RESUMO
BACKGROUND: Childhood obesity is an increasing health problem globally. Overweight and obesity may be established as early as 2-5 years of age, highlighting the need for evidence-based effective prevention and treatment programs early in life. In adults, mobile phone based interventions for weight management (mHealth) have demonstrated positive effects on body mass, however, their use in child populations has yet to be examined. The aim of this paper is to report the study design and methodology of the MINSTOP (Mobile-based Intervention Intended to Stop Obesity in Preschoolers) trial. METHODS/DESIGN: A two-arm, parallel design randomized controlled trial in 300 healthy Swedish 4-year-olds is conducted. After baseline measures, parents are allocated to either an intervention- or control group. The 6- month mHealth intervention consists of a web-based application (the MINSTOP app) to help parents promote healthy eating and physical activity in children. MINISTOP is based on the Social Cognitive Theory and involves the delivery of a comprehensive, personalized program of information and text messages based on existing guidelines for a healthy diet and active lifestyle in pre-school children. Parents also register physical activity and intakes of candy, soft drinks, vegetables as well as fruits of their child and receive feedback through the application. Primary outcomes include body fatness and energy intake, while secondary outcomes are time spent in sedentary, moderate, and vigorous physical activity, physical fitness and intakes of fruits and vegetables, snacks, soft drinks and candy. Food and energy intake (Tool for Energy balance in Children, TECH), body fatness (pediatric option for BodPod), physical activity (Actigraph wGT3x-BT) and physical fitness (the PREFIT battery of five fitness tests) are measured at baseline, after the intervention (six months after baseline) and at follow-up (12 months after baseline). DISCUSSION: This novel study will evaluate the effectiveness of a mHealth program for mitigating gain in body fatness among 4-year-old children. If the intervention proves effective it has great potential to be implemented in child-health care to counteract childhood overweight and obesity. TRIAL REGISTRATION: ClinicalTrials.gov NCT02021786 ; 20 Dec 2013.
Assuntos
Telefone Celular , Internet , Obesidade Infantil/prevenção & controle , Avaliação de Programas e Projetos de Saúde/estatística & dados numéricos , Pré-Escolar , Feminino , Frutas , Humanos , Estilo de Vida , Masculino , Obesidade/prevenção & controle , Aptidão Física , Projetos de Pesquisa , Suécia , Envio de Mensagens de Texto , VerdurasRESUMO
INTRODUCTION: Introduction: practice of physical activity and the ketogenic diet monitoring can have a double effect in helping in processes of weight loss and improvement of body composition and lipid profile. Objective: the objective of this review was to investigate the work done with obese patients who undertook a ketogenic diet and a physical exercise program, as well as to calculate the overall effect size in terms of improvements in fat mass, through a meta-analysis. Methods: the selection of studies was based on the following criteria: experimental studies; a) experimental studies (randomized controlled designs) and quasi-experimental (e.g. pre-test/post-test); b) studies with low-carbohydrate diet (< 30%) or very low in carbohydrates (5-10%) (< 50 g Ch) and/or high in fats (> 35%); c) studies were admitted exclusively with subjects that facility overweight or obesity (BMI > 25; and d) with measurements of body composition and/or Lipid profile at the beginning and end of the intervention. Results: for the methodological review, 7 articles and 3 reviews were analyzed. All studies, whether by establishing aerobic or strength training and show significant weight loss in all outcomes. Conclusions: comparing different types of exercise, we could say that interventions based on endurance exercise reported a decrease in muscle mass, however there was a maintenance, and even an increase, in studies with resistance exercises. Meta-analysis showed significant results at the global level with a medium heterogeneity, therefore, there will be greater reduction of fat mass in groups that realize diets with low carbohydrates and exercise that in those who do not undertake this type of diet, and those only perform exercise.
INTRODUCCIÓN: Introducción: la práctica de actividad física y el seguimiento de una dieta cetogénica pueden suponer un doble efecto con mejores resultados en los procesos de pérdida de peso y mejora de la composición corporal y perfil lipídico. Objetivo: el objetivo de esta revisión fue investigar los trabajos realizados con pacientes obesos que siguen una dieta cetogénica y un programa de ejercicio físico, así como calcular el tamaño del efecto en cuanto a las mejoras en la masa grasa, a través de un metaaanálisis. Métodos: la selección de estudios se basó en los siguientes criterios: estudios experimentales; a) estudios experimentales (diseños controlados aleatorizados) y cuasi-experimentales (por ejemplo: pre-test/post-test); b) estudios con dieta baja en carbohidratos (< 30%) o muy baja en carbohidratos (5-10%) (< 50 g Ch) y/o alta en grasas (> 35%); c) se admitieron estudios exclusivamente con sujetos que padecieran sobrepeso u obesidad (IMC > 25 y/o enfermedad metabólica relacionada; y d) con mediciones de composición corporal y/o perfil lipídico al principio y al final de la intervención. Resultados: se analizaron 7 artículos y 3 revisiones. Comparando los diferentes tipos de ejercicio se podría afirmar que destaca la disminución de masa muscular en aquellos en los que las intervenciones son con ejercicio aeróbico, manteniéndose e incluso aumentando, en los estudios donde se realizó un ejercicio de fuerza. El metaanálisis nos muestra una reducción significativa de la masa grasa con una heterogeneidad media, por lo tanto, habrá mayor reducción de masa grasa en grupos que realizan dieta baja en carbohidratos y ejercicio que en los que no realizan dieta o tan solo realizan ejercicio. Conclusiones: la combinación de dieta cetogénica y ejercicio físico puede reducir la masa grasa en comparación con realizar solo dieta o solo ejercicio físico.
