Previous studies had shown that multidisciplinary programs, focused on modifying lifestyle habits, are beneficial in improving body composition and biochemical alterations in obese children and teenagers. Therefore, and given that obesity in pediatric age is the preamble to adult obesity and, therefore, morbidity and mortality from cardiovascular disease, it is considered that slowing or reducing the prevalence of the disease at an early age is of paramount interest.

Against this background, the research team developed an intervention program that integrated the practice of physical activity together with dietary advice, which showed positive results on the health of the participants. In addition, the beneficial effect on adiposity observed in schoolchildren and teenagers participating in the combined program of nutritional intervention and regulated physical activity was significantly higher than that observed in those who only received intervention with a nutritional component.

The work was born from the collaboration between the Pediatric Nutrition Research Group of INCL and the Physical and Sports Performance Research Unit (UIRFIDE) of the UV. This union involves the integration of a highly qualified professional team, led by the main researchers: Cecilia Martínez Costa, Professor of Pediatrics of the University of Valencia and Head of the Pediatrics Service at the Clinical Hospital of Valencia and Principal Investigator of the Pediatric Nutrition Research Group. INCLIVA; and Consolación García Lucerga, full professor of the Department of Physiotherapy at the UV.

The pilot program of nutritional intervention, together with regulated physical activity, was developed over 2 periods of four months in 2021. It allowed to observe significant improvements in body composition parameters, with significant reductions in the body mass index corrected for age and sex (z-score), and body fat percentage. These improvements in body composition reflected improvement in glucose metabolism parameters such as the HOMA index, in liver enzymes, and inflammation.

The main conclusion of the study is that the only truly effective measure to decrease the prevalence of childhood obesity and its complications is to establish combined dietetic-nutritional and exercise intervention programs from an early age in life, that is, during childhood, as well as through detection and intervention in at-risk families.

The research has been carried out in the consultations of Child Cardiology and Gastroenterology and Pediatric Nutrition of the University Clinical Hospital of Valencia and in the sports facilities of the Faculty of Physical Activity and Sport Sciences of the UV. The study was part of the doctoral thesis entitled ‘Effect of nutritional intervention on schoolchildren and teenagers with obesity with and without insulin resistance’ by Paula Grattarola, who had a predoctoral grant from the Valencian Government (ACIF / 2016 / 029, European Social Fund).

This research has also had the intervention of pediatricians with extensive experience in the treatment of obesity, such as Francisco Núñez, head of the Child Cardiology section and Elena Crehuá Gaudiza, of the Pediatric Gastroenterology and Nutrition Section, as well as dietitians-nutritionists specialised in research and nutrition in pediatric age, Paula Grattarola, Mª Ángeles Montal and Beatriz Padilla López, all of them from the same INCLIVA Research Group. For its part, the UV group has the participation of Consolación García Lucerga, the head professor of the Department of Physical Education and Sports, María Cristina Blasco Lafarga, with extensive background in the field of sports training both in elite athletes and in special populations, and Ana Cordellat Marzal, specialist in technical training in the editions of the program carried out.

On obesity

Obesity is a multifactorial disease in whose development environmental factors play a fundamental role. The reduction in physical activity and increased sedentary lifestyle together with different unhealthy dietary habits in our population can lead to an energy imbalance that triggers an increase in the deposit of body fat and, therefore, obesity. In Spain, around 17% of children have obesity (Aladino Study, 2019), a percentage that places our country in the third most prevalent position in Europe, only behind Greece and Italy.

The concern increases if it is taken into account that the child with obesity is increasingly early in the development of associated comorbidities such as disorders in lipid metabolism, liver disease, arterial hypertension, type 2 diabetes and metabolic syndrome.

Article:

Cordellat, Ana, Beatriz Padilla, Paula Grattarola, Consolación García-Lucerga, Elena Crehuá-Gaudiza, Francisco Núñez, Cecilia Martínez-Costa, and Cristina Blasco-Lafarga. 2020. «Multicomponent Exercise Training Combined with Nutritional Counselling Improves Physical Function, Biochemical and Anthropometric Profiles in Obese Children: A Pilot Study». Nutrients 12, no. 9: 2723. https://doi.org/10.3390/nu12092723