Long-term follow-up of cardiovascular disease risk factors in children after an obesity intervention1,2

Reinehr, Thomas; Sousa, Gideon de; Toschke, André Michael; Andler, Werner

doi:10.1093/ajcn/84.3.490

Cited by 220 publications

(179 citation statements)

References 29 publications

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“…3,5 Since the achieved weight loss did not differ between the end of intervention and 3 years after the end of intervention, these improvements were also very likely to sustain. Furthermore, the degree of mean SDS-BMI reduction 3 years after the end of the 1-year intervention as compared to baseline has been demonstrated to reduce insulin resistance, and to improve hypertension and dyslipidemia in obese children.…”

Section: Discussionmentioning

confidence: 99%

“…4 The 1-year intervention 'Obeldicks' has been described in detail elsewhere. 3,4,5 Briefly, this program is based on physical exercise (1 year), nutrition education and behavior therapy for children and parents separately (first 3 months) and individual psychological care of the child and its family (months 4-9). The exercise therapy consists of sports, instructions in physical exercise as part of all-day life, and in reduction of the amount of time spent watching television.…”

Section: Methodsmentioning

confidence: 99%

“…1,2 In previous studies, we have demonstrated that obese children participating in the 1-year outpatient obesity intervention 'Obeldicks' reduced their overweight. 3,4,5 The maintenance of the achieved weight loss for several years after the end of intervention has not been proved so far. Therefore, the following study was performed to analyze whether the benefits in weight status were sustained 3 years after the end of intervention.…”

Section: Introductionmentioning

confidence: 99%

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Four-year follow-up of children and adolescents participating in an obesity intervention program

et al. 2007

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Background: Since obesity affects children's health and social integration, treatment concepts with long-term efficiency are necessary. Methods: We analyzed changes of standard deviation score of body mass index (SDS-BMI) quarterly in the first year and once a year during the next 3 years in all obese children participating in the 1-year outpatient intervention program 'Obeldicks', which was based on physical exercise, nutrition education and behavior therapy. All analyses were performed on the intention-to-treat approach. Results: One hundred and thirty-one children (77%) of the 170 children (mean age 10.5 years, 51% female, mean BMI 26.9 kg/m 2 , mean SDS-BMI 2.54) attending the 'Obeldicks' intervention program reduced their overweight at the end of intervention (mean SDS-BMI reduction 0.41) and 122 (66%) 3 years after end of intervention (mean SDS-BMI reduction 0.48). The reduction of overweight was independent of the child's gender, age and parental age and BMI. Reduction of 0.33 SDS-BMI in the first 3 months was the best predictor for long-term success (95% predictive value). Conclusions: Participating in the 1-year outpatient obesity intervention program 'Obeldicks' was associated with a decrease of overweight, which was sustained 3 years after the end of intervention. Reduction of overweight in the first 3 months of the intervention was highly predictive for long-term success.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Four-year follow-up of children and adolescents participating in an obesity intervention program

et al. 2007

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“…The achieved overweight reduction and improvement of HOMA-IR and QUICKI in our intervention program were comparable to those in the previous reports. 1,11,16 Interestingly, we found only a weak correlation between change of weight status and changes of the HOMA-IR, QUICKI and HOMA-B%, suggesting further influence factors for example, different genetic backgrounds. The T allele at rs7903146 was associated with a significant negative dosage effect per allele on the improvement of HOMA-IR and QUICKI after the lifestyle intervention independently of gender.…”

Section: Discussionmentioning

confidence: 63%

“…10 The intervention 'Obeldicks' has been described elsewhere in detail. 11 Briefly, this outpatient intervention program was based on physical exercise, nutrition education and behavior therapy including individual psychological care of the child and his/her family.…”

