Page 138 - Go4it

significant intervention effect on BMIsds, waist circumference and HDL was found at 18-months follow-up (Chapter 3).
Quality of Life
Chapter 4 describes the effect of Go4it on Health-Related Quality of Life (HRQoL). HRQoL was examined using the generic reliable and validated Paediatric Quality of Life InventoryTMVersion 4.0 (PedsQLTM4.0) and the generic Child Health Questionnaire (CHQ). PedsQLTM4.0 assesses physical, emotional, social and school functioning while CHQ assesses physical, behavioural, mental and social functioning. Body esteem was examined using the Body Esteem Scale (BES) and assesses general feelings about appearance, weight satisfaction and evaluations of attributions to others about one’s body and appearance. Our sample of obese adolescents experienced lower levels of physical and psychosocial well-being scores than a healthy reference group. At 18 months follow-up, we found small but beneficial intervention effects on all subscales of the PedsQLTM4.0 and BES questionnaires. Two subscales of the PedsQLTM4.0 improved significantly, i.e. physical health and school functioning. Go4it had small but beneficial effects on quality of life of obese adolescents (Chapter 4).
Energy requirements
The ability to predict resting energy expenditure (REE) accurately in overweight and obese adolescents is important to establish reachable goals for dietary intake and weight-loss programs. Energy requirement can be measured by indirect calorimetry. However this method is expensive and therefore often unfeasible in the general dietetic setting. In daily practice predictive equations to determine REE are used as an alternative. There is no consensus on which REE equation to use in adolescents with overweight or obesity. Currently, the FAO/WHO/UNU weight equation for age 10-18 years is the most widely used predictive equation in the Netherlands. Chapter 5 described the validation of the resting energy expenditure equations (REE) in the overweight or obese adolescents who participated in our study using a comparison with indirect calorimetry. The most accurate and precise equation for overweight or obese adolescents was the Molnar equation, which predicted 74% overweight or obese adolescents accurately.
Body composition
Accurate assessment of fat mass (FM) and fat-free mass (FFM) in obese adolescents is necessary for establishing reachable goals for healthy weight loss and evaluation of treatment. One of the main objectives of obesity management is to reduce FM and to preserve FFM during weight loss. Body composition (FFM and FM) can be assessed by dual energy X-ray absorptiometry (DXA). DXA is acknowledged as the standard and most precise method to assess body fat mass, although it can only be used in special setting and requires the use of a
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