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This version published online on August 14, 2007
Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc.2007-0779
A more recent version of this article appeared on November 1, 2007
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Submitted on April 5, 2007
Accepted on August 7, 2007

Exercise alone reduces insulin resistance in obese children independently of changes in body composition

Lana M. Bell, Katie Watts, Aris Siafarikas, Alisha Thompson, Nirubasini Ratnam, Max Bulsara, Judith Finn, Gerry O'Driscoll, Daniel J Green, Timothy W. Jones, and Elizabeth A Davis*

Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia; Department of Endocrinology and Diabetes, Princess Margaret Hospital, School of Population Health, University of Western Australia; School of Human Movement and Exercise Science, The University of; Western Australia; Advanced Heart Failure & Cardiac Transplant Service, Royal Perth; Hospital; School of Medicine, University of Notre Dame, Fremantle Western; Australia; Research Institute for Sport and Exercise Sciences, Liverpool John Moores University

* To whom correspondence should be addressed. E-mail: Elizabeth.davis{at}health.wa.gov.au.

Context: The number of obese children with insulin resistance and type 2 diabetes is increasing but the best management strategy is not clear.

Objective: To assess the effect of a structured eight-week exercise training program on insulin resistance and changes in body composition in obese children.

Design: Eight weeks of structured supervised exercise intervention with outcome measures pre- and post- the exercise period.

Subjects: 14 obese children (12.70 +/- 2.32 yr, 8M, 6F) with high fasting insulin levels were enrolled into the study.

Intervention: Eight weeks of supervised circuit-based exercise training, composed of three fully supervised one-hour sessions per week.

Outcome measures: These were assessed pre- and post-training program and included insulin sensitivity (euglycaemic-hyperinsulinaemic clamp studies), fasting insulin and glucose levels, body composition using dual energy X-ray absorptiometry (DEXA) scan, lipid profile and liver function tests.

Results: Insulin sensitivity improved significantly after eight weeks of training (Mlbm 8.20 ± 3.44 to 10.03 ± 4.33 mg/kg/min, P < 0.05). Submaximal exercise heart rate responses were significantly lower following the training (p < 0.05), indicating an improvement in cardiorespiratory fitness. DEXA scans revealed no differences in lean body mass or abdominal fat mass.

Conclusion: An eight-week exercise training program increases insulin sensitivity in obese children, and this improvement occurred in the presence of increased cardiorespiratory fitness but is independent of measurable changes in body composition.


Key words: Child • Obesity • Insulin Resistance • Exercise




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