ClinicalTrials.gg
RecruitingNCT06848478Updated Oct 2, 2026

Level Up! (The Combined and Independent Effects of Exercise Training and Dietary Enhancement on Cardiometabolic Health in Adolescents With Obesity)

An interventional study of Exercise Intervention and Nutritional Intervention in Obesity, sponsored by Arkansas Children's Hospital Research Institute. Recruiting at 2 sites in United States. Open to participants aged 12 Years to 17 Years. Per ClinicalTrials.gov, last updated 2026-10-02.

Sponsored by Arkansas Children's Hospital Research Institute · Not applicable, Interventional, and Basic science

From the registry’s dates

  • Started Jun 2026; still recruiting 5 months later.
Updated Oct 2, 2026Eligibility revisedPrimary outcomes revisedGo to Updates ↓
Phase
Not applicable
Study type
Interventional
Enrollment
120
Allocation
Randomized
Ages
12 Years to 17 Years
Sex
All
01

Where this study stands

Counted across the records on this site · 2026-11-12

Among 12 studies in Obesity by Arkansas Children's Hospital Research Institute — 3 open to participants now, 5 under way, none of them phase 3. Obesity · Arkansas Children's Hospital Research Institute.

Started
2026
the only one that year
No phase
9 of 12
3 open now
Registered
11th of 12
by date

Among the 12 studies in Obesity by Arkansas Children's Hospital Research Institute, this one is the only one that started in 2026, is one of 9 with no phase, and was the 11th registered.

By phase

12 studies; the count open now beside each. This study's row is marked.

No phasethis study9 · 3 open
Observational3 · 0 open

By the year they started

First in 2012; this study’s year is marked. 1 started in 2026.

Size and results

Median enrollment 106 across the 9 interventional studies, 82 across the 3 observational. Of the 7 that completed or were terminated, 0 (0%) have results posted.

Was this useful?
Watch this landscapeDownload CSVWith an account: a weekly mail of what changed among 12 studies in Obesity by Arkansas Children's Hospital Research Institute, or all of them as a file.
02

Study summary

The goal of this clinical trial is to determine whether adding structured exercise training and a structured fruit and vegetable dietary program to standard multidisciplinary obesity care improves cardiometabolic health in adolescents with obesity enrolled in a weight management program. The main questions it aims to answer are:

  • Does adding structured exercise training to standard multidisciplinary obesity care improve cardiometabolic health?
  • Does adding a structured fruit and vegetable dietary program to standard multidisciplinary obesity care improve cardiometabolic health?
  • Does combining structured exercise training and the fruit and vegetable dietary program with standard multidisciplinary obesity care improve cardiometabolic health?

Researchers will compare four groups to evaluate the independent and combined effects of structured exercise training and a structured fruit and vegetable dietary program:

  • Standard Care Group: Receives standard multidisciplinary obesity care.
  • Exercise Group: Receives standard care plus a 12-week supervised, structured multicomponent exercise program, weekly exercise counseling, and continuous physical activity monitoring using a tracker.
  • Dietary Group: Receives standard care plus a 12-week fruit and vegetable enrichment program involving daily smoothie consumption designed to provide one cup of fruit and one cup of vegetables per day, using frozen smoothie ingredient packages delivered to participants' homes, and weekly dietary coaching.
  • Combined Exercise and Dietary Group: Receives standard care plus both the structured exercise and fruit and vegetable dietary programs.

During the 12-week study, participants will complete assessments at baseline, week 6, and week 12. Some procedures may be completed at home or split across more than one day. Assessments may include:

  • Providing blood, urine, and stool samples.
  • Completing questionnaires about health, sleep, diet, physical activity, mood, and other health behaviors.
  • Undergoing body-composition scans to measure fat, lean, and bone mass.
  • Completing blood-vessel function, liver-fat, and skin-carotenoid assessments.
  • Completing continuous glucose monitoring.
  • Assessing resting energy expenditure.
  • Completing fitness and muscle-strength tests.
  • Completing a standardized meal-based metabolic assessment.
  • Completing 3-day dietary records.
  • Wearing activity and sleep monitors to assess physical activity and sleep patterns.
Read the detailed description

The Level Up! study has a 12-week intervention period. Assessments are planned at baseline, week 6, and week 12 at the Arkansas Children's Nutrition Center (ACNC). Some procedures may be completed at home or split across more than one day. On-site assessments may last up to six hours, and some procedures require participants to fast, with water permitted after midnight. Trained personnel will conduct assessments according to standardized procedures.

