The metabolic and environmental determinants of obesity in childhood: observational and interventional studies

The prevalence of obesity in childhood and adolescence is increasing and is often accompanied by poor physical and psychological health. Cardiovascular risk factors such as hypertension and impaired glucose tolerance are prevalent in up to 30% of obese children whilst psychological impairments such as low self-esteem and depression are also commonly observed. Numerous factors have been implicated in the development of obesity, and include both metabolic and environmental factors. This thesis explored these determinants with particular reference to the role of physical activity, dietary intake and cardiorespiratory fitness. Obese children and adolescents demonstrated very low levels of physical activity, reduced cardiorespiratory fitness and significant psychological impairments. Many interventions have been employed to counteract obesity in childhood; however most are limited by high attrition rates. Children and young people are unwilling to give up sedentary behaviours and therefore the development of interactive media games offers a potential strategy to increase physical activity. This thesis identified dance mat exercise as being sufficiently intense to improve cardiorespiratory fitness in obese, sedentary children and young people. Furthermore 12 weeks of dance mat exercise promoted favourable changes in body composition, cardiorespiratory fitness and psychological well-being; all of which point towards an improved quality of life