Effekte von hochintensivem Intervalltraining (HIIT) auf Body-Mass-Index (BMI) und Körperfettanteil von übergewichtigen und adipösen Kindern – eine systematische Übersichtsarbeit

Zusammenfassung

Hintergrund Mehr als 340 Millionen Kinder gelten weltweit als übergewichtig oder adipös, ihre Anzahl nahm in den letzten Jahren – auch durch die Coronapandemie – erheblich zu. Eine alternative Behandlung zur Reduzierung des Übergewichts, die in den Empfehlungen bisher keine große Beachtung findet, stellt das sogenannte hochintensive Intervalltraining (HIIT) dar.

Ziel Darstellung der Wirksamkeit von hochintensivem Intervalltraining auf den BMI und Körperfettanteil übergewichtiger und adipöser Kinder im Alter von 6–13 Jahren.

Methode Die Erstellung der systematischen Übersichtsarbeit orientierte sich an den PRISMA-Guidelines. Für die Literaturrecherche wurden die Datenbanken MEDLINE, Cochrane Library, CINAHL, Embase, Sports Medicine & Education Index und Web of Science nach Studien mit hochintensivem Intervalltraining für übergewichtige und adipöse Kinder durchsucht. Die Bewertung der methodischen Studienqualität erfolgte mittels PEDro-Skala, MINORS und Risk of Bias. Die Berichtsqualität wurde anhand von CONSORT und TREND bewertet.

Ergebnisse Es wurden 6 randomisierte kontrollierte Studien und 2 kontrollierte klinische Studien mit 479 HIIT-Teilnehmenden betrachtet. Diese zeigten, dass hochintensives Intervalltraining positive Auswirkungen auf den BMI und Körperfettanteil übergewichtiger und adipöser Kinder hat.

Schlussfolgerung Hochintensives Intervalltraining ist eine kinderfreundliche und zugleich effektive Alternative zur Behandlung von übergewichtigen und adipösen Kindern. Weitere klinische Studien sind erforderlich, um die Ergebnisse zu bekräftigen.

Abstract

Background More than 340 millions of children worldwide are considered overweight or obese. This number has increased significantly in recent years, partly as a result of the corona pandemic. An alternative treatment to reduce obesity, which has so far not received much attention in the recommendations, is the so-called high-intensity interval training (HIIT).

Objective To show the effectiveness of high-intensity interval training on the BMI and body fat percentage of overweight and obese children aged 6–13 years.

Method The creation of the systematic review was based on the PRISMA guidelines. For the literature search, the databases MEDLINE, Cochrane Library, CINAHL, Embase, Sports Medicine & Education Index and Web of Science were searched for studies with high-intensity interval training for overweight and obese children. The methodological study quality was assessed using PEDro scale, MINORS and Risk of Bias. The report quality was assessed using CONSORT and TREND.

Results A total of 6 randomized controlled trials and 2 controlled clinical trials with 479 HIIT-participants were considered. These showed that high-intensity interval training has positive effects on the BMI and body fat percentage of overweight and obese children.

Conclusion High-intensity interval training is a child-friendly and effective alternative for the treatment of overweight and obese children. Further clinical studies are needed to confirm the results.