Assessments include:

  • Medical history, vital signs, and anthropometric measurements, including height, body mass, sitting height, and body circumferences.
  • Whole-body and regional body composition measured by dual-energy X-ray absorptiometry (DXA), including fat, lean, and bone mass.
  • Fasting venous blood, spot and 24-hour urine, and stool sample collection.
  • Continuous glucose monitoring using an interstitial glucose sensor.
  • Brachial artery flow-mediated dilation assessed by ultrasound.
  • Liver steatosis and stiffness assessed by FibroScan, and skin carotenoid levels measured using the Veggie Meter.
  • Resting metabolic rate measured by indirect calorimetry.
  • Cardiorespiratory fitness assessed by cardiopulmonary exercise testing (CPET) on a cycle ergometer, with breath-by-breath gas-exchange measurement to determine peak oxygen uptake.
  • Knee extensor and flexor strength assessed by isokinetic dynamometry, and handgrip strength measured using a digital handheld dynamometer.
  • Physical activity and sleep monitored using accelerometers worn at the wrist and hip, and dietary intake assessed using three-day food records.
  • Substrate utilization assessed during a mixed-meal tolerance test (MMTT) using indirect calorimetry.
  • Questionnaires assessing sleep, anxiety and depressive symptoms, substance use, physical activity enjoyment, socioeconomic background, and pubertal status.
03

Conditions studied

  • Obesity

Keywords

  • exercise
  • obesity
  • diet
  • cardiometabolic
04

Who can participate

The criteria were revised on the registry on Oct 2, 2026. See what changed

Ages eligible
12 Years to 17 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Male or female aged 12 to 17 years.
  • Enrolled in the weight management program at the COACH clinic.
  • Class I obesity (≥95th percentile to \<120% of the 95th percentile), class II obesity (≥120% to \<140% of the 95th percentile, or ≥35 to \<40 kg/m²), and class III obesity (≥140% of the 95th percentile, or BMI ≥40 kg/m²).
  • Less than 60 min/day of moderate to vigorous physical activity.
  • Fruit intake ≤1.5 cup equivalent per day.
  • Vegetable intake ≤1.5 cup equivalent per day.
  • Medical release from COACH clinic to perform exercise.

Exclusion criteria

Exclusion criteria

  • Type 1 and Type 2 diabetes mellitus.
  • Asthma that requires the use of rescue inhalers (e.g., albuterol) >2 days per week.
  • Exercise-induced asthma.
  • Epilepsy.
  • Cancer.
  • Chronic kidney disease.
  • Bleeding disorders (e.g., hemophilia).
  • Chronic infections (e.g., , , ).
  • Other pre-existing medical conditions or medications as determined by the investigators to affect the outcomes of interest.
  • Pregnancy (urine test).
  • Dislike of all the fruit and vegetable smoothie options pre-defined by the study team at the initial visit.
  • Parent/child refusal to have blood drawn.
  • Refusal to authorize study investigators to access data from the COACH clinic.
Terms in these criteria, in plain language(4)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

BMI (body mass index)

Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.

What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

05

Study design

Phase
Not applicable
Primary purpose
Basic science
Allocation
Randomized
Intervention model
Factorial assignment
Masking
Single (Outcomes assessor)
Enrollment
120 participants (estimated)

Study arms

  • No intervention
    Control

    Participants receive standard of care for obesity.

  • Experimental
    Exercise intervention

    In addition to the standard of care, participants engage in exercise coaching and a 12-week exercise program, encompassing three 60-minute supervised sessions per week.

    Behavioral: Exercise Intervention

  • Experimental
    Nutritional Intervention

    In addition to the standard of care, participants receive dietary coaching and engage in a 12-week daily dietary program enriched with a blend of fruits and vegetables.

    Behavioral: Nutritional Intervention

  • Experimental
    Exercise and Nutritional Intervention

    In addition to the standard of care, participants receive a combined exercise and dietary intervention, as described in the other two intervention arms.

