Excessive body fat has been associated with increased inflammation. Behavioral interventions can be effective in reducing childhood obesity, but we are limited in understanding the most effective method to decrease inflammation. So the aim of this study was to compare the effects of behavioral counseling with or without supervised recreational physical activity (PA) on inflammatory biomarkers in adolescents with obesity.


Seventy-four adolescents (13 to 18y, 40 girls) with obesity (BMI z-score ≥ 2.0) were randomized into behavior counseling alone (BC; n=37) or behavior counseling plus supervised recreational physical activity (BC+PA; n=37).Adolescents from both groups received behavior counseling in small groups (1 hour each) once a week for 12 weeks and monthly for another 12 weeks. BC+PA adolescents participated in supervised recreational physical activity sessions twice a week in small groups (1 hour each) for the first 12 weeks. Blood levels of adiponectin, leptin, PAI-1 and FGF-21 were measured at baseline, after 12 weeks of intervention and at 24 weeks.


Both groups had an increase in PAI-1 (p=0.007) and FGF-21 circulating levels (p=0.029). Leptin (ng/mL) was decreased from 150.55±12.07 to 120.07±14.39 in BC+PA (p=0.038); and from 177.51±16.71 to 138.70±15.43 in BC (p=0.012). Adiponectin levels were reduced only in BC+PA group (p=0.048).


Behavioral counseling, either with or without supervised physical activity, failed to improve inflammatory status among adolescents with obesity. Further studies are needed to identify strategies to reduce inflammation.