الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Obesity in children and adolescents is a global public health concern and is associated with a range of short- and long-term health complications . It increased rapidly all over the world and affecting virtually both developed and developing countries of all socioeconomic groups including all age groups thereby posing an alarming problem, described by the World Health Organization (WHO) as an “escalating global epidemic.” An association between plasma Adiponectin and plasma leptin concentrations with body composition had been describd in obese adolescents, finding from recent reports suggested that Intervention with structured exercise and diet program can play an important role in improving the level of these hormones and the health for obese children.
The aim of this work is to identify the factors that affect the body composition in obese adolescents through identification of the role of adiponectin and leptin hormones (after physical activity and dietary restriction program for six month) to modulate the role of these hormones.
In order to achieve these objectives, this work was conducted on sixty adolescents suffering from obesity, based on their body mass index; which is greater than the 95th percentile for age and gender based Egyptian Growth Reference charts. Studieded obese adolescents subdivided into two groups: Group A:30 obese adolescents. The mean age were 13.2 ± 0.9years 53%males ,46.7 females were subjected to exercise and nutrition program ,Group B:30 obese adolescents The mean age were 13.1 ± 0.9years 50%males ,50% females were subjected to diet program only . Both groups A&B were collected from Nutritional clinic at the National Research Center were included in the study . . All obese adolescents under went physical activity and dietary restriction program were subjected to the following before and after 6 months of the program :full medical history taking, anthropometric measurements ,body composition analysis , thorough clinical examination,lipid profile and hormonal assessment.
There was highly statistically significant elevation in the serum level of adiponectin in both groups A&B after the application of the program, In the same time there was no significant difference between the studied groups (A&B).
There was a positive correlation between serum adiponectin and cholesterol in group A after the intervention program.
There was statistically significant positive correlation between adiponectin and age in group A before the intervention program.
The present study showed that adiponectin elevation in males in group A was statistically significant than females after the intervention program .
In the current study ,the decrease in serum leptin during the program was statistically significant in both groups A&B after application of the program, In the same time there was no significant difference between the studied groups (A&B).
There was a statistically significant positive correlation in group A between leptin with age and with RBS.
The Study showed there was a statistically significant negative correlation in group A after the program between leptin and BMI,leptin and DBP ,leptin and Adiponectin.
The study showed that there was a statistically significant decrease in leptin level in females than males in group B after the program.
There was a statistically significant reduction in (weight ,BMI, WC,HC, WHR) in both groups A&B after the application of the program. There was no statistical significant difference between both groups in weight reduction, however the reduction was more significant in group A after the application of the program.
Females in group A revealed statistically significant decreased in (Weight,BMI,WC,WHR)., where females in group B revealed statistically significant decreased in (Weight, BMI, WC, HC).
There was statistically significant decrease in systolic and diastolic blood pressure in both groups(A&B) after the intervention programme. There was no significant difference between both groups (A&B) after the application of the program.
There was statistically significant decrease in (Fat%,VF ,with slight reduction in FFM , no significant changes in MM ). There was significant difference between both groups(A&B)after the program with more reduction in fat% in group A.
Comparing fat% between males and females in our study, it was found that females in group B reveales statistically significant decrease in fat% than males.
Regarding the lipid profile in the present study there was statistically significant reduction in both groups in (TG, Cholesterol, LDL,) whereas the HDL level showed no significant changes in both groups(A&B)after the program. No significant difference between both groups.
There was statistically significant reduction in random blood sugar in both groups(A&B). No significant difference between both groups .
There was no statistical significant difference between both group as regards pubertal onset and age of menarche where both groups showed normalpubertal onset .There was no statistical significant difference between frequencies of cases with delayed puberty in both groups (A&B).
Regarding dietary pattern, the percentage of adolescents that skip breakfast was high in both groups (A&B),with no statistical significant differences between both group, There was also an increase in the frequency of fast food consumption in both groups.
There was a statistical significant high score of Health Eating Index percentage of obese adolescents who need improvement in food quality in both groups. Current study showed that, there was a significant positive correlation between HEI and age in group A and between HEI and random blood glucose in group B.
Result of the present study showed decrease in the frequency of having moderate physical activity in both groups before the program It showed that frequent increase in time spent per day watching television and using computers in both groups.
In conclusion The body of research reviewed suggests that lifestyle interventions incorporating a dietary component along with an exercise and/or behavioral therapy component are effective in treating childhood obesity and improving their anthropometric measurments ,body composition, lipid profile and hormonal assay range of conditions at least up to 6 months.
To draw firm clinical recommendations, future studies should provide details of all intervention components, participant characteristics, also, to encourage the physical activity and health food culture and allow adolescents to participate in activity programs .Also require social changes in the form of healthier policies, system reforms and environmental changes where children live, learn and play. Health care clinicians and health care systems can be effective partners in formulating policy decisions and community design that nurture healthy children.