Energy cost of walking and body composition changes during a 9-month multidisciplinary weight reduction program and 4-month follow-up in adolescents with obesity

Abstract

The purpose of the present study was to investigate changes in the energy cost of locomotion during walking (Cw) related to changes in body mass (BM, kg) and body composition in adolescents with obesity. Twenty-six (12 boys and 14 girls) obese adolescents (mean: body mass index, 33.6 ± 3.7 kg·m–2; 42.7 ± 4.5% fat mass (FM)) followed a 9-month multidisciplinary inpatient weight-reduction program consisting of lifestyle education, moderate energy restriction, and regular physical activity in a specialised institution. At baseline (M0), the end of the 9-month program (M9), and after the 4-month follow-up (M13), oxygen consumption and carbon dioxide production of the standardised activity program were assessed by whole-body indirect calorimetry over 24 hours, and body composition was assessed by dual-energy X-ray absorptiometry. At M9, adolescents showed an 18% reduction in BM (p < 0.001) and 40% in total FM, while fat-free mass (kg) remained stable in boys but decreased by ∼6% in girls (p = 0.001). Similarly, the mean Cw decreased by 20% (p < 0.001). At M13, BM, FM, and Cw were slightly higher compared with at M9. In conclusion, moderate energy restriction and regular moderate physical activities improved walking economy, improved exercise tolerance, and induced beneficial changes in the body composition of adolescents with obesity. Novelty: Reduction of FM in the trunk region, and consequently reducing the work carried out by respiratory muscles, contributes to reducing Cw in adolescents with obesity. A lower walking cost can be effective in improving exercise tolerance and quality of life in obese adolescents.