An Interdisciplinary Weight Loss Program Improves Body Composition and Metabolic Profile in Adolescents With Obesity: Associations With the Dietary Inflammatory Index

Abstract

Background and Aims: The prevalence of overweight and obesity consitutes a global epidemic and it is growing around the world. Food and nutrition are essential requirements for promoting health and protecting against non-communicable chronic diseases, such as obesity and cardiovascular disease. Specific dietary components may modulate inflammation and oxidative stress in obese individuals. The Dietary Inflammatory Index (DII®) was developed to characterize the anti- and pro-inflammatory effects of individuals' diet. Few studies have investigated the role of diet-associated inflammation in adolescents with obesity. The present study aims to investigate the effects of an interdisciplinary weight loss therapy on DII scores and cardiometabolic risk in obese adolescents and possibles correlations. Methods: A total of 45 volunteers (14–19 years old) were recruited and enrolled for long-term interdisciplinary therapy including clinical, nutritional, psychological counseling, and exercise training. Adolescents had access to videos about health education weekly. Body composition and inflammatory and serum profiles were evaluated at baseline and after intervention. The food intake was obtained by 24-h food recall. Data was used to calculate energy-adjusted DII (E-DII) scores. Negative scores indicate an anti-inflammatory diet and positive scores indicates a pro-inflammatory diet. The sample was divided according to whether individuals increased or decreased E-DII scores after therapy. Results: After therapy the body mass index (BMI), body weight, body fat, abdominal, waist, neck, and hip circumferences decreased significantly. The mean of high-density lipoprotein cholesterol (HDL-c) increased after the therapy. There was found an improvement of inflammatory and cardiometabolic parameters. In exploratory analyses, this occurred mainly when the EDII improved. Conclusion: Long-term interdisciplinary therapy combined with a health education website improved inflammatory serum markers in obese adolescents. Reduction in DII scores was associated with reduction of cardiometabolic parameters, suggesting that an anti-inflammatory diet may be an effective strategy to prevent and treat obesity and related comorbidities. Trial: http://www.ensaiosclinicos.gov.br/rg/RBR-6txv3v/ , Register Number: RBR-6txv3v

Long-Term Effects of Vitamin D Supplementation in Obese Children During Integrated Weight-Loss Programme - A Double Blind Randomized Placebo-Controlled Trial

“…Several previous studies showed that integrated multidisciplinary weight-loss programmes, which include the child's family as well, are the most effective [9][10][11]. Reduction of fat mass is associated with normalisation of metabolic parameters, such as inflammatory markers, lipid profile, insulin resistance and arterial blood pressure [12][13][14]. Therefore, early and efficient intervention increases likelihood of staying healthy in the future.…”

Long-Term Effects of Vitamin D Supplementation in Obese Children During Integrated Weight–Loss Programme—A Double Blind Randomized Placebo–Controlled Trial

“…Till now, to the best of our knowledge, no studies were carried out in children or adolescents regarding the effects of vitamin D supplementation on body mass reduction during an organized lifestyle modification program. As we presented, adding a 1200 IU/day dose of vitamin D did not lead to higher changes in BMI (BMI centile) or fat mass as well as fat free mass changes in children aged [6][7][8][9][10][11][12][13][14]. It needs to be stated that the results presented show that although there was a reduction in BMI in vitamin D group compared to placebo group (-0.46 ± 1.80 vs. 0.11 ±1.84) and BMI centiles also showed higher reduction in children supplemented with vitamin D (-4.28 ± 8.43 vs. -2.53 ±6.10) none of those results was statistically significant (p = 0.203 and p = 0.319 respectively).…”

“…Several previous studies showed that integrated multidisciplinary weight-loss programs, which include the child's family as well, are the most effective [9][10][11]. Reduction of fat mass is associated with normalization of metabolic parameters, such as inflammatory markers, lipid profile, insulin resistance and arterial blood pressure [12][13][14]. Therefore, early and efficient intervention increases likelihood of staying healthy in the future.…”

Dietary Inflammatory Index (DII) – Nützlicher Wegweiser in der praktischen Beratung oder rein theoretisches Modell in der Ernährungsforschung?

“…Interventionelle bzw. experimentelle Humanstudien, in denen der DII als Tool für eine antiinflammatorische Ernährung genutzt wurde, sind bis dato kaum vorhanden [55][56][57][58][59]. Daher wurden hier hauptsächlich die inzwischen gut ausgearbeiteten Metaanalysen zur Klärung des aktuellen wissenschaftlichen Stands und des Nutzens des DII in Theorie und Praxis herangezogen und sollen im Folgenden eingehender diskutiert werden.…”

“…Diese Daten besitzen zwar nur eine begrenzte Aussagekraft auf das Entstehungsrisiko verschiedener Erkrankungen, allerdings gehen die Ergebnisse aus den bereits massenhaft untersuchten Datensätzen der Metaanalysen in die überwiegend einheitliche Richtung, dass eine proinflammatorische Ernährungsweise die Risiken erhöhen und bestätigen somit frühere Erkenntnisse. Erfreulicherweise gibt es inzwischen auch ein zunehmendes Interesse daran, den DII in klinischen Interventionsstudien einzusetzen und über eine recht praktische Herangehensweise das Inflammationspotenzial einer Ernährung zu erfassen und anhand dessen die Diät innerhalb der untersuchten Population zu korrigieren [56,57,59]. Demnach könnte der DII bei größer angelegten Interventionsstudien eingesetzt werden, da das Inflammationspotenzial im Allgemeinen und nicht die jeweilige (regionale) Diät als solche evaluiert wird.…”