Track 5 Physical Activity, Exercise and Sport P130

P130 Results indicate that severely obese children and adolescents tend to be sedentary when they have the choice, i.e. afternoons after school and in the Prediction of energy expenditure in a whole body indirect calorimeter at weekends. Future obesity interventions on young people may need to place both low and high levels of physical activity particular emphasis on adolescents and try to promote weekend activity for L de Jonge1, T Nguyen1, S Smith1, J Zachwieja1, HRoy1, and G Bray1 adolescents and girls. 1Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge LA. REFERENCE: 1: Cole, TJ, et al. (1995). Archive of Disease in Childhood. 73: 70808-4 124 USA. E-mail: [email protected] 25±29 INTRODUCTION: In studies that involve the use of a room calorimeter, 24 h energy intake is often larger than 24 h energy expenditure (24-H EE), due to P132 limited space. The objective of this study was to develop a method for Role of non-exercise physical activity in body mass index predicting an individual's 24-H EE in a room calorimeter at both low and high levels of physical activity. M Yoshioka1, M Ayabe1, T Yahiro1, H Higuchi1, Y Higaki2, H Miyazaki3, METHODS: Two methods that predict an individual's 24-H EE in a metabolic H Yoshitake4, M Shindo1, and H Tanaka1 chamber are presented. The ®rst method was based on 3 components: 1) a 1Faculty of Sport and health Science, Fukuoka University, Fukuoka, Japan; 30 min measurement of resting metabolic rate (RMR) using a ventilated hood 2Department of Community Health Science, Saga Medical School, Saga, Japan; system; 2) measurement of exercise energy expenditure during 10 min of 3Department of Preventive Dentistry, School of Dentistry, Niigata University, treadmill walking; and 3) estimation of free-living energy expenditure using a Niigata, Japan; 4Kanoya Physical Education University, Kagoshima, Japan tri-axial motion sensor. Using these measurements we calculated the amount INTRODUCTION: Weight gain occurs in healthy adults when energy intake of treadmill time needed for each individual in order to obtain a total 24-H EE persistently exceeds energy expenditure. In response to overfeeding, the at either a low (1.4ÂRMR) or a high (1.8ÂRMR) level of physical activity. For variability in fat gain is inversely related to the subjects' ability to increase the second method we developed an algorithm that could predict total 24-H non-voluntary exercise (NEAT) (1). In real life, however, some people resist EE at 2 time points during the chamber stay. This would allow us to adjust the gain in weight by restrained eating and purposeful exercise. Therefore, we amount of treadmill walking or energy intake during the day in order to investigate the role of non-exercise physical activity (NEPA) in body mass achieve energy balance. index (BMI) in a free-living condition. RESULTS: Method 1: There was no signi®cant difference in expected and METHODS: 384 male and 343 female Japanese volunteers aged from 18 to 84 measured 24-H EE under either low (9.35Æ 0.56 MJ=d vs 9.51Æ 0.47 MJ=d; yrs were divided into two groups according to their BMI (non-obese group: measured vs. predicted) or high activity conditions (13.41Æ 0.74 MJ=dvs less than 25 and obese group: 25 or more). Physical activity data was collected 13.97Æ 0.78 MJ=d; measured vs. predicted). Method 2: The prediction pro- for 1 to 4 wks by using an accelerometer (Lifecorder, Suzuken Co. Ltd., gram predicted 24-H EE for 97.6Æ 4.0% of the ®nal value at 3 hours into the Nagoya, Japan). Exercise physical activity (EPA) was counted with 9 levels test day, and for 98.6Æ 3.7% at 7 hours into the test day. when more than 3 steps of activity for every 4 s was detected more than once CONCLUSIONS: Both methods provide accurate prediction of energy expen- for 2 min. When small physical movement(s) was detected and=or when EPA is diture in a room calorimeter at both high and low levels of physical activity. It 0 for each 4 s for 3 min after its movement(s), the activity is accumulate as equally shows that it is possible to accurately predict total 24-hour energy NEPA. NEPA approximately corresponds to 0.3 Mets and intensity levels 1 to 9 expenditure from energy expenditure values obtained at 3 and 7 hours into approximately correspond to 1.7 to 7.2 Mets. Age, sex, BMI, EPA=body the study. weight (BW), NEPA=BW, step, and time taken for physical activity at intensity level of 0 < 1, 1 3, 4 6, and 7 9 were used for data analysis. RESULTS: Obese group showed signi®cantly lower EPA=BW, NEPA=BW, step and time taken for physical activity at intensity level of 4 to 6 and 7 to 9 compared to the non-obese group. Logistic regression analysis revealed P131 signi®cant odds ratios of age (1.016) and NEPA=BW (0.534) for obese. CONCLUSION: These results suggest that NEPA such as a talk with standing Objectively measured physical activity patterns of severely obese children position, posture change and so on play an important role in the development and adolescents: age and gender differences of obesity. E Stamatakis1, A Page1, JP Shield2, LJ Foster1, AR Cooper1, and EC Crowne2 REFERENCE: 1: Levine et al., Science 283: 212 ± 214, 1999. 1Dept. of Exercise and Health Sciences, University of Bristol, Bristol; 2Institute of Child Health, University of Bristol, Bristol Low physical activity has an important role in the development of obesity in youth. To date, little evidence exists on the physical activity patterns of P133 severely obese young people and no study has examined their habitual Insulin and exercise induced adipose tissue vasodilatation activity using objective measurements. The aims of this study were to 1) objectively determine physical activity patterns of severely obese children and JBuÈlow1, L Enevoldsen1, and L Simonsen1 adolescents and 2) assess the within-sample gender and age differences. 1Department of Clinical Physiology, Bispebjerg Hospital, DK-2400 Copenhagen Subjects-recruited from an obesity clinic- were 16 children (MÆ SD 9.4Æ 1.9 NV, Denmark years) and 12 adolescents (14.8Æ 1.7 years), all above the 99th percentile of INTRODUCTION: Insulin has been suggested to play a role in the regulation 1 the UK body mass index reference curves . They were given the Computer of adipose tissue blood ¯ow. However, recent evidence shows that insulin per Science and Applications Inc. (CSA, #7164) uni-axial accelerometer to wear se does not play a primary role in the regulation of adipose tissue blood ¯ow during waking hours for a period of seven days. The CSA can store onboard (1). The purpose of the present experiments was to elucidate whether an minute by minute activity data. After the measurement period, the recorded elevated insulin concentration might in¯uence the vasodilatation normally CSA data were retrieved and the average minutes of moderate or greater taking place in adipose tissue during exercise. intensity physical activity (AMA) per registered hour were computed using METHODS: 8 normal weight healthy subjects with normal insulin sensitivity age-speci®c CSA cut points. The average weekday and weekend day activity were studied. Abdominal, subcutaneous adipose tissue metabolism was mea- patterns were plotted for all four sub-groups and the whole sample. Using log sured by the Fick's principle (2). The experiments were performed during 1 hour transformed AMA scores, paired and independent samples t-tests assessed rest in the postabsorptive state. Thereafter a euglycemic insulin clamp was differences between weekdays and weekends within each sub-group and established. When a steady state glucose infusion rate was reached (after about between the age and gender sub-groups, respectively. The graphic representation of the AMA revealed a sharp decrease in Control Clamp Clamp exercise activity after 16:00 h across all sub-groups and the sample as a whole. Over the 7 days, adolescents (4.6Æ 2.2 vs 3.2Æ 2.2 min=hr, log transformed Insulin (pmol=l) 43Æ 879Æ 11 87Æ 12 t 3.366, df 11, p .006) and girls (6.6Æ 4.6 vs 5.8Æ 5.0 min=hr, log transformed t 2.20, df 16, p .04) were signi®cantly less active at the Adrenaline (nmol=l) 0.22Æ 0.04 0.21Æ 0.03 0.38Æ 0.06 weekends compared with weekdays. The between-groups comparisons found ATBF (ml=100 g=min) 3.1Æ 0.7 2.8Æ 0.5 4.8Æ 0.7 that children performed signi®cantly more AMA minutes per registered hour Glycerol output 0.29Æ 0.10 0.19Æ 0.07 0.43Æ 0.14 than adolescents on weekdays (10.1Æ 4.9 vs 4.6Æ 2.2 min=hr ,log trans- (nmol=100 g=min) formed t 3.93, df 26, p .001) and on weekend days (10.1Æ 5.9 vs FFA output (nmol=100 g=min) 0.84Æ 0.28 0.33Æ 0.14 1.37Æ 0.53 3.2Æ 2.2 min=hr, log transformed t 4.68, df 26, p .000). Track 5 Physical activity, exercise and sport

