Metabolic improvement after exercise training in children with obesity: Possible role of the six-minute walking test.

Giuseppina Bernardelli, Mara Malacarne, Daniela Lucini, Matteo Vandoni, Luca Giovanelli, Vittoria Carnevale Pellino, Valeria Calcaterra, Gianvincenzo Zuccotti, Simone Facchetti

Journal: PloS one 2025;20(3):e0320209

PMID: 40153416

Abstract

The aims of this study are to evaluate the effectiveness of an online supervised training program in modulating lipid and glucose metabolism in children with obesity and to investigate the possible role of the 6-minute walking test (6MWT) as a predictor of metabolic improvement. A total of 35 Caucasian children with obesity (aged 8-13) were enrolled in the study and tested before (T0) and after (T1) a 12-week online supervised exercise training protocol: cardiovascular fitness (by means of 6MWT), metabolic biochemical profile, lifestyle (with ad hoc questionnaires focusing on physical activity, nutrition, sedentariness, sleep hours and quality, health perception) and Cardiac Autonomic Regulation (CAR) were assessed. Spearman correlations between the variations in the studied outcomes were explored. After intervention, the distance covered during 6MWT significantly increased (p < 0.001), and nutrition quality improved slightly but significantly (p = 0.03). The improvement in the 6MWT performance was shown to be significantly correlatee with the reduction of insulin levels (r = -0.455; p = 0.02), HOMA-IR Index (r = -0.452; p = 0.02), total cholesterol values (r = -0.549; p = 0.004) and Atherogenic Index of Plasma (AIP) (r = 0.422; p = 0.04). Moreover, there was a significant correlation between the improvement in 6MWT and health perception (r = 0.578; p = 0.002). We observed that the improvement in the 6MWT performance correlates with better metabolic profile after exercise training in children with obesity suggesting the goodness of this simple test on unveil changes in pathogenetic processes underlying obesity.

Copyright: © 2025 Giovanelli et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Address: BIOMETRA Department, University of Milan, Milan, Italy.; IRCCS Istituto Auxologico Italiano, Exercise Medicine Unit, Milan, Italy.; DISCCO Department, University of Milan, Milan, Italy.; Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, Pavia, Italy.; Department of Biomedical and Clinical Science, University of Milan, Milano, Italy.; Department of Biomedical and Clinical Science, University of Milan, Milano, Italy.; Pediatric Department, Buzzi Children's Hospital, Milano, Italy.; Pediatric Department, Buzzi Children's Hospital, Milano, Italy.; Pediatric and Adolescent Unit, Department of Internal Medicine, University of Pavia, Pavia, Italy.; BIOMETRA Department, University of Milan, Milan, Italy.; IRCCS Istituto Auxologico Italiano, Exercise Medicine Unit, Milan, Italy.
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