Limited Weight Loss or Simply No Weight Gain following Lifestyle-Only Intervention Tends to Redistribute Body Fat, to Decrease Lipid Concentrations, and to Improve Parameters of Insulin Sensitivity in Obese Children

Abstract

Objectives. To investigate whether lifestyle-only intervention in obese children who maintain or lose a modest amount of weight redistributes parameters of body composition and reverses metabolic abnormalities. Study Design. Clinical, anthropometric, and metabolic parameters were assessed in 111 overweight or obese children (CA of 11.3 ± 2.8 years; 63 females and 48 males), during 8 months of lifestyle intervention. Patients maintained or lost weight (1–5%) (group A; n: 72) or gained weight (group B). Results. Group A patients presented with a decrease in systolic blood pressure (SBP) and diastolic blood pressure (DBP) ( and , resp.), BMI (), z-score BMI (), waist circumference (), fat mass (), LDL-C (), Tg/HDL-C ratio (), fasting and postprandial insulin (), and HOMA (), while HDL-C () and QUICKI increased (). Conversely, group B patients had an increase in BMI (), waist circumference (), SBP (), and in QUICKI (), while fat mass (), fasting insulin (), and HOMA () decreased. Lean mass, DBP, lipid concentrations, fasting and postprandial glucose, postprandial insulin, and ultrasensitive C-reactive protein (CRP) remained stable. Conclusions. Obese children who maintain or lose a modest amount of weight following lifestyle-only intervention tend to redistribute their body fat, decrease blood pressure and lipid levels, and to improve parameters of insulin sensitivity.

The Effect of a Low Fructose and Low Glycemic Index/Load (FRAGILE) Dietary Intervention on Indices of Liver Function, Cardiometabolic Risk Factors, and Body Composition in Children and Adolescents With Nonalcoholic Fatty Liver Disease (NAFLD)

“…The current study findings are similar to those of others, where changes in the quality of carbohydrate intake (such as reductions in dietary GI and total fructose intake) have been associated with reductions in expression of cardiometabolic risk factors such as elevated BP, TG, IR, and liver dysfunction in obese children and in obese adults in a variety of clinical populations such as NAFLD and DM 48 – 52 . However, none of these studies have examined the combined effects of a low fructose and GI/GL diet (FRAGILE) on markers of cardiometabolic risk and liver dysfunction in children with NAFLD.…”

Change in obesity‐related metabolic abnormalities associated with body mass index improvement through life‐style intervention: A meta‐regression

“…In total, 68 studies reported metabolic measures and details of these are listed in Table , alongside the outcome(s) of interest from each study. While various glucose measures were reported, we focused on fasting‐glucose measurements for this article (56 studies), as fasting glucose is used clinically to identify prediabetes and diabetes.…”

Cardiometabolic and Fitness Improvements in Obese Girls Who Either Gained or Lost Weight during Treatment

“…Our finding that, of those who had the MHO phenotype at baseline, only participants in the weight gain group became metabolically unhealthy at 6 months supports previous reports' that adiposity mediates the relation between CRF and MetS in adolescents (15, 32). Although the degree of weight loss is a determinant of the magnitude of improvement in metabolic health (16), reductions in risk factors were previously reported in adolescents who gained weight but lost fat mass (8). The transition from metabolically healthy to metabolically unhealthy obese in some participants who gained weight but none who lost weight suggests that body composition might also mediate any relation between improvements in FFM and MetS.…”

“…Short- and long-term improvements in body composition, CRF and metabolic risk factors have been reported in adolescents, independent of weight loss (7-12). In the absence of weight loss, reduced frequencies of metabolic risk factors were coincident with the preservation of fat-free mass (FFM) (7, 8, 10, 11). Fat mass, however, did not increase in any of the aforementioned studies, and, importantly, the association between CRF and metabolic syndrome (MetS) appears to be mediated by adiposity (15).…”