An after-school dance and lifestyle education program reduces risk factors for heart disease and diabetes in elementary school children.

BACKGROUND: Forty-three percent of New York City's (NYC) school-age children are overweight or obese, placing them at risk for heart disease and type 2 diabetes mellitus (T2DM). OBJECTIVE: The objective of this study was to determine if an intensive after-school dance and lifestyle education program would reduce risk factors for heart disease, T2DM, and improve lifestyle choices. SUBJECTS: Subject include 64 fourth- and fifth-grade students at an elementary school in NYC. METHODS: Students received freestyle dance and lifestyle classes for 16 weeks and were evaluated for changes in body composition, endurance, biochemical measurements, and lifestyle choices. RESULTS: Significant improvements in BMI percentiles were found among children in the overweight and obese categories as well as in endurance and biochemical measurements that reflect heart disease and diabetes risk. Improvement was also reported in lifestyle choices. CONCLUSION: An intensive after-school dance and lifestyle education program can reduce risk factors for heart disease and T2DM and improve lifestyle choices among elementary school children.

A ballroom dance classroom program promotes moderate to vigorous physical activity in elementary school children.

PURPOSE: To determine if an existing ballroom dance classroom program meets national recommendations to engage children in moderate to vigorous physical activity (MVPA) for ≥50% of class time and to determine class effects on body mass index (BMI). DESIGN: Prospective descriptive study. Setting . Two New York City public schools. PARTICIPANTS: Seventy-nine fourth and fifth grade students. MEASUREMENTS: The System for Observing Fitness Instruction Time (SOFIT) and direct heart rate monitoring were used to determine participants' MVPA levels during class time. Weight and height were measured to calculate BMI. ANALYSIS: Means were calculated for continuous variables; frequency counts and percentages were calculated for categorical variables. Change in BMI percentiles was assessed by using Bhapkar's χ(2) test of overall marginal homogeneity. RESULTS: Data from SOFIT observations showed that a mean of 50.0% and 67.0% of class time in the first and second halves of the program, respectively, were spent in MVPA. Data from the heart rate monitoring revealed that 71.1% of students were at ≥25% heart rate reserve, which indicated MVPA for ≥50% of class time. Improvement was seen in BMI percentile (p= .051). CONCLUSION: Ballroom dance provides MVPA in elementary school children for ≥50% of class time and has a positive impact on BMI percentiles.

Psychiatric adverse effects of rimonobant in adults with Prader Willi syndrome.

BACKGROUND: Prader Willi syndrome (PWS) without strict environmental modifications can lead to obesity associated with significant morbidity and mortality. In addition to increased appetite, these individuals have decreased energy expenditure with lower insulin like growth factor 1 (IGF1), which contributes to adiposity. No effective treatment is available for this condition. Endocannabinoid receptor CB1 antagonist, rimonobant, has been effective for treatment of obesity in adult subjects. Rimonabant promotes weight loss by multiple proposed mechanisms, including decreased appetite and lipogenesis, and increased energy expenditure. Therefore, we conducted this pilot study to evaluate the effect of rimonabant on body weight and composition of adults with PWS. METHOD: This was a double blind placebo controlled study. Body weight, total fat mass, fasting ghrelin, leptin, IGF1 and insulin like growth factor binding protein (IGFBP-3) were collected at baseline, and after 90 and 180 days of treatment with placebo or 20 mg of rimonabant. RESULTS: Due to psychiatric adverse effects, 50% of subjects in the rimonabant group withdrew, and the study was terminated early (N=10) for safety concerns. There was a trend for weight loss, lower fat mass and higher IGF1 level at the end of study in this group. Leptin followed the fat mass and decreased with rimonabant treatment. CONCLUSION: Rimonabant administration may be efficacious for weight loss in adults with PWS; unfortunately it is associated with an unacceptably high risk of psychiatric side effects. Future CB1 antagonists will need a better psychiatric profile before considered in the treatment of obesity in this genetic condition.

Carbohydrate- vs fat-controlled diet effect on weight loss and coronary artery disease risk: a pilot feeding study.

This pilot study compared weight loss and serum indicators of coronary artery disease (CAD) risk between 2 weight loss (energy-deficit) diets, one controlled for carbohydrate as a percentage of total calories and the other controlled for fat as percentage of total calories. Participants were randomized to 1 of 2 diets and fed on an outpatient basis for 70 days, after which they followed their diets using their own resources for an additional 70 days. Energy deficit for the diets was determined by indirect calorimetry with a 500- to 750-calorie per day adjustment. Weight and CAD risk indicators and serum lipid and C-reactive protein levels were measured at baseline, day 70, and day 140. The study was completed by 16 of 20 participants who were able to comply with the feeding portion of the study as well as with follow-up appointments during the second (self-management) period of the study. Participants lost weight in both diet groups (24.4 lbs, carbohydrate controlled; 18.5 lbs, fat controlled), and serum CAD risk factors decreased in both groups. There were no significant differences in CAD risk factors between diet groups, although there was a trend toward lighter low-density lipoprotein (LDL) size in the carbohydrate-controlled group. During the self-management portion of the study, weight loss stalled or regained from loss during the previous feeding period. The results, although underpowered, are consistent with recent studies in which macronutrient ratio of total calories in diet did not affect degree of weight loss and in which carbohydrate-controlled diets produced a predominance of lighter LDLs.