Schlüsselwörter

hochintensives Intervalltraining - Therapie - Übergewicht - Adipositas - Kinder

Key words

high-intensity interval training - therapy - overweight - obesity - children

Publication History

Received: 20 January 2021

Accepted: 21 May 2021

Article published online:
23 August 2021

• Literatur

• 1 World Health Organization, Hrsg. Obesity and overweight. Genf: 07.01.2021. Im Internet (Stand: 09.01.2021): www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
• 2 Ng M, Fleming T, Robinson M. et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2014; 384: 766-781 DOI: 10.1016/S0140-6736(14)60460-8.
• 3 Robert Koch-Institut, Hrsg. Erkennen – Bewerten – Handeln: Zur Gesundheit von Kindern und Jugendlichen in Deutschland. Robert Koch-Institut; 2008. DOI: 10.25646/3071
• 4 Robert Koch-Institut, Hrsg. Prävalenz von Untergewicht, Übergewicht und Adipositas bei Kindern und Jugendlichen in Deutschland – Einordnung der Ergebnisse aus KiGGS Welle 2 nach internationalen Referenzsystemen. J Health Monitor 2018; 3: 60-74 DOI: 10.17886/RKI­GBE­2018­080.
• 5 Reinehr T, Wabitsch M. Diagnostik der Adipositas bei Kindern und Jugendlichen. In: Hiort O, Danne T, Wabitsch M. Hrsg. Pädiatrische Endokrinologie und Diabetologie. Springer Reference Medizin. 2. Aufl.. Berlin, Heidelberg: Springer; 2020: 285-296 DOI: 10.1007/978-3-662-57309-9_22
• 6 Pietrobelli A, Faith MS, Allison DB. et al. Body mass index as a measure of adiposity among children and adolescents: A validation study. J Pediatr 1998; 132: 204-210 DOI: 10.1016/S0022-3476(98)70433-0.
• 7 Manz K, Schlack R, Poethko-Müller C. et al. Körperlich-sportliche Aktivität und Nutzung elektronischer Medien im Kindes- und Jugendalter: Ergebnisse der KiGGS-Studie. Erste Folgebefragung (KiGGS Welle 1). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2014; 57: 840-848 DOI: 10.1007/s00103-014-1986-4.
• 8 Berkey CS, Rockett HR, Field AE. et al. Activity, dietary intake, and weight changes in a longitudinal study of preadolescent and adolescent boys and girls. Pediatr 2000; 105: E56 DOI: 10.1542/peds.105.4.e56.
• 9 Webber L, Hill C, Saxton J. et al. Eating behaviour and weight in children. Int J Obes (Lond) 2009; 31: 21-28 DOI: 10.1038/ijo.2008.219.
• 10 Pietrowsky R. Hunger und Sättigung. In: Herpertz S. Hrsg. Handbuch Essstörungen und Adipositas. Mit 21 Tabellen. Heidelberg: Springer Medizin; 2008: 124-129 DOI: 10.1007/978-3-540-76882-1_21
• 11 Kalra SP, Dube MG, Pu S. et al. Interacting appetite-regulating pathways in the hypothalamic regulation of body weight. Endocr Rev 1999; 20: 68-100 DOI: 10.1210/edrv.20.1.0357.
• 12 Must A, Jacques PF, Dallal GE. et al. Long-term morbidity and mortality of overweight adolescents. A follow-up of the Harvard Growth Study of 1922 to 1935. N Engl J Med 1992; 327: 1350-1355 DOI: 10.1056/NEJM199211053271904.
• 13 Statistisches Bundesamt. Statistisches Jahrbuch 2019, Kapitel 4 Gesundheit (30.10.2019). Im Internet (Stand 04.07.2021): www.destatis.de/DE/Themen/Querschnitt/Jahrbuch/jb-gesundheit.html
• 14 World Health Organization. Disease, injury and causes of death country estimates 2000–2015. Im Internet (Stand: 09.01.2021): www.who.int/healthinfo/global_burden_disease/estimates_regional_2000_2015/en
• 15 Flechtner-Mors M, Thamm M, Rosario AS. et al. Hypertonie, Dyslipoproteinämie und BMI-Kategorie charakterisieren das kardiovaskuläre Risiko bei übergewichtigen oder adipösen Kindern und Jugendlichen: Daten der BZgA-Beobachtungsstudie (EvAKuJ-Projekt) und der KiGGS-Studie. Klin Padiatr 2011; 223: 445-449 DOI: 10.1055/s-0031-1280766.
• 16 Weiss R, Dziura J, Burgert TS. et al. Obesity and the metabolic syndrome in children and adolescents. N Engl J Med 2004; 350: 2362-2374 DOI: 10.1056/NEJMoa031049.
• 17 Claessen H, Kvitkina T, Narres M. et al. Inzidenzen von Folgeerkrankungen des Diabetes mellitus. Diabetologe 2019; 15: 79-88 DOI: 10.1007/s11428-018-0406-z.
