S(I)) following the PA intervention.
Main Methods:
- An open-label, home-based intervention was conducted over 10 weeks with biweekly home visits.
- Participants (n=15, aged 8-18 years) received personalized PA plans, using pedometers and diaries for self-monitoring.
- Insulin sensitivity (S(I)) was measured using the frequently sampled intravenous glucose tolerance test.
Main Results:
- Mean daily steps significantly increased from baseline (10,363) to week 10 (13,013) (p<0.05).
- Insulin sensitivity (S(I)) significantly improved post-intervention and was maintained at follow-up.
- No significant changes in BMI-SDS were observed, despite improvements in S(I).
Conclusions:
- A home-based PA program is a feasible approach for improving metabolic health in obese youth.
- Improvements in insulin sensitivity can occur independently of significant weight loss.
- Further rigorous studies are recommended to confirm these findings and explore long-term effects.
Objectives:
To explore the feasibility of conducting a 10-week home-based physical activity (PA) programme and evaluate the changes in insulin sensitivity (S(I)) commensurate with the programme in obese young people.
Design:
Open-labelled intervention.
Setting:
Home-based intervention with clinical assessments at a tertiary paediatric hospital.
Subjects:
18 obese (body mass index (BMI)>International Obesity Task Force age and sex-specific cut-offs) children and adolescents (8-18 years, 11 girls/7 boys) were recruited. 15 participants (nine girls/six boys, mean+/-SE age 11.8+/-0.6 years, BMI-SD scores (BMI-SDS) 3.5+/-0.1, six prepubertal/nine pubertal) completed the intervention.
Intervention:
The programme comprised biweekly home visits over 10 weeks with personalised plans implemented aiming to increase moderate-intensity PA. Pedometers and PA diaries were used as self-monitoring tools. The goals were to (1) teach participants behavioural skills related to adopting and maintaining an active lifestyle and (2) increase daily participation in PA.
Outcome Measures:
Mean steps/day were assessed. S(I) assessed by the frequently sampled intravenous glucose tolerance test and other components of the insulin resistance syndrome were measured.
Results:
Mean steps/day increased significantly from 10 363+/-927 (baseline) to 13 013+/-1131 (week 10) (p<0.05). S(I) was also significantly increased, despite no change in BMI-SDS, and remained so after an additional 10-week follow-up.
Conclusions:
The results suggest that such a home-based PA programme is feasible. S(I) improved without changes in BMI-SDS. More rigorous evaluations of such programmes are warranted.
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