Featured Oral Abstracts

Is it really a lost generation? Lifestyle, sedentary behaviour and early preventive measures in childhood and adolescence.

Friday, 15 May 2015, 11:00-12:30

378

5 year follow-up of an inpatient lifestyle intervention program in overweight and obese children and effects on lipid levels and physical activity

M Siegrist¹, B Geilhof¹, H Langhof², T Giegerich³, R Oberhoffer³, M Heitkamp¹, M Halle⁴

¹Department of Prevention, Rehabilitation and Sports Medicine, Technische Universit?M?, Munich, Germany

²Rehabilitation Clinic Sch?cht, Berchtesgaden, Germany

³Institute of Preventive Pediatrics, Technische Universit?M?, Munich, Germany

⁴Department of Prevention, Rehabilitation and Sports Medicine, DZHK (Munich Heart Alliance), Else Kr?-Fresenius-Zentrum, Technische Universit?M?, Munich, Germany

Topic: Sports cardiology

Purpose:Obesity in childhood often leads to early cardiometabolic comorbidities as hypertension and changes in lipid profile as well as increased morbidity and mortality in adulthood. Therefore effective and particularly sustainable lifestyle intervention programs for children are mandatory.

Methods:We examined 168 overweight and obese children after 5 yr follow-up (mean age therapy start: 13.5±2.3 years, mean BMI: 32.8±5.9 kg/m2, 104 girls), who had previously underwent a standardized lifestyle intervention program (10 h/week structured physical activity, 6h/week unstructured physical activity, calorie restricted balanced diet, behavioural counselling) for 4 to 6 weeks. Anthropometric parameters, blood pressure, blood samples and physical activity (questionnaire) were examined at therapy start and after five years. Children were divided in BMI categories (overweight > 90th percentile; obese > 97th percentile, severely obese > 99.5th percentile) according to age- and sex-specific percentiles for BMI.

Results:1. After 5 yr follow-up, 58 children (34.5%) showed improved BMI category compared to therapy start, 90 children (53.7%) remained in the same BMI category and 20 children (11.9%) had an increase in BMI category. 2. Children with sustainable BMI reduction showed a better lipid profile after 5 years than children with stable or increased BMI category (HDL < 40 mg/dl: 8.6 % versus 20.0 %; triglycerides = 150 mg/dl: 13.8 % vs. 27.3 %). Elevated blood pressure (= 130/85 mm Hg) after 5 years was found in 32.8 % of children with improved BMI category compared to 50.0 % of children with unchanged or increased BMI category. 3. The number of days with physical activity = 60 min/days was 3.2±2.2 days/week in children with sustainable BMI reduction compared to 2.9±2.2 days/week in children with stable or increased BMI category (p=0.361). The amount of physical activity after five years remained unchanged compared to therapy start.

Conclusions:Children with sustainable BMI reduction long-term after a lifestyle intervention program had a better cardiometabolic risk profile than those who gained weight during the five years of follow-up. No significant difference between self-reported physical activity and long term BMI changes was observed.