The Role of High Intensity Interval Training in the Treatment of Adolescent Obesity

项目摘要/摘要：结合饮食调整的以家庭为基础的生活方式干预， 体力活动(PA)和行为支持是儿童肥胖治疗的标准护理；然而， 不同研究方法的异质性使得很难确定哪些具体的策略是最 很有效。尽管针对PA的干预措施只会导致有限的体重减轻，但PA的健康益处是 广泛的；而且，将PA训练与饮食改变相结合的干预措施似乎是最有力的 对体重的影响。因此，PA仍然是儿童肥胖症的主要治疗靶点。这个 针对PA的有效干预的重要性在青春期可能特别突出，当PA 这一水平急剧下降。尽管指导方针支持定期、持续的适度到 精力充沛的PA，适合年龄的活动计划的理想组成部分，包括所需的锻炼 特别是对青少年而言，这一现象尚未得到很好的证实。高强度间歇训练(HIIT) 它由反复短暂的高强度PA组成，中间可能有短暂的恢复期 在改善健康方面特别有效，因为它比更传统的有氧训练需要更少的时间。尽管 越来越多的文献支持HIIT训练是安全和有效的，可以改善身体成分和 成人的心肺健康，很少有研究调查HIIT对儿童和儿童的作用 青少年，特别是在使用严格的研究设计的全面肥胖治疗的背景下。 因此，本申请建议进行试点随机对照试验，以确定其可行性 在既定的生活方式中整合两种不同的运动训练方法的初步效果 对青少年肥胖的干预。具体地说，56名年龄在12-16岁之间的肥胖青少年参加了 为期12周的生活方式干预将被随机分配到参加两个运动训练课程中的一个 条件：1)高强度间歇训练(HIIT)或2)持续中等强度训练(CMIT)。两者都有 锻炼计划将由每周三次监督课程组成。此外，所有青少年都将参加 在每周针对特定饮食目标和促进自我监控的行为体重管理会议上 行为。评估将在基线、干预后(12周)和1个月随访(16周)时完成 几周)。研究结果将被用来1)确定HIIT和CMIT作为 综合干预青少年肥胖的生活方式；2)调查HIIT的初步疗效， 与能量匹配CMIT相比，对青少年肥胖症、心肺功能和心脏代谢的影响 风险因素；以及，3)探索运动训练条件(HIIT或CMIT)是否影响短期PA水平和 在完成生活方式干预后保持体重。这些初步调查的结果将 介绍一项研究HIIT在青少年肥胖综合治疗中的作用的全能试验。

PROJECT SUMMARY/ABSTRACT: Family-based lifestyle interventions that combine dietary modification, physical activity (PA), and behavioral support are the standard of care for pediatric obesity treatment; however, methodologic heterogeneity across studies make it difficult to determine which specific strategies are most efficacious. Although interventions targeting PA alone result in limited weight loss, the health benefits of PA are extensive; and, interventions that combine PA training with dietary changes appear to have the most robust impact on weight. Thus, PA remains a key therapeutic target for the primary treatment of pediatric obesity. The importance of effective interventions that target PA may be particularly salient during adolescence, when PA levels decline dramatically. Although guidelines endorse the importance of regular, continuous moderate-to- vigorous PA, the ideal components of an age-appropriate activity program, including the required exercise intensity, have not yet been well-established, particularly for adolescents. High-intensity interval training (HIIT) which consists of repeated brief bouts of high-intensity PA with intervening short periods of recovery may be particularly efficacious in improving health as it requires less time than more traditional aerobic training. Despite a growing literature that supports HIIT training as safe and effective in improving body composition and cardiorespiratory fitness among adults, fewer studies have investigated the role of HIIT in children and adolescents, particularly in the context of the comprehensive obesity treatment using a rigorous study design. As a result, this application proposes to conduct a pilot randomized controlled trial to determine the feasibility and preliminary efficacy of integrating two distinct approaches to exercise training within an established lifestyle intervention for adolescent obesity. Specifically, 56 adolescents, age 12-16 years, with obesity participating in a 12-week lifestyle intervention will be randomly assigned to participation in one of two exercise training session conditions: 1) high-intensity interval training (HIIT) or 2) continuous, moderate-intensity training (CMIT). Both exercise programs will consist of three supervised sessions per week. In addition, all adolescents will participate in weekly behavioral weight management sessions that target specific dietary goals and promote self-monitoring behaviors. Assessments will be completed at baseline, post-intervention (12 weeks), and 1-month follow-up (16 weeks). Study results will be used to 1) determine the feasibility and acceptability of HIIT and CMIT as part of a comprehensive lifestyle intervention for adolescents with obesity; 2) investigate the preliminary efficacy of HIIT, compared with energy-matched CMIT, on adolescent adiposity, cardiorespiratory fitness and cardiometabolic risk factors; and, 3) explore if exercise training conditions (HIIT or CMIT) influence short-term PA levels and weight maintenance after completion of the lifestyle intervention. Results of these preliminary investigations will inform a fully powered trial examining the role of HIIT in the comprehensive treatment of adolescent obesity.