None listed
Conditions
Brief summary
This is a randomised control trial designed to test the hypothesis that three months of whole body vibration training (WBVT) will enhance the effect of lifestyle intervention, diet and exercise on improving insulin sensitivity and metabolic/cardiovascular profile in overweight adolescents with hyperinsulinemia. Obesity in children and adolescents is often associated with high insulin levels and other complications such as high blood pressure, high blood fats, fatty liver and polycystic ovarian syndrome. Adolescents with high untreated insulin levels are likely to progress to Type 2 diabetes. Lifestyle changes such as diet and exercise can improve obesity, reduce high insulin levels and reduce the risk of cardiovascular sequelae. It is well known that exercise makes more muscle. Increased muscle tissue allows uptake of blood sugars more easily and thereby decreases insulin levels. We plan to see if whole body vibration training, a novel low impact form of resistance training, will lower insulin levels by increasing the muscle tissue in these young people. This in turn may improve their glucose uptake and reduce their insulin resistance. This new form of training may condition overweight adolescents by increasing their muscle strength and allowing them to take part in more structured physical activity. The promotion of physical activity and lifestyle change may prevent the onset of Type 2 diabetes and associated cardiovascular complications in later life.
Interventions
Whole body vibration training:
This is a novel form of resistance training for muscles of the lower limbs, buttocks and trunk.
Whole body vibration training has been shown to be effective in improving both muscle power and skeletal structure.The improvements seen in skeletal muscle are similar to that of “power training”. Vibration training can produce similar effects on skeletal muscle in a shorter period than progressive resistance training.
Participants in will be supplied with and instr
Whole body vibration training: This is a novel form of resistance training for muscles of the lower limbs, buttocks and trunk. Whole body vibration training has been shown to be effective in improving both muscle power and skeletal structure.The improvements seen in skeletal muscle are similar to that of “power training”. Vibration training can produce similar effects on skeletal muscle in a shorter period than progressive resistance training. Participants in will be supplied with and instructed on how to use a GalileoTM home vibration platform (Stratec, Pforzheim, Germany). The 12 week WBVT programme will involve a 15 minute program with a vibration frequency between 12 to 20 Hz per day. Participants, under parental/carers supervision, will be instructed to do three blocks of WBVT: three minutes WBVT followed by a three minute break (i.e. three minutes of WBVT, three minutes break, three minutes of WBVT, three minutes break, three minutes of WBVT). A home visit (duration 15 minutes) will be undertaken in week 1 to ensure correct use of the platform. A vibration diary should be completed by each participant during the three months. Lifestyle measures: All participants will have clearly defined weight loss and physical activity goals. Dietary advice- All participants will be seen by one of two weight management dieticians at The Children's Hospital at Westmead (CHW) at baseline, 2, 6, 10 weeks. The initial appointment at baseline will be 30 minutes, subsequent appointments will be 10-15 minutes. Participants will be prescribed a diet based on moderate carbohydrate, increased protein diet; 40-45 % total energy (moderate glycaemic index and minimal refined carbohydrate), 30-35% fat (= 10% saturated fat), 25-30% protein. Energy restriction will be tailored on an individual basis to incorporate an energy restriction of approximately 500-1000 kJ/day. Nutrition intervention will utilise a structured meal plan and coaching model as routinely used in the Weight Management Services at CHW. Exercise: All participants will be assessed by staff at The Children’s Hospital Institute of Sports Medicine (CHISM) according to the schedule. Participants will be given an exercise prescription with the aim of four, home based, 45 minute sessions of physical activity each week. The exercise program will incorporate an age-appropriate mix of both aerobic and resistance training and will be reviewed according to the schedule to avoid boredom. In addition increasing incidental physical activity, decreasing sedentary behaviours and active transport will be encouraged.
Sponsors
The Children's Hospital at Westmead
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
10 Years to 18 Years
Healthy volunteers
No
Inclusion criteria
10-18 year olds who have acanthosis nigricans/Polycystic Ovarian Syndrome (PCOS) and a fasting insulin > 90 pmol/L and < 300 pmol/L). BMI must also be greater than the 85th centile of Center for Disease Control and prevention (CDC charts).
Exclusion criteria
Type 1 or Type 2 diabetes secondary causes of obesity psychiatric disturbance significant medical illness inability to take part in physical activity taking weight loss medications insulin sensitizers pregnancy.
Outcome results
None listed