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Eating disorders in weight-related therapy (EDIT): Protocol for a systematic review with individual participant data meta-analysis of eating disorder risk in behavioural weight management.
Jebeile, H, Lister, NB, Libesman, S, Hunter, KE, McMaster, CM, Johnson, BJ, Baur, LA, Paxton, SJ, Garnett, SP, Ahern, AL, et al
PloS one. 2023;(7):e0282401
Abstract
The Eating Disorders In weight-related Therapy (EDIT) Collaboration brings together data from randomised controlled trials of behavioural weight management interventions to identify individual participant risk factors and intervention strategies that contribute to eating disorder risk. We present a protocol for a systematic review and individual participant data (IPD) meta-analysis which aims to identify participants at risk of developing eating disorders, or related symptoms, during or after weight management interventions conducted in adolescents or adults with overweight or obesity. We systematically searched four databases up to March 2022 and clinical trials registries to May 2022 to identify randomised controlled trials of weight management interventions conducted in adolescents or adults with overweight or obesity that measured eating disorder risk at pre- and post-intervention or follow-up. Authors from eligible trials have been invited to share their deidentified IPD. Two IPD meta-analyses will be conducted. The first IPD meta-analysis aims to examine participant level factors associated with a change in eating disorder scores during and following a weight management intervention. To do this we will examine baseline variables that predict change in eating disorder risk within intervention arms. The second IPD meta-analysis aims to assess whether there are participant level factors that predict whether participation in an intervention is more or less likely than no intervention to lead to a change in eating disorder risk. To do this, we will examine if there are differences in predictors of eating disorder risk between intervention and no-treatment control arms. The primary outcome will be a standardised mean difference in global eating disorder score from baseline to immediately post-intervention and at 6- and 12- months follow-up. Identifying participant level risk factors predicting eating disorder risk will inform screening and monitoring protocols to allow early identification and intervention for those at risk.
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Aerobic Training Performed at Ventilatory Threshold Improves Psychological Outcomes in Adolescents With Obesity.
Fidelix, Y, Lofrano-Prado, MC, Fortes, LS, Hill, JO, Caldwell, AE, Botero, JP, do Prado, WL
Journal of physical activity & health. 2019;(10):851-856
Abstract
BACKGROUND Physical activity may be as effective as some drugs for improving psychological outcomes; however, vigorous exercise may be needed for improving these outcomes in adolescents with obesity. The aim of this study is to examine the effects of low- and high-intensity training on self-esteem and symptoms of depression and anxiety in adolescents with obesity. METHODS A total of 62 pubertal adolescents with obesity (age 15 [1.5] y, body mass index 34.87 [4.22] kg/m2) were randomized into high-intensity group (HIG, n = 31) or low-intensity group (LIG, n = 31) for 24 weeks. All participants also received nutritional, psychological, and clinical counseling. Body composition and measures of depressive symptoms, anxiety, and self-esteem were assessed at baseline and after 24 weeks. RESULTS Depressive symptoms decreased significantly in both HIG (d = 1.16) and LIG (d = 0.45) (P ≤ .01). Trait anxiety decreased after 24 weeks for HIG (d = 0.81, P = .002) and LIG (d = 0.31, P = .002). No changes were observed in state anxiety or self-esteem. CONCLUSIONS Results from the present study demonstrate that 24 weeks of multidisciplinary intervention improves depression and anxiety symptoms in adolescents with obesity; however, the magnitude of changes is higher in HIG compared with LIG.
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Aerobic training performed at ventilatory threshold improves liver enzymes and lipid profile related to non-alcoholic fatty liver disease in adolescents with obesity.
de Lira, CT, Dos Santos, MA, Gomes, PP, Fidelix, YL, Dos Santos, AC, Tenório, TR, Lofrano-Prado, MC, do Prado, WL
Nutrition and health. 2017;(4):281-288
Abstract
BACKGROUND Despite the positive effects of high-intensity training on weight management and health-related outcomes, it is postulated that high-intensity training may also induce oxidative stress, increasing hepatic damage. AIM: The aim of this study was to compare the effects of low versus high-intensity training on biomarkers related to non-alcoholic fatty liver disease (NAFLD) in adolescents with obesity. METHODS For this study 107 adolescents (15 ± 1 years) with obesity (BMI = 34.7 ± 4.1 kg/m2) were randomized into High-Intensity Training (HIT, n = 31), Low-Intensity Training (LIT, n = 31) or Control Group (CG, n = 45). Adolescents from HIT and LIT received nutritional, psychological and clinical counseling. Blood lipids, Castelli risk index, glucose, insulin and hepatic enzymes were measured at baseline and after 12 weeks. RESULTS Castelli risk index 1 was reduced in all groups ( p < 0.001) with moderate effect size ( d) for HIT ( d = 0.62) and LIT ( d = 0.66). Castelli risk index 2 also decreased ( p < 0.001 for all groups; HIT d = 0.65; LIT d = 0.79). High-density lipoprotein increased in all groups ( d = 0.25 and d = 0.18 in HIT and LIT), while alanine aminotransferase tended to reduce ( p = 0.062) in HIT ( d = 0.34) and LIT ( d = 0.73) and aspartate aminotransferase decreased ( p = 0.024) in both HIT ( d = 0.24) and LIT ( d = 0.45). There were no changes in glucose, insulin and insulin resistance. CONCLUSION Both high and low-intensity training improved biomarkers related to NAFLD. Thus, high-intensity training can be a safe and effective alternative to prevent and treat NAFLD in adolescents with obesity.
