We investigated if children with excess weight who submitted to two types of intervention at school for 16 months showed improvements in thyroid and glycemic function and food intake. Children (8–11 years) with a body mass index-for-age (BMI/A) of ≥1 Z score were divided into two groups: Treatment 1 (n = 73) involved motivation to adopt healthier lifestyle; Treatment 2 (n = 103) involved performing weekly nutritional education, motivational, and physical activities at school. A semi-quantitative food frequency questionnaire was used. The delta BMI/A were similar after 16 months; Treatment 1 showed higher decrease in thyroid-stimulating hormone (TSH; median (range)): −0.45 (−3.19 to 2.17) and 0.06 (−4.57 to 1.63) mIU/L, p = 0.001), FreeT3 (−0.46 (−2.92 to 1.54) and −0.15 (−2.46 to 1.38) pmol/L, p = 0.038), and FreeT4 −1.41 (−6.18 to 3.47) and −0.90 (−4.89 to 2.96) pmol/L, p = 0.018), followed by decrease in energy intake (7304 (6806 to 7840) and 8267 (7739 to 8832) kJ, Ptreatment = 0.439, Ptime <0.001, interaction group–time p < 0.001), macronutrients and sugar. A positive correlation between FreeT3 and BMI/A, and a negative correlation with FreeT4 and insulin were found at baseline (r 0.212, p < 0.01; r −0.155, p < 0.01, respectively) and follow-up (r 0.222, p < 0.01; r −0.221, p < 0.01). The decrease in overall diet and particularly sugar intake was accompanied by a greater reduction in TSH and FreeT3 in Treatment 1, demonstrating the impact of dietary intake on thyroid function.

The double burden of malnutrition (DBM) has been described in many low/middle-income countries. We investigated food addiction, thyroid hormones, leptin, the lipid/glucose profile, and body composition in DBM children/adolescents. Subjects were allocated into groups according nutritional status: control (C, n=28), weight excess (WE, n=23), and DBM (weight excess plus mild stunting, n=22). Both the DBM and WE groups showed higher insulin concentrations than the control (mean pmol/l [CI]: DBM=57.95 [47.88-70.14], WE=74.41 [61.72-89.80], C=40.03 [34.04-47.83], P<0.001). WE and DBM showed more food addiction symptoms than the control (3.11 [2.33–3.89], 3.41 [2.61-4.20] and 1.66 [0.95-2.37]). In DBM individuals addiction symptoms were correlated with higher body fat and higher insulin and leptin levels. These data provide preliminary evidence consistent with the suggestion that DBM individuals have a persistent desire to eat, but further studies are required to confirm these results in a larger study. These hormonal changes and high body fat contribute to development of diabetes in long-term.