The effect of a 12-week multidisciplinary treatment on the vascular function in obese children in the age of 8-17 years.

The past two decades, the prevalence of obesity in children in USA, but also in
The Netherlands, has doubled. This increase in prevalence of obesity in
children emphasizes the importance of primary prevention of obesity in
children. Moreover, childhood obesity is associated with several risk factors
for later heart disease, diabetes, other chronic diseases and osteoartrosis.

Several previous studies examined the effect of childhood obesity on the
vascular function. It is found that even obese children at the age of 8-10
demonstrate endothelial dysfunction (which is a precursor to atheroslcerotic
diseases and is present in subjects with cardiovascular disease and risk
factors). In addition, childhood obesity leads to structural changes in the
arterial wall (increased intima-media thickness), increased levels of
homosyteine and a hyperviscosity of the blood. These changes are associated
with an increased risk of cardiovascular disease.

Primary prevention may be the key to decreasing obesity and limiting its
societal impact. Physical inactivity and life style changes (food ingestion)
are the most important factors that should be altered when preventing
(childhood) obesity. Especially starting an intervention at a young age may be
beneficial since it has been proposed that encouraging the development of
physical activity habits in children helps establish patterns that continue
into their adulthood.

1) To examine the effect of a 12-week multidisciplinary treatment on
endothelial function, intima-media thickness and blood cholesterol in obese
children (8-17 years).

2) Investigate the changes in vascular function in obese children (8-17 years).

Observational pilotstudy in which a 12-week multidisciplinary treatment is
applied as an intervention.

All participants start with a non-invasive and minimally challenging assessment
of the vascular characteristics. First, echo-Doppler measurements are used to
examine baseline blood flow, intima-media thickness, arterial lumen and
endothelial function of 3 major conduit arteries (carotid, brachial,
superficial femoral artery). These assessments are not harmful and no risks are
associated. Several years of experience is present at the department of
Physiology regarding these experiments. In the past, these tests were used to
examine a broad group of subjects (elderly, spinal cord injury, metabolic
syndrome, obesity in adolescents and middle-aged, endurance athletes). The only
possible burden for the participants is the collection of capillary blood
(optional test). However, this collection is without any risks.