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Effectiveness of a 16-month multi-component and environmental school-based intervention for recovery of poor income overweight/obese children and adolescents: study protocol of the health multipliers program.
Patriota, PF, Filgueiras, AR, de Almeida, VBP, Alexmovitz, GAC, da Silva, CE, de Carvalho, VFF, Carvalho, N, de Albuquerque, MP, Domene, SMA, do Prado, WL, et al
BMC public health. 2017;(1):708
Abstract
BACKGROUND Excess of weight is a serious public health concern in almost all countries, afflicting people of different ages and socioeconomic backgrounds. Studies have indicated the need for developing treatment strategies that intervene directly in the obesogenic environment. This study aims to evaluate the effectiveness of a multi-component and environmental school-based intervention, lasting 16 months, on the recovery of the nutritional status of low-income children and adolescents with overweight/ obesity. METHODS/STUDY DESIGN The study was conducted by the Center for Recovery and Nutritional Education (CREN) in São Paulo, Brazil. Two schools located in poor neighborhoods were selected for the intervention, between March 2016 and June 2017. The participants were all students aged 8 to 12 years from the two participating schools. At the beginning of the intervention, anthropometric measurements were carried out to assess the nutritional status of the students. For convenience, students from one of the schools were considered as the control group, while those from the other school formed the experimental group. The intervention in the experimental group (n = 438) consists of the following weekly activities at school: psychological counseling in groups, theoretical/practical nutrition workshops, and supervised physical education classes. In addition, theoretical and practical educational activities are held regularly for parents, teachers, and cooks. Students with excess of weight (≥1 body mass index [BMI] -for-age Z score, n = 138) received clinical and nutritional care periodically at the outpatient care at CREN. Students enrolled in the control group (n = 353) participated in psychological counseling groups and theoretical/practical nutrition workshops for 6 months held in the school environment to provide motivation to entire classrooms. In the following 10 months, students with excess of weight from the control group (n = 125) were invited to attend the routine outpatient care at CREN. DISCUSSION This study is the first to assess the effectiveness of a multi-component and environmental school-based intervention for the recovery of low-income, overweight/obese children and adolescents. If positive, the results demonstrate the feasibility for the recovery of excess of weight in populations of similar conditions and age. TRIAL REGISTRATION Brazilian Registry of Clinical Trials - ReBEC Primary Id Number RBR-9t2jr8 . Registration Date: Nov. 30, 2016. Retrospectively registered. Protocol version: 3.
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Acute effects of aerobic exercise on mood and hunger feelings in male obese adolescents: a crossover study.
Lofrano-Prado, MC, Hill, JO, Silva, HJ, Freitas, CR, Lopes-de-Souza, S, Lins, TA, do Prado, WL
The international journal of behavioral nutrition and physical activity. 2012;:38
Abstract
BACKGROUND The aim of this study was to determine the acute effects of exercise intensity on anxiety, mood states and hunger in obese adolescents. METHODS Subjects were eight male obese adolescents (age 15.44 ± 2.06 y; BMI 33.06 ± 4.78 kg/m2). Each subject underwent three experimental trials: (1) Control, seated for 30 min; (2) Low intensity exercise (LIE)--exercise at 10% below ventilatory threshold (VT); (3) High intensity exercise (HIE)--exercise at 10% above VT. Anxiety (STAI Trait/State), mood (POMS) and hunger (VAS) were assessed before and immediately after the experimental sessions. Comparisons between trials and times were assessed using Kruskal-Wallis and Wilcoxon tests, respectively. Associations between variables were described using a Spearman test. RESULTS The largest increase in hunger was observed after LEI (914.22%). Both exercise sessions increased anxiety, fatigue and decreased vigor (p < 0.05). CONCLUSIONS Acute exercise bouts are associated with negative changes in anxiety and mood, and with increases in hunger in obese adolescents.