Can a Multidisciplinary Weight Loss Treatment Improve Motor Performance in Children with Obesity? Results from an Observational Study.

In the last two decades, the relationship between weight status and children's motor skill competence has been receiving increasing attention, given its possible role in the prevention and treatment of obesity. This study aimed to evaluate the effect of a multidisciplinary obesity treatment on motor performance in a sample of Italian children and adolescents. Visual and auditory reaction time (VRT and ART), vertical jump elevation (VJE) and power (VJP), body mass index (BMI) and BMI-standard deviation score (BMI-SDS), waist circumference (WC), body composition, dietary habits and physical activity (PA) levels were assessed at baseline and at 6- and 12-month follow-up. Significant improvements were observed in BMI-SDS and FFM, diet and PA levels. Adolescents showed significant improvements in VRT and ART. Jump elevation and power increased in both children and adolescent subgroups. Girls exhibited greater changes than boys in both VRT and ART and VJP but lower changes in VJE. VRT improvement was related to age (OR = 0.285, 95%CI 0.098-0.830, p = 0.021) and FFM (OR = 0.255, 95%CI 0.070-0.933, p = 0.039). An increase in VJE was associated with BMI-SDS (OR = 0.158, 95%CI 0.036-0.695, p = 0.015) and with PA level (OR = 19.102, 95%CI 4.442-82.142, p < 0.001); the increase in VJP was related with the increase in PA (OR = 5.564, 95%CI 1.812-17.081, p = 0.003). These findings suggest the possible effects of a multidisciplinary obesity treatment on children's motor competence. Since the improvement in motor skills can increase children's motivation and adherence to weight loss treatment in the long term, these aspects should be further investigated.

Adherence to Mediterranean Diet among athletes participating at the XXX summer universiade.

Background: A well-balanced diet is essential in sport. Due to its typical content in high-quality proteins, low glycemic index foods, and unsaturated fats, Mediterranean Diet (MD) may represent a good choice to cover nutritional needs of athletes. The aim of this study was to explore how the dietary habits of elite athletes, such as those competing at the XXX Summer Universiade, comply with the MD model. A comparison between athletes coming from the Mediterranean and non-Mediterranean countries was also assessed. Methods: The Mediterranean Diet Serving Score (MDSS) questionnaire was administered to a sample of 433 university student athletes from all over of the world to evaluate the level of adherence to the MD pattern and possible differences between geographical areas. Results: The total sample showed a medium adherence to the MD, with a mean MDSS of 15.73 ± 3.71 out of a total of 23 points. A satisfactory consumption of fruits and vegetables was reported. Athletes from Northern European countries had a lower MD pattern adherence than the other ones. Conclusions: These findings suggest that the MD model is common among elite athletes, and it may be promoted as a healthy dietary pattern in the sport setting.

Multidisciplinary Treatment for Childhood Obesity: A Two-Year Experience in the Province of Naples, Italy.

Childhood obesity must be faced through an integrated multi-level preventive approach. This study was aimed at assessing the adherence and the outcomes of an outpatient service for childhood obesity treatment activated in the province of Naples, Italy, throughout a 2-year follow-up period. At first visit (T0), weight, height, waist circumference, and body composition of children were assessed, together with sociodemographic features and physical activity levels of children and parents. Anthropometric and body composition parameters of children were measured at 6 ± 3 months (T1) and 12 ± 3 months (T2). A total of 451 non-related children who accessed the service were analyzed: 220 (48.7%) of them returned at least once (attrition rate 51.3%). Returner outpatients showed higher age (p = 0.046) and father's educational level (p = 0.041) than non-returner ones. Adherence to the treatment was found to be related to father's (Rho = 0.140, p = 0.005) and mother's (Rho = 0.109, p = 0.026) educational level. All the outcomes improved between T0 and T1 (p < 0.001), while only body mass index (BMI) decreased significantly at T2. Changes in BMI-SDS were associated with baseline value (OR 0.158, 95%CI 0.017−0.298, p = 0.029). The multidisciplinary approach seems to be promising to treat childhood obesity in this geographic context. Lower parents' educational level should be considered as an attrition determinant.

