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Longitudinal changes in activity patterns, physical capacities, energy expenditure, and body composition in severely obese adolescents during a multidisciplinary weight-reduction program

Abstract

OBJECTIVE:

To determine the longitudinal changes in body composition, physical capacities, and time and energy expenditure (EE) devoted to various activities in the course of a 9-month weight-reduction period.

DESIGN:

Longitudinal, clinical intervention including lifestyle education, moderate energy restriction, progressive training, and psychological follow-up.

SUBJECTS:

A total of 27 (13 boys and 14 girls) severely obese adolescents (mean BMI: 33.9 kg/m2; 41.5% fat mass (FM)), aged 12–16 y.

MEASUREMENTS:

Before the beginning and after the weight-reduction program, body composition was assessed by dual-energy X-ray absorptiometry (DXA), physical capacities by multistage treadmill test, and EE both by whole-body calorimetry and in free-living conditions using the heart rate-recording method. During 8 months of the weight-reduction period, type and duration of each activity were recorded using a daily controlled activity diary.

RESULTS:

One boy resigned after 5 months. Body weight (BW) and FM decreased (−19 and −42%, respectively, P<0.001) both in boys and in girls, but fat-free mass (FFM) decreased only in girls (−6%, P<0.001). VO2max (l/min) did not vary significantly, but strength and fitness were improved (P<0.001). Time and EE spent at sedentary activities decreased significantly (P<0.001) to the benefit of moderate (recreational) activities and total physical activities (P<0.001) at the institution during the weekdays, and at home during the weekends and holidays.

CONCLUSION:

The great BW and FM losses, preservation of FFM, and improvement of physical capacities of obese adolescents obtained under experimental conditions were associated with increases in leisure physical activities in free-living conditions at the expense of sleep and sedentary activities.

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Acknowledgements

We thank X Deries, MD, Director of the Children Medical Centre, the teachers of adolescents, and A Itier, dietitian, for their contribution to set up the study. We are grateful to the volunteers for their cooperation, J-M Bonnet, G Ducher, F Rodriguez, and J Verney for their valuable contribution in carrying out physical training; L Morin, M Brandolini, and the staff of the Protein-Energy Metabolism Research Unit for their kind assistance during the study; and Dr R Taylor for revising the English. The study was supported by INRA (Institut National de la Recherche Agronomique) and the University of Auvergne. S Lazzer was granted by Guigoz Laboratories, the Roche Institute for Obesity through the Association Française d’Etude et de Recherche sur l’Obésité (AFERO).

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Correspondence to M Vermorel.

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Lazzer, S., Boirie, Y., Poissonnier, C. et al. Longitudinal changes in activity patterns, physical capacities, energy expenditure, and body composition in severely obese adolescents during a multidisciplinary weight-reduction program. Int J Obes 29, 37–46 (2005). https://doi.org/10.1038/sj.ijo.0802845

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