    Behavioral: Exercise Intervention · Behavioral: Nutritional Intervention

Interventions

  • BehavioralExercise Intervention

    In addition to the standard of care, participants engage in exercise coaching and a 12-week exercise program, encompassing three 60-minute supervised sessions per week.

  • BehavioralNutritional Intervention

    In addition to the standard of care, participants receive dietary coaching and engage in a 12-week daily dietary program enriched with a blend of fruits and vegetables.

06

What researchers measure

Primary outcomes

  1. Group differences in changes in the composite cardiometabolic health score over time

    The primary outcome is a composite cardiometabolic health score. It is calculated as the mean of standardized z-scores for fasting triglycerides (mg/dL), total cholesterol/HDL-cholesterol ratio, HOMA2-IR, systolic blood pressure (mmHg), fat-mass index \[whole-body fat mass (kg)/height² (m²)\], and inverse peak oxygen uptake (mL O₂/kg/min).

    Time frame: Baseline, 6 weeks, and 12 weeks.

Secondary outcomes

  1. Group differences in changes in low-density lipoprotein (LDL) cholesterol (mg/dL) over time

    Time frame: Baseline, 6 weeks, and 12 weeks.

  2. Group differences in changes in brachial artery flow-mediated dilation (%) over time

    Time frame: Baseline and 12 weeks.

  3. Group differences in changes in liver steatosis (dB/m) over time

    Time frame: Baseline and 12 weeks.

  4. Group differences in changes in appendicular lean mass index (kg/m²) over time

    Time frame: Baseline, 6 weeks, and 12 weeks.

07

Study locations

2 of 2 sites recruiting
08

References and documents

Individual participant data

Plan to share: Undecided

No publications or documents are linked to this record.

09

Timeline

1 registry update since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Jun 2026 (actual). Primary completion is estimated for Mar 2029, 33 months after the start.

Of 3,680 non-industry interventional studies with no phase under Obesity, half reached primary completion within 23 months of starting (the median), counting those still running; a quarter within 10 and three quarters within 43. This study's planned 33 months is above that.

Counting every sponsor, half of 3,843 studies reached it within 22 months; a quarter within 10 and three quarters within 42.

How these figures are worked out, and which studies are left out of them.

