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Effect of Alpha-Lipoic Acid Supplementation on Endothelial Function and Cardiovascular Risk Factors in Overweight/Obese Youths: A Double-Blind, Placebo-Controlled Randomized Trial.
Tromba, L, Perla, FM, Carbotta, G, Chiesa, C, Pacifico, L
Nutrients. 2019;11(2)
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Children who are obese or overweight are at a higher risk of developing heart disease. Damage to the lining of the blood vessels may be an early indicator of potential heart disease. Alpha-lipoic acid (ALA) is a supplement that has anti-oxidant and anti-inflammatory effects, and has been shown to improve blood vessel function in adults with metabolic diseases, and children with type 1 diabetes. It is not yet known whether ALA supplementation can benefit cardiovascular health in overweight/obese youths. The aim of this double-blind placebo-controlled randomised trial was to investigate whether supplementation with ALA improved endothelial function and risk factors for cardiovascular disease in overweight and obese youths. 64 overweight/obese youths aged 8-16 years old were given either 800mg ALA or a placebo for 12 weeks. All participants were instructed to follow a balanced low-calorie diet and advised to engage in a moderate daily exercise program (60 min/day at least five days a week). At the end of the study, blood vessel function, as assessed by flow-mediated dilation (FMD) of the brachial artery, did not change significantly in either of the groups. However, the basal and peak diameter of the brachial artery significantly increased after ALA treatment, compared to placebo. There were no significant changes between groups or over time for blood pressure, weight or body mass index (BMI), nor were there any significant changes in glucose, insulin or fat levels within the blood. The authors concluded that ALA supplementation improves the tone of blood vessels and may have a beneficial effect on heart health in overweight/obese youths.
Abstract
Endothelial dysfunction is recognized as an early sign of systemic atherosclerosis, and it represents a therapeutic target to prevent long-term cardiovascular (CV) consequences. Alpha-lipoic acid (ALA) is a commonly used dietary supplement exerting anti-oxidant and anti-inflammatory effects. We investigated whether a three-month treatment with ALA improves endothelial function, as assessed by flow-mediated dilation (FMD) of the brachial artery, and clinical and metabolic risk factors in overweight/obese youths. We enrolled 67 overweight/obese children, and 22 normal-weight metabolically healthy controls. Overweight/obese youths were randomly allocated in a double-blinded manner to receive ALA (n = 34) or placebo (n = 33). Of these, 64 (32 ALA, 32 placebo) completed the follow-up. At baseline, in ALA and placebo groups, FMD was similar, but lower as compared with that in controls (p = 0.045). At three months, within the ALA and placebo groups, FMD did not change significantly. However, the basal and peak diameter of brachial artery significantly increased after ALA treatment as compared to placebo (p = 0.036 and p = 0.01, respectively). There were no significant within- and between-group changes for anthropometric and metabolic variables. The results show that ALA supplementation improves vascular tone and may have a beneficial effect on CV health in overweight/obese youths.
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Positive effects on bone mineralisation and muscular fitness after 10 months of intense school-based physical training for children aged 8-10 years: the FIT FIRST randomised controlled trial.
Larsen, MN, Nielsen, CM, Helge, EW, Madsen, M, Manniche, V, Hansen, L, Hansen, PR, Bangsbo, J, Krustrup, P
British journal of sports medicine. 2018;52(4):254-260
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Fractures in older people are a huge public health challenge. Low bone strength in childhood is associated with a higher fracture risk in later life. Weight-bearing activities during childhood can improve muscle and bone strength, potentially reducing the risk of falls and fractures in later life. This study looked at the impact of frequent exercise sessions on bone strength in children aged 8-10 years. 295 Danish school children were divided into three groups: a small-sided ball game group (SSG), a circuit strength training group (CST) or a control group. Exercise sessions lasted for 40 minutes, three times a week for 10 months. Scans were used to determine bone mineral density (BMD), bone mineral content (BMC) and lean body mass (LBM). A variety of tests to determine muscular fitness were carried out at the beginning and end of the study. Both exercise groups saw significant improvements in BMD. Both training types resulted in significant improvements in postural balance and jump length. No differences between the groups were observed for sprint performance or LBM. The authors concluded that 40 min sessions 3 times a week with SSG or CST over a full school year improves bone mineralisation and several aspects of muscular fitness of children aged 8-10 years, suggesting that well-organised physical education classes can contribute positively to musculoskeletal health in young children.
