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Changes and challenges faced by families in a pediatric weight management intervention: A preliminary analysis
abstract
training performed 2-3 times/week. Anthropometric measurements, cardiometabolic risk factors, Framingham scores, and exercise capacity were measured at baseline and after nine months of the program. results: No adverse events were noted during HIIT training. Weekly energy expenditure was in line with recommendations (1582±284 kcal). Significant and clinically relevant improvements were found for body mass (-5.3±5.2 kg, p<0,0001), BMI (-1.9±1.9 kg/m2, p<0,0001), waist circumference (-5.8±5.4 cm, p<0,0001), and maximal exercise capacity (+1.26±0.84 METs, p<0,0001). Total fat mass and trunk fat mass (p<0,0001), lipid profile, insulin sensitivity (p<0,0001), and Framingham scores (p<0.05) were also significantly improved. At the end of the program, 32.5% of MetS subjects no longer possessed MetS diagnostic criteria (p<0.05). Independent predictors of being a responder to body mass and waist circumference (WC) decrease were: baseline BMI and resting metabolic rate, as well as smoking status for WC, and baseline WC and triglycerides/HDL-cholesterol ratio for BMI decrease. conclusion: Long-term lifestyle intervention associated with optimized HIIT improve body composition, cardiometabolic risk factors, cardiovascular risk, MetS prevalence, and exercise tolerance in obese subjects. This intervention appeared safe, efficient, welltolerated, and could improve adherence to exercise training programs in this population. 187 Long-term high-intensity interval training improves Qt dispersion parameters in metabolic syndrome patients J. Drigny1, T. Guiraud1,2, V. Gremeaux1,3, M. Gayda1, M. Juneau1,4, and A. Nigam1,4 1 Cardiovascular Prevention Centre, Montreal Heart Institute, Montreal, Quebec, Canada; 2Clinique de Rééducation Cardiovasculaire et Pulmonaire de Saint Orens, Saint Orens de Gameville, France; 3Pôle RééducationRéadaptation, CHU de Dijon, Dijon, France; 4Research Centre and Université de Montréal, Montreal, Quebec, Canada.
188 changes and challenges faced by families in a pediatric weight management intervention: a preliminary analysis K.C. Neely, G.D.C. Ball, C.J. Knight, K.A. Ambler, A.S. Newton, J.C. Spence, and N.L. Holt University of Alberta, Edmonton, Alberta, Canada Although parent-based interventions are becoming increasingly popular for pediatric weight management, the experiences and expectations of parents and overweight children during the course of treatment have not been well characterized. This case study examined the changes made and the challenges faced by overweight children and their parents who were enrolled in a 16-week weight-management intervention. Data were collected from two families who participated in the intervention designed for parents exclusively. Semi-structured interviews were conducted with the child and one parent from each family before, during, and after the intervention (12 interviews in total). Interviews were transcribed verbatim and subjected to inductive qualitative analysis techniques. Findings are presented as cases of each family. One family increased their daily serving of fruits and vegetables and increased their weekly physical activity, but found it challenging to stay on track and stick to their goals. The second family did not implement any specific changes as a result of the intervention, however they recognized that making change is a work in progress. This family found it challenging to find the time to be physically active together and to motivate their child to make healthy choices on her own. Although the experiences in making changes and the challenges faced in making these changes were unique to each family, results revealed that the intervention provided parents from both families with knowledge and support that enabled them to make lifestyle changes. This information may be valuable for improving interventions to enable family success in weight management. 189
Introducton: The aim of this study was to compare long-term effects of two different modes of exercise training (moderate intensity continuous exercise (MICE) vs. high-intensity interval training (HIIT)) on QT dispersion (QTd) parameters in patients with metabolic syndrome (MetS). Methods: Sixty-five MetS patients (53±9 years) were assigned to either a MICE (30 minutes at 60% of peak power output) or a HIIT exercise prescription (two sets of 10 minutes of repeated bouts of 15/30s at 80% of peak power output interspersed by 15/30 sec of passive recovery) performed three times/week during nine months. Ventricular repolarization parameters (QT dispersion=QTd, standard deviation of QT= SDQT, relative dispersion of QT=RDQT, QT corrected dispersion= QTcd), cardiometabolic risk factors, and exercise capacity were assessed at baseline and after the training period. results: No adverse events were noted during HIIT training. QTd decreased significantly in both groups (pre vs. post = 50 vs. 44 ms in MICE group, p<0.0001; 38 vs. 34 ms in HIIT group, p<0.01). Other ventricular repolarization parameters also improved significantly in both groups. Exercise capacity improved (+0.9 and +1.2 METs (p<0.0001) in MICE and HIIT group, respectively), as well as lipid profile. Changes in QTd correlated with changes in METs (r=-0.21, p<0.03), triglycerides level (r=0.27, p<0.02), and triglycerides/HDLcholesterol ratio (r=0.21, p<0.03) in HIIT group. No associations were identified for MICE group. HIIT induced a significantly higher decrease compared to MICE in weight (-4.85 vs. -2.1 kg, p <0.05), BMI (-1.72 vs. -0.81 kg/m2), and waist circumference (-5.4 vs. -0.5 cm, p< 0.05). conclusion: Long-term HIIT exercise-training program safely led to greater improvements in body composition than MICE, with similar effects on ventricular repolarization parameters, in MetS patients. Our results suggest that improvements in QTd parameters are primarily induced by exercise training, whatever the type, rather than by improvement in body composition and metabolic profile.
