{"title":"饮食和体育活动干预对肥胖儿童肥胖的不同影响。","authors":"Anekchoke Tangtongsoong, Chonnikant Visuthranukul, Yuda Chongpison, Sirinuch Chomtho","doi":"10.3345/cep.2024.01347","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Managing obesity in children remains challenging. In addition to body mass index (BMI), incorporating body composition into evaluations of postobesity interventions would help assess changes in adiposity.</p><p><strong>Purpose: </strong>This study aimed to identify the relationship between dietary intake, physical activity, and changes in BMI z scores and adiposity among children with obesity.</p><p><strong>Methods: </strong>Children aged 7-15 years with obesity received monthly dietary and physical activity instructions for 6 months. Three-day dietary records and physical activity questionnaires were collected at 0, 3, and 6 months. Body composition was measured using bioelectrical impedance analysis. These relationships were analyzed using uni- and multivariate linear regression analyses.</p><p><strong>Results: </strong>A total of 155 children with obesity completed the 6-month study. A higher total protein intake per ideal weight for height was significantly correlated with a decrease in BMI z score and trunk fat mass index (trunk fat mass [FM] in kg/height in m2). Mean dietary fiber intake was negatively correlated with BMI z score, FM, FM index (FMI, FM in kg/height in m2), and visceral fat area (VFA) at 6 months. Each 1 g/kg/day increase in protein intake and additional 1 g/day of dietary fiber intake led to a 0.191 kg/m2 (95% confidence interval [CI], -0.309 to -0.072) and 0.028 kg/m2 (-0.05 to -0.005) reduction in BMI z score. Each 1 g/day increase in protein intake led to a reduction of 0.009 kg/m² in trunk FMI (-0.016 to -0.002) and 0.21 cm² in VFA (-0.418 to -0.002). The outcomes observed at 6 months were consistent with the overall 6-month findings, reinforcing the efficacy of the intervention.</p><p><strong>Conclusion: </strong>Our study showed beneficial effects of high dietary protein and fiber intakes on BMI z scores and adiposity of children with obesity. Fine-tuning dietary interventions that emphasize appropriate protein and fiber intakes may be more practical for managing childhood obesity.</p>","PeriodicalId":36018,"journal":{"name":"Clinical and Experimental Pediatrics","volume":" ","pages":"370-378"},"PeriodicalIF":3.2000,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062386/pdf/","citationCount":"0","resultStr":"{\"title\":\"Differential effects of dietary and physical activity interventions on adiposity of children with obesity.\",\"authors\":\"Anekchoke Tangtongsoong, Chonnikant Visuthranukul, Yuda Chongpison, Sirinuch Chomtho\",\"doi\":\"10.3345/cep.2024.01347\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Managing obesity in children remains challenging. In addition to body mass index (BMI), incorporating body composition into evaluations of postobesity interventions would help assess changes in adiposity.</p><p><strong>Purpose: </strong>This study aimed to identify the relationship between dietary intake, physical activity, and changes in BMI z scores and adiposity among children with obesity.</p><p><strong>Methods: </strong>Children aged 7-15 years with obesity received monthly dietary and physical activity instructions for 6 months. Three-day dietary records and physical activity questionnaires were collected at 0, 3, and 6 months. Body composition was measured using bioelectrical impedance analysis. These relationships were analyzed using uni- and multivariate linear regression analyses.</p><p><strong>Results: </strong>A total of 155 children with obesity completed the 6-month study. A higher total protein intake per ideal weight for height was significantly correlated with a decrease in BMI z score and trunk fat mass index (trunk fat mass [FM] in kg/height in m2). Mean dietary fiber intake was negatively correlated with BMI z score, FM, FM index (FMI, FM in kg/height in m2), and visceral fat area (VFA) at 6 months. Each 1 g/kg/day increase in protein intake and additional 1 g/day of dietary fiber intake led to a 0.191 kg/m2 (95% confidence interval [CI], -0.309 to -0.072) and 0.028 kg/m2 (-0.05 to -0.005) reduction in BMI z score. Each 1 g/day increase in protein intake led to a reduction of 0.009 kg/m² in trunk FMI (-0.016 to -0.002) and 0.21 cm² in VFA (-0.418 to -0.002). The outcomes observed at 6 months were consistent with the overall 6-month findings, reinforcing the efficacy of the intervention.</p><p><strong>Conclusion: </strong>Our study showed beneficial effects of high dietary protein and fiber intakes on BMI z scores and adiposity of children with obesity. Fine-tuning dietary interventions that emphasize appropriate protein and fiber intakes may be more practical for managing childhood obesity.</p>\",\"PeriodicalId\":36018,\"journal\":{\"name\":\"Clinical and Experimental Pediatrics\",\"volume\":\" \",\"pages\":\"370-378\"},\"PeriodicalIF\":3.2000,\"publicationDate\":\"2025-05-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062386/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical and Experimental Pediatrics\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.3345/cep.2024.01347\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/2/3 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical and Experimental Pediatrics","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3345/cep.2024.01347","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/2/3 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"PEDIATRICS","Score":null,"Total":0}
Differential effects of dietary and physical activity interventions on adiposity of children with obesity.
Background: Managing obesity in children remains challenging. In addition to body mass index (BMI), incorporating body composition into evaluations of postobesity interventions would help assess changes in adiposity.
Purpose: This study aimed to identify the relationship between dietary intake, physical activity, and changes in BMI z scores and adiposity among children with obesity.
Methods: Children aged 7-15 years with obesity received monthly dietary and physical activity instructions for 6 months. Three-day dietary records and physical activity questionnaires were collected at 0, 3, and 6 months. Body composition was measured using bioelectrical impedance analysis. These relationships were analyzed using uni- and multivariate linear regression analyses.
Results: A total of 155 children with obesity completed the 6-month study. A higher total protein intake per ideal weight for height was significantly correlated with a decrease in BMI z score and trunk fat mass index (trunk fat mass [FM] in kg/height in m2). Mean dietary fiber intake was negatively correlated with BMI z score, FM, FM index (FMI, FM in kg/height in m2), and visceral fat area (VFA) at 6 months. Each 1 g/kg/day increase in protein intake and additional 1 g/day of dietary fiber intake led to a 0.191 kg/m2 (95% confidence interval [CI], -0.309 to -0.072) and 0.028 kg/m2 (-0.05 to -0.005) reduction in BMI z score. Each 1 g/day increase in protein intake led to a reduction of 0.009 kg/m² in trunk FMI (-0.016 to -0.002) and 0.21 cm² in VFA (-0.418 to -0.002). The outcomes observed at 6 months were consistent with the overall 6-month findings, reinforcing the efficacy of the intervention.
Conclusion: Our study showed beneficial effects of high dietary protein and fiber intakes on BMI z scores and adiposity of children with obesity. Fine-tuning dietary interventions that emphasize appropriate protein and fiber intakes may be more practical for managing childhood obesity.