Stage to Change Eating behavior and physical activity among adolescents with an excess body mass: impact on metabolic profile
Keywords:adolescent behavior, eating habits, pediatric obesity, metabolic syndrome
Introduction: Obesity in children and adolescents is usuallyrelated to metabolic alterations, and intervention programs are one of the strategies for the treatment of obesity and associated comorbidities. At the beginning of the intervention, the stages of readiness to change behavior indicate specific habits that the teenager plans to modify or not, and how long he or she intends to make the alterations.
Objective: To assess the metabolic profile and their association with the stages of readiness to change eating habits and exercise behaviors in adolescents with overweight.
Methods: Eighty-three adolescents with excess body weight underwent an assessment of anthropometric variables and metabolic profile (glucose, total cholesterol, LDL-c, HDL-c, non-HDL-c, VLDL, triglycerides, insulin). Besides, the stages of readiness to change behaviors for “size and amount of portions,” “amount of fat in the diet,” fruits and vegetable consumption,” and “physical activity practice,” anthropometric variables and metabolic profile were compared according to the stages of change.
Results: About “fruits and vegetable consumption,” adolescents in the Maintenance group presented lower body weight than those from Action and Preparation groups. The Action group presented higher body weight than group “Contemplation” and it showed higher non-HDL-cholesterol than the groups “Pre-contemplation” and “Preparation.” In “physical activity practice,” the Maintenance group presented lower body weight, Body Mass Index, and body fat (in kg) than Action, Preparation, and Contemplation groups. The alterations in HDL-cholesterol reduced as the stages of change progressed in the “physical activity practice” domain.
Conclusion: The stages of readiness to change behaviors impact anthropometric and metabolic variables in adolescents with excess body weight, and it is a recommended instrument to monitor intervention programs.
Ho M, Garnett SP, Baur, LA. Childhood obesity and insulin resistance: how should it be managed? Curr Treat Options Cardiovasc Med.2014 Dec; 16(12): 351. DOI: https://doi.org/10.1007/s11936-014-0351-0
Ho HCH, Maddaloni E, and Buzzetti, R. Risk factors and predictive biomarkers of early cardiovascular disease in obese youth. Diabetes Metab Res Rev. 2019; 35:e3134. Doi: 10.1002/dmrr.3134.
Mayerhofer E, Ratzinger F, Kienreich NE, et al. A multidisciplinary intervention in childhood obesity acutely improves insulin resistance and inflammatory markers independent from body composition. Front Pediatr. 2020 feb21;8:52. Doi: 10.3389/fped.2020.00052.
Ruminska M, Witkowska-Sedek E, Artemniak-Wojtowicz D, et al. Changes in leukocyte profile and C-reactive protein concentration in overweight and obese adolescents after reduction of body weight. Cent Eur J Immunol. 2019; 44(3):307-3015. Doi: 10.5114/ceji.2019.89608.
Moraes ACF, Fulaz CS, Oliveira ERN, Reichert FF. Prevalência de síndrome metabólica em adolescentes: uma revisão sistemática. Cad Saúde Pública. 2009; 25(6): 1195-202.
Kuschnir MCC, Bloch KV, Szklo M, et al. ERICA: prevalence of metabolic symdrome in Brazilian adolescents. Rev SaúdePública. 2016; 50(suppl 1):11s.
Weiss R, Dziura J, Burgest TS, Tamborlane WV, Taksali SE, Yeckel CW.et al, Obesity and the metabolic Syndrome in Children and Adolescents. N Engl J Med. 2004 Jun; 350:2362. DOI: https://doi.org/10.1056/NEJMoa031049
Elitok GK, Duru NS, Elevil M, et al. Prevalence of Metabolic Syndrome in Middle School Chidren and Evaluation of Components Of Metabolic Syndrome. SisliEtfalHastan Tip Bul. 2019 Nov 21;53(4):403-408. Doi: 10.14744/SEMB.2018.50479.
Cook S, Weitzman M, Auinger P, Nguyen M, Dietz W H. Prevalence of metabolic syndrome phenotype in adolescents: findings from the third national health and nutrition examination survey, 1988-1994. Arch Pediatr Adolesc Med. 2003 Aug; 157(8): 821-7.
Rizzo AP, Goldberg T, Silva CC, Kurokawa CS, Nunes H, Corrente J. Metabolic Syndrome Risk Factors in Overweight, Obese, and Extremely Obese Brasilian Adolescents. Nutr J. 2013 Jan 30; 12: 19. DOI: https://doi.org/10.1186/1475-2891-12-9
Hintze LJ, Cattai, GBP, Da Silva DF, Nardo Junior N. Estágio de prontidão para mudança de adolescentes interessados e ingressar no programa multiprofissional de tratamento da obesidade. Rev Paul Pediatr. 2012; 30(2): 237–43.