addition of calcium to a green tea and caffeine beverage decreases its thermogenic effect G. Major1, M. Beaumont1, D. Grathwohl1, M. Valdez2, and K.Macé1 1 Nestlé Research Centre, Lausanne, Switzerland; 2Nestlé Product Technology Center, Marysville, Ohio, U.S.A. The development of functional food to activate energy metabolism is of interest in the actual context of obesity epidemic. Caffeine and green tea catechins are amongst the rare, safe ingredients, whose combination has been shown to increase energy expenditure. This is also the case for calcium, although its thermogenic effect is controversial. The effect on energy expenditure of two beverages with similar caffeine and green tea catechins, but different calcium content, was assessed in 49 healthy men and women (mean ±Std: 24.3±2.8 years and 21.7±1.7kg/m2). After a thirty--minute resting metabolic rate measurement, participants consumed in a randomized, crossover design three different beverages (placebo, caffeine, and green tea catechins with or without calcium), after which measurement were continued for four hours. The increase in energy expenditure above fasting values was significantly greater following ingestion of the beverage without calcium, compared to the placebo (p<0.001). This beverage also induced a significantly greater increase in fat oxidation compared to both placebo and the beverage with calcium (p<0.01 and 0.05, respectively). These results indicate that a beverage containing caffeine and green tea catechins in an amount comparable to what is found in a cup of coffee and green tea, respectively, increases energy expenditure and fat oxidation. However, the presence of calcium seems to blunt these ingredients’ thermogenic effect.
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training performed 2-3 times/week. Anthropometric measurements, cardiometabolic risk factors, Framingham scores, and exercise capacity were measured at baseline and after nine months of the program. results: No adverse events were noted during HIIT training. Weekly energy expenditure was in line with recommendations (1582±284 kcal). Significant and clinically relevant improvements were found for body mass (-5.3±5.2 kg, p<0,0001), BMI (-1.9±1.9 kg/m2, p<0,0001), waist circumference (-5.8±5.4 cm, p<0,0001), and maximal exercise capacity (+1.26±0.84 METs, p<0,0001). Total fat mass and trunk fat mass (p<0,0001), lipid profile, insulin sensitivity (p<0,0001), and Framingham scores (p<0.05) were also significantly improved. At the end of the program, 32.5% of MetS subjects no longer possessed MetS diagnostic criteria (p<0.05). Independent predictors of being a responder to body mass and waist circumference (WC) decrease were: baseline BMI and resting metabolic rate, as well as smoking status for WC, and baseline WC and triglycerides/HDL-cholesterol ratio for BMI decrease. conclusion: Long-term lifestyle intervention associated with optimized HIIT improve body composition, cardiometabolic risk factors, cardiovascular risk, MetS prevalence, and exercise tolerance in obese subjects. This intervention appeared safe, efficient, welltolerated, and could improve adherence to exercise training programs in this population. 187 Long-term high-intensity interval training improves Qt dispersion parameters in metabolic syndrome patients J. Drigny1, T. Guiraud1,2, V. Gremeaux1,3, M. Gayda1, M. Juneau1,4, and A. Nigam1,4 1 Cardiovascular Prevention Centre, Montreal Heart Institute, Montreal, Quebec, Canada; 2Clinique de Rééducation Cardiovasculaire et Pulmonaire de Saint Orens, Saint Orens de Gameville, France; 3Pôle RééducationRéadaptation, CHU de Dijon, Dijon, France; 4Research Centre and Université de Montréal, Montreal, Quebec, Canada.
