OBJECTIVE: To study effectiveness of weight reduction programme conducted in sanatorium in obese children. DESIGN: A short-term longitudinal study. SUBJECTS: Thirty-three obese children (20 F; 13 M); age: 12-14 years; BMI: 23.4-36.3 kg/m2. MEASUREMENTS: During a 3-week programme: body composition - FM and LBM obtained by the BIA method, daily energy expenditure by twenty-four hour heart rate monitoring, skinfold thickness. After six months: body composition, skinfold thickness. RESULTS: After a 3-week programme, body weight decreased by -5.3 kg ± 1.3 (p<0.0001), FM by -2.9 kg ± 1.1 (p<0.0001), LBM by -2.2 kg ± 1.3 (p<0.0001), and skinfold thickness by -3.7mm ± 2.7 (p<0.0001). Total daily energy expenditure (TDEE) exceeded the energy intake of 6.39MJ ± 1.63 and was correlated with the loss of body weight (r=-0.690; p<0.0001) as well as with the loss of FM (r=-0.432; p<0.01). The TDEE depended on the energy cost of physical activity (r=0.910; p<0.0001) while the latter was negatively correlated with children's body weight (r=-0.553; p<0.001). After six months, body weight increased by 4.1 kg ± 7.2 (p<0.05) but mainly due to FFM gain (2.5 kg ± 3.9; p<0.05). Correlation between the loss of LBN during therapy and weight gain after six months was close to be statistically significant (r=-0.469; p<0.06). CONCLUSIONS: Treatment of obese children conducted in sanatorium, seems to give satisfactory short-term results. Effectiveness of the programme could be well predicted by assessment of energy balance. The higher negative energy balance, the greater reduction of body weight. Attention should be paid to physical activity of obese children since it has a significant influence on the results of energy balance. Heart rate monitoring can be recommended as a simple way of evaluation of the obese children's activity during exercising. More obese children tend to avoid physical activity. Changes in LBM during weight reduction programme seems, to some extent, to predict its long-term outcome.
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