Lifestyle Modification Improves Insulin Resistance and Carotid Intima-Media Thickness in a Metabolically Healthy Obese Prepubescent Population
This work was supported by grants from the Instituto de Salud Carlos III, cofinanced by the Fondo Europeo de Desarrollo Regional-FEDER (“Centros de Investigación En Red” (CIBER, CB06/03/0018)). M Rosa Bernal-Lopez was supported by “Miguel Servet Type I” program (CP15/00028) from the ISCIII-Madrid (Spain), cofinanced by the Fondo Europeo de Desarrollo Regional-FEDER.
The authors report no conflicts of interest.
ABSTRACT
Objectives:
The aim of this study was to analyze effects of a 12-month lifestyle modification that involved a Mediterranean diet (MedDiet) and physical activity (PA) program in a population of metabolically healthy obese children (MHOCh).
Methods:
We included a population of MHOCh with ≤1 of the following criteria: waist circumference and blood pressure ≥90 percentile, triglycerides >150 mg/dL, high-density lipoprotein-cholesterol (HDL-c) <40 mg/dL, or impaired fasting glucose. After 12 months of intensive lifestyle modification, anthropometric measurements, glycemic and lipid profiles, adherence to the MedDiet, energy intake, PA, body composition, and carotid intima-media thickness (cIMT) were analyzed.
Results:
One hundred thirty-one MHOCh (70 boys and 61 girls; P = 0.65, age: 7.9 ± 1.3 years, body mass index [BMI]: 24.7 ± 3.5 kg/m2) were included. After 12 months of intervention, a significant decrease in standard deviation (SD) units of body weight (−0.5 ± 0.1; P < 0.001) and BMI (−0.5 ± 0.1; P < 0.001) were observed in the total population. A significant improvement in adherence to the MedDiet (+2 points) and a significant reduction in protein, fatty acids, total fat, and cholesterol intake in the entire population were observed. All participants did more moderate-vigorous PA, which led to a significant increase in lean and total mass and decrease in total fat. Significant improvements in the glycemic profile (insulin levels [−6.6 μIU/mL, P < 0.001] and HOMA index [−1.2, P < 0.001]) were observed. Participants with pathological cIMT values reduced this cardiovascular predictor to normal values.
Conclusions:
A 12-month lifestyle modification intervention involving weight loss with MedDiet and PA in MHOCh yielded improvements in MedDiet adherence, lipid intake, moderate-vigorous PA, body composition, insulin resistance, and cIMT.
