Abstract

Childhood obesity has become a global pandemic in the last decades. Children with obesity have a higher risk of developing non-alcoholic fatty liver disease (NAFLD), the liver component of the metabolic syndrome. The NAFLD affects a third of the children with overweight being the most common liver disease in early childhood.

Lifestyle interventions represents the cornerstone of the prevention and the management of pediatric NAFLD. However, there are no previous studies examining the effect of a supervised exercise program on hepatic fat measured by accurate methods in prepubertal children. Moreover, to date, limited data are available regarding the association of physical fitness, physical activity and nutrition with hepatic steatosis in children.

There is, therefore, a need to examine the effect of supervised exercise on hepatic fat accumulation in prepubertal population of children. The EFIGRO project compares the effect of a family-based lifestyle and psycho-education intervention with this same lifestyle program plus supervised exercise in children with overweight obesity aged 8 to 12 years. The EFIGRO project is a non-randomized parallel assignment interventional study performed in Vitoria-Gasteiz between 2013 and 2016 where more than 110 families participated.

Study aims

The main aim of the EFIGRO project is to evaluate the additional effect of supervised exercise on hepatic fat percentage in children with overweight/obesity participating in a 22 weeks family-based healthy lifestyle education and psycho-educational program.

Secondary objectives of the project are to analyze the effects of supervised exercise on others cardiovascular disease risk factors such as total and visceral adipose tissue, insulin resistance, lipid profile, and liver enzymes, as well as on health-related physical fitness, dietary habits, physical activity, and psychological variables.

Current state

Analysis of additional tests, data analysis, and production of publication.

Funding

This project was supported by the Spanish Ministry of Health, “Fondo de Investigación Sanitaria del Instituto de Salud Carlos III” (PI13/01335), “Fondos Estructurales de la Unión Europea (FEDER), Una manera de hacer Europa”, and by the University of the Basque Country (GIU14/21).

UCEENS researchers

Idoia Labayen Goñi idoia.labayen@unavarra.es

Maddi Oses maddi.oses@unavarra.es

Lide Arenaza lide.arenaza@unavarra.es

María Medrano maria.edrano@unavarra.es

Funded amount

136.972€

Dates

2013-2016

Publications

1. Arenaza L, Medrano M, Oses M, Amasene M, Diez I, Rodríguez-Vigil B, Labayen I. The Effect of a Family-Based Lifestyle Education Program on Dietary Habits, Hepatic Fat and Adiposity Markers in 8–12-Year-Old Children with Overweight/Obesity. Nutrients. 2020;12(5):1443.
2. Labayen I, Medrano M, Arenaza L, Maíz E, Osés M, Martínez-Vizcaíno V, Ruiz JR, Ortega FB. Effects of exercise in addition to a family-based lifestyle intervention program on hepatic fat in children with overweight. Diabetes Care, 2020;43(2):306-313.
3. Medrano M, Arenaza L, Migueles JH, Rodríguez-Vigil B, Ruiz JR, Labayen I. Associations of physical activity and fitness with hepatic steatosis, liver enzymes, and insulin resistance in children with overweight/obesity. Pediatric Diabetes. 2020;21(4):565-574.
4. Ubago-Guisado E, Gracia-Marco L, Medrano M, Cadenas-Sanchez C, Arenaza L, Migueles JH, Mora-Gonzalez J, Tobalina I, Escolano-Margarit MV, Oses M, Martín-Matillas M, Labayen I, Ortega FB. Differences in areal bone mineral density between metabolically healthy and unhealthy overweight/obese children: the role of physical activity and cardiorespiratory fitness. Pediatric Research. 2020; 87(7):1219-1225.
5. Medrano M, Arenaza L, Ramírez-Vélez R, Ortega FB, Ruiz JR, Labayen, I. Prevalence of responders for hepatic fat, overall and abdominal adiposity and gamma-glutamyl transferase in response to a lifestyle intervention with or without supervised exercise in children with overweight/obesity: secondary analyses of the EFIGRO randomized controlled trial. Pediatric Diabetes, 2019. 21(2):215-223.
6. Gómez-Butrón A, Arenaza L, Medrano M, Mora-González J, Cadenas-Sánchez C, Migueles JH, Muñoz-Hernández MV, Merchan-Ramirez E, Martínez-Avila D, Maldonado-Lozano J, Oses M, Tobalina I, Gracia-Marco L, Vicente-Rodríguez G, Ortega FB, Labayen I. Associations of dietary energy density with body composition and cardiometabolic risk in children with overweight and obesity: Role of energy density calculations, under-reporting energy intake and physical activity. British Journal of Nutrition, 2019; 121(9):1057-1068.
7. Arenaza L, Muñoz-Hernández V, Medrano M, Oses M, Amasene M, Merchán-Ramírez E, Cadenas-Sánchez C, Ortega FB, Ruiz JR, Labayen I. Association of breakfast quality and energy density with cardiometabolic risk factors in overweight/obese children: role of physical activity. Nutrients, 2018;10(8):e1066.
8. Muñoz-Hernández V, Arenaza L, Gracia-Marco L, Medrano M, Merchan-Ramírez E, Martínez-Ávila D, Oses M, Ruiz JR, Ortega FB, Labayen I. Influence of Physical Activity on Bone Mineral Content and Density in Overweight and Obese Children with Low Adherence to the Mediterranean Dietary Pattern. Nutrients, 2018;10(8):e1075.
9. Delisle C, Henriksson P, Martínez-Vizcaíno V, Medrano M, Cadenas-Sánchez C, Arias-Palencia NM, Löf M, Ruiz JR, Labayen I, Sánchez-López M, Ortega FB. Does cardiorespiratory fitness attenuate the adverse effects of severe/morbid obesity on cardiometabolic risk and insulin resistance in children? A pooled analysis. Diabetes Care, 2017;40(11):1580–1587.
10. Medrano M, Maiz E, Maldonado-Martín S, Arenaza L, Rodríguez-Vigil B, Ortega FB, Ruiz JR, Larrarte E, Díez I, Sarasúa A, Tobalina I, Barrenechea L, Pérez-Asenjo J, Kannengiesser S, Manhães-Savio A, Echaniz O, Labayen I. The effect of a multidisciplinary intervention program on hepatic adiposity in overweight-obese children: Protocol of the EFIGRO study. Contemporary Clinical Trials, 2015; 45 (Pt B): 346-355.