A telehealth intervention for ensuring continuity of care of pediatric obesity during the CoVid-19 lockdown in Italy.

BACKGROUND AND AIMS: Restriction measures adopted during the Coronavirus Disease-19 pandemic favored unhealthy behaviors. Tele-health offered the opportunity to pursue alternative ways of chronic diseases management. This retrospective study sought to determine the effects of a telehealth counselling intervention during the lockdown to children and adolescents with obesity previously engaged in a family-based secondary care program in an outpatient clinic of South Italy. METHODS AND RESULTS: 117 out of 156 patients participated to the tele-health intervention. Participants underwent videocalls with each component of the multidisciplinary team to receive support in adopting adequate dietary habits and to practice exercise at home. They were included in a closed social group to watch age-adapted tutorials on healthy habits. 75 patients returned to the Center after the end of the lockdown, while only 7 patients who did not participate to the videocalls, took part to the follow-up. Body Mass Index and body composition were assessed in all these patients. BMI z score did not increase in both groups. However, a significant increase of fat mass was observed in the non-participating group (0.046), while the intervention group showed an increase of fat free mass (p < 0.000). CONCLUSION: Notwithstanding the limited sample size, the telehealth intervention allowed the maintenance of baseline weight status in participants, with an increase of fat-free mass. As the CoViD-19 pandemic moves forward, the increasing adoption of the new technologies may help the continuity of care, even in pediatric obesity treatment.

An exercise-based educational and motivational intervention after surgery can improve behaviors, physical fitness and quality of life in bariatric patients.

INTRODUCTION: Unhealthy lifestyles may hinder bariatric surgery outcomes. This non-randomized controlled study aimed to evaluate the effects of an integrated post-operative exercise-based educational and motivational program in improving behaviors, quality of life, anthropometric features, cardiorespiratory and physical fitness in bariatric patients respect to the only surgical intervention. METHODS: A group of adult sedentary bariatric patients chose to attend a 12-month exercise program integrated with diet education and motivational support, or to receive usual care. Dietary habits, binge eating disorder, physical activity, obesity-related quality of life, Body Mass Index, waist and hip circumference, VO2max, strength and flexibility were assessed at the start and at the end of the study in both groups. RESULTS: On a total of 82 patients enrolled, follow-up measures were obtained from 28 (85.7% females, mean age 38.2±8.7) and 42 (71.4% females, mean age 40.2±9.5) patients included in the intervention and control group, respectively. All the behavioral and physical outcomes improved significantly in the participants to the intervention, while the control group showed lesser changes, especially regarding quality of life and physical fitness. CONCLUSIONS: Notwithstanding the self-selection, these results suggest that a timely postoperative behavioral multidisciplinary program for bariatric patients may be effective in establishing healthy behaviors which can lead to better surgery outcomes.

Classroom Active Breaks to Increase Children's Physical Activity: A Cross-Sectional Study in the Province of Naples, Italy.

BACKGROUND: Classroom Active Breaks (CABs), short active sessions integrated in the school time, have been recognized as a promising tool to reduce sedentary behavior and increase Physical Activity (PA) levels in children. "AulAttiva" is a six-month CABs-based program implemented in primary schools of the province of Naples. The aim of this study was to evaluate its effectiveness by comparing PA and sedentary time of participating pupils respect to a control group, considering also their weight status. METHODS: Four third-grade classes, each from 4 schools out of 32 participating in AulAttiva, and 4 third-grade classes, each from 4 schools out of 74 that did not take part, were randomly selected. Finally, 58 children composed the intervention group and 57 the control group. Age, gender, weight and height were registered for each participant. Weight status was classified as non-overweight and overweight/obesity. Sedentary time and PA were assessed through accelerometers along a school day. RESULTS: Light PA was 4 min higher in the AulAttiva group with respect to controls (p = 0.046). Within the non-overweight children, the AulAttiva group spent less time in sedentary behavior and more time in light and total PA than controls. No significant differences were found between the overweight/obese subgroups. CONCLUSIONS: The results support the effectiveness of CABs in increasing PA during the school day. Greater effects were registered among normal weight pupils, suggesting the possible influence of weight status on children's participation to the intervention. Further studies are needed to improve the compliance of overweight/obese children to this intervention.