A multicomponent intervention program modifies the cluster of insulin biomarkers, body composition, physical fitness, and behaviors in adolescents with overweight and obesity: a network perspective

Objective: To analyze the relationships between sociodemographic, behavioral, breastfeeding, body composition, physical fitness, and insulin biomarkers before and after a multicomponent intervention among adolescents with overweight and obesity using network analysis. Methods: This was a quasi-experimental study with 37 adolescents with overweight/obesity (17 and 20 participants in the intervention and control groups, respectively). The program lasted 6 months, with three weekly sessions comprising physical exercises and nutritional and psychological orientation. The assessment of body composition, physical fitness, insulin biomarkers, and lifestyle indicators was performed before and after the intervention. The network analysis was carried out using three centrality indicators: proximity, strength, and expected influence; which identify the most influential or central nodes or edges, indicating their importance or crucial role in the structure and dynamics of the network. Results: Two networks, one each for before and after the intervention, were generated. Before the intervention, the results were as follows: for closeness, sex (1.059) and pubertal stage (1.268); for strength, pubertal stage (1.268), physical activity (1.160), and screen time (1.388); for expected influence, age (1.658), HOMA-IR (1.171), glucose (1.304), and waist circumference (1.394). After the intervention, for closeness, sex (1.102), type of school (1.221), and waist/hip ratio (1.221); for strength, breastfeeding (1.099), screen time (1.465), waist/hip ratio (1.131), and groups (1.280); for expected influence, breastfeeding (1.574), HOMA-IR (1.017), resistin (2.276), body mass index (1.008), and waist circumference (1.154). Conclusion: The multicomponent intervention demonstrated beneficial relationships by modifying and approximating the clusters of factors of body composition, physical fitness, and insulin biomarkers.