Assuntos
Composição Corporal/fisiologia , Dieta Cetogênica , Exercício Físico/fisiologia , Redução de Peso/fisiologia , HumanosRESUMO
BACKGROUND: Childhood obesity is an increasing health problem globally. Obesity may be established already at pre-school age. Further research in this area requires accurate and easy-to-use methods for assessing the intake of energy and foods. Traditional methods have limited accuracy, and place large demands on the study participants and researchers. Mobile phones offer possibilities for methodological advancements in this area since they are readily available, enable instant digitalization of collected data, and also contain a camera to photograph pre- and post-meal food items. We have recently developed a new tool for assessing energy and food intake in children using mobile phones called the Tool for Energy Balance in Children (TECH). OBJECTIVE: The main aims of our study are to (1) compare energy intake by means of TECH with total energy expenditure (TEE) measured using a criterion method, the doubly labeled water (DLW) method, and (2) to compare intakes of fruits and berries, vegetables, juice, and sweetened beverages assessed by means of TECH with intakes obtained using a Web-based food frequency questionnaire (KidMeal-Q) in 3 year olds. METHODS: In this study, 30 Swedish 3 year olds were included. Energy intake using TECH was compared to TEE measured using the DLW method. Intakes of vegetables, fruits and berries, juice, as well as sweetened beverages were assessed using TECH and compared to the corresponding intakes assessed using KidMeal-Q. Wilcoxon matched pairs test, Spearman rank order correlations, and the Bland-Altman procedure were applied. RESULTS: The mean energy intake, assessed by TECH, was 5400 kJ/24h (SD 1500). This value was not significantly different (P=.23) from TEE (5070 kJ/24h, SD 600). However, the limits of agreement (2 standard deviations) in the Bland-Altman plot for energy intake estimated using TECH compared to TEE were wide (2990 kJ/24h), and TECH overestimated high and underestimated low energy intakes. The Bland-Altman plots for foods showed similar patterns. The mean intakes of vegetables, fruits and berries, juice, and sweetened beverages estimated using TECH were not significantly different from the corresponding intakes estimated using KidMeal-Q. Moderate but statistically significant correlations (ρ=.42-.46, P=.01-.02) between TECH and KidMeal-Q were observed for intakes of vegetables, fruits and berries, and juice, but not for sweetened beverages. CONCLUSION: We found that one day of recordings using TECH was not able to accurately estimate intakes of energy or certain foods in 3 year old children.
RESUMO
Introducción: la práctica de actividad física y el seguimiento de una dieta cetogénica pueden suponer un doble efecto con mejores resultados en los procesos de pérdida de peso y mejora de la composición corporal y perfil lipídico. Objetivo: el objetivo de esta revisión fue investigar los trabajos realizados con pacientes obesos que siguen una dieta cetogénica y un programa de ejercicio físico, así como calcular el tamaño del efecto en cuanto a las mejoras en la masa grasa, a través de un metaaanálisis. Métodos: la selección de estudios se basó en los siguientes criterios: estudios experimentales; a) estudios experimentales (diseños controlados aleatorizados) y cuasi-experimentales (por ejemplo: pre-test/post-test); b) estudios con dieta baja en carbohidratos (< 30%) o muy baja en carbohidratos (5-10%) (< 50 g Ch) y/o alta en grasas (> 35%); c) se admitieron estudios exclusivamente con sujetos que padecieran sobrepeso u obesidad (IMC > 25 y/o enfermedad metabólica relacionada; y d) con mediciones de composición corporal y/o perfil lipídico al principio y al final de la intervención. Resultados: se analizaron 7 artículos y 3 revisiones. Comparando los diferentes tipos de ejercicio se podría afirmar que destaca la disminución de masa muscular en aquellos en los que las intervenciones son con ejercicio aeróbico, manteniéndose e incluso aumentando, en los estudios donde se realizó un ejercicio de fuerza. El metaanálisis nos muestra una reducción significativa de la masa grasa con una heterogeneidad media, por lo tanto, habrá mayor reducción de masa grasa en grupos que realizan dieta baja en carbohidratos y ejercicio que en los que no realizan dieta o tan solo realizan ejercicio. Conclusiones: la combinación de dieta cetogénica y ejercicio físico puede reducir la masa grasa en comparación con realizar solo dieta o solo ejercicio físico
Introduction: practice of physical activity and the ketogenic diet monitoring can have a double effect in helping in processes of weight loss and improvement of body composition and lipid profile. Objective: the objective of this review was to investigate the work done with obese patients who undertook a ketogenic diet and a physical exercise program, as well as to calculate the overall effect size in terms of improvements in fat mass, through a meta-analysis. Methods: the selection of studies was based on the following criteria: experimental studies; a) experimental studies (randomized controlled designs) and quasi-experimental (e.g. pre-test/post-test); b) studies with low-carbohydrate diet (< 30%) or very low in carbohydrates (5-10%) (< 50 g Ch) and/or high in fats (> 35%); c) studies were admitted exclusively with subjects that facility overweight or obesity (BMI > 25; and d) with measurements of body composition and/or Lipid profile at the beginning and end of the intervention. Results: for the methodological review, 7 articles and 3 reviews were analyzed. All studies, whether by establishing aerobic or strength training and show significant weight loss in all outcomes. Conclusions: comparing different types of exercise, we could say that interventions based on endurance exercise reported a decrease in muscle mass, however there was a maintenance, and even an increase, in studies with resistance exercises. Meta-analysis showed significant results at the global level with a medium heterogeneity, therefore, there will be greater reduction of fat mass in groups that realize diets with low carbohydrates and exercise that in those who do not undertake this type of diet, and those only perform exercise