S69 changes were noted in all variables. Body mass was reduced by 5.4 kg 2 hours), the subjects exercised for about 1 hour at 50% of their peak oxygen (87.9Æ 27.6 kg week 0; 82.5Æ 25.8 kg week 6), % body fat by 4% consumption. The insulin infusion rate was kept constant during exercise and (47Æ 6% week 0; 43Æ 6% week 6) and aerobic ®tness (VO @ 85% the glucose infusion rate was increased to keep the subjects euglycemic. 2 max. heart rate) increased by 0.28 l.min71 (2.1Æ 0.7 l.min71 week 0; 2.37Æ RESULTS: The ®ndings are given in the table as meanÆ SE. 0.7 l.min71 week 6) which actually increased above the mean level of absolute CONCLUSION: During exercise moderate hyperinsulinemia in subjects with aerobic ®tness for the comparison group. In contrast to these improvements, normal insulin sensitivity does not moderate the exercise induced vasodilata- the comparison group showed a signi®cant increase (P < 0.001) in body mass tion normally found under otherwise similar conditions (2). The vasodilatation of 1.1 kg (55.8Æ 11.7 kg week 0; 56.9Æ 11.4 kg week 6), and there was no takes place irrespective of a relatively reduced lipolytic rate and NEFA change in % body fat or aerobic ®tness. mobilisation as compared to the normal physiological situation. CONCLUSIONS: The programme was successful in achieving signi®cant REFERENCES: 1: Stallknecht B et al.: Am J Physiol 279: E376 ± E385, 2000 improvements in children's health. It seems that the children enrolled on 2: AL Mulla N et al: J Physiol 524: 919 ± 928, 2000 the camp programme were more active than the comparison group that were free to choose from a range of activities that were available to them during their summer holiday. The primary aim of the programme was to equip the children with the necessary skills to participate in physical activity, exercise and sport. Follow-up studies are currently underway in order to assess whether this P134 aim has been achieved. THIS RESEARCH WAS SUPPORTED BY THE NATIONAL HEART RESEARCH FUND Comparison of energy expenditure by accelerometry and in the chamber (U.K.) JM Oppert1, A Lluch1,2, P Terrier 1,2, D Durrer-Schutz2, B Guy-Grand1, and Y Schutz2 1Nutrition Dept, HoÃtel-Dieu, Paris, France; 2Institute of Physiologie, Lausanne, Switzerland P136 INTRODUCTION: In studies on obesity, there is a need for better technologies Abstract withdrawn to assess habitual levels of physical activity (PA) and estimate energy expenditure (EE) during PA. Portable accelerometers record the acceleration of the trunk in one or several directions and give an estimate of EE during PA. Our aim was to compare EE estimated by a uni-axial (Caltrac1) and a triaxial (TriTrac1) accelerometer with EE measured by indirect calorimetry in a respiration chamber (Chb). P137 METHODS: 13 women (age: 29.2Æ 8.3 y; BMI: 29.4Æ 5.4 kg=m2,mÆ SD) wore the 2 devices at the waist during a 10-hr stay (9 am to 7 pm) in the Chb, Intraday and interday variability of three methods used for body following a standardized programme including 7Â15-min moderate intensity composition analysis exercise sessions (treadmill walking at 4 speeds, free deambulation, step-test). M Wertli1, M Scheumann1, and F Horber1 RESULTS: MeanÆ SD for total 10-h EE (kcal=10 h) were: Chb: 1146Æ 182; 1Clinic Hirslanden, Switzerland Caltrac: 1238Æ 250 (difference vs Chb: 9.6%); Tritrac: 1037Æ 150 (difference vs Chb: 79.0%). Using Bland-Altman method, for both devices, the DEXA (dual energy x-ray absorptiometry) is the standard method to measure difference between methods was uncorrelated with the means of methods body composition with its subcompartments. SFB3 (bioelectric impendance (Tritrac-Chb: r 70.29, p 0.34; Caltrac-Chb: r 0.32, p 0.29); however, analysis (BIA) measured between hand and leg) and Omron (BIA measured the SD of the difference between methods was 2 times higher for the Caltrac between the hands) are two methods frequently used (easy to handle and compared to the Tritrac (266 vs 119 kcal=10 h). Using regression analysis with cheap). However intraday and interday variations within and between the 10-h EE measured in the Chb as dependent variable and 10-h EE estimated by three methods are vastly unknown in patients with varying BMI between 25 2 accelerometry as independent variable, R2 was 0.58 for Tritrac and 0.07 for and 4 kg=m . Therefore three patients with weight of 78, 107 and 120 kg were Caltrac. measured 10 times the same day with all three devices. Results are given CONCLUSION: To estimate the difference in EE between individuals perform- in table 1. Moreover 2 patients were measured monthly for 6 months during ing everyday life physical activities, the use of the Tritrac appears more Table 1 accurate than the Caltrac. BMI Balance kg Tissue Method Mean kg SD Range CV