• 18 Mayer H, Wabitsch M. Dicke Kinder – kranke Erwachsene. Wir züchten uns unsere Patienten von morgen!. MMW Fortschr Med 2003; 145: 30-34
• 19 Adoración Villarroya M, Manuel Esquivel J, Tomás C. et al. Foot structure in overweight and obese children. Int J Pediatr Obes 2008; 3: 39-45 DOI: 10.1080/17477160701520298.
• 20 de Sá Pinto AL, de Barros Holanda PM, Radu AS. et al. Musculoskeletal findings in obese children. J Paediatr Child Health 2006; 42: 341-344 DOI: 10.1111/j.1440-1754.2006.00869.x.
• 21 Wabitsch M, Horn M, Esch U. et al. Silent slipped capital femoral epiphysis in overweight and obese children and adolescents. Eur J Pediatr 2012; 1461-1465 DOI: 10.1007/s00431-012-1743-3.
• 22 Holliday KL, McWilliams DF, Maciewicz RA. et al. Lifetime body mass index, other anthropometric measures of obesity and risk of knee or hip osteoarthritis in the GOAL case-control study. Osteoarthritis Cartilage 2011; 19: 37-43 DOI: 10.1016/j.joca.2010.10.014.
• 23 Eisenberg ME, Neumark-Sztainer D, Haines J. et al. Weight-teasing and emotional well-being in adolescents: longitudinal findings from Project EAT. J Adolesc Health 2006; 38: 675-683 DOI: 10.1016/j.jadohealth.2005.07.002.
• 24 Libbey HP, Story MT, Neumark-Sztainer DR. et al. Teasing, disordered eating behaviors, and psychological morbidities among overweight adolescents. Obesity (Silver Spring) 2008; 16: S24-S29 DOI: 10.1038/oby.2008.455.
• 25 Knoll KP, Hauner H. Kosten der Adipositas in der Bundesrepublik Deutschland. Eine aktuelle Krankheitskostenstudie. Adipositas 2008; 02: 204-210 DOI: 10.1055/s-0037-1618649.
• 26 Wolfenstetter SB. Adipositas und die Komorbidität Diabetes mellitus Typ 2 bei Kindern und Jugendlichen in Deutschland: Entwicklung und Krankheitskostenanalyse. Gesundheitswesen 2006; 68: 600-612 DOI: 10.1055/s-2006-927181.
• 27 Arbeitsgemeinschaft Adipositas im Kindes- und Jugendalter, Hrsg. S3-Leitlinie zur Therapie und Prävention der Adipositas im Kindes- und Jugendalter. AWMF online; 2019. Im Internet (Stand: 09.01.2021): www.awmf.org/uploads/tx_szleitlinien/050-002l_S3_Therapie-Praevention-Adipositas-Kinder-Jugendliche_2019-11.pdf
• 28 Vi Viana RB, de Lira CAB, Naves JPA. et al. Can We Draw General Conclusions from Interval Training Studies?. Sports Med 2018; 48: 2001-2009 DOI: 10.1007/s40279-018-0925-1.
• 29 Zabinski MF, Saelens BE, Stein RI. et al. Overweight children's barriers to and support for physical activity. Obes Res 2003; 11: 238-246 DOI: 10.1038/oby.2003.37.
• 30 Bailey RC, Olson J, Pepper SL. et al. The level and tempo of children's physical activities: an observational study. Med Sci Sports Exerc 1995; 27: 1033-1041 DOI: 10.1249/00005768-199507000-00012.
• 31 Epstein LH, Wing RR, Koeske R. et al. A comparison of lifestyle change and programmed aerobic exercise on weight and fitness changes in obese children. Behav Ther 1982; 13: 651-665 DOI: 10.1016/S0005-7894(82)80022-1.
• 32 Lambrick D, Westrupp N, Kaufmann S. et al. The effectiveness of a high-intensity games intervention on improving indices of health in young children. J sports sciences 2016; 190-198 DOI: 10.1080/02640414.2015.1048521.
• 33 Delgado-Floody P, Latorre-Román P, Jerez-Mayorga D. et al. Feasibility of incorporating high-intensity interval training into physical education programs to improve body composition and cardiorespiratory capacity of overweight and obese children: A systematic review. J Exerc Sci Fit 2019; 17: 35-40 DOI: 10.1016/j.jesf.2018.11.003.
• 34 Cao M, Quan M, Zhuang J. Effect of High-Intensity Interval Training versus Moderate-Intensity Continuous Training on Cardiorespiratory Fitness in Children and Adolescents: A Meta-Analysis. Int J Environ Res Pub Health 2019; 16: 1533 DOI: 10.3390/ijerph16091533.
• 35 Wewege M, van den Berg R, Ward RE. et al. The effects of high-intensity interval training vs. moderate-intensity continuous training on body composition in overweight and obese adults: a systematic review and meta-analysis. Obes Rev 2017; 18: 635-646 DOI: 10.1111/obr.12532.