Abstract
OBJECTIVES We investigated whether musculoskeletal fitness of school children aged 8-10 years was affected by frequent intense PE sessions. DESIGN AND PARTICIPANTS 295 Danish school children aged 8-10 years were cluster randomised to a small-sided ball game group (SSG) (n=96, four schools, five classes), a circuit strength training group (CST) (n=83, four schools, four classes) or a control group (CON, n=116, two schools, five classes). INTERVENTION SSG or CST was performed 3×40 min/week over 10 months. Whole-body dual-energy X-ray absorptiometry (DXA) scans were used to determine areal bone mineral density (aBMD), bone mineral content (BMC) and lean body mass (LBM). Flamingo balance, standing long jump and 20-m sprint tests were used to determine muscular fitness. RESULTS Analysis of baseline-to-10 months change scores showed between-group differences in favour of the interventions in whole-body aBMD (SSG vs CON: 8 mg/cm2, 95% CI 3 to 13; CST vs CON: 7 mg/cm2, 95% CI 2 to 13, p<0.05) and leg BMC (SSG vs CON: 11 g, 95% CI 4 to 18; CST vs CON: 11 g, 95% CI 3 to 18, p<0.05). SSG had higher change scores in leg aBMD compared with CON and CST (SSG vs CON: 19 mg/cm2, 95% CI 11 to 39, p<0.05; SSG vs CST: 12 mg/cm2, 95% CI 3 to 21, p<0.05), and CST had higher change scores in whole-body BMC compared with CON (CST vs CON: 25 g, 95% CI 10 to 39, p<0.05). Both training types resulted in higher change scores in postural balance (SSG vs CON: 2.4 fewer falls/min, 95% CI 0.3 to 4.5, CST vs CON: 3.6 fewer falls/min, 95% CI 1.3 to 5.9, p<0.05) and jump length (SSG vs CON: 10%, 95% CI 5 to 16%; CST vs CON: 9%, 95% CI 3 to 15%, p<0.05). No between-group differences were observed for sprint performance or LBM (p>0.05). CONCLUSIONS In conclusion, 3×40 min/week with SSG or CST over a full school year improves bone mineralisation and several aspects of muscular fitness of children aged 8-10 years, suggesting that well-organised intense physical education classes can contribute positively to develop musculoskeletal health in young children. TRIAL REGISTRATION NUMBER NCT02000492, post results.
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New Insights about How to Make an Intervention in Children and Adolescents with Metabolic Syndrome: Diet, Exercise vs. Changes in Body Composition. A Systematic Review of RCT.
Albert Pérez, E, Mateu Olivares, V, Martínez-Espinosa, RM, Molina Vila, MD, Reig García-Galbis, M
Nutrients. 2018;10(7)
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Metabolic Syndrome is the term used to group a cluster of health concerns including overweight, obesity, hypertension, elevated cholesterol, blood glucose intolerance and insulin resistance which together can contribute to the development of Type II Diabetes and Cardiovascular Disease. Diagnosis is usually given if a patient has three or more of these conditions however the diagnosis in children and adolescents is often inconsistent, and so guidelines for therapeutic strategies for metabolic syndrome also vary greatly. This review looked at 9 studies of children aged up to 19 years old, all diagnosed with metabolic syndrome, and given dietary, physical, psychological, and pharmacological interventions, to try and understand what the best clinical approach might be. It was found that a balanced diet combined with aerobic and resistance exercise helped to significantly reduce body mass, more so than the trials which included treatment with Metformin. A balance diet included calorie restriction and carbohydrate reduction, carefully planned around the daily exercise program of 2-3 resistance sessions each week and frequent cardio sessions of differing intensity and duration. They concluded that a minimum of 6 months was needed to reach optimal weight loss and body fat loss. Overall, the findings of this study support diet and physical exercise as beneficial clinical interventions, whilst the use of medication is still unclear.
Abstract
OBJECTIVE To record which interventions produce the greatest variations in body composition in patients ≤19 years old with metabolic syndrome (MS). METHOD search dates between 2005 and 2017 in peer reviewed journals, following the PRISMA method (Preferred Reporting Items for Systematic reviews and Meta-Analyses). The selection criteria were: diagnostic for MS or at least a criterion for diagnosis; randomized clinical trials, ≤19 years of age; intervention programs that use diet and/or exercise as a tool (interventions showing an interest in body composition). RESULTS 1781 clinical trials were identified under these criteria but only 0.51% were included. The most frequent characteristics of the selected clinical trials were that they used multidisciplinary interventions and were carried out in America. The most utilized parameters were BMI (body mass index) in kg/m² and BW (body weight) in kg. CONCLUSIONS Most of the clinical trials included had been diagnosed through at least 2 diagnostic criteria for MS. Multidisciplinary interventions obtained greater changes in body composition in patients with MS. This change was especially prevalent in the combinations of dietary interventions and physical exercise. It is proposed to follow the guidelines proposed for patients who are overweight, obese, or have diabetes type 2, and extrapolate these strategies as recommendations for future clinical trials designed for patients with MS.