The Effect of Diet and Exercise on Obesity in Children Living in Aksaray

Öz

Overweight and obesity are defined as being overweight. This situation impairs the health status of both children and adults. In this study, we aimed to examine the effects of diet and exercise on obese children. The sample of this descriptive study was retrospectively collected with 30 patients who were admitted to the Aksaray University Pediatrics outpatient clinic between November 2019-December 2020 with complaints of weight gain / obesity. FITT (frequency, time, type, severity) exercise program was applied to the participants in the study in obese / overweight patients. Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), weight and routine blood tests were repeated for the patients who were called for control two months later. When the changes in HOMA-IR due to the weight differences of the patients were examined, a positive and significant correlation was found (r = 0.583; p = 0.001,). When the changes in HOMA-IR due to weight differences for male and female patients were examined, a positive significant correlation was found (r = 0.624; p = 0.013) and (r = 0.682; p = 0.005), respectively. A significant and positive correlation was found between triglyceride and HOMA-IR (r = 0.721, p = 0.001). When the relationship between HDL and HOMA-IR was examined before diet + exercise, there was a significant and negative correlation (r = -0.551, p = 0.002), and a significant and negative correlation after diet + exercise (r = -0.443, p = 0.014). There was no correlation between LDL and HOMA-IR (r = -0.234, p = 0.260). A positive and highly significant correlation was found between insulin and HOMA-IR (r = 0.981, p = 0.0001). Although no significant correlation was found between LDL cholesterol and weight loss (r=,-0.091, p=0.664), a significant decrease in LDL cholesterol levels after a 2-month family-based diet + exercise therapy approach was one of the important results found in this study (r=. 0.725, p=0.0001).

Diyet ve Egzersizin Aksaray da Yaşayan Çocuklarda Obezite Üzerine Etkisi

Öz

Aşırı kilo ve obezite şişmanlık olarak tanımlanmaktadır. Bu durum hem çocukların hem de yetişkinlerin sağlık durumlarını bozmaktadır. Biz bu çalışmada obez çocuk hastalarda diyet ve egzersiz uygulamasının etkilerini incelemeyi amaçladık. Tanımlayıcı tipteki bu çalışmanın örneklemi Aksaray Üniversitesi Çocuk Sağlığı ve Hastalıkları polikliniğine Kasım 2019-Aralık 2020 tarihleri arasında kilo alma/obezite şikayeti ile başvuran 30 hasta ile retrospektif olarak toplandı. Çalışmaya katılan katılımcılara, obez/aşırı kilolularda önerilen FITT (sıklık, zaman, tip, şiddet) egzersiz programı uygulanmıştır. İki ay sonra kontrole çağrılan hastaların Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), kilo ve rutin kan tetkikleri tekrarlandı. Hastaların kilo farklarına bağlı olarak HOMA-IR deki değişimleri incelendiğinde pozitif yönde ve anlamlı bir korelasyon saptandı (r=0.583; p=0.001,). Erkek ve kız hastalar için kilo farklarına bağlı olarak HOMA-IR deki değişimlere bakıldığında sırasıyla (r=0.624; p=0.013) ve (r= 0.682; p=0.005) pozitif yönde anlamlı korelasyon tespit edildi. Trigliserit ve HOMA-IR arasında anlamlı ve pozitif yönde bir korelasyon saptandı (r= 0.721, p=0.001). HDL ve HOMA-IR arasındaki ilişkiye diyet + egzersiz öncesi bakıldığında anlamlı ve negatif yönde korelasyon (r=-0.551, p=0.002), diyet + egzersiz sonrası bakıldığında ise anlamlı ve negatif yönde korelasyon saptandı (r=-0.443, p= 0.014). LDL ve HOMA-IR arasında korelasyon saptanmadı (r=-0.234, p=0.260). İnsülin ve HOMA-IR arasında pozitif ve yüksek oranda anlamlı bir korelasyon saptandı (r=0.981, p=0.0001). LDL kolesterol ve kilo verme arasında belirgin bir korelasyon saptanamamasına rağmen (r=,-0.091, p=0.664), 2 aylık aile temelli diyet + egzersiz tedavisi yaklaşımı onucunda LDL kolesterol düzeylerinde anlamlı bir düşüşün olması bu çalışmada saptanan önemli sonuçlardan birisi idi (r=0.725, p=0.0001).

Anahtar Kelimeler

• homa-indeks
• obezite
• egzersiz
• Diyet

Kaynakça

1. 1. Hales CM, Fryar CD, Carroll MD, et al. Trends in obesity and severe obesity prevalence in US youth and adults by sex and age, 2007-2008 to 2015-2016. JAMA 2018;319:1723-1725.
2. 2. Lavie CJ, Laddu D, Arena R, et al. Healthy weight and obesity prevention: JACC health promotion series. J Am Coll Cardiol 2018;72:1506- 1531.
3. 3. Carbone S, Del Buono, M. G Ozemek, et al. Obesity, risk of diabetes and role of physical activity, exercise training and cardiorespiratory fitness. Progress in cardiovascular diseases, 2019; 62(4), 327-333.
4. 4. Güngör, N. K. Overweight and obesity in children and adolescents. Journal of clinical research in pediatric endocrinology, 2014; 6(3), 129.
5. 5. European Congress on Obesity (2018). https://eco2018.easo.org/eco-highlights/
6. 6. World Health Organization. Obesity and overweight fact sheet. WHO Media centre 2016.
7. 7. Türkiye İstatistik Kurumu (TÜİK) (2017). http://www.tuik.gov.tr/basinOdasi/haberler/2017_31_20170607.pdf.
8. 8. Hills AP, Byrne NM. State of the science: a focus on physical activity. Asia Pac J Clin Nutr 2006;15:40–8.

