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The Metabolic Syndrome and the Effects of Different Types of Exercise Modalities in Adolescents with Obesity: a HEARTY Study

Purpose: The metabolic syndrome (MetS) is a cluster of metabolic abnormalities including high waist circumference and blood pressure, elevated triglyceride, glucose, and, insulin concentrations and low high density lipoprotein cholesterol concentrations. The prevalence of MetS in overweight and obese adolescents ranges from 10 to 66% depending of the definition used and the population studied. Obese adolescents are more prone to have MetS, highlighting the necessity of designing effective none pharmacological interventions targeting the specific needs of adolescents and to improve the management of the metabolic syndrome. Objectives: The objectives of this thesis were first, to perform a secondary data analysis of the Healthy Eating Aerobic and Resistance Training in Youth (HEARTY) trial to determine the effects of different modalities of exercise training on the prevalence of the MetS and second, to do a critical analysis of the literature surrounding the MetS concept and diagnostic for the pediatric population. Methods: Among the 304 participants of the HEARTY trial, 65 (21%) participants were classified as having MetS by the International Diabetes Federation. Measures of waist circumference, blood pressure, fasting plasma concentrations of lipids, glucose and insulin and prevalence of MetS were compared to baseline and post-6 months intervention (Aerobic training, Resistance training, Combined aerobic and resistance training and Control). Results: There were no significant changes in the prevalence of MetS within and between Aerobic, Resistance, Combined aerobic and resistance and Control groups after the 6-month intervention. However, significant improvements in MetS parameters were observed from baseline to post-intervention within groups. Aerobic and Resistance training alone significantly decreased waist circumference and systolic and diastolic blood pressure. Combined aerobic and resistance significantly decreased triglyceride concentrations and increased high density lipoprotein cholesterol concentrations whereas Control significantly decreased systolic blood pressure and insulin levels. Conclusions: Exercise, regardless of the modality, and diet counseling were not statistically effective for reducing the prevalence of MetS but did improve some of the independent MetS parameters. The absence of statistical difference in the prevalence of the MetS may be due to a lack of statistical power. Moreover, the critical analysis of the MetS literature bring us to conclude that the first step towards a standard definition of MetS for the adolescent population is to define the true clinical purpose of a MetS diagnostic in the pediatric population.

Identiferoai:union.ndltd.org:uottawa.ca/oai:ruor.uottawa.ca:10393/31970
Date January 2015
CreatorsFrappier, Alexandrine
ContributorsPrud'homme, Denis
PublisherUniversité d'Ottawa / University of Ottawa
Source SetsUniversité d’Ottawa
LanguageEnglish
Detected LanguageEnglish
TypeThesis

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