29.40 77.60 Lean DEXA 49.80 0.29 1.00 0.60 Omron 48.83 0.16 0.40 0.30 SFB3 50.54 0.17 0.50 0.30 P135 Fat DEXA 29.51 0.30 1.00 1.00 Obese children on a six week residential weight loss camp achieive Omron 28.76 0.18 0.50 0.70 successful weight reduction SFB3 27.01 0.19 0.50 0.60 34.90 106.80 Lean DEXA 71.65 0.46 1.60 0.60 PJ Gately1, CB Cooke1, AJ Hill1, JH Barth1, and BM Bewick1 1School of Leisure & Sport, Leeds Metropolitan University, Leeds, LS6 3QS, UK Omron 72.18 0.20 0.70 0.30 SFB3 73.52 0.65 1.80 0.90 INTRODUCTION: Childhood obesity is rapidly increasing with few effective Fat DEXA 37.59 0.40 1.40 1.10 intervention studies currently available. It is therefore essential to establish the ef®cacy of intervention strategies for children. This study assessed the ef®cacy Omron 34.62 0.20 0.70 0.60 of a residential weight loss programme that uses skill-based fun-type physical SFB3 33.19 0.67 1.80 2.00 activity, moderate calori®c restriction and education. 38.10 120.90 Lean DEXA 82.94 1.41 3.90 1.70 METHODS: 65 children (28 boys & 37 girls) mean age 14 years were enrolled Omron 82.14 0.08 0.30 0.10 on the camp programme and compared with 38 age matched children (19 SFB3 82.73 0.62 1.80 0.80 boys & 19 girls) mean age 14 years. All children on the camp were assessed for Fat DEXA 40.12 1.42 4.10 3.50 body mass, stature, %body fat and aerobic ®tness pre and post the six-week Omron 38.76 0.08 0.30 0.20 intervention, while the comparison group were assessed over eight weeks. SFB3 38.04 0.69 2.20 1.80 During the camp programme energy intake was based on an approximation of basal metabolic rate (1300 ± 3300 kca1.day71), children participated in six 1-hour physical activity sessions per day and three weekly educational sessions. The physical activity sessions promoted choice of fun type skill weight loss induced by gastric-bypass (Table 2). Intraday variability for lean based exercise in a range of activities. As this programme was over the and fat mass as expressed by its coef®cient of variation (CV) was similar using summer vacation the normal weight comparison group were free to engage either method, but was highest using DEXA-technology (Table 1). With in activities available to them without the restrictions imposed by attendance respect to interday variability similar results were observed, in that mean at school. values of all three methods were comparable; however standard deviation was RESULTS: During the six-week programme highly signi®cant (P < 0.001) lowest in the DEXA group and higher in the two groups using BIA.