Rank M, Siegrist M, Wilks DC, Langhof H, Wolfarth B, Haller B, et al. The Cardio-Metabolic Risk of Moderate and Severe Obesity in Children and Adolescents. J Pediatr. 2013 Jul; 163(1): 137-42. DOI: https://doi.org/10.1016/j.jpeds.2013.01.020
Ricco RC, Rubens GR, Almeida CAN, Ramos APP. Estudo comparativo de fatores de risco em crianças e adolescentes com diagnóstico antropométrico de sobrepeso ou obesidade. Rev Paul Pediatr. 2010;28(4): 320-5.
SIGN. Scottish Intercollegiate Guidelines Network. Management of obesity. a national clinical guideline. Edinburgh: SIGN; 2010.
Sutton K, Logue E, Jarjoura D, et al. Assessing dietary and exercise stage of change to optimize weight loss interventions. Obes Res. 2003; 11(5):641-52. Doi: 10.1038/oby.2003.92.
Da Silva DF, Bianchini JAA, Lopera CA, Capelato DA, Hintze LJ, Nardo CCS, et al. Impact of readiness to change behavior on the effects of a multidisciplinary intervention in obese Brazilian children and adolescents. Appetite. 2015 Apr; 87: 229-35. DOI: https://doi.org/10.1016/j.appet.2014.12.221
Cole TJ, Lobstein, T. Extended international (IOTF) body mass index cutoffs for thinness, overweight and obesity. Pediatr Obes. 2012 Aug; 7(4): 284-94. DOI: https://doi.org/10.1111/j.2047-6310.2012.00064.x
Back GI, Caramelli B, Pellanda L. I diretriz brasileira para a prevenção da aterosclerose na infância e na adolescência. Arq Bras Cardiol. 2005; 85(Suppl 6): 4–36.
International Diabetes Federation (IDF). IDF consensus definition of the metabolic syndrome in children and adolescents. Brussels: IDF; 2007. p. 2–19.
Cattai GBP, Hintze LJ, Nardo Junior N. Validação interna do questionário de estágio de prontidão para mudança do comportamento alimentar e de atividade física. Rev Paul Pediatr. 2010; 28(2): 194-9. DOI: http://www.scielo.br/pdf/rpp/v28n2/v28n2a11.pdf
Matias T, Andrade A, Maciel G, et al. O estágio de manutenção para o exercício está associada à uma melhor percepção de diferentes indicadores de saúde na adolescência. Rev Bras Ativ Fís & Saúde. 2017; 22(5):1-7. Doi: https://doi.org/10.12820/rbafs.v.22n5p479-485.
Moore JB, Singletary CR, Skelton JA, et al. The Design of A Clinical Trial to Increase Self-Monitoring of Physical Activity and Eating Behaviors Among Adolescents: Protocol for the ImPACT Feasibility Study. JMIR Publication. 2020. Doi: 10.2196/18098.
Toral N, Slater B, Cintra I de P, Fisberg M. Comportamento alimentar de adolescentes em relação ao consumo de frutas e verduras. 2006. Rev Nutr. 2006 maio-jun; 19(3): 331-40. DOI: http://www.scielo.br/pdf/rn/v19n3/30138.pdf
Maddison R, Prapavessis H. Exercise behavior among New Zealand adolescents. A test of the transtheoretical model. Pediatric Exercise Science. 2006;18 (3): 351–63; 2006. DOI: https://doi.org/10.1123/pes.18.3.351
Prochaska JO, DiClemente CC.Stage and process of self-change in smoking. Toward an integrative model of change. J Consult Clin Psychol. 1983 Jun; 51(3): 390-5.
Chae SM, Kwon I, Kim CJ, Jang J. Analysis of weight control in Korean adolescents using the transtheoretical model. West J Nurs Res. 2010 Jun; 32(4): 511-29. DOI: https://doi.org/10.1177/0193945909355996
DiClemente CC, Prochaska JO, Fairhurst SK, Velicer WF, Velasquez MM, Rossi JS. The process of smoking cessation. An analysis of precontemplation, contemplation, and preparation stages of change. J Consult Clin Psychol. 1991 Apr; 59(2): 295-304.
Prochaska JO. Decision making in the transtheoretical model of behavior change. Med Decis Making. 2008 Nov-Dec; 28(6): 845-9. DOI: https://doi.org/10.1177/0272989X08327068
Kelly AS, Wetzsteon RJ, Kaiser DR, et al. Inflammation, insulin, and endothelial function in overweight children and adolescents: the role of exercise. J Pediatr 2004; 145: 731-6.
Chen AK, Roberts CK, Barnard RJ. Effect of a short-term diet and exercise intervention on metabolic syndrome in overweight children. Metabolism. 2006 Jul; 55(7): 871-8.
Copyright (c) 2020 Marciele Alves Bolognese, Danilo Fernandes da Silva, Josiane Aparecida Alves Bianchini, Rose Mari Benemmamm, Nelson Nardo Junior
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