188 changes and challenges faced by families in a pediatric weight management intervention: a preliminary analysis K.C. Neely, G.D.C. Ball, C.J. Knight, K.A. Ambler, A.S. Newton, J.C. Spence, and N.L. Holt University of Alberta, Edmonton, Alberta, Canada Although parent-based interventions are becoming increasingly popular for pediatric weight management, the experiences and expectations of parents and overweight children during the course of treatment have not been well characterized. This case study examined the changes made and the challenges faced by overweight children and their parents who were enrolled in a 16-week weight-management intervention. Data were collected from two families who participated in the intervention designed for parents exclusively. Semi-structured interviews were conducted with the child and one parent from each family before, during, and after the intervention (12 interviews in total). Interviews were transcribed verbatim and subjected to inductive qualitative analysis techniques. Findings are presented as cases of each family. One family increased their daily serving of fruits and vegetables and increased their weekly physical activity, but found it challenging to stay on track and stick to their goals. The second family did not implement any specific changes as a result of the intervention, however they recognized that making change is a work in progress. This family found it challenging to find the time to be physically active together and to motivate their child to make healthy choices on her own. Although the experiences in making changes and the challenges faced in making these changes were unique to each family, results revealed that the intervention provided parents from both families with knowledge and support that enabled them to make lifestyle changes. This information may be valuable for improving interventions to enable family success in weight management. 189
Introducton: The aim of this study was to compare long-term effects of two different modes of exercise training (moderate intensity continuous exercise (MICE) vs. high-intensity interval training (HIIT)) on QT dispersion (QTd) parameters in patients with metabolic syndrome (MetS). Methods: Sixty-five MetS patients (53±9 years) were assigned to either a MICE (30 minutes at 60% of peak power output) or a HIIT exercise prescription (two sets of 10 minutes of repeated bouts of 15/30s at 80% of peak power output interspersed by 15/30 sec of passive recovery) performed three times/week during nine months. Ventricular repolarization parameters (QT dispersion=QTd, standard deviation of QT= SDQT, relative dispersion of QT=RDQT, QT corrected dispersion= QTcd), cardiometabolic risk factors, and exercise capacity were assessed at baseline and after the training period. results: No adverse events were noted during HIIT training. QTd decreased significantly in both groups (pre vs. post = 50 vs. 44 ms in MICE group, p<0.0001; 38 vs. 34 ms in HIIT group, p<0.01). Other ventricular repolarization parameters also improved significantly in both groups. Exercise capacity improved (+0.9 and +1.2 METs (p<0.0001) in MICE and HIIT group, respectively), as well as lipid profile. Changes in QTd correlated with changes in METs (r=-0.21, p<0.03), triglycerides level (r=0.27, p<0.02), and triglycerides/HDLcholesterol ratio (r=0.21, p<0.03) in HIIT group. No associations were identified for MICE group. HIIT induced a significantly higher decrease compared to MICE in weight (-4.85 vs. -2.1 kg, p <0.05), BMI (-1.72 vs. -0.81 kg/m2), and waist circumference (-5.4 vs. -0.5 cm, p< 0.05). conclusion: Long-term HIIT exercise-training program safely led to greater improvements in body composition than MICE, with similar effects on ventricular repolarization parameters, in MetS patients. Our results suggest that improvements in QTd parameters are primarily induced by exercise training, whatever the type, rather than by improvement in body composition and metabolic profile.
addition of calcium to a green tea and caffeine beverage decreases its thermogenic effect G. Major1, M. Beaumont1, D. Grathwohl1, M. Valdez2, and K.Macé1 1 Nestlé Research Centre, Lausanne, Switzerland; 2Nestlé Product Technology Center, Marysville, Ohio, U.S.A. The development of functional food to activate energy metabolism is of interest in the actual context of obesity epidemic. Caffeine and green tea catechins are amongst the rare, safe ingredients, whose combination has been shown to increase energy expenditure. This is also the case for calcium, although its thermogenic effect is controversial. The effect on energy expenditure of two beverages with similar caffeine and green tea catechins, but different calcium content, was assessed in 49 healthy men and women (mean ±Std: 24.3±2.8 years and 21.7±1.7kg/m2). After a thirty--minute resting metabolic rate measurement, participants consumed in a randomized, crossover design three different beverages (placebo, caffeine, and green tea catechins with or without calcium), after which measurement were continued for four hours. The increase in energy expenditure above fasting values was significantly greater following ingestion of the beverage without calcium, compared to the placebo (p<0.001). This beverage also induced a significantly greater increase in fat oxidation compared to both placebo and the beverage with calcium (p<0.01 and 0.05, respectively). These results indicate that a beverage containing caffeine and green tea catechins in an amount comparable to what is found in a cup of coffee and green tea, respectively, increases energy expenditure and fat oxidation. However, the presence of calcium seems to blunt these ingredients’ thermogenic effect.
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