Efeito do exercício físico nos fatores de risco cardiometabólicos em pré-adolescentes e adolescentes com obesidade grave: uma revisão sistemática
DOI:
https://doi.org/10.47197/retos.v56.103920Palavras-chave:
Pérdida de peso, síndrome metabólico, Factores de riesgo cardiovascular, EntrenamientoResumo
Objetivo: Esta revisão sistemática teve como objetivo avaliar o efeito do exercício físico nos fatores de risco cardiometabólicos em pré-adolescentes e adolescentes com obesidade grave. Metodologia: Foi realizada uma busca sistemática da literatura nas bases de dados Web of Science, PubMed, Scopus, Scielo, Cochrane e EBSCO, para artigos publicados até 17 de agosto de 2022. Foram incluídos estudos nos quais participaram pré-adolescentes ou adolescentes entre adolescentes. 10 e 18 anos com obesidade grave, ambos em intervenção de treinamento físico estruturado ou não estruturado de pelo menos 4 semanas. Resultados: Foram observadas melhorias significativas após a intervenção no peso corporal, IMC, circunferência da cintura, percentual de gordura corporal, pressão arterial, glicemia de jejum, insulina, HOMA-IR, colesterol total, colesterol HDL, colesterol LDL, sem alterações significativas nos triglicerídeos, em comparação com o início da intervenção. Ao comparar os resultados com o grupo controle, foram relatadas diferenças significativas apenas no peso corporal, IMC e percentual de gordura corporal. Conclusão: O exercício físico foi associado à diminuição de alguns fatores de risco cardiometabólicos, porém os resultados foram inconsistentes quando comparados com um grupo controle.
Palavras-chave: Perda de peso, síndrome metabólica, fatores de risco cardiovascular, treinamento.
Referências
Alba-Martín, R. (2016, April). Prevalencia de obesidad infantil y hábitos alimentarios en educación primaria. https://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1695-61412016000200003
Amézquita G., M. V., Baeza L., C., Ríos E., M., Francesetti M., V., Rybertt V., V., Gutiérrrez R., M., Amézquita G., M. V., Baeza L., C., Ríos E., M., Francesetti M., V., Rybertt V., V., & Gutiérrrez R., M. (2020). Cirugía bariátrica en adolescentes con obesidad severa: Recomendaciones de la Rama de Nutrición, Sociedad Chilena de Pediatría. Revista Chilena de Pediatría, 91(4), 631–641. https://doi.org/10.32641/RCHPED.V91I4.1600
Baker, J. L., Olsen, L. W., & Sørensen, T. I. A. (2007). Childhood Body-Mass Index and the Risk of Coronary Heart Disease in Adulthood. The New England Journal of Medicine, 357(23), 2329. https://doi.org/10.1056/NEJMOA072515
Bendor, C. D., Bardugo, A., Pinhas-Hamiel, O., Afek, A., & Twig, G. (2020). Cardiovascular morbidity, diabetes and cancer risk among children and adolescents with severe obesity. Cardiovascular Diabetology 2020 19:1, 19(1), 1–14. https://doi.org/10.1186/S12933-020-01052-1
Bentham, J., Di Cesare, M., Bilano, V., Bixby, H., Zhou, B., Stevens, G. A., Riley, L. M., Taddei, C., Hajifathalian, K., Lu, Y., Savin, S., Cowan, M. J., Paciorek, C. J., Chirita-Emandi, A., Hayes, A. J., Katz, J., Kelishadi, R., Kengne, A. P., Khang, Y. H., … Cisneros, J. Z. (2017). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. Lancet (London, England), 390(10113), 2627. https://doi.org/10.1016/S0140-6736(17)32129-3
Cardel, M. I., Atkinson, M. A., Taveras, E. M., Holm, J. C., & Kelly, A. S. (2020). Obesity Treatment Among Adolescents A Review of Current Evidence and Future Directions. JAMA PEDIATRICS, 174(6), 609–617. https://doi.org/10.1001/jamapediatrics.2020.0085
Chu, S. Y., Jung, J. H., Park, M. J., & Kim, S. H. (2019). Risk assessment of metabolic syndrome in adolescents using the triglyceride/high-density lipoprotein cholesterol ratio and the total cholesterol/high-density lipoprotein cholesterol ratio. Annals of Pediatric Endocrinology & Metabolism, 24(1), 41. https://doi.org/10.6065/APEM.2019.24.1.41