International Journal of Obesity Track 5 Physical activity, exercise and sport

S70 Table 2 tisfaction, low self-esteem, and victimisation experiences are common in obese children, and intensify with age. Accordingly, any effective treatment Tissue Method Mean SD Max. Min. Range must demonstrate psychosocial bene®ts alongside weight loss. Such bene®ts are rarely monitored. Moreover, there is concern that intensive weight loss Lean DEXA 75.40 6.32 86.80 66.80 20.00 treatments may undermine an already fragile state. This study therefore Omron 73.14 8.90 88.20 61.10 27.10 examined the potential for psychological bene®t or jeopardy of a residential, SFB3 72.76 9.30 86.30 60.40 25.90 activity-based weight loss camp for obese children and adolescents. Fat DEXA 51.00 9.82 68.00 36.50 31.50 METHODS: Fifty eight obese children (33 girls and 25 boys, mean age 13.9, mean BMI 32.6) completed assessments of self-esteem (Self-Perception Pro®le Omron 51.50 10.70 70.60 34.10 36.50 for Children, Harter, 1985), salience of weight and shape concerns (Wadden SFB3 51.86 12.30 74.90 26.90 46.00 et al, 1991), and body shape perception at the start and end of the camp. The camp was organised for 6 consecutive weeks, the mean duration of stay being 4 weeks. In addition, data were collected from a comparison group of 39 CONCLUSION: Comparable results with respect to intraday and interday normal weight children matched for age. variability were observed using all three devices. These results suggest that in RESULTS: MANOVA revealed a signi®cant effect of obesity on self-esteem clinical practice Omron and SBF3, measuring body composition using BIA, are (F(6,86) 7.86, p < .001) with univariate tests showing obese children to useful and reproducable, however subcompartement analysis is only possible have lower global self-worth, scholastic competence, athletic competence, using DEXA devices. Moreover variability seems to be higher in subjects physical appearance and behavioural conduct. Signi®cant time by camp loosing weight using BIA when compared to DEXA. In addition subjects interactions showed an increase in obese children's self-worth, athletic com- with fat content above 50% can not be analyzed using the Omron device. petence and physical appearance, but no changes in the comparison group. Obese children worried signi®cantly more than lean peers about their appearance and more generally. The camp did not increase the salience of these worries or the importance attached to physical appearance or athletic competence. There was a decrease in body shape rating consistent with a P138 signi®cant mean weight loss of 5.5 kg. CONCLUSIONS: These positive psychological outcomes are notable and A comparison between lean and obese women of the 6-minute-walk test consistent with an earlier pilot study. Girls and boys showed similar bene®t to assess functional exercise capacity although by the end of the camp they still had lower self-esteem and more M Hulens1, G Vansant 2, R Lysens1, AL Claessens3, and E Muls2 worries than lean peers. Maintenance of these gains is being encouraged and monitored by regular home-based contact. Activity-based programmes show 1Dept of Physiotherapy, Katholieke Univ. Leuven, B-3000, Belgium; 2Nutrition, Katholieke Univ. Leuven, B-3000, Belgium; 3Kinesiology, Katholieke Univ. promise for both weight loss and psychological well-being, in contrast to Leuven, B-3000, Belgium many children's experience of sport in school. INTRODUCTION: The aim of this study was ®rst, to assess the differences in walking capacity, perceived exertion and physical complaints between lean and obese women and second, to identify the variables that contribute to the variability in the distance achieved during a 6-minute walk test in lean and P140 obese women. METHODS: 213 obese females (18 ± 65 years, body mass index 2 2 Fat distribution and associations with socio-demographic factors and (BMI) 30 kg=m ) and 81 sedentary lean female volunteers (BMI 26 kg=m ) physical activity in adults of the SU.VI.MAX Study were recruited. Weight, height, body composition (bioelectrical impedance method), physical activity pattern (Baecke questionnaire), hours TV watching, S Czernichow1, J-M Oppert 2, M Zarebska1, S Bertrais1, P Preziosi1, P Galan1, depression (Beck Depression Inventory - BDI), isokinetic concentric quadriceps and S Hercberg1 1ISTNA=CNAM, HoÃtel-Dieu, Paris, France; 2Nutrition Department, Hotel-Dieu, strength (Cybex) and peak oxygen uptake (VO2max - bicycle ergometer) were measured. A 6-minute walk test was performed and heart rate, walking Paris, France distance, Borg rating scale (BRS) of perceived exertion and physical complaints INTRODUCTION: Abdominal fat accumulation is recognized as a cardiovas- after the test were recorded. cular risk factor in adults of both gender, independently of overall corpulence. RESULTS: Obese women walked slower (5.6 km=h vs. 7.2 km=h), were more In the context of the current obesity epidemic, it has been recommended exerted (BRS 13.1Æ 1.8 vs. 12.4Æ 2.0) and complained more frequently of (International Obesity Task Force) that more obesity prevalence data be dyspnea (4.2% vs. 0%) and musculoskeletal pain (23.8% vs. 11.7%) at the collected in all regions of the world. In addition, there are few data available end of the walk than lean women. In a multiple regression analysis, 57% of the on fat distribution in national samples of adults. The aim of this study was to variance in walking distance achieved by the obese women could be assess the prevalence of an upper-body fat distribution pro®le and its relation- explained by BMI, VO2max, quadriceps muscle strength and age. Hours TV ships with age, education level and physical activity in a sample of middle- watching but not physical activity score accounted for an additional 2% and aged French adults of both gender participating in the SU.VI.MAX study. depression scores for an additional 1% of the variance in the distance achieved METHODS: The SU.VI.MAX study is a randomized double-bind, placebo- during the 6-minute walk. In the lean women, VO2max and age explained controlled, primary prevention trial designed to test the ef®cacy of a daily only 27% of the variance in walking distance and entering the other variables supplementation with antioxidants vitamins and minerals at nutritional doses 2 into the prediction equation did not improve the R . on cardiovascular disease and cancer, with a planned follow-up of 8 years. CONCLUSION: These data suggest that in contrast with lean women, walking Baseline measured height, weight, waist and hip circumferences were ability of obese women is hampered not only by overweight, but also by obtained for 3547 women and 3731 men, both over 45 years. Upper-body perceived discomfort and pain, reduced quadriceps strength, a sedentary life fat distribution was de®ned as a waist-hip ratio (WHR) 0.80 for women and style and depression. Therefore, to improve functional walking performance of 0.95 for men. Physical activity (equivalent to 1 hour walking=day, yes=no), obese women, time spent on sedentary activities should be reduced and education level and smoking status were obtained through self-administered depression should be managed appropriately questionnaires. RESULTS: In this sample, the prevalence of obesity (BMI 30) was 7.5% in women and 8.5% in men, the upper-body fat pro®le prevalence was 33.9% in women and 33.1% in men. Upper-body fat distribution was associated with increasing age, current smoking and physical inactivity in both gender, and P139 with a low education level in men only. Using logistic regression analysis, the odds-ratio of having an upper-body fat distribution pro®le for physically active Psychological outcomes associated with a residential, activity-based subjects compared to inactive subjects after adjustment for age, BMI, smoking weight loss camp for obese children status and education level was in men: OR 0.80 [CI 95%: 0.67 ± 0.95], in women: OR 0.71 [CI 95%: 0.60 ± 0.84]. 1 1 2 2 2 LMM Walker , AJ Hill , PJ Gately , BM Bewick , and CB Cooke CONCLUSIONS: Using these WHR cut-offs, one in three adults in this sample 1 Academic Unit of Psychiatry & Behavioural Sciences, Leeds University School of exhibited increased abdominal fatness. These cross-sectional data suggest a 2 Medicine, 15 Hyde Terrace, Leeds LS2 9LT; School of Leisure and Sports signi®cant protective effect of physical activity on abdominal fatness, inde- Studies, Leeds Metropolitan University, Leeds, UK pendent of overall corpulence. A more detailed investigation of the relation- INTRODUCTION: Psychosocial problems are the most prevalent form of ships between the various dimensions of physical activity and abdominal morbidity associated with childhood obesity. Body shape and weight dissa- fatness is ongoing in these subjects.

