Abstract
ObjectiveThe aim of this study was to determine whether a combined exercise and dietary intervention improved cognitive and physical self-control and whether pre-to-post interventional changes in self-control were mediated by changes in body mass index (BMI) and maximal grip strength (MGS), in a sample of obese adolescents.MethodsForty-four obese adolescents were randomly assigned to a combined exercise and dietary program or to a waitlist control group; the data from 36 participants (n = 18 for each group) were analyzed. The combined exercise and dietary program was performed over 6 weeks and was supervised by qualified trainers in a closed boot camp. The exercise consisted primarily of typical aerobic training, sports, outdoor training, yoga, and resistance training. Participants were placed on moderate dietary restriction according to individual target body weight (30 kcal/kg × target weight). The primary outcomes of this study were metrics based on cognitive and physical self-control, assessed by the Stroop task and a handgrip task, respectively. Secondary outcomes included BMI and MGS.ResultsThe combined exercise and dietary intervention significantly improved both cognitive and physical self-control. Similar positive effects were also found for reduced BMI and enhanced MGS. Correlation analyses showed that the reduced BMI and enhanced MGS were significantly closely associated with improved cognitive and physical self-control. The mediation analyses revealed that the pre-to-post intervention changes in BMI and MGS significantly mediated physical self-control, but did not mediate cognitive self-control.ConclusionOur combined exercise and dietary intervention is an effective approach to improve multiple aspects of self-control, reduce BMI, and strengthen MGS among obese adolescents. These findings also suggest that reduced BMI and enhanced MGS mediate specific aspects of self-control.
Highlights
With the adoption in recent years of high caloric intake and sedentary lifestyles, the prevalence of obesity in childhood and adolescence has steadily increased worldwide, including in China
Independent t-tests indicated no significant differences between the two groups for the demographic variables of their age, height, weight, body mass index (BMI), Physical Activity Physical activity level was evaluated using the short form of the International Physical Activity Questionnaire (IPAQ-SF), which was developed as a global surveillance tool for physical activity (Bauman et al, 2009)
The results (Table 5) showed that the indirect effect of the EXD intervention improving self-control performance through changes in BMI or maximal grip strength (MGS) was significant with respect to physical self-control [βBMI = −0.580, and 95% confidence interval (CI) (−1.057, −0.052), βMGS = 0.447, and 95% CI (0.224, 0.705), excluding zero] but not significant for cognitive self-control [βBMI = −0.105, and 95% CI (−0.573, 1.044), βMGS = 0.104, and 95% CI (−0.269, 0.543), including zero]. These results indicated that BMI and MGS significantly mediated the relationship between exercise and dietary intervention and physical
Summary
With the adoption in recent years of high caloric intake and sedentary lifestyles, the prevalence of obesity in childhood and adolescence has steadily increased worldwide, including in China. Adverse obesity-related health consequences have been linked to poor self-control. Maintenance of long-term lower weight may require strong self-control in order to consistently reinforce positive health-behavior lifestyles. Bickel et al (2018) showed that individuals who succeed in maintaining their weight loss exhibited superior self-control compared to those of the control group. Datar and Chung (2018) found that poor self-control in school-aged children was an important risk factor for an increase in unhealthy body mass index (BMI) during the transition to adolescence over the 8 years. Datar and Chung (2018) suggested that a better understanding of ways to promote self-control may be important for improving the effectiveness of obesity-prevention programs
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