Chung, Y. L., & Rhie, Y. J. (2021). Severe Obesity in Children and Adolescents: Metabolic Effects, Assessment, and Treatment. JOURNAL OF OBESITY & METABOLIC SYNDROME, 30(4), 326–335. https://doi.org/10.7570/jomes21063
Cooper, C., Sarvey, S., Collier, D., Willson, C., Green, I., Pories, M. L., Rose, M. A., Escott-Stump, S., & Pories, W. (2006). For comparison: experience with a children’s obesity camp. Surgery for Obesity and Related Diseases, 2(6), 622–626. https://doi.org/10.1016/j.soard.2006.07.010
Durán, P. (2016). Body-mass index in 2.3 million adolescents and cardiovascular death in adulthood. Archivos Argentinos de Pediatria, 114(6), e464–e465. https://doi.org/10.1056/NEJMOA1503840/SUPPL_FILE/NEJMOA1503840_DISCLOSURES.PDF
Fernandez, A. C., Túlio de Mello, M., Tufik, S., Morcelli de Castro, P., & Fisberg, M. (2004). Influence of the aerobic and anaerobic training on the body fat mass in obese adolescents. Revista Brasileira de Medicina Do Esporte, 10(3), 152–158. https://doi.org/10.1590/S1517-86922004000300004
Fernández, J. C., Quiñones, I. T., Robles, Á. S., & Padilla, J. M. S. (2018). Revisión sistemática sobre los estudios de intervención de actividad física para el tratamiento de la obesidad (Systematic Review of Physical Activity Programs for the treatment of Obesity). Retos, 33(33), 261–266. https://doi.org/10.47197/RETOS.V0I33.52996
Flowers, E., Molina, C., Mathur, A., & Reaven, G. M. (2015). Use of plasma triglyceride/high-density lipoprotein cholesterol ratio to identify increased cardio-metabolic risk in young, healthy South Asians. The Indian Journal of Medical Research, 141(1), 68. https://doi.org/10.4103/0971-5916.154506
Gueugnon, C., Mougin, F., Simon-Rigaud, M. L., Regnard, J., Nègre, V., & Dumoulin, G. (2012). Effects of an in-patient treatment program based on regular exercise and a balanced diet on high molecular weight adiponectin, resistin levels, and insulin resistance in adolescents with severe obesity. Applied Physiology, Nutrition, and Metabolism = Physiologie Appliquee, Nutrition et Metabolisme, 37(4), 672–679. https://doi.org/10.1139/H2012-045
Henson, L. C., Poole, D. C., Donahoe, C. P., & Heber, D. (1987). Effects of exercise training on resting energy expenditure during caloric restriction. The American Journal of Clinical Nutrition, 46(6), 893–899. https://doi.org/10.1093/AJCN/46.6.893
Invitti, C., Guzzaloni, G., Gilardini, L., Morabito, F., & Viberti, G. (2003). Prevalence and Concomitants of Glucose Intolerance in European Obese Children and Adolescents. Diabetes Care, 26(1), 118–124. https://doi.org/10.2337/DIACARE.26.1.118
Jackson, S. L., Zhang, Z., Wiltz, J. L., Loustalot, F., Ritchey, M. D., Goodman, A. B., & Yang, Q. (2018). Hypertension Among Youths — United States, 2001–2016. Morbidity and Mortality Weekly Report, 67(27), 758. https://doi.org/10.15585/MMWR.MM6727A2
Juhola, J., Magnussen, C. G., Berenson, G. S., Venn, A., Burns, T. L., Sabin, M. A., Srinivasan, S. R., Daniels, S. R., Davis, P. H., Chen, W., Kähönen, M., Taittonen, L., Urbina, E., Viikari, J. S. A., Dwyer, T., Raitakari, O. T., & Juonala, M. (2013). Combined Effects of Child and Adult Elevated Blood pressure on Subclinical Atherosclerosis: The International Childhood Cardiovascular Cohort Consortium. Circulation, 128(3), 217–224. https://doi.org/10.1161/CIRCULATIONAHA.113.001614
Kelley, G. A., Kelley, K. S., & Pate, R. R. (2021). Exercise and Cardiovascular Disease Risk Factors in Children and Adolescents With Obesity: A Systematic Review With Meta-Analysis of Randomized Controlled Trials: Https://Doi.Org/10.1177/1559827620988839. https://doi.org/10.1177/1559827620988839
Lazzer, S., Boirie, Y., Montaurier, C., Vernet, J., Meyer, M., & Vermorel, M. (2004). A Weight Reduction Program Preserves Fat-Free Mass but Not Metabolic Rate in Obese Adolescents. Obesity Research, 12(2), 233–240. https://doi.org/10.1038/OBY.2004.30
