Changes in Thyroid and Glycemic Status and Food Intake in Children with Excess Weight Who Were Submitted for a Multi-Component School Intervention for 16 Months

Abstract

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.

Effects of exercise on thyroid hormones in children and adolescents with thyroid function disorders: A Systematic Review

“…28 Exercise, or any form of regular physical activity leads to changes in BMI related to thyroid hormones. 9,25,27 No significant study evidenced thyroid hormones returning to normal within the intervention period or post it. However, studies showed some changes in thyroid hormones due to exercise or physical activity linked with weight loss.…”

“…9 Furthermore, subclinical hypothyroidism shows increased TSH concentrations with normal fT3 and free T4(fT4) concentrations. 27 Wolters et al (2012) studied the relationship between TSH and thyroid hormones fT3 fT4 and weight status, as well as their changes, during and after lifestyle intervention. The baseline values in the study of TSH and fT3 were high, and the study results showed differences in TSH and fT3 but not fT4 during the intervention period, which was not significant.…”

“…They also observed structural changes in the thyroid gland, which returned to normal. 27,29 Wissal Abassi et al (2020) showed improving thyroid function status in children post-high-intensity interval training compared with moderate-intensity interval training and no exercise. The change in the response witnessed can be due to intensity-and leptin production-induced hypothalamic hormonal regulation.…”

“…Exercise benefits in decreased BMI with changes in cardiovascular adaptations, increase in muscular strength, and improve the quality of life of children and adolescents with thyroid function disorders. 9,22,[25][26][27][29][30][31] Conclusions Studies with aerobic exercise training for eight to 16 weeks show benefits in improving thyroid functions. However, the study quality was low-level.…”

Food addiction symptoms and metabolic changes in children and adolescents with the double burden of malnutrition

“…It is believed that the decrease in these hormones aims to reduce energy expenditure. In contrast, excess weight increases insulin (17) , leptin (18) and thyroid hormones (19) . Some authors have suggested that the increase in leptin and thyroid hormones could counteract the excess energy stored and facilitate increased expenditure (20,21) .…”