In digital press

Modificar los estilos de vida es “una estrategia eficaz” para tratar el hígado graso pediátrico, según un estudio (https://www.20minutos.es/noticia/3688064/0/modificar-estilos-vida-es-estrategia-eficaz-para-tratar-higado-graso-pediatrico-segun-estudio/#xtor=AD-15&xts=467263)

Un estudio de la UPNA incide en el cambio de hábitos contra el hígado graso pediátrico https://www.diariodenavarra.es/noticias/navarra/2019/06/30/un-estudio-upna-incide-cambio-habitos-contra-higado-graso-pediatrico-656384-300.html

La mala calidad nutricional del desayuno afecta negativamente a la salud cardiovascular en la infancia, incluso con ejercicio diario (https://www.lasexta.com/tecnologia-tecnoxplora/sinc/mala-calidad-desayuno-empeora-salud-cardiovascular-infancia_201810175bc7007a0cf27786d212b112.html) o (http://www.unavarra.es/historicoActualidad/noticias?contentId=238176)

Poor breakfast quality has a negative effect on cardiovascular health in childhood (https://cordis.europa.eu/article/id/124155-poor-breakfast-quality-has-a-negative-effect-on-cardiovascular-health-in-childhood)

La ingesta de bebidas azucaradas por menores con sobrepeso incrementa la cantidad de grasa acumulada en el hígado (https://www.zamora24horas.com/texto-diario/mostrar/1360258/ingesta-bebidas-azucaradas-menores-sobrepeso-incrementa-cantidad-grasa-acumulada-higado) o https://www.lagacetadesalamanca.es/salud/los-riesgos-de-la-ingesta-de-bebidas-azucaradas-por-menores-con-sobrepeso-MJ803680

Nueva alerta sobre los refrescos: una investigación de la UPNA concluye que aumentan la grasa en el hígado de los niños https://navarra.elespanol.com/articulo/sociedad/ingesta-bebidas-azucaradas-menores-sobrepeso-obesidad-cantidad-grasa-acumulada-higado-investigacion-upna/20190318164314252632.html

Los niños obesos y en buena forma tienen menor riesgo cardiovascular que aquellos con peso normal y mala forma física https://ecodiario.eleconomista.es/salud/noticias/8823970/12/17/los-ninos-obesos-y-en-buena-forma-tienen-menor-riesgo-cardiovascular-que-aquellos-con-peso-normal-y-mala-forma-fisica.html

La profesora Idoia Labayen recoge el premio del Ministerio de Sanidad por una investigación sobre menores con sobrepeso (https://www.europapress.es/navarra/noticia-profesora-idoia-labayen-recoge-premio-ministerio-sanidad-investigacion-menores-sobrepeso-20191206131751.html)

Premiada una investigación de la UPNA sobre el efecto del ejercicio físico en menores con sobrepeso (https://www.noticiasdenavarra.com/actualidad/sociedad/2019/04/16/premiada-investigacion-upna-efecto-ejercicio/823093.html)

El ejercicio físico supervisado combate la aparición de hígado graso en la infancia y adolescencia, según una tesis (https://www.20minutos.es/noticia/4103187/0/el-ejercicio-fisico-supervisado-combate-la-aparicion-de-higado-graso-en-la-infancia-y-adolescencia-segun-una-tesis/) o https://www.noticiasdenavarra.com/actualidad/sociedad/2019/12/31/ejercicio-fisico-supervisado-combatir-higado/1012123.html o https://www.europapress.es/navarra/noticia-ejercicio-fisico-supervisado-combate-aparicion-higado-graso-infancia-adolescencia-tesis-20200101171844.html

El ejercicio físico combate la aparición de hígado graso en la infancia y adolescencia https://www.noticiasdenavarra.com/vivir-on/salud/2019/12/30/ejercicio-fisico-frena-aparicion-higado/1012024.html

Tres horas de ejercicio a la semana para combatir el hígado graso infantil (https://www.innovaspain.com/ejercicio-higado-graso-infantil/)