Lee, Y. H., Song, Y. W., Kim, H. S., Lee, S. Y., Jeong, H. S., Suh, S. H., Park, J. K., Jung, J. W., Kim, N. S., Noh, C. Il, & Hong, Y. M. (2010). The Effects of an Exercise Program on Anthropometric, Metabolic, and Cardiovascular Parameters in Obese Children. Korean Circulation Journal, 40(4), 179–184. https://doi.org/10.4070/KCJ.2010.40.4.179
Montero, D., Dutheil, F., Walther, G., Perez-Martin, A., Soto-Esclapez, L., Vinet, A., & Roche, E. (2021). Changes in the profile of circulating HDL subfractions in severe obese adolescents following a weight reduction program. Nutrition, Metabolism, and Cardiovascular Diseases : NMCD, 31(5), 1586–1593. https://doi.org/10.1016/J.NUMECD.2021.01.025
Mühlig, Y., Wabitsch, M., Moss, A., & Hebebrand, J. (2014). Weight Loss in Children and Adolescents: A Systematic Review and Evaluation of Conservative, Non-Pharmacological Obesity Treatment Programs. Deutsches Ärzteblatt International, 111(48), 818. https://doi.org/10.3238/ARZTEBL.2014.0818
Nemet, D., Ben-Haim, I., Pantanowits, M., & Eliakim, A. (2013). Effects of a combined intervention for treating severely obese prepubertal children. Journal of Pediatric Endocrinology & Metabolism : JPEM, 26(1–2), 91–96. https://doi.org/10.1515/JPEM-2012-0225
Obert, P., Gueugnon, C., Nottin, S., Vinet, A., Gayrard, S., Rupp, T., Dumoulin, G., Tordi, N., & Mougin, F. (2013). Impact of Diet and Exercise Training-Induced Weight Loss on Myocardial Mechanics in Severely Obese Adolescents. Obesity, 21(10), 2091–2098. https://doi.org/10.1002/OBY.20495
Ortega, R., Grandes, G., Sanchez, A., Montoya, I., & Torcal, J. (2019). Cardiorespiratory fitness and development of abdominal obesity. Preventive Medicine, 118, 232–237. https://doi.org/10.1016/J.YPMED.2018.10.020
Page, M. J., Moher, D., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., Mcdonald, S., … Mckenzie, J. E. (2021). PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ, 372. https://doi.org/10.1136/BMJ.N160
Paulis, W. D., Silva, S., Koes, B. W., & Van Middelkoop, M. (2014). Overweight and obesity are associated with musculoskeletal complaints as early as childhood: a systematic review. Obesity Reviews, 15(1), 52–67. https://doi.org/10.1111/OBR.12067
PEDro - Escala PEDro. (1999). https://pedro.org.au/portuguese/resources/pedro-scale/
Poitras, V. J., Gray, C. E., Borghese, M. M., Carson, V., Chaput, J. P., Janssen, I., Katzmarzyk, P. T., Pate, R. R., Connor Gorber, S., Kho, M. E., Sampson, M., & Tremblay, M. S. (2016). Systematic review of the relationships between objectively measured physical activity and health indicators in school-aged children and youth. Applied Physiology, Nutrition and Metabolism, 41(6), S197–S239. https://doi.org/10.1139/APNM-2015-0663/ASSET/IMAGES/APNM-2015-0663TAB11.GIF
Racil, G., Goebel, R. T., Haddad, M., Coquart, J., Chamari, K., & Amri, M. (2016). Rating of Perceived Exertion and Serum Leptin Responses to Maximal Exercise in Obese Female Adolescents: Effects of Exercise Training Intensity. 167–170. https://doi.org/10.15405/EPSBS.2016.06.23
Rankin, J., Matthews, L., Cobley, S., Han, A., Sanders, R., Wiltshire, H. D., & Baker, J. S. (2016). Psychological consequences of childhood obesity: psychiatric comorbidity and prevention. Adolescent Health, Medicine and Therapeutics, 7, 125. https://doi.org/10.2147/AHMT.S101631
Reinehr, T. (2017). Long-term effects of adolescent obesity: time to act. Nature Reviews Endocrinology 2018 14:3, 14(3), 183–188. https://doi.org/10.1038/nrendo.2017.147
Reinehr, T., & Andler, W. (2004). Changes in the atherogenic risk factor profile according to degree of weight loss. Archives of Disease in Childhood, 89(5), 419. https://doi.org/10.1136/ADC.2003.028803
