Clinical Analysis Department.
Internal Medicine Department, Instituto de Investigacion Biomedica de Malaga (IBIMA), Regional University Hospital of Malaga, University of Malaga.
J Pediatr Gastroenterol Nutr. 2021 Jan 1;72(1):127-134. doi: 10.1097/MPG.0000000000002901.
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).
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.
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.
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.
本研究旨在分析涉及地中海饮食（MedDiet）和身体活动（PA）方案的 12 个月生活方式改变对代谢健康肥胖儿童（MHOCh）的影响。
我们纳入了符合以下标准之一的 MHOCh 人群：腰围和血压≥90 百分位数、甘油三酯>150mg/dL、高密度脂蛋白胆固醇（HDL-c）<40mg/dL 或空腹血糖受损。经过 12 个月的强化生活方式改变，分析了人体测量学指标、血糖和血脂谱、对 MedDiet 的依从性、能量摄入、PA、身体成分和颈动脉内膜中层厚度（cIMT）。
共纳入 131 名 MHOCh（70 名男孩和 61 名女孩；P=0.65，年龄：7.9±1.3 岁，体重指数 [BMI]：24.7±3.5kg/m2）。干预 12 个月后，总人群体重的标准差（SD）单位（-0.5±0.1；P<0.001）和 BMI（-0.5±0.1；P<0.001）显著下降。在整个人群中，对 MedDiet 的依从性显著提高（+2 分），蛋白质、脂肪酸、总脂肪和胆固醇的摄入量显著减少。所有参与者都进行了更多的中等强度到高强度的 PA，这导致瘦体重和总体重的显著增加和总脂肪的减少。血糖谱显著改善（胰岛素水平[-6.6μIU/mL，P<0.001]和 HOMA 指数[-1.2，P<0.001]）。患有病理性 cIMT 值的参与者将此心血管预测因子降低至正常水平。
在 MHOCh 中进行为期 12 个月的生活方式改变干预，包括减肥、地中海饮食和 PA，可以改善 MedDiet 依从性、脂质摄入、中等强度到高强度的 PA、身体成分、胰岛素抵抗和 cIMT。
