Pediatric Weight Management

PWM: Physical Activity (2006)

Physical Activity interventions to treat pediatric overweight

• Intervention
  How do different physical activity interventions compare as part of a multicomponent childhood obesity treatment program?

  • Conclusion

    High-dose and high-intensity physical activity interventions, included as part of a multi-component pediatric weight management program, may bring about improvements in body composition. However, because of differences in program design, it is unclear how different physical activity regimens interact with other program interventions to bring about longer-term (more than one year) improvements in adiposity and body composition in children and adolescents.

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: Differences in Physical Activity Interventions in Pediatric Weight Management Programs
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Epstein LH, Paluch RA, Gordy CC, Dorn J. Decreasing sedentary behaviors in treating pediatric obesity. Arch Pediatr Adolesc Med 2000; 154 (3):220-6.
      • Epstein LH, Valoski A, Wing RR, McCurley J. Ten-year outcomes of behavioral family-based treatment for childhood obesity. Health Psychology. 1994, 13:373-383.
      • Epstein LH, Wing RR, Koeske R, Valoski A. A Comparison of Lifestyle Exercise, Aerobic Exercise, and Calisthenics on Weight Loss in Obese Children. Behavior Therapy 1985;16;345-56.
      • Gutin B, Barbeau P, Owens S, Lemmon C, Bauman M, Allison J, Kang H, Litaker M. Effects of exercise intensity on cardiovascular fitness, total body composition, and visceral adiposity of obese adolescents Am J Clin Nutr 2002;75:818-26.
      • Sothern, M., Loftin, M., Udall, J., Suskind R., Ewing, T., Tang, S., & Blecker, U. Safety, feasibility and efficacy of a resistance training program in preadolescent obese children. American Journal of the Medical Sciences, 2000; 319: 370-375. 
  • Search Plan and Results: Treatment Focus: Comparing Physical Activity Interventions 2004
     
  What is the effectiveness of using a program to decrease sedentary behaviors as a part of an intervention program to treat childhood obesity?

  • Conclusion

    In children (ages six to 12) the addition of interventions to decrease sedentary activities is associated with improved adiposity outcomes in multi-component childhood overweight programs. For adolescents however, the results are promising, but less clear.

  • Grade: II
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: What Is the effectiveness of using a program to decrease sedentary behaviors as a part of an intervention program to treat childhood obesity?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Epstein LH, Paluch RA, Gordy CC, Dorn J. Decreasing sedentary behaviors in treating pediatric obesity. Arch Pediatr Adolesc Med 2000; 154 (3):220-6.
      • Epstein LH, Paluch RA, and Raynor HA. Sex Differences in Obese Children and Siblings in Family-based Obesity Treatment. Obesity Research 2001;9:746-753 
      • Epstein LH, Valoski AM, Vara LS, McCurley J, Wisniewski L, Kalarchian MA, Klein KR, Shrager LR. Effects of decreasing sedentary behavior and increasing activity on weight change in obese children.  Health Psychol 1995;14:109-15.
      • Levine, M., Ringham, R., Kalarchian, M., Wisniewski, L., and Marcus, M. Is family-based behavioral weight control appropriate for severe pediatric obesity? Int J Eat Disord. 2001 Nov;30(3):318-28.
      • Robinson TN. Reducing children’s television viewing to prevent obesity: a randomized controlled trial. JAMA 1999; 282: 1561-7.
      • Saelens B, Sallis J, Wilfley D, Patrick K, Cella J, and Buchta R. Behavioral Weight Control for Overweight Adolescents Initiated in Primary Care. Obesity Research 2002;10:22-32
    • Related Topics
  • Search Plan and Results: Treatment Focus: Decreasing Sedentary Behaviors 2004
     
  What is the effectiveness of using a program to increase physical activity as a part of an intervention program to treat childhood obesity?

  • Conclusion

    Using a program to increase physical activity as part of a pediatric weight-management program results in significant improvements in weight status and adiposity in children and adolescents.

  • Grade: I
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: Increasing physical activity as a part of an intervention program to treat childhood obesity
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Becque MD, Katch V, Rocchini A, Marks C, and Moorehead C. Coronanry Risk Incidence of Obese Adolescents: Reduction by Exercise Plus Diet Intervention/ Pediatrics 1988;81;605-12.
      • Epstein LH, Paluch RA, Gordy CC, Dorn J. Decreasing sedentary behaviors in treating pediatric obesity. Arch Pediatr Adolesc Med 2000; 154 (3):220-6.
      • Epstein LH, Valoski A, Wing RR, McCurley J. Ten-year outcomes of behavioral family-based treatment for childhood obesity. Health Psychology. 1994, 13:373-383.
      • Epstein LH, Wing RR, Koeske R, Valoski A. Effects of diet plus exercise on weight change in parents and children. Journal of Consulting and Clinical Psychology 1984; 52:429-437.
      • Epstein LH, Wing RR, Penner BC, Kress MJ. Effect of diet and controlled exercise on weight loss in obese children.  J Pediatr 1985;107:358-61.
      • Gutin B, Barbeau P, Owens S, Lemmon C, Bauman M, Allison J, Kang H, Litaker M. Effects of exercise intensity on cardiovascular fitness, total body composition, and visceral adiposity of obese adolescents Am J Clin Nutr 2002;75:818-26.
      • Owens S, Gutin B, Allison J, Riggs S, Ferguson M, Litaker M, Thompson W. Effect of physical training on total and visceral fat in obese children. Medicine & Science in Sports & Exercise 1999;31:143-148
      • Rocchini AP, Katch V, Anderson J, Hinderliter J, Becque D, Martin M, Marks C. Blood Pressure in Obese Adolescents: Effect of Weight Loss. Pediatrics 1988;82:16-23.
      • Schwingshandl J, Sudi K, et al. Effect of an individualized training programme during weight reduction on body composition: a randomized trial. Arch Dis Child 1999; 81:426-8.
    • Related Topics
  • Search Plan and Results: Treatment Focus: Increasing Physical Activity 2004