Beneficial effects on anthropometric and metabolic parameters in overweight and obese boys after 1 year nutritional-behavioral intervention

Background and aim: The prevalence of obesity and the risk for metabolic, cardiovascular, and liver diseases in childhood are increasing. The current gold standard for treating pediatric obesity is eating habits and lifestyle modifications. The goal of our study was to determine the impact of a dietary intervention by means of the Mediterranean Diet and the Health Eating Plate on anthropometric and metabolic parameters in obese and overweight children. Methods: We studied a multi-ethnic population of 126 overweight/obese boys, including anthropometric measurements, blood biochemistry and nutrient intakes evaluation by means of Food Frequency Questionnaire at baseline, 6 and 12 months after a nutritional-behavioural intervention. Analysis of variance for repeated measures followed by Fisher’s Protected Least Significant Difference and Chi-squared test for trend was used to compare quantitative and qualitative variables. T-test for unpaired data was used for subgroups comparison. Associations were tested by regression analysis. Analyses were carried out by StatView Software (SAS Institute, Cary NC). Results: Significant reductions in energy intake (expressed as kcal/kg body weight, from 37.9 ± 1.04 at baseline to 27.8 ± 0.85 after one year, p<0.001), protein intake (expressed as g/kg body weight, from 1.45 ± 0.04 at baseline to 1.16 ± 0.03 after one year, p<0.001), carbohydrates intake (expressed as g/kg body weight, from 5.47 ± 0.17 at baseline to 3.85 ± 0.12 after one year, p<0.001) and total fats intake (expressed as g/kg body weight, from 1.28 ± 0.04 at baseline to 3.85 ± 0.12 after one year, p<0.001) were observed. The proportion of obese boys decreased by 33% (chi square for trend 21.7, p<0.001). In obese boys, ALT decreased significantly after 1-year, in terms of absolute concentrations (F=9.150, p<0.001) and abnormal findings (chi test for trend: 7.50, p<0.05); these changes correlated with the reduction of BMI-SDS. Parameters of insulin resistance were associated with body and fat mass, with positive association with BMI-SDS detected for insulin, HOMA-IR, HOMA-B% (r=0.39, p<0.001; r=0.41, p<0.001; r=0.33, p<0.005, respectively) and negative association detected for 1/HOMA-IR, QUICKI and McAuley (r=0.44, p<0.001; r=0.46, p<0.001; r=-0.46, p<0.001, respectively). In obese boys, considering lipid profile, significant decreases were observed for total and LDL cholesterol. Conclusion: 1-year nutritional-behavioral intervention in overweight and obese boys showed beneficial effects on metabolic and anthropometric risk factors.