International Journal of Obesity Track 5 Physical activity, exercise and sport

S71 P141 P143

Evaluation of physical activity in overweight=obese outpatients with Lipolysis in skeletal muscle and adipose tissue during graded knee associated metabolic disorders extension exercise F Pasanisi1, C Finelli1, G Cacace1, E Celentano1, C De Caprio1, P Colicchio1, B Stallknecht1, JW Helge1, EA Richter1, H Galbo1, and B Kiens1 G Saldalamacchia1, and F Contaldo1 1Copenhagen Muscle Research Centre: Department of Medical Physiology and 1Department of Clinical and Experimental Medicine, CISRO, Medical School, Department of Human Physiology, University of Copenhagen, DK-2200 Federico II University, Naples, Italy Copenhagen N, Denmark INTRODUCTION: Physical activity is a variable component of total daily INTRODUCTION: It is at present not clear how lipolysis in individual tissues energy expenditure. Increased or decreased physical exercise can therefore changes during exercise of different intensities in humans. affect body weight and composition in¯uencing both muscle mass and METHODS: We used the microdialysis technique and the two-leg knee adipose deposits as well as energy balance. extension exercise model to evaluate this. We measured interstitial glycerol Aim of our study was to evaluate total daily physical activity using a concentrations and blood ¯ow in quadriceps muscle and in subcutaneous, standardized validated questionnaire in an outpatient population in our abdominal adipose tissue and arterial glycerol concentrations in nine healthy, department. young men who were kicking with both legs at 25% of maximal power (Wmax) 2 METHODS: We studied 200 overweight=obese (BMI 25 ± 35 kg=m ) patients for 45 min (23Æ 1% of whole-body maximal oxygen uptake (VO2max)) and (85 males, 115 females), age 18 ± 65 years with associated metabolic dis- then simultaneously with one leg at 65% and the other leg at 85% Wmax for orders. All patients answered multiple questions on daily physical activity 35 min (40Æ 1% VO2max). either at home, at work and during free time; a score was given for each RESULTS: Glycerol concentrations in skeletal muscle, adipose tissue and answer and a total score was calculated extimating a total actvity index. arterial plasma increased during low intensity exercise and increased even RESULTS: Mean age of patients was 44.1Æ 13.0 years, BMI 28.9Æ 2.4 kg=m2, more during moderate intensity exercise (P < 0.05). However, in muscle the calculated activity index averaged 10118Æ 8905 (range 1575 to 52275). Total interstitial-arterial concentration difference was unchanged at low exercise activity score was inversely related with BMI in the whole group (r 7.148, intensity and decreased at moderate and high exercise intensities (basal: p 0.03). Patients were divided into two groups: 1) overweight (BMI < 30) or 19Æ 10 mM, 25% Wmax:16Æ 7 mM, 65% Wmax: 7 11Æ 17 mM, 85% Wmax: 2) obese (BMI 30), the two groups being comparable for age (43.0Æ 13.0 vs 7 12Æ 13 P 0.05), while it increased with increasing intensity in adipose 46.4Æ 13.0 years, n.s.). Activity score was signi®cantly higher in group 1 tissue (basal: 155Æ 28 mM, low: 262Æ 50 mM, moderate: 335Æ 57 mM, compared to group 2 (10511Æ 859 vs 7943Æ 823, p < 0.005). When sexes P < 0.05). Skeletal muscle blood ¯ow increased with increasing exercise were evaluated separately activity score in men was similar in group 1 and 2 intensity up to 65% Wmax (P < 0.05), while adipose tissue blood ¯ow did (13046Æ 1270 vs 11548Æ 1773, n.s.) age being 45.5Æ 10 vs 46.1Æ 13.0 not change signi®cantly with exercise. years (n.s.) respectively. On the other hand, activity score in women was CONCLUSION: Skeletal muscle lipolysis peaks at low exercise intensity despite 8649Æ 1134 and 6815Æ 831 respectively (p < 0.03), age being 40.4Æ 15.0 vs further increase of lipolysis with exercise intensity in adipose tissue. 46.5Æ 13.0 years (n.s.). CONCLUSION: These data show that a speci®c questionnaire is a useful tool to assess daily physical activity in a outpatient population and that obese clearly appear less active than overweight patients. A more accurate knowl- edge of total physical activity of each patient could be helpful in any weight reduction program. P144

