Effect of behavioral counseling therapy with or without physical activity on inflammatory markers in adolescents with obesity: a randomized clinical trial

Background The aim of the present study was to compare the effects 24 weeks of counseling-based therapy with or without recreational physical activity (RPA) on adipokines, biochemical parameters and anthropometric measurements in adolescents with obesity. Methods Seventy-four adolescents with obesity (40 girls) were randomly assigned into Counseling Group (CG) or Counseling + Recreational Physical Activity Group (C + RPAG). Both groups underwent behavioral counseling meetings weekly (1 h) for 12 weeks followed by monthly meetings for additional 12 weeks. C + RPAG adolescents performed RPA twice a week (1 h each) in the first 12 weeks. FGF21, PAI-1, leptin and adiponectin, glucose, insulin, blood lipids and anthropometric measurements were assessed at baseline and after 24 weeks. Results Time was important inducing reduction in BMI z-score ( p = 0.03) and waist circumference ( p = 0.01). The comparisons between groups showed no differences. Largest effect size was observed in C + RPAG for both measurements (BMI z-score, d = 0.60 and WC, d = 0.48). For biochemical parameters time was important with increase in glucose ( p = 0.01, higher in CG, d = 0.57), cholesterol ( p = 0.008, only in CG, d = 0.71), LDL-c ( p = 0.05, higher in CG, d = 0.82), PAI-1 ( p = 0.01, higher in C + RPAG, d = 0.54) and decrease in triacylglycerol ( p = 0.05, higher in C + RPAG, d = 0.72). Conclusion Both therapies improved anthropometric parameters and, although there were no differences in the type of therapy applied in biochemical and adipokine parameters, better effects were observed in the group that had RPA. Brazilian Registry of Clinical Trials (ReBEC) (July, 22 2020) identification number RBR-7tmpdb ( http://www.ensaiosclinicos.gov.br/rg/RBR-7tmpdb/ )