Prevalence of responders for hepatic fat, adiposity and liver enzyme levels in response to a lifestyle intervention in children with overweight/obesity: EFIGRO randomized controlled trial

María Medrano; Lide Arenaza; Robinson Ramírez-Vélez; Francisco B Ortega; Jonatan R Ruiz; Idoia Labayen

doi:10.1111/pedi.12949

Prevalence of responders for hepatic fat, adiposity and liver enzyme levels in response to a lifestyle intervention in children with overweight/obesity: EFIGRO randomized controlled trial

Pediatr Diabetes. 2020 Mar;21(2):215-223. doi: 10.1111/pedi.12949. Epub 2019 Dec 10.

Authors

María Medrano¹, Lide Arenaza¹, Robinson Ramírez-Vélez², Francisco B Ortega^{3

4}, Jonatan R Ruiz^{3

4}, Idoia Labayen¹

Affiliations

¹ ELIKOS group, Institute for Innovation & Sustainable Development in Food Chain (IS-FOOD), Department of Health Sciences, Public University of Navarra, Pamplona, Spain.
² Navarrabiomed-Universidad Pública de Navarra (UPNA)-Complejo Hospitalario de Navarra (CHN), Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, Spain.
³ PROFITH "PROmoting FITness and Health through physical activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.
⁴ Department of Biosciences and Nutrition at NOVUM, Karolinska Institutet, Huddinge, Sweden.

PMID: 31778277
DOI: 10.1111/pedi.12949

Abstract

Background/objective: Exercise and lifestyle interventions have been shown to reduce hepatic fat (HF) and adiposity in youth. However, the interindividual response in HF after a lifestyle intervention with or without exercise in children is unknown. The aim of the present study was to compare interindividual variability for HF, adiposity, gamma-glutamyl transferase (GGT), and the aspartate aminotransferase to alanine aminotransferase ratio (AST/ALT) in children with overweight/obesity participating in a 22-week lifestyle intervention with (intensive intervention) or without exercise (control intervention).

Methods: Data from 102 children (9-12 years, 55% girls) with overweight/obesity participating in the EFIGRO randomized controlled trial were analyzed. Percentage HF (magnetic resonance imaging), weight, body and fat mass index (BMI and FMI), GGT, AST/ALT, cardiorespiratory fitness (CRF, 20 meters shuttle run test) were assessed before and after the intervention by the same trained researchers. The control intervention consisted in 11 sessions of a family-based lifestyle and psycho-educational program. The intensive intervention included the control intervention plus supervised exercise (3 sessions/week).

Results: The prevalence of responders for HF (54% vs. 34%), weight (27% vs. 11%), BMI (71% vs. 47%), FMI (90% vs. 60%), and GGT (69% vs. 39%) was higher in the intensive than in the control group (Ps < 0.05). Responders for weight (16 ± 3 vs. 6 ± 2 laps) and BMI (11 ± 2 vs. 3 ± 4 laps) improved more CRF levels than non-responders (Ps < 0.05).

Conclusions: The addition of exercise to a lifestyle intervention may increase the responder rates for HF, adiposity, and GGT in children with overweight/obesity. Improvements in CRF may explain differences between weight and BMI responders and non-responders.

Clinical trial registration: ClinicalTrials.gov Identifier: NCT02258126.

Keywords: cardiorespiratory fitness; exercise intervention; interindividual variability; nonalcoholic fatty liver disease; pediatric obesity.

Publication types

Comparative Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adiposity
Child
Exercise*
Female
Healthy Lifestyle*
Humans
Liver / enzymology
Male
Non-alcoholic Fatty Liver Disease / therapy*
Pediatric Obesity / therapy*
Risk Reduction Behavior
Weight Reduction Programs

Associated data

ClinicalTrials.gov/NCT02258126