A multidisciplinary lifestyle intervention for childhood obesity : effects on body composition, exercise tolerance, quality of life and gut hormones

Vos, R.C. (2011)

Doctoral Thesis

The general aim of the studies described in this thesis is the effect evaluation of a family-based multidisciplinary cognitive behavioral treatment on several domains related to childhood obesity compared to standard care. The main findings from these studies are a modest long-term reduction of both total and abdominal adiposity accompanied by improved physical fitness, while unchanged adiposity in the untreated controls led to decreased physical fitness and deteriorating insulin sensitivity. In addition, we found significantly impaired health related quality of life in the obese children compared to their normal weight peers. We showed that our multidisciplinary lifestyle treatment improved health related quality of life of the obese children after 1 year. We observed a significantly increased postprandial ghrelin response after the multidisciplinary treatment, but no effect on inflammatory markers, nor on gut hormones PYY and GLP-1. Finally, we propose an alternative for the definition of the metabolic syndrome in children, since the usefulness of its current dichotomous form is questionable. We show that a multivariate prediction model based on the individual components of the metabolic syndrome expressed as standard deviation scores (SDS) has a good predictive value regarding increased HOMA-IR SDS.

• Children
• Ghrelin
• GLP-1
• Health related quality of life
• Inflammation
• Insulin resistance
• Metabolic syndrome
• Obesity
• Physical fitness
• PYY

• All authors: Vos, R.C.
• Supervisor: Wit, J.M.; Pijl, H.
• Co-supervisor: Houdijk, E.C.A.M.
• Qualification: Doctor (dr.)
• Awarding Institution: Leiden University Medical Center (LUMC), Leiden University
• Date: 2011-04-07
• Sponsorship: Pfizer BV, Stichting Vrienden van het JKZ