9. 9. Hills AP, King NA, Armstrong TP. The contribution of physical activity and sedentary behaviours to the growth and development of children and adolescents: implications for overweight and obesity. Sports Med 2007; 37: 533–45.
10. 10. Hills AP, Andersen L. B, Byrne N. M. Physical activity and obesity in children. British journal of sports medicine, 2011; 45(11), 866-870.
11. 11. Han JC, Kimm SYS. Childhood Obesity-2010: Progress and Challenges. Lancet 2010; 375:1737-1748.
12. 12. Neyzi O, Bundak R, Gökçay G, et al. Reference Values for Weight, Height, Head Circumference, and Body Mass Index in Turkish Children. J Clin Res Pediatr Endocrinol. 2015;7(4):280-293.
13. 13. Smith GL, McGuinness TM. Adolescent Psychosocial Assessment: The HEEADSSS. J Psychosoc Nurs Ment Health Serv. 2017 ;1;55(5):24-27.
14. 14. Wang Y, Lobstein T. Worldwide trends in childhood overweight and obesity. Int J Pediatr Obes 2006;1:11–25.
15. 15. Kelishadi R. Childhood overweight, obesity, and the metabolic syndrome in developing countries. Epidemiol Rev 2007; 29: 62–76.
16. 16. Klish WJ. Clinical evaluation of the obese child and adolescent. In:Motil KJ, Geffner M (section eds) and Hoppin AG (Deputy ed). Up to date. www.uptodate.comc2013UpToDate.
17. 17. World Health Organization. Obesity: Preventing and Managing the Global Epidemic. Report of a WHO Consultation, WHO Technical Report Series No. 894. Geneva: WHO, 2000.
18. 18. Hills AP, King NA, Armstrong TP. The contribution of physical activity and sedentary behaviours to the growth and development of children and adolescents: implications for overweight and obesity. Sports Med 2007; 37 :533–45.
19. 19. Brown T, Moore TH, Hooper L, et al. Interventions for preventing obesity in children. Cochrane Database Syst Rev. 2019;7(7):CD001871.
20. 20. Hills AP, Okely AD, Baur LA. Addressing childhood obesity through increased physical activity. Nat Rev Endocrinol 2010;6:543–9.
21. 21. Ludwig DS, Pollack HA. Obesity and the economy: from crisis to opportunity. JAMA 2009;301:533–5.
22. 22. Janssen I, Katzmarzyk PT, Boyce WF, et al. Overweight and obesity in Canadian adolescents and their associations with dietary habits and physical activity patterns. J Adolesc Health 2004;35:360–7.
23. 23. Vandewater EA, Shim MS, Caplovitz AG. Linking obesity and activity level with children’s television and video game use. J Adolesc 2004;27:71–85.
24. 24. Caroli M, Argentieri L, Cardone M, et al. Role of television in childhood obesity prevention. Int J Obes Relat Metab Disord 2004 ;28(Suppl 3):S104–8.
25. 25. Hesketh K, Wake M, Graham M, et al. Stability of television viewing and electronic game/computer use in a prospective cohort study of Australian children: relationship with body mass index. Int J Behav Nutr Phys Act 2007; 4: 60.
26. 26. Strong WB, Malina RM, Blimkie CJ, et al. Evidence based physical activity for school-age youth. J Pediatr 2005;146:732–7.
27. 27. Barnett LM, Morgan PJ, van Beurden E, et al. Perceived sports competence mediates the relationship between childhood motor skill proficiency and adolescent physical activity and fitness: a longitudinal assessment. Int J Behav Nutr Phys Act 2008; 5: 40.
28. 28. Fogelholm M. Physical activity, fitness and fatness: relations to mortality, morbidity and disease risk factors. A systematic review. Obes Rev 2010;11:202–21.
29. 29. Dwyer T, Hosmer D, Hosmer T, et al. The inverse relationship between number of steps per day and obesity in a population-based sample: the AusDiab study. Int J Obes (Lond) 2007;31:797–804.
30. 30. Hills AP, Andersen LB, Byrne NM. Physical activity and obesity in children. Br J Sports Med. 2011; 45(11): 866-870.
31. 31. Koplan JP, Liverman CT, Kraak VI, Wisham SL. Progress in preventing childhood obesity: how do we measure up? Washington: National Academy Press, Institute of Medicine; 2007.
32. 32. Barlow SE. Expert committee. Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics. 2007; 120(Suppl 4):S164–92
33. 33. Birch LL, Davison KK. Family environmental factors influencing the developing behavioral controls of food intake and childhood overweight. Pediatr Clin N Am. 2001;48(4):893–907
34. 34. Sung-Chan P, Sung YW, Zhao X, Brownson RC. Family-based models for childhood-obesity intervention: a systematic review of randomized controlled trials. Obes Rev. 2013;14(4):265–78.
35. 35. Manganello J, Blake N. A study of quantitative content analysis of health messages in U.S. Media from 1985 to 2005. Health Commun. 2010;25(5):387–96.
36. 36. Chen AY, Escarce JJ. Family structure and childhood obesity, early childhood longitudinal study—kindergarten cohort. Prev Chronic Dis. 2010; 7(3):A50.
37. 37. Gibson LY, Byrne SM, Davis EA, Blair E, Jacoby P, Zubrick SR. The role of family and maternal factors in childhood obesity. Med J Aust. 2007;186(11): 591–5.
38. 38. Friedland O, Nemet D, Gorodnitsky N, Wolach B, Eliakim A. Obesity and lipid profiles in children and adolescents. J Pediatr Endocrinol Metab. 2002;15:1011–1016
39. 39. Belay B, Belamarich P, Racine AD. Pediatric precursors of adult atherosclerosis. Pediatr Rev. 2004; 25 :4 –16.