Carla Pedrosa

Excess weight may be related to the development of adverse cardiometabolic risk factors in children. The aim of this study was to evaluate the effect of a lifestyle intervention program (nutrition and exercise counseling) on anthropometric parameters and metabolic syndrome (MS) components in Portuguese overweight/obese children. A total of 83 overweight/obese children aged 7–9 years were assigned to a 1-year individual or group-based treatment (GT); 61 children (z-score BMI (zBMI): 1.93 ± 0.28; 27 boys and 34 girls) completed the program. Anthropometric and biochemical parameters were assessed at baseline, at 6 months and at 1 year. The overweight/obese children, compared to normal-weight ones, presented significantly higher blood pressure, total-cholesterol, total-cholesterol/high density lipoprotein cholesterol (HDL) ratio, triglycerides, Apolipoprotein B and C-reactive protein levels, while HDL and Apolipoprotein A-I were significantly lower. At baseline, the prevalence of MS was 16.4% in overweight/obese and 0% in normal-weight children. The number of components of MS was significantly higher in children with higher zBMI. Lifestyle intervention led to a significant improvement in zBMI, waist circumference/height ratio, HDL, triglycerides, Apolipoprotein A-I, and Apolipoprotein B levels. The prevalence of MS decreased to 14.8%. The GT intervention seems to be more successful, with a significant decrease in zBMI and an increase in HDL and a lower drop-out rate. Overweight/obese children have multiple risk factors associated with the MS. Lifestyle intervention, both individual and group-based treatment, led to an improvement in the degree of overweight/obesity and in MS components.

The aim of this study was to evaluate the effect of a lifestyle intervention programme (nutrition and exercise counselling) on metabolic syndrome (MS) components, adipokines (leptin, adiponectin) and ghrelin levels in overweight children. A total of 61 overweight children aged 7–9 years (≥85th body mass index (BMI) percentile; 27 boys/34 girls) were randomly assigned and completed a 1-year individual (IT) or group-based treatment (GT). Anthropometric and biochemical parameters were assessed at baseline, at 6 months and at 1 year. Twenty-two normal weight children (<85th BMI percentile; 7–9 years old; 13 boys/nine girls) were also evaluated at baseline. Insulin resistance (IR) was determined by the homeostasis model assessment of IR (HOMA-IR). Overweight children presented significantly higher blood pressure, triglycerides, apolipoprotein B, insulin, HOMA-IR, leptin, C-reactive protein and homocysteine levels, while apolipoprotein A-I was significantly lower. At baseline, MS was present in ten overweight children, of which only five maintained it at 1 year. Leptin and ghrelin levels were associated with IR and MS components. MS was predicted by apolipoprotein A-I, insulin and pre-puberty. The lifestyle intervention led to a significant improvement in standard deviation score of BMI, waist circumference/height ratio and lipid profile. Changes in insulin, HOMA-IR, leptin and adiponectin were not significant. Ghrelin behaved differently between IT and GT. The GT intervention seems to be more successful, with a decrease in BMI Z-score and an improvement of metabolic parameters. In conclusion, overweight children have multiple risk factors associated with MS. A lifestyle intervention programme seems to be an effective mean for reducing obesity and MS components and improving adipokines concentrations.

Body fat is related to changes in lipid profile, blood pressure and metabolism of insulin and glucose, known as the metabolic syndrome (MS). The aim of this study was to estimate the prevalence of metabolic syndrome (MS) and its components among overweight and obese Portuguese schoolchildren, and to identify associated clinical and biochemical characteristics.

Objective: To estimate the prevalence of overweight and obesity in schoolchildren from Aveiro, Portugal, according to two criteria: the International Obesity Task Force (IOTF) and the US Centers for Disease Control and Prevention (CDC) cut-offs.Design: Weight, height and waist circumference were measured. Using the BMI, gender- and age-specific prevalences of overweight and obesity were determined according to the IOTF cut-offs extrapolated from an adult BMI of 25 and 30 kg/m²and the CDC cut-off values of 85th and 95th BMI percentile.Setting: Aveiro, Portugal.Subjects: A random representative sample of 905 children (457 boys; 448 girls) aged 7–9 years.Results: The prevalence of excess weight (overweight and obesity) was lowest according to IOTF cut-offs compared to CDC (28·1 %v.31·2 %), especially obesity (8·1 %v.14·0 %). However, the CDC and IOTF criteria have a strong agreement (Cohen’sk= 0·755;P< 0·001). There were significant differences in excess weight between boys and girls according to the CDC (26·9 %v.35·7 %;P= 0·003). Obese children are younger and the majority present abdominal obesity.Conclusions: The present study shows a high prevalence of excess weight in Aveiro children, similar to other Portuguese regions and among the highest in Europe, especially in the female gender. The IOTF cut-off values give a lower prevalence of excess weight, namely obesity.