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Effects of exercise training and its cessation on components of the insulin resistance syndrome in obese children
Ferguson MA, Gutin B, Le NA, Karp W, Litaker M, Humphries M, Okuyama T, Riggs S, Owens S
International Journal of Obesity and Related Metabolic Disorders 1999 Aug;23(8):889-895
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To determine the effect of exercise training (ET) on components of the insulin resistance syndrome (IRS) in obese children. DESIGN: Randomized, modified cross-over study, with subjects assigned to one of two conditions: (1) 4 months of ET followed by 4 months of no-ET; or (2) 4 months of no-ET followed by 4 months of ET. Measurements were made at three time points: 0, 4 and 8 months. SUBJECTS: 79 obese, but otherwise healthy children (age 7 to 11 y, percent fat (%fat) 27 to 61%). MEASUREMENTS: Plasma lipid and lipoprotein concentrations, plasma insulin and glucose concentrations; % fat; submaximal heart rate (HR) as an index of fitness. EXERCISE TRAINING: ET was offered 5 d/week 40 min/d. For the 73 children who completed 4 months of ET, the mean attendance was 80% (that is, 4 d/week) and the average HR during ET was 157 bpm. RESULTS: Significant (p < 0.05) group x time interactions were found for plasma triglyceride (TG) and insulin concentrations and % fat. The average change for both groups, from just before ET to just after the 4 month ET was -0.24 mmol/l for TG, -25.4 pmol/l for insulin and -1.6 units for % fat. When group 1 ceased ET, over the following 4 month period the average change for insulin was +26.6 pmol/l and for % fat +1.3 units. CONCLUSION: Some components (plasma TG, insulin, % fat) of the IRS are improved as a result of 4 months of ET in obese children. However, the benefits of ET are lost when obese children become less active.

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