Impact of Lifestyle Modifications on Alterations in Lipid and Glycemic Profiles and Uric Acid Values in a Pediatric Population

Abstract

Cardiometabolic risk factors are frequent in children and adolescents with excess weight. The aim of this study was to evaluate the effects of lifestyle modifications on alterations in lipid and glycemic profiles and uric acid values in a pediatric population at increased cardiovascular risk. The study involved 276 subjects with a mean age of 10.6 (2.3) years. Body mass index (BMI) z-score and biochemical parameters (serum low-density lipoprotein (LDL) cholesterol, triglycerides and uric acid and homeostasis model assessment to quantify insulin resistance (HOMA index)) were assessed at baseline and at the end of a median follow-up of 14.7 (12.4, 19.3) months. Throughout follow-up, all children received a non-pharmacological treatment based on increased physical activity, reduced sedentary activity and administration of a personalized, healthy and balanced diet. All children attended periodic quarterly control visits during follow-up. Multivariable statistical analyses showed that each BMI z-score point reduction at follow-up was associated with an 8.9 (95%CI −14.2; −3.6) mg/dL decrease in LDL cholesterol (p = 0.001), 20.4 (95%CI −30.0; −10.7) mg/dL in triglycerides (p < 0.001), 1.6 (95%CI −2.2; −1.0) in HOMA index (p < 0.001), and 0.42 (95%CI −0.66; −0.18) mg/dL in uric acid (p = 0.001) values. At each reduction of the BMI z-score by one point, the odds of presenting with insulin resistance and hyperuricemia at follow-up significantly decreased (OR 0.23, 95%CI 0.10–0.50, and OR 0.32, 95%CI 0.10–0.95, p < 0.001 and p < 0.05, respectively). Improvement of dietary habits and lifestyles may improve lipid and glycemic profiles and serum uric acid values in a pediatric population.

Role of Insulin Resistance as a Mediator of the Relationship between Body Weight, Waist Circumference, and Systolic Blood Pressure in a Pediatric Population

“…A randomized study showed beneficial effects on body weight associated with insulin resistance improvement in overweight children undergoing dietary treatment [ 34 ]. Moreover, in our previous study, we observed that the factor most strongly associated with improved insulin resistance values in a pediatric population undergoing a dietary-behavioral intervention was the decrease in BMI z-score [ 11 ]. In the present study, the greater the weight reduction during follow-up, the greater the decrease in systolic blood pressure, and this effect appeared totally mediated by the amount of reduction in insulin resistance.…”

“…In previous studies, we described that non-pharmacological treatment based on lifestyle modifications was associated with a reduction in BP, BMI and WC values in a pediatric population with excess weight and/or elevated BP values [ 10 , 11 ].…”

The Effect of Healthy Lifestyle Strategies on the Management of Insulin Resistance in Children and Adolescents with Obesity: A Narrative Review

“…This dietary approach implies different ranges of energy restriction, depending on age target, and a macronutrient distribution approximately equals to 50–60%En from CHO, 15–20%En from proteins and <30%En from fats [ 130 ]. Several clinical trials have been reporting the positive effects of this approach on several indicators of glucose metabolism, including HOMA-IR, insulin levels, adiponectin, and resistin, in children and adolescents with obesity [ 134 , 135 , 136 ].…”

Consequences of Insulin Resistance Long Term in the Body and Its Association with the Development of Chronic Diseases

“…when there are risk factors for CVD keeping track of healthy eating habits is critical [37]. Moreover, weight loss and lifestyle modification (healthy food and physical activity) are the most common advice for improving insulin sensitivity [38].…”