Increase in physical activity is not associated with changes in BMI in 8 ± 9 year old children: 6-mo analysis of an on-going 2-y intervention program P142 CM Filozof 1, CD Gonzalez2, and Saenz S1 1Biology Department, John f Kennedy University; 2Pharmacology Department, AMAS-2000 Metabolic improvement in overweight men exposed to Buenos Aires University moderate altitude Low levels of physical activity are associated with weight gain. Increases in 1 2 3 4 M Lechleitner , E Humpeler , W Schobersberger , and F Hoppichler physical activity levels were reported to be associated to a decrease in body 1 2 UniversitaÈtsklinik fuÈr Innere Medizin, Innsbruck; Institut fuÈr Balneologie, mass index in children (Robinson TN, JAMA 1999). 3 4 Bregenz; UniversitaÈtsklinik fuÈr AnaÈsthesie, Innsbruck; Krankenhaus der OBJECTIVES: To evaluate the impact of a school-based health behavior Barmherzigen BruÈder, Salzburg intervention program on physical activity levels and body weight among INTRODUCTION: Insulin resistance and the cascade of symptoms summar- Argentinean boys and girls in grades 3 to 4. ized as the metabolic syndrome signi®cantly increase the cardiovascular risk. DESIGN: Randomized controlled school-based trial. The following are ad The metabolic syndrome is strongly related to an increase in sympathetic interim 6-mo analysis of an on-going 2-y intervention program. nervous activity, which is known to be modulated by a stay at different SUBJECTS AND METHODS: 90 third- and fourth-grade students (meanÆ SD, altitudes, but until now no data are available about the in¯uence of altitude age: 8.5Æ 0.6 years, BMI: 18.8Æ 4.5 Kg=m2) were studied. Weight, height and on parmeters of the metabolic syndrome. physical activity levels were evaluated at baseline and at 6- months. Levels of METHODS: 22 male subjects with a metabolic syndrome were selected, and, physical activity were estimated over 48h in free living conditions by an after baseline investigations these participants spent 3 weeks at 1700 m accelerometer. Body fat was estimated at baseline by bioelectrical impedance. altitude simulating a holiday stay. Fasting glucose, glycated hemoglobin INTERVENTION: 45 children (meanÆ SD, age: 8.5Æ 0.6 years, BMI: (HbA1c) and lipid values were determined according to routine procedures. 19.5Æ 5.4 Kg=m2, body fat: 29.3Æ 3.9%) received a 12-lesson curriculum. As a measurement for insulin resistance Homeostasis Model Assessment Mean age, BMI and body fat from the children in the control group were (HOMA) was used. Statistic values are given as medians, for univariate testing similar to the ones in the intervention group (meanÆ SD, age: 8.5Æ 0.6 years, the paired t-test was applied. BMI: 18.1Æ 3.1 Kg=m2, body fat: 29.2Æ 4.6%). The sessions were given by a RESULTS: Fasting plasma glucose levels revealed a decrease from dietitian. They focused on decreasing Television viewing and increasing 109.2Æ 33.6 mg=dL at the baseline control to 102.1Æ 61.8 mg=dL after the moderate and vigorous physical activity. stay at moderate altitude, and HbA1c levels decreased from 6.3Æ 1.5% to RESULTS: Compared with controls, children in the intervention group had 4.6Æ 0.53% (p < 0.069). Fasting insulin levels were 16.2Æ 11.3 mU=mL at the signi®cant increases in physical activity levels (intervention group: 657Æ 226 baseline control, and 11.6Æ 5.9 mU=mL after the stay in the mountains, which and 929Æ 328 counts, baseline and 6-months respectively; control group: was paralleled by a decrease in the HOMA index from 4.8Æ 4.1 to 3.3Æ 1.9 625Æ 211 and 698Æ 218 counts, baseline and 6-months, respectively); (p < 0.036) indicating an improved insulin sensitivity. No signi®cant changes (two-way ANOVA with repeated measures and interaction analysis, group could be observed in total cholesterol and LDL-cholesterol levels, while serum effect: p 0.003; interaction: P 0.004). Increases in physical activity levels triglycerides decreased from 218.6Æ 135.5 mg=dL to 196.3Æ 116.9 mg=dL. were not related to BMI, gender and=or socioeconomic status. Despite HDL-cholesterol showed a signi®cant increase from 45.5Æ 12.3 mg=dL to increased physical activity levels, children from the intervention group did 54.7Æ 4.6 mg=dL (p < 0.001). not have any change in BMT when compared to the children from the control CONCLUSIONS: Our data indicate that insulin sensitivity increases during a group (BMI change in intervention Vs control group: 0.07Æ 1.4 Kg=m2 and stay at moderate altitude, which is supported by the decrease in glucose and 0.15Æ 0.7 Kg=m2,NS) insulin levels, as well as the improvement of the HOMA index. CONCLUSIONS: Increase in physical activity levels did not prevent weight change, at least at 6-month follow up.

