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

项目总结/摘要：以家庭为基础的生活方式干预，结合联合收割机饮食调整， 身体活动（PA）和行为支持是儿科肥胖症治疗的护理标准;然而， 跨研究的方法异质性使得很难确定哪些特定策略最重要。 灵验。虽然单独针对PA的干预措施导致有限的体重减轻，但PA的健康益处 广泛;并且，将联合收割机PA培训与饮食改变相结合的干预措施似乎具有最强大的 影响体重。因此，PA仍然是儿童肥胖症主要治疗的关键治疗靶点。的 针对PA的有效干预措施的重要性在青春期可能特别突出， 水平急剧下降。尽管指南认可定期、持续的中度至中度 充满活力的PA，适合年龄的活动计划的理想组成部分，包括所需的锻炼 然而，目前还没有很好地确定，特别是对青少年而言。高强度间歇训练（HIIT） 由高强度PA的反复短暂发作和短暂的恢复期组成， 在改善健康方面特别有效，因为它比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训练安全有效地改善身体成分， 由于成人的心肺健康，很少有研究调查HIIT在儿童中的作用， 青少年，特别是在综合肥胖治疗的背景下，使用严格的研究设计。 因此，本申请建议进行试点随机对照试验，以确定可行性 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疗效 青少年肥胖的干预措施。具体而言，56名12-16岁的肥胖青少年参与了一项研究。 12-一周的生活方式干预将被随机分配到两个运动训练课程之一的参与 条件：1）高强度间歇训练（HIIT）或2）连续中等强度训练（CMIT）。两 锻炼计划将包括每周三次有监督的训练。此外，所有青少年都将参加 在每周一次的行为体重管理会议上，针对特定的饮食目标，促进自我监测， 行为。评估将在基线、干预后（12周）和1个月随访（16 周）。研究结果将用于1）确定HIIT和CMIT作为 对青少年肥胖者进行综合生活方式干预; 2）调查HIIT的初步疗效， 与能量匹配的CMIT相比， 风险因素; 3）探索运动训练条件（HIIT或CMIT）是否影响短期PA水平， 在完成生活方式干预后维持体重。这些初步调查的结果将 为一项充分研究HIIT在青少年肥胖综合治疗中的作用的试验提供信息。

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.