• 36 Astorino TA, Schubert MM. Changes in fat oxidation in response to various regimes of high intensity interval training (HIIT). Eur J Appl Physiol 2018; 118: 51-63 DOI: 10.1007/s00421-017-3756-0.
• 37 Nogueira-de-Almeida CA, Del Ciampo LA, Ferraz IS. et al. COVID-19 and obesity in childhood and adolescence: a clinical review. J Pediatr 2020; 96: 546-558 DOI: 10.1016/j.jped.2020.07.001.
• 38 World Health Organization. Child Growth Standards based on length/height, weight and age. Acta Paediatr Suppl 2006; 450: 76-85 DOI: 10.1111/j.1651-2227.2006.tb02378.x.
• 39 Slaughter MH, Lohman TG, Boileau RA. et al. Skinfold equations for estimation of body fatness in children and youth. Hum Biol 1988; 60: 709-723
• 40 Dietzel R, Begerow B, Bollert G. et al. Leitlinie Physiotherapie und Bewegungstherapie bei Osteoporose. physioscience 2009; 5: 65-75 DOI: 10.1055/s-0028-1109425.
• 41 Slim K, Nini E, Forestier D. et al. Methodological index for non-randomized studies (minors): development and validation of a new instrument. ANZ J Surg 2003; 73: 712-716 DOI: 10.1046/j.1445-2197.2003.02748.x.
• 42 Schulz KF, Altman DG, Moher D. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMJ 2010; 340: c332 DOI: 10.1136/bmj.c332.
• 43 Des Jarlais DC, Lyles C, Crepaz N. Improving the reporting quality of nonrandomized evaluations of behavioral and public health interventions: the TREND statement. Am J Public Health 2004; 94: 361-366 DOI: 10.2105/ajph.94.3.361.
• 44 Higgins JPT, Altman DG, Gøtzsche PC. et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ 2011; 343: d5928 DOI: 10.1136/bmj.d5928.
• 45 OCEBM Levels of Evidence — Centre for Evidence-Based Medicine (CEBM). University of Oxford; 2021. Im Internet (Stand: 09.01.2021): www.cebm.ox.ac.uk/resources/levels-of-evidence/ocebm-levels-of-evidence
• 46 Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften, Hrsg. AWMF-Regelwerk Leitlinien: Graduierung der Empfehlungen. Im Internet (Stand: 09.01.2021): www.awmf.org/leitlinien/awmf-regelwerk/ll-entwicklung/awmf-regelwerk-03-leitlinienentwicklung/ll-entwicklung-graduierung-der-empfehlungen.html
• 47 Corte de Araujo AC, Roschel H, Picanço AR. et al. Similar health benefits of endurance and high-intensity interval training in obese children. PLoS One 2012; 7: e42747 DOI: 10.1371/journal.pone.0042747.
• 48 Lau PWC, Del Wong P, Ngo JK. et al. Effects of high-intensity intermittent running exercise in overweight children. Eur J Sport Sci 2015; 15: 182-190 DOI: 10.1080/17461391.2014.933880.
• 49 Chuensiri N, Suksom D, Tanaka H. Effects of High-Intensity Intermittent Training on Vascular Function in Obese Preadolescent Boys. Child Obes 2018; 14: 41-49 DOI: 10.1089/chi.2017.0024.
• 50 Cvetković N, Stojanović E, Stojiljković N. et al. Exercise training in overweight and obese children: Recreational football and high-intensity interval training provide similar benefits to physical fitness. Scand J Med Sci Sports 2018; 28: 18-32 DOI: 10.1111/sms.13241.
• 51 Delgado-Floody P, Espinoza-Silva M, García-Pinillos F. et al. Effects of 28 weeks of high-intensity interval training during physical education classes on cardiometabolic risk factors in Chilean schoolchildren: a pilot trial. Eur J Pediatr 2018; 177: 1019-1027 DOI: 10.1007/s00431-018-3149-3.
• 52 Espinoza-Silva M, Latorre-Román P, Párraga-Montilla J. et al. Response of obese schoolchildren to high-intensity interval training applied in the school context. Endocrinología, Diabetes y Nutrición (English ed.) 2019; 66: 611-619 DOI: 10.1016/j.endien.2019.11.004.
• 53 Paahoo A, Tadibi V, Behpoor N. Effect of Two Chronic Exercise Protocols on Pre-Atherosclerotic and Anti-Atherosclerotic Biomarkers Levels in Obese and Overweight Children. Iran J Pediatr 2020; 30 DOI: 10.5812/ijp.99760.
• 54 Moher D, Liberati A, Tetzlaff J. et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009; 6: e1000097 DOI: 10.1371/journal.pmed.1000097.