International Journal of Obesity Track 5 Physical activity, exercise and sport

S72 P145 obese individuals are compensating by lower energy intake, these activity patterns may contribute to worsening the degree of obesity. Minute-by- The effects of exercise and sugar drinks on food intake and body weight minute accelerometry is a valuable tool for the assessment of activity patterns in women and may be useful to highlight periods of inactivity for intervention. DA Hughes1, S Whybrow1, C Reid1, NA King2, JE Blundell2, and RJ Stubbs1 1ACERO, Rowett Research Institute, Bucksbum, Aberdeen AB21 95B, UK; 2 BioPsychology Group, University of Leeds, UK P147 This study examined the effects of a 4-week exercise intervention with and without a 1.5 MJ sugar drink (1 l=d) on body weight and ad libitum food Differential associations between adiposity and physical activity at work intake in 9 normal weight (NW), 8 overweight (OW) and 8 sugar drink- or during leisure-time in adults in a population survey supplemented overweight (OWS) women. Subjects were studied over a 13- 1 1 1 1 1 1 week period. They exercised ( 1.3 MJ=d) on a bicycle ergometer during MA Charles , J-M Oppert , N Thibult , J-M Borys , A Lommez , A Basdevant , 1 1 weeks 5 ± 8 inclusive. Self-weighed food intakes and energy expenditure (EE) P DucimetieÁre , and the Fleurbaix-Laventie Ville Sante Study Group 1 (estimated from continuous heart rate monitoring) were recorded for 3 INSERM U 258, Villejuif; HoÃtel-Dieu, Paris, FLVS Association, Lille France consecutive days during weeks 0 (Baseline), 4 (Pre-Ex), 8 (Ex) and 12 (Post- INTRODUCTION: Differential associations between various types of physical Ex). Body weight was recorded weekly. Energy intake (El), expenditure and activity and total, abdominal and subcutaneous fat measurements are not well change in weight (BW) are given below. OWS intakes include supplement, described. except during baseline. METHODS: The subjects were participants in the Fleurbaix-Laventie Ville Sante II, a longitudinal study on the determinants of obesity in children and Group Baseline Pre-Ex Ex Post-Ex P their parents. At the baseline examination in 1999, 222 fathers and 269 mothers (mean age: 43 years) answered the Modi®able Activity Questionnaire Energy NW 6.7 7.1 7.1 6.9 NS (Kriska A et al, Diabetes Care 1990). Past-year physical activity was quanti®ed Intake OW 8.6 8.6 8.6 8.6 NS in average MET-h=week (or Kcal=kg.wk) and classi®ed in leisure-time physical (MJ=d) OWS 8.8 9.8 8.6 8.4 0.066 activity other than walking (LTPAo), walking for leisure (LTW), and occupa- Energy NW 10.9 10.4 11.2 11.7 0.09 tional physical activity (OPA). Waist circumference (WC), the sum of two measures of the bicipital, tricipital subscapular and suprailiac skinfolds (SKF) Expenditure OW 10.8 11.9 12.9 12.8 0.062 and the percent body fat (%BF) obtained from bipodal bioimpedance (MJ=d) OWS 12.0 12.0 14.1 11.4 NS (TanitaTBF-310) were used to examine the relationship between adiposity Cumulative NW 0 7 0.3 7 0.4 7 0.9 NS and quartiles of each physical activity categories by age-adjusted analysis of Weight OW 0 0 7 0.2 7 0.5 NS covariance. Change OWS 0 7 0.2 0.1 7 0.2 NS RESULTS: The median [interquartile range] for the different physical activity categories were in men: LTPAo: 14 [5 ± 27], LTW: 0.6 [0 ± 27] , OPA: 80 [32 ± 190], and in women: LTPAo: 7 [2 ± 12] , LTW: 1.6 [0 ± 4.9], OPA: 74 [36 ± 135] Neither mild=moderate exercise nor supplementation signi®cantly increased MET-h=wk. In men, %BF, WC and SKF were all negatively related to LTPAo or decreased BW, suggesting that over the 4 weeks compensation occurred for (p < 0.03, 0.002, 0.30, respectively) but not to LTW; OPA was negatively these interventions. Low 3d EI values indicated underreporting. 12 weeks of associated with SKF only (p < 0.06). In women, %BF, WC and SKF were all sugar supplementation did not affect BW, suggesting that this drink of low negatively associated with LTPAo (p < 0.03, 0.02, 0.07); the absence of LTW energy density was compensated for. Longer term increases in exercise and was associated with an increase of all adiposity parameters (p < 0.02, 0.006, sugar drink intake did not affect energy balance. 0.007), and OPA was not associated with adiposity. Results were unchanged after exclusion of subjects with a body mass index 30 kg=m2. CONCLUSION: In both gender, leisure-time physical activity was associated with decreased total, abdominal and subcutaneous adiposity. This was true for walking in women only, probably because women walked more often for leisure than men. OPA, the major part of total weekly PA in men, was not P146 related to lower adiposity suggesting that this type of physical activity is associated with behaviours with opposite effects on adiposity, and more Assessment of physical activity patterns of obese and non-obese adults speci®cally in men, on abdominal adiposity. using minute by minute accelerometry AR Cooper1, A Page1, U Foster1, and MG Davis1 1University of Bristol, Department of Exercise and Health Sciences, Priory House, 8 Woodland Road, Bristol BS8 1TN, UK P148 Accurate measurement of physical activity in free-living individuals is impor- Physical activity as a factor associated with body weight in the 1982 ± tant to better understand the relationship between activity levels and the 1997 Finrisk Studies development of obesity. Accelerometers that provide minute-by-minute mea- 1 1 1 1 surements provide an objective means of assessing the amount and pattern of M Lahti-Koski , P Pietinen , M HelioÈvaara , and E Vartiainen 1 activity over a prolonged period. This study used minuteby-minute accelero- National Public Health Institute, Mannerheimintie 166, FIIN-00300 Helsinki, metry to investigate the activity of normal, overweight and obese adults. One Finland hundred and eighty four participants employed in sedentary occupations INTRODUCTION: The worldwide increase in the prevalence of obesity may be were recruited of whom 157 (77 m, 80 f; mean age 39.5Æ 9.8 yrs) completed attributable to an environment that promotes sedentariness and excessive all measurements. Participants wore an accelerometer (Computer Science and food intake. However, population surveys which have examined an increase in Applications Inc. (CSA) model 7164) during waking hours for a continuous body mass index (BMI) in relation to changes in lifestyle variables measured period of seven days, removing the monitor only for waterbased activities and within the same population are scarce. In this study, associations of BMI and bathing. Stored activity counts were then downloaded for analysis. No obesity with physical activity were investigated. In addition, we examined the signi®cant differences in physical activity were identi®ed between normal consistency of these associations over time aiming at assessing whether the weight (BMI < 25; n 81) and overweight (BMI 25 ± 29.9; n 56) partici- signi®cance of physical activity as a correlate of obesity has increased over a pants, and these were pooled for subsequent analysis. Two-way ANOVA 15-year period. identi®ed that obese participants (n 20) were signi®cantly less active than METHODS: Independent cross-sectional surveys were carried out in 1982, the non-obese during weekdays (270.7Æ 81.9 vs 388.1Æ 133.6 counts.min71 1987, 1992, and 1997. Altogether 24 604 randomly selected men and p < 0.001) and at weekends (224.7Æ 97.4 vs 395.2Æ 196.5 counts.min71 women (aged 25 ± 64 y) participated in these surveys. The weight and p < 0.001). There was no signi®cant main effect for gender or interaction height of the subjects were measured, and data on physical activity were between gender and BMI. Obese participants were signi®cantly less active collected by self-administered questionnaires. during the weekend than on weekdays (p 0.05; non-obese n.s.). Hour by RESULTS: In men and women, leisure-time physical activity was inversely hour physical activity patterns (07:00 to 24:00) demonstrated that obese associated with obesity, as was activity at work in men. However, heavy work participants were less active than the non-obese for every hour of the weekday had a positive association with obesity in women. The inverse association and the weekend. This difference was particularly pronounced in non-work between physical activity and obesity seemed to strengthen over time. periods. Obese participants were substantially less active than the non-obese, CONCLUSION: The signi®cance of avoiding sedentariness has increased over particularly when there was a choice of whether to be active or not. Unless time as a factor associated with normal weight.

