Lifestyle intervention improves lipoprotein particle size and distribution without weight loss in obese Latino adolescents

Abstract

Childhood obesity is associated with a pro-atherogenic phenotype contributing to increased cardiovascular disease (CVD) risk. This single-arm pilot study examined the effects of a lifestyle intervention on lipoprotein particle size and cholesterol distribution in obese Latino adolescents. Fifteen obese Latino adolescents (15.0±1.0 years) completed a 12-week nutrition education and exercise intervention. LDL particle size and distribution of cholesterol in lipoprotein subclasses were determined via polyacrylamide gel electrophoresis. The intervention resulted in increases in mean LDL-particle size (269.3±3.4 to 271.6±2.9Å, p=0.0003) and cholesterol in large HDL subfractions (22.4±11.2 to 26.8±10.6% area, p=0.007) along with decreases of cholesterol in small LDL (1.6±2.0 to 0.6±1.2% area, p<0.01) and HDL subfractions (23.2±9.4 to 19.0±6.7% area, p=0.05). These improvements were observed independent of changes in weight (90.7±26.2 to 89.9±27.8 kg, p>0.05) and suggest that lifestyle modification in obese youth may reduce cardiovascular risk by shifting lipoprotein particle size and cholesterol distribution to a less atherogenic phenotype.

Treatment Options for Severe Obesity in the Pediatric Population: Current Limitations and Future Opportunities

“…Despite its low overall success rate for weight loss, lifestyle modification therapy can be quite effective for a small percentage of youth with severe obesity. Importantly, lifestyle modification therapy can be effective in treating the comorbid conditions that often accompany pediatric severe obesity, which may improve even in the absence of clinically meaningful weight loss . Successful completion of lifestyle modification therapy programs has been shown to improve dyslipidemia, hypertension status, glycemic control, insulin sensitivity, functional mobility, exercise tolerance, and quality of life .…”

Estimation of LDL Particle Size Using Lipid Indices: A Population-Based Study of 1578 Schoolchildren

“…These different observations may be caused by varying effects of genetic and environmental factors affecting LDL particle size. [26][27][28] With regard to correlations between LDL particle size and simple lipid measures, moderate correlations were observed between LDL particle size and both TG and HDL-C concentrations; correlation coefficients by sex were -0.31 (boys) and -0.28 (girls) and 0.37 (both sex), respectively. In contrast, the correlations between LDL particle size and LDL-C and ApoB were weak but statistically significant.…”

Exercise for Obese Youth

“…Since very little exercise data exist, we bring attention to our recently completed 12-week lifestyle intervention in obese Latino adolescents. (34) The intervention included an hour of nutrition education along with three, 60-minute moderate to vigorous (heart rate > 150 BPM) physical activity classes per week. (34, 36).…”

“…(34) The intervention included an hour of nutrition education along with three, 60-minute moderate to vigorous (heart rate > 150 BPM) physical activity classes per week. (34, 36). The intervention resulted in increases in mean LDL-particle size and cholesterol in large HDL subfractions along with decreases of cholesterol in small LDL and HDL subfractions.…”

“…In contrast, a growing body of literature suggests that it is plausible for lifestyle modification, and more specifically exercise, to improve cardiometabolic health even in the absence of weight loss. (21, 31, 34, 36, 40, 41) Given that the majority of obese youth will remain as such for the remainder of their lives, we propose an alternative approach that targets reducing disease risk factors through exercise rather than weight loss.…”