Ruotsalainen, H., Kyngäs, H., Tammelin, T., & Kääriäinen, M. (2015). Systematic review of physical activity and exercise interventions on body mass indices, subsequent physical activity and psychological symptoms in overweight and obese adolescents. Journal of Advanced Nursing, 71(11), 2461–2477. https://doi.org/10.1111/JAN.12696
Sedlock, D. A., Fissinger, J. A., & Melby, C. L. (1989). Effect of exercise intensity and duration on postexercise energy expenditure. Medicine and Science in Sports and Exercise, 21(6), 662–666. https://doi.org/10.1249/00005768-198912000-00006
Skinner, A. C., Perrin, E. M., Moss, L. A., & Skelton, J. A. (2015). Cardiometabolic Risks and Severity of Obesity in Children and Young Adults. New England Journal of Medicine, 373(14), 1307–1317. https://doi.org/10.1056/NEJMOA1502821/SUPPL_FILE/NEJMOA1502821_DISCLOSURES.PDF
Srivastava, G., O’hara, V., & Browne, N. (2019). Use of Lisdexamfetamine to Treat Obesity in an Adolescent with Severe Obesity and Binge Eating. Children 2019, Vol. 6, Page 22, 6(2), 22. https://doi.org/10.3390/CHILDREN6020022
Stoner, L., Rowlands, D., Morrison, A., Credeur, D., Hamlin, M., Gaffney, K., Lambrick, D., & Matheson, A. (2016). Efficacy of Exercise Intervention for Weight Loss in Overweight and Obese Adolescents: Meta-Analysis and Implications. Sports Medicine (Auckland, N.Z.), 46(11), 1737–1751. https://doi.org/10.1007/S40279-016-0537-6
Ward, Z. J., Long, M. W., Resch, S. C., Giles, C. M., Cradock, A. L., & Gortmaker, S. L. (2017). Simulation of Growth Trajectories of Childhood Obesity into Adulthood. New England Journal of Medicine, 377(22), 2145–2153. https://doi.org/10.1056/NEJMOA1703860/SUPPL_FILE/NEJMOA1703860_DISCLOSURES.PDF
Yeste, D., Arciniegas, L., Vilallonga, R., Fàbregas, A., Soler, L., Mogas, E., Campos, A., & Clemente, M. (2020). ENCUENTRO CON EL EXPERTO Obesidad severa del adolescente. Complicaciones endocrino-metabólicas y tratamiento médico Severe obesity in adolescents. Endocrine-metabolic complications and medical treatment. Rev Esp Endocrinol Pediatr, 11(1). https://doi.org/10.3266/RevEspEndocrinolPediatr.pre2020.Aug.593
Zhao, L., Dong, X., Gao, Y., Jia, Z., Han, S., Zhang, J., & Gao, Y. (2022). Effects of exercise combined with diet intervention on body composition and serum biochemical markers in adolescents with obesity: a systematic review and meta-analysis. Journal of Pediatric Endocrinology and Metabolism, 35(11), 1319–1336. https://doi.org/10.1515/JPEM-2022-0193/ASSET/GRAPHIC/J_JPEM-2022-0193_FIG_008.JPG
Downloads
Publicado
Como Citar
Edição
Secção
Licença
Direitos de Autor (c) 2024 Retos
Este trabalho encontra-se publicado com a Licença Internacional Creative Commons Atribuição-NãoComercial-SemDerivações 4.0.
Autores que publicam nesta revista concordam com os seguintes termos:
- Autores mantém os direitos autorais e assegurar a revista o direito de ser a primeira publicação da obra como licenciado sob a Licença Creative Commons Attribution que permite que outros para compartilhar o trabalho com o crédito de autoria do trabalho e publicação inicial nesta revista.
- Os autores podem estabelecer acordos adicionais separados para a distribuição não-exclusiva da versão do trabalho publicado na revista (por exemplo, a um repositório institucional, ou publicá-lo em um livro), com reconhecimento de autoria e publicação inicial nesta revista.
- É permitido e os autores são incentivados a divulgar o seu trabalho por via electrónica (por exemplo, em repositórios institucionais ou no seu próprio site), antes e durante o processo de envio, pois pode gerar alterações produtivas, bem como a uma intimação mais Cedo e mais do trabalho publicado (Veja O Efeito do Acesso Livre) (em Inglês).
Esta revista é a "política de acesso aberto" de Boai (1), apoiando os direitos dos usuários de "ler, baixar, copiar, distribuir, imprimir, pesquisar, ou link para os textos completos dos artigos". (1) http://legacy.earlham.edu/~peters/fos/boaifaq.htm#openaccess
