Clinical Pediatric Weight Management Physical Activity Program Results In Decreased Cvd Risk Factors

Abstract

PURPOSE: Assessment of exercise/physical activity tolerance and indirect assessment of aerobic fitness in obese children and adolescents is necessary to improve interventions that will result in long-term, successful participation and evaluate the effectiveness of the intervention. 216 youth 58% females (F) and 51% African-Americans (AA) who were enrolled in a clinical weight management program were examined to determine changes in a 400m walk test, BMI and lipid levels before and after participation in a clinical, pediatric weight management program. METHODS: A 400m walk test was preformed as part of a clinical initial assessment and again following completion of Phase I of the weight management program. At each assessment, participants were instructed to briskly walk the measured corridor. Walk time (WT), pre-WT and post-WT HR and BP, fasting lipids, glucose, insulin and BMI was assessed at each assessment. RESULTS: Repeated measures ANOVA revealed a significant decrease in WT before & following the intervention (pretest WT = 333.5(31.6) vs posttest WT = 315.9(29.9); p<0.0001). The average length of the intervention program was 279(199) days (F=276(204), M=283(193); AA=301(206), C=253(174); NS for gender & race). There were no significant changes in BMI (pre=34.6(7.9) - post=35.2(14.1) following the intervention. However, WT (p<0.005) & BMI (p<0.02) was significantly greater prior to the intervention for AA, but change in WT & BMI was not significantly different by gender or race. Additionally, age was not associated with either the change in WT or BMI. Total cholesterol (pre=162.1(32.0) - post=156.4(31.0); p<0.001), LDL (104.8(64.5) - 96.9(27.6); p<0.09), Triglycerides (92.7(59.4) - 80.8(43.8); p<0.005) and insulin (28.4(21.8) - 23.8(13.8); p<0.005) were significantly and positively changed as a function of the intervention; only insulin was significantly greater as a function of race (AA>C) prior to the intervention (p<0.05). CONCLUSIONS: This clinical weight management intervention results in favorable changes in aerobic fitness, fasting lipids and insulin levels without a decrease in BMI. Also, the 400m walk test is a sensitive and appropriate approach for field testing populations with low exercise tolerance such as obese adolescents in a clinical setting.