Registered
Jan 17, 2025
First posted
Feb 27, 2025
StartActual
Jun 4, 2026
Primary completionEst.
Mar 31, 2029
CompletionEst.
Mar 31, 2029
Last update
Oct 2, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
Eligibility
Minimum age 13 Years→12 Years; 4 inclusion criteria edited; 4 exclusion criteria edited, 4 removed
What changed in the criteria
Inclusion criteria
  • EditedMale or female aged 1312 to 17 years.
  • EditedNewly enrolledEnrolled in athe weight management program at the COACH clinic.
  • EditedExcessive weight: Class I obesity I (≥95%95th percentile to < 120% of the 95th percentile), class II Obesityobesity (≥120% to <140% of the 95th percentile, or BMI ≥35 to < 40 gkg/m2m²), and class III obesity (≥140% of the 95th percentile, or BMI ≥40 kg/m²).
  • EditedMedical release from COACH clinic to perform exercise.
Exclusion criteria
  • EditedType 1 and Type 2 diabetes mellitus.
  • RemovedAsthma that requires daily use of inhalers to keep symptoms under control.
  • RemovedAutism spectrum disorder (e.g., Autistic disorder, Rett disorder, Asperger disorder, childhood disintegrative disorder, pervasive developmental disorder not otherwise specified (PDD-NOS).
  • RemovedHormonal disease (e.g., hypothyroidism and growth hormone deficiency).
  • RemovedAutoimmune diseases (e.g., lupus, thyroiditis, juvenile idiopathic arthritis).
  • EditedPregnancy (urine test).
  • ChangedBefore Dislike of > 1 study product assessed at the initial visit.Now Dislike of all the fruit and vegetable smoothie options pre-defined by the study team at the initial visit.
  • EditedRefusal to authorize study investigators to access data from the clinical recordsCOACH clinic.
Oct 2, 2026
Primary outcomes
1 edited
What changed in the outcomes
  • EditedGroup differences in changes in the composite score of cardiometabolic health changesscore over time.Time frame: Baseline, 6 weeks, and 12 weeks.
Oct 2, 2026
Secondary outcomes
4 edited
What changed in the outcomes
  • EditedGroup differences in changes in low-density lipoprotein (LDL) cholesterol (mg/dL) changes over time.Time frame: Baseline, 6 weeks, and 12 weeks.
  • EditedGroup differences in fowchanges in brachial artery flow-mediated dilation (%) changes over time.Time frame: Baseline, 6 weeks, and 12 weeks. → Baseline and 12 weeks.
  • EditedGroup differences in changes in liver steatosis (dB/m) changes over time.Time frame: Baseline and 12 weeks.
  • EditedGroup differences in changes in appendicular lean mass index changes(kg/m²) over time.Time frame: Baseline, 6 weeks, and 12 weeks.
Oct 2, 2026
Show all 1 update
  1. Oct 2, 2026
    Eligibility Minimum age 13 Years→12 Years; 4 inclusion criteria edited; 4 exclusion criteria edited, 4 removed
    What changed in the criteria
    Inclusion criteria
    • EditedMale or female aged 1312 to 17 years.
    • EditedNewly enrolledEnrolled in athe weight management program at the COACH clinic.
    • EditedExcessive weight: Class I obesity I (≥95%95th percentile to < 120% of the 95th percentile), class II Obesityobesity (≥120% to <140% of the 95th percentile, or BMI ≥35 to < 40 gkg/m2m²), and class III obesity (≥140% of the 95th percentile, or BMI ≥40 kg/m²).
    • EditedMedical release from COACH clinic to perform exercise.
    Exclusion criteria
    • EditedType 1 and Type 2 diabetes mellitus.
    • RemovedAsthma that requires daily use of inhalers to keep symptoms under control.
    • RemovedAutism spectrum disorder (e.g., Autistic disorder, Rett disorder, Asperger disorder, childhood disintegrative disorder, pervasive developmental disorder not otherwise specified (PDD-NOS).
    • RemovedHormonal disease (e.g., hypothyroidism and growth hormone deficiency).
    • RemovedAutoimmune diseases (e.g., lupus, thyroiditis, juvenile idiopathic arthritis).
    • EditedPregnancy (urine test).
    • ChangedBefore Dislike of > 1 study product assessed at the initial visit.Now Dislike of all the fruit and vegetable smoothie options pre-defined by the study team at the initial visit.
    • EditedRefusal to authorize study investigators to access data from the clinical recordsCOACH clinic.
    Primary outcomes 1 edited
    What changed in the outcomes
    • EditedGroup differences in changes in the composite score of cardiometabolic health changesscore over time.Time frame: Baseline, 6 weeks, and 12 weeks.
    Secondary outcomes 4 edited
    What changed in the outcomes
    • EditedGroup differences in changes in low-density lipoprotein (LDL) cholesterol (mg/dL) changes over time.Time frame: Baseline, 6 weeks, and 12 weeks.
    • EditedGroup differences in fowchanges in brachial artery flow-mediated dilation (%) changes over time.Time frame: Baseline, 6 weeks, and 12 weeks. → Baseline and 12 weeks.
    • EditedGroup differences in changes in liver steatosis (dB/m) changes over time.Time frame: Baseline and 12 weeks.
    • EditedGroup differences in changes in appendicular lean mass index changes(kg/m²) over time.Time frame: Baseline, 6 weeks, and 12 weeks.
    + 2 other changes: description and arm descriptions

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT06848478
Responsible party
Sponsor
First posted
Feb 27, 2025
Start date
Jun 4, 2026
Primary completion
Mar 31, 2029 (estimated)
Completion
Mar 31, 2029 (estimated)
Last update
Oct 2, 2026

Study contacts

Hannah Aston, MPH
Contact
AstonHJ@archildrens.org
501-364-3055
Florêncio Sousa, Ph.D.
Contact
JFDinizdesousa@uams.edu
Elisabet Borsheim, Ph.D
principal investigator · Arkansas Children's Research Institute

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Interested in this study?

Eligibility is decided by the study team. Share this record with your doctor or contact the team directly.

Contact study team

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion