Journal of Obesity & Metabolic Syndrome

Search

Article

Korean J Obes 2014; 23(3): 156-161

Published online September 30, 2014

Copyright © Korean Society for the Study of Obesity.

Exercise Strategies for the Prevention and Treatment of Obesity in Children

Jin-Kyung Cho1.2, Jin-Hee Han1, Hyun-Sik Kang1, Jin-Hwan Yoon2.*

School of Sports Science1, Sungkyunkwan University, Suwon; Department of Sports Science2, College of Life Science & Nanotechnology, Hannam University, Daejeon, Korea

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Childhood obesity has more than doubled in children and adolescents in the last decade. Obese youth are more likely to have risk factors for cardiovascular disease and type 2 diabetes such as high cholesterol, high blood pressure, insulin resistance, and metabolic syndrome. There is no single or simple solution to the childhood obesity epidemic, but to learn that obesity is closely related to lifestyle factors including poor fitness and physical inactivity as well as prolonged sitting time in conjunction with westernized dietary habits. In addition to a healthy and balanced diet, promotion of physical activity combined with carefully supervised resistance exercise training, and reduced screen time is a primary recommendation for the prevention and treatment of obesity in children and adolescents. This review provides evidence based data to support this multiple-step physical activity strategy as the most effective and preventive means against childhood obesity.

Keywords: Obesity, Metabolic syndrome, Childhood, Physical activity, Dietary habit

Fig. 1. Relative roles of physical activity and diet for obesity prevention and treatment.
Fig. 2. The 3 components of human daily energy expenditure are the basal metabolic rate (about 60% of daily energy expenditure); the thermic effect of food (about 10% of daily energy expenditure); and activity thermogenesis (both exercise and nonexercise activity thermogenesis).
  1. Mueller WH. The changes with age of the anatomical distribution of fat. Soc Sci Med 1982;16:191-6.
    CrossRef
  2. Naumova EN, Must A, Laird NM. Tutorial in biostatistics: evaluating the impact of ‘critical periods’ in longitudinal studies of growth using piecewise mixed effects models. Int J Epidemiol 2001;30:1332-41.
    Pubmed CrossRef
  3. Park YS, Lee DH, Choi JM, Kang YJ, Kim JH. Trend of obesity in school age children in Seoul over the past 23 years. Korean J Pediatr 2004;47:247-57.
  4. Korea Centers for Disease Control and Prevention. Korea Health Statistics 2009: Korea National Health and Nutrition Examination Survey (KNHANES IV-3). Seoul: Ministry of Health and Welfare;2010.
  5. Stettler N, Zemel BS, Kumanyika S, Stallings VA. Infant weight gain and childhood overweight status in a multicenter, cohort study. Pediatrics 2002;109:194-9.
    Pubmed CrossRef
  6. Andersen RE, Crespo CJ, Bartlett SJ, Cheskin LJ, Pratt M. Relationship of physical activity and television watching with body weight and level of fatness among children: results from the Third National Health and Nutrition Examination Survey. JAMA 1998;279:938-42.
    Pubmed CrossRef
  7. Goldfield GS, Kalakanis LE, Ernst MM, Epstein LH. Open-loop feedback to increase physical activity in obese children. Int J Obes Relat Metab Disord 2000;24:888-92.
    Pubmed CrossRef
  8. Kim YH, Yang YO. Effects of walking exercise on metabolic syndrome risk factors and body composition in obese middle school girls. J Korean Acad Nurs 2005;35:858-67.
  9. Barlow SE, Dietz WH. Obesity evaluation and treatment: Expert Committee recommendations. The Maternal and Child Health Bureau, Health Resources and Services Administration and the Department of Health and Human Services. Pediatrics 1998;102:E29.
    Pubmed CrossRef
  10. Bhargava SK, Sachdev HS, Fall CH, Osmond C, Lakshmy R, Barker DJ, et al. Relation of serial changes in childhood bodymass index to impaired glucose tolerance in young adulthood. N Engl J Med 2004;350:865-75.
    Pubmed KoreaMed CrossRef
  11. Wei M, Gibbons LW, Mitchell TL, Kampert JB, Lee CD, Blair SN. The association between cardiorespiratory fitness and impaired fasting glucose and type 2 diabetes mellitus in men. Ann Intern Med 1999;130:89-96.
    Pubmed CrossRef
  12. Jeon CY, Lokken RP, Hu FB, van Dam RM. Physical activity of moderate intensity and risk of type 2 diabetes: a systematic review. Diabetes Care 2007;30:744-52.
    Pubmed CrossRef
  13. Parsons TJ, Power C, Logan S, Summerbell CD. Childhood predictors of adult obesity: a systematic review. Int J Obes Relat Metab Disord 1999;23 Suppl 8:1-107.
  14. Whitaker RC, Wright JA, Pepe MS, Seidel KD, Dietz WH. Predicting obesity in young adulthood from childhood and parental obesity. N Engl J Med 1997;337:869-73.
    Pubmed CrossRef
  15. Barker M, Robinson S, Osmond C, Barker DJ. Birth weight and body fat distribution in adolescent girls. Arch Dis Child 1997;77:381-3.
    Pubmed CrossRef
  16. Daniels SR, Arnett DK, Eckel RH, Gidding SS, Hayman LL, Kumanyika S, et al. Overweight in children and adolescents: pathophysiology, consequences, prevention, treatment. Circulation 2005;111:1999-2012.
    Pubmed CrossRef
  17. Henriksen EJ. Invited review: Effects of acute exercise and exercise training on insulin resistance. J Appl Physiol (1985) 2002;93:788-96.
    Pubmed CrossRef
  18. Holloszy JO. Exercise-induced increase in muscle insulin sensitivity. J Appl Physiol (1985) 2005;99:338-43.
    Pubmed CrossRef
  19. Ren JM, Semenkovich CF, Gulve EA, Gao J, Holloszy JO. Exercise induces rapid increases in GLUT4 expression, glucose transport capacity, insulin-stimulated glycogen storage in muscle. J Biol Chem 1994;269:14396-401.
    Pubmed
  20. DuBose KD, Eisenmann JC, Donnelly JE. Aerobic fitness attenuates the metabolic syndrome score in normal-weight, at-risk-foroverweight, overweight children. Pediatrics 2007;120:e1262-8.
    Pubmed CrossRef
  21. Eisenmann JC, DuBose KD, Donnelly JE. Fatness, fitness, insulin sensitivity among 7- to 9-year-old children. Obesity (Silver Spring) 2007;15:2135-44.
    Pubmed CrossRef
  22. Barlow SE; Expert Committee. Expert committee recommendations regarding the prevention, assessment, treatment of child and adolescent overweight and obesity: summary report. Pediatrics 2007;120 Suppl 4:164-92.
    Pubmed CrossRef
  23. Brambilla P, Pozzobon G, Pietrobelli A. Physical activity as the main therapeutic tool for metabolic syndrome in childhood. Int J Obes (Lond) 2011;35:16-28.
    Pubmed CrossRef
  24. Blair SN, Kampert JB, Kohl HW 3rd, Barlow CE, Macera CA, Paffenbarger RS Jr, et al. Influences of cardiorespiratory fitness and other precursors on cardiovascular disease and all-cause mortality in men and women. JAMA 1996;276:205-10.
    Pubmed CrossRef
  25. Shaibi GQ, Cruz ML, Ball GD, Weigensberg MJ, Salem GJ, Crespo NC, et al. Effects of resistance training on insulin sensitivity in overweight Latino adolescent males. Med Sci Sports Exerc 2006;38:1208-15.
    Pubmed CrossRef
  26. Irwin ML, Yasui Y, Ulrich CM, Bowen D, Rudolph RE, Schwartz RS, et al. Effect of exercise on total and intra-abdominal body fat in postmenopausal women: a randomized controlled trial. JAMA 2003;289:323-30.
    Pubmed CrossRef
  27. Cuff DJ, Meneilly GS, Martin A, Ignaszewski A, Tildesley HD, Frohlich JJ. Effective exercise modality to reduce insulin resistance in women with type 2 diabetes. Diabetes Care 2003;26:2977-82.
    Pubmed CrossRef
  28. Gan SK, Kriketos AD, Ellis BA, Thompson CH, Kraegen EW, Chisholm DJ. Changes in aerobic capacity and visceral fat but not myocyte lipid levels predict increased insulin action after exercise in overweight and obese men. Diabetes Care 2003;26:1706-13.
    Pubmed CrossRef
  29. Nassis GP, Papantakou K, Skenderi K, Triandafillopoulou M, Kavouras SA, Yannakoulia M, et al. Aerobic exercise training improves insulin sensitivity without changes in body weight, body fat, adiponectin, inflammatory markers in overweight and obese girls. Metabolism 2005;54:1472-9.
    Pubmed CrossRef
  30. van der Heijden GJ, Wang ZJ, Chu ZD, Sauer PJ, Haymond MW, Rodriguez LM, et al. A 12-week aerobic exercise program reduces hepatic fat accumulation and insulin resistance in obese, Hispanic adolescents. Obesity (Silver Spring) 2010;18:384-90.
    Pubmed CrossRef
  31. Meyer AA, Kundt G, Lenschow U, Schuff-Werner P, Kienast W. Improvement of early vascular changes and cardiovascular risk factors in obese children after a six-month exercise program. J Am Coll Cardiol 2006;48:1865-70.
    Pubmed CrossRef
  32. Davis CL, Pollock NK, Waller JL, Allison JD, Dennis BA, Bassali R, et al. Exercise dose and diabetes risk in overweight and obese children: a randomized controlled trial. JAMA 2012;308:1103-12.
    Pubmed KoreaMed CrossRef
  33. Brooks N, Layne JE, Gordon PL, Roubenoff R, Nelson ME, Castaneda-Sceppa C. Strength training improves muscle quality and insulin sensitivity in Hispanic older adults with type 2 diabetes. Int J Med Sci 2007;4:19-27.
    KoreaMed CrossRef
  34. van der Heijden GJ, Toffolo G, Manesso E, Sauer PJ, Sunehag AL. Aerobic exercise increases peripheral and hepatic insulin sensitivity in sedentary adolescents. J Clin Endocrinol Metab 2009;94:4292-9.
    Pubmed KoreaMed CrossRef
  35. Bell LM, Watts K, Siafarikas A, Thompson A, Ratnam N, Bulsara M, et al. Exercise alone reduces insulin resistance in obese children independently of changes in body composition. J Clin Endocrinol Metab 2007;92:4230-5.
    Pubmed CrossRef
  36. Lee S, Bacha F, Hannon T, Kuk JL, Boesch C, Arslanian S. Effects of aerobic versus resistance exercise without caloric restriction on abdominal fat, intrahepatic lipid, insulin sensitivity in obese adolescent boys: a randomized, controlled trial. Diabetes 2012;61:2787-95.
    Pubmed KoreaMed CrossRef
  37. Levine JA, Vander Weg MW, Hill JO, Klesges RC. Non-exercise activity thermogenesis: the crouching tiger hidden dragon of societal weight gain. Arterioscler Thromb Vasc Biol 2006;26:729-36.
    Pubmed CrossRef
  38. Robinson TN, Hammer LD, Killen JD, Kraemer HC, Wilson DM, Hayward C, et al. Does television viewing increase obesity and reduce physical activity? Cross-sectional and longitudinal analyses among adolescent girls. Pediatrics 1993;91:273-80.
    Pubmed
  39. Murphy EC, Carson L, Neal W, Baylis C, Donley D, Yeater R. Effects of an exercise intervention using Dance Dance Revolution on endothelial function and other risk factors in overweight children. Int J Pediatr Obes 2009;4:205-14.
    Pubmed CrossRef
  40. Holman RM, Carson V, Janssen I. Does the fractionalization of daily physical activity (sporadic vs. bouts) impact cardiometabolic risk factors in children and youth? PLoS One 2011;6:e25733.
    Pubmed KoreaMed CrossRef