International Journal of Obesity Track 5 Physical activity, exercise and sport

S73 P149 bene®ts and barriers (p < .05). Cluster analysis divided the children in 3 groups: 1) low self-ef®cacy (SE) towards PA, moderately active, low SE towards Physical activity patterns in non-obese and obese children using minute- food intake, to much fat intake, 2) low SE towards PA, moderately active, by-minute accelerometry moderate SE towards food intake, healthy fat intake, 3) moderate SE towards PA, highly active, moderate SE towards food intake, healthy fat intake. Page Angie1, Cooper Ashley1, Foster Lucy1, and Fox Ken1 1 Although these subgroups had a similar ABMI at the end of treatment, their University of Bristol, Department of Exercise and Health Sciences, Priory House, ABMI 1,5 year later differs (p < .05), with group 1 having the highest ABMI 8 Woodland Road, Bristol BS81TN, UK (168%), group 3 the lowest ABMI (140%) and group 2 having an ABMI of INTRODUCTION: A secular decrease in energy expenditure is an important 157%. contributing factor for the rapid and recent increase in obesity in adults, but CONCLUSION: The combination of food & exercise behaviour and SE has an the role of physical activity in the aetiology of obesity in children is less clear. important role in weight loss maintenance. The purpose of this paper was to determine the levels and patterns of weekend and weekday physical activity in a group of obese ( > 95th percentile BMI) and non-obese ( < 95th percentile BMI) children using minute-by- P151 minute accelerornetry (Computer Science and Applications Inc. Shalimar, FI). The lipidic and glycemtc prophile in the obese before and after METHODS: This was a cross-sectional study of physical activity levels over a hypocaloric diet and physical exercise

7-day period using accelerometers programmed to collect minute-by-minute 1 1 1 1 1 data. Children were recruited from primary and secondary schools in southern C Tudor , Jeberean Rorica , V Lungu , Danciu Simina , Vizman Carmen , and C Vizman1 England. 154 (mean age 11.34Æ 2.07 years) children who recorded at least 1 one weekend day and one weekday. Fifteen (19.4%) of the 77 girls and 10 First Medical Clinic, University of Medicine and Pharmacy, B-dul Tudor (12.9%) of the 77 boys were above the 95th percentile for BMI according to Viadimirescu Nr.16, ap.2, 1900 Timisoara, Romania national age and gender reference points. During its evolution, android obesity generates metabolic complications RESULTS: Obese boys were signi®cantly less active than non-obese boys (diabetes mellitus, hyperuricemia and hyperlipoproteinemia) the incidence during weekdays (597.64Æ 122.58 vs 741.65Æ 200.76 counts.min71; of which depends on the weight excess and alimentary habits. These com- 1 3.319, p 0.006), and at weekends (453.36Æ 197.75 vs 669.46Æ plications are major cardiovascular risk factors. The disorders of plasmatic 312.63 counts.min71;1 2.949; p < 0.009). For girls there were no signi®- lipids, the glucose intolerance and diabetes mellitus appear early in the obesity cant differences in counts per minute for either the weekday or weekend but evolution and have important consequences upon the cardiovascular system. both obese and non-obese girls were signi®cantly less active than non-obese Long-term hypocaloric diet and physical exercise diminish the incidence of the boys for both periods. Hourly patterns of activity indicated that obese boys complications above, limiting the appearance of cardiovascular complications. were less active than nonobese boys at time points where activity was more The study included 180 patients: 95 males with BMI 35.6Æ 2.9 kg=m2 and likely to be determined by free choice. mean age 42.2Æ 12.4 years and 85 women with BMJ 36.8Æ 2.2 kg=m2 and CONCLUSION: Obese boys demonstrated patterns of physical activity that mean age of 41.6Æ 9.8 years. During hospitalization, the energetic intake was may have contributed to and are likely to sustain their obesity. Non-obese girls 200 kcal=24 h and after hospitalization 1200 kcal=24 h. showed levels of activity similar to those of obese boys but there were no clear At admission and after 6 weeks of diet and physical exercise, glycemia (G), differences between obese and non-obese girls. Minute-by-minute accelero- total cholesterol (TC) and tryglycerides (TG) were determined using the metry is a valuable tool for the assessment of activity patterns. It is sensitive to enzimatic method, LDL cholesterol and HDL cholesterol by unphotometric individual and group differences and highlights important distinctive patterns method, and lipoprotein a (aLP) using ELISA methods; values are given in of activity according to gender and level of overweight. mg=dl. The weight loss in men (BMI 32.5Æ 2.8 kg=m2) and women (33.4Æ 2.3 kg=m2) as a result of decreasing the alimentary intake and of physical P150 exercise directly correlates with the decreasing of TC, TG and LDL cholesterol 1.5 year follow-up of obese children after a 10 month residential program as atherogen factors and increasing of HDL cholesterol as a vascular protective factor. In conclusion the authors consider that the appropriate long-term B Deforche1, I De Bourdeaudhuij1, and J Bouckaert1 1 management of obesity determines the weight loss and in most cases brings Department of Movement and Sport Sciences, Ghent University, to normal the plasmatic lipid values and balances the diabetes mellitus. Watersportlaan 2,9000 Ghent, Belgium INTRODUCTION: This study investigates the evolution of overweight and health behaviour 1.5 year after treatment. METHODS: At the end of treatment and 1,5 year later, physical activity (PA) Moment G TC TG HDL chol LDL chol aLP Sex (Taylor questionnaire), determinants of PA (structured interview), fat and ®bre intake (Flemish short fat and ®bre test) were measured in 24 children (pre Before 185Æ 25 197Æ 26 210Æ 82 35Æ 8 143Æ 23 22Æ 12 Male treatment Adjusted Body Mass Index (ABMI) 179.1Æ 24.6%) treatment RESULTS: Although children have a quite healthy food and xercise behaviour, 210Æ 18 202Æ 38 163Æ 62 42Æ 8 157Æ 38 26Æ 16 Female their ABMI 1.5 year after treatment has increased from 122Æ 14% to 154Æ 22% (p < .001). They participate more in low intensity PA (p < .01) After 122Æ 16 185Æ 22 153Æ 72 37Æ 6 122Æ 21 18Æ 12 Male and less in moderate and high intensity PA (p < .001) compared with at the treatment end of treatment. Important determinants of PA have decreased: they report 127Æ 14 192Æ 38 142Æ 38 44Æ 6 132Æ 18 22Æ 13 Female less modelling of friends, less social support of family and less perceived

International Journal of Obesity