• 55 Iranian Registry of Clinical Trials, IRCT, Hrsg. Anti-atherosclerosis effects of 12 weeks high intensity interval and aerobic training on serum levels salusin-α and -β, nitric oxide, inflammatory markers and lipid profile in overweight and obese childrens. Registration 2020-02-11, 1398/11/22. Im Internet (Stand: 05.01.2021): https://en.irct.ir/trial/45099
• 56 Singer S. Power, p-Wert und Stichprobengröße. Psychother Psychosom Med Psychol 2010; 60: 329-330 DOI: 10.1055/s-0030-1248522.
• 57 González-Correa CH, Caicedo-Eraso JC. Bioelectrical impedance analysis (BIA): a proposal for standardization of the classical method in adults. J Phys Conf Ser 2012; 407: 12018 DOI: 10.1088/1742-6596/407/1/012018.
• 58 Dal Cin S, Braga M, Molinari M. et al. Role of bioelectrical impedance analysis in acutely dehydrated subjects. Clinical Nutrition 1992; 11: 128-133 DOI: 10.1016/0261-5614(92)90072-X.
• 59 Póvoas SCA, Krustrup P, Castagna C. et al. Reliability of Submaximal Yo-Yo Tests in 9- to 16-Year-Old Untrained Schoolchildren. Pediatr Exerc Sci 2018; 30: 537-545 DOI: 10.1123/pes.2017-0139.
• 60 Calders P, Deforche B, Verschelde S. et al. Predictors of 6-minute walk test and 12-minute walk/run test in obese children and adolescents. Eur J Pediatr 2008; 167: 563-568 DOI: 10.1007/s00431-007-0553-5.
• 61 Marinov B, Kostianev S, Turnovska T. Modified treadmill protocol for evaluation of physical fitness in pediatric age group--comparison with Bruce and Balke protocols. Acta Physiol Pharmacol Bulg 2003; 27: 47-51
• 62 Ward DS, Bar-Or O. Use of the Borg scale in exercise prescription for overweight youth. Can J Sport Sci 1990; 15: 120-125
• 63 Moore JB, Yin Z, Hanes J. et al. Measuring Enjoyment of Physical Activity in Children: Validation of the Physical Activity Enjoyment Scale. J Appl Sport Psychol 2009; 21: S116-S129 DOI: 10.1080/10413200802593612.
• 64 Lee S, Spector J, Reilly S. High-intensity interval training programme for obese youth (HIP4YOUTH): A pilot feasibility study. J sports sciences 2017; 35: 1-5 DOI: 10.1080/02640414.2016.1237671.
• 65 Sallis JF, Prochaska JJ, Taylor WC. A review of correlates of physical activity of children and adolescents. Med Sci Sports Exerc 2000; 32: 963-975 DOI: 10.1097/00005768-200005000-00014.
• 66 Yackobovitch-Gavan M, Nagelberg N, Phillip M. et al. The influence of diet and/or exercise and parental compliance on health-related quality of life in obese children. Nutr Res 2009; 29: 397-404 DOI: 10.1016/j.nutres.2009.05.007.
• 67 Miguet M, Fearnbach NS, Metz L. et al. Effect of HIIT versus MICT on body composition and energy intake in dietary restrained and unrestrained adolescents with obesity. Appl Physiol Nutr Metab 2020; 45: 437-445 DOI: 10.1139/apnm-2019-0160.
• 68 Bervoets L, van Noten C, van Roosbroeck S. et al. Reliability and Validity of the Dutch Physical Activity Questionnaires for Children (PAQ-C) and Adolescents (PAQ-A). Arch Public Health 2014; 47 DOI: 10.1186/2049-3258-72-47.
• 69 Cole TJ, Lobstein T. Extended international (IOTF) body mass index cut-offs for thinness, overweight and obesity. Pediatr Obes 2012; 7: 284-294 DOI: 10.1111/j.2047-6310.2012.00064.x.
• 70 Barlow SE, Dietz WH. Obesity evaluation and treatment: Expert Committee recommendations. The Maternal and Child Health Bureau, Health Resources and Services Administration and the Department of Health and Human Services. Pediatr 1998; 102: E29 DOI: 10.1542/peds.102.3.e29.
• 71 Póvoas SCA, Krustrup P, Castagna C. et al. Reliability of Submaximal Yo-Yo Tests in 9- to 16-Year-Old Untrained Schoolchildren. Pediatr Exerc Science 2018; 30: 537-545 DOI: 10.1123/pes.2017-0139.
• 72 Lambrick D, Jakeman J, Grigg R. et al. The efficacy of a discontinuous graded exercise test in measuring peak oxygen uptake in children aged 8 to 10 years. Biol Sport 2017; 34: 57-61 DOI: 10.5114/biolsport.2017.63734.
• 73 Mahon AD, Marjerrison AD, Lee JD. et al. Evaluating the Prediction of Maximal Heart Rate in Children and Adolescents. Res Quar Exerc and Sport 2010; 81: 466-471 DOI: 10.1080/02701367.2010.10599707.