Impact of Significant Weight Loss on Maximal Oxygen Uptake in Obese Children and Adolescents

Abstract

Background

The prevalence of pediatric obesity has increased over the past few decades in all ethnic, gender, and age groups. The treatment of obesity, especially in children with moderate to severe conditions, is difficult. In this study, we examined the impact of significant weight loss as a result of participation in a multi-disciplinary weight management program on maximal oxygen uptake (VO₂max) in obese children and adolescents.

Methods

Eleven obese children and adolescents (7 to 14 years of age; mean age, 12.3±1.9 years) were enrolled in a weight management program at the Children's Hospital of New Orleans. The treatment program included a high-protein, very low-calorie diet (VLCD; protein intake, 1.5 to 2.0 g/kg of ideal body weight per day; and 800 kcal/d). Diets were supplemented with extra fluid, minerals, and vitamins. All subjects attended weekly 2-hour clinic sessions. During these sessions, they received nutrition instruction, participated in a moderate-intensity, progressive exercise program, and learned behavior-modification techniques. Weight, height, body mass index ([BMI]; wt/htβ), and VO₂max by indirect calorimetry were obtained at enrollment and at the end of 10 weeks of treatment.

Results

There was a significant decrease in body weight after 10 weeks. The BMI decreased significantly from 34.1±4.8 on entry to 29.4±3.5 (mean±SD; P<0.0001). Despite the significant weight loss, VO₂max increased significantly (P<0.001) from entry (19.2 ± 3.0 mL/kg/min) to completion of 10 weeks (22.4 ± 5.8 mL/kg/min). However, absolute VO₂max L/min was unchanged.

Conclusions

We conclude that relative VO₂max mL/kg/min is significantly improved in obese youth after significant weight loss with a VLCD and moderate-intensity, progressive exercise. However, because absolute VO₂max L/min was unchanged, this improvement seems to result from the reduction in total body weight as opposed to the effect of the moderate-intensity exercise intervention.

Keywords

obesity weight management children very low-calorie diets hypocaloric diets exercise behavior modification maximal oxygen uptake

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