Section: Methodsmentioning

confidence: 99%

Evidence for an influence of TCF7L2 polymorphism rs7903146 on insulin resistance and sensitivity indices in overweight children and adolescents during a lifestyle intervention

et al. 2008

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Objective: The T allele of the single-nucleotide polymorphism rs7903146 in TCF7L2 (transcription factor 7 like 2 gene) is associated with type 2 diabetes mellitus. The aim of this study was to analyze whether there is an allele-dosage effect on changes of insulin resistance and sensitivity indices in overweight children participating in a lifestyle intervention. Methods: We genotyped rs7903146 in 236 overweight children (mean age 10.7 years, mean body mass index (BMI) 28.1 kg/m 2 ) completing a 1-year lifestyle intervention. Degree of overweight as BMI-SDS, homeostasis model assessment for insulin resistance (HOMA-IR) and the insulin sensitivity index QUICKI were measured before and after intervention. Results: Lifestyle intervention resulted in an overweight reduction of À0.29 ± 0.02 BMI-SDS. HOMA-IR (À0.63 ± 0.22) and QUICKI ( þ 0.008 ± 0.003) indices improved significantly (Po0.05) in the course of the intervention in the 155 children with a decrease of BMI-SDS. There was an additive negative effect of T allele on changes of HOMA-IR (P ¼ 0.041) and QUICKI (P ¼ 0.001) in linear regression analyses adjusted to changes of weight status, age, gender and pubertal stage. Conclusions: Overweight children showed a negative dosage-allele effect per T allele at single-nucleotide polymorphism rs7903146 in TCF7L2 concerning an improvement of insulin resistance and sensitivity after overweight reduction in a lifestyle intervention. This finding further suggests that this polymorphism might be involved in glucose metabolism.

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Onset of Puberty and Cardiovascular Risk Factors in Untreated Obese Children and Adolescents

Reinehr

Toschke²

2009

Arch Pediatr Adolesc Med

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To determine the course of obesityassociated nonalcoholic fatty liver disease (NAFLD) and the cardiovascular risk factors of hypertension, dyslipidemia, and disturbed glucose metabolism in untreated obese children.Design: Obese children were examined prospectively at baseline and 1 year later.Setting: Obesity clinic.Participants: A total of 287 untreated obese children; 53.3% were girls, the mean age was 11.4 years, and the mean body mass index (calculated as weight in kilograms divided by height in meters squared) was 28.2.Main Outcome Measures: Homeostasis model assessment of insulin resistance (HOMA-IR) values and prevalence of hypertension, dyslipidemia, impaired fasting glucose level, and NAFLD.Results: At baseline, 20.6% of obese children had hypertension, 22.3% had dyslipidemia, 4.9% had impaired fasting glucose levels, and 29.3% had NAFLD. These preva-lences, as well as weight status, remained stable at the 1-year follow-up visit. Increases (SDs) in prevalence of hypertension ( 16.1% [51.8%]), hypertriglyceridemia (9.7% [59.3%]), and impaired fasting glucose level (8.1% [32.9%]), as well as mean HOMA-IR value (0.42 [1.22]), were observed in 62 children entering puberty. In contrast, mean decreases (SDs) in hypertension (−18.8% [53.2%]), hypertriglyceridemia (−12.5% [53.1%]), impaired fasting glucose level (−6.3% [38.1%]), and NAFLD prevalence (−18.8% [44.5%]), as well as mean HOMA-IR value (−0.83 [2.56]), were observed in 50 children entering late puberty (PϽ.01 for change of pubertal status in the multivariate model). Changes in HOMA-IR values were only weakly related to changes in prevalence of cardiovascular risk factors or transaminase levels (r Ͻ0.2).Conclusions: Cardiovascular risk factors worsened at onset of puberty and improved in late puberty in obese children whose weight status did not change. The weak correlation between HOMA-IR value and cardiovascular risk factors suggests that other characteristics may affect these disorders.

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Long-term follow-up of cardiovascular disease risk factors in children after an obesity intervention1,2

Abstract: Long-term multidisciplinary intervention led to a reduction in SDS-BMI in most of the obese children 1 y after the end of the intervention. Reduction in SDS-BMI was accompanied by an improvement in CVD risk factors.

Cited by 220 publications

References 29 publications

Four-year follow-up of children and adolescents participating in an obesity intervention program

Four-year follow-up of children and adolescents participating in an obesity intervention program

Evidence for an influence of TCF7L2 polymorphism rs7903146 on insulin resistance and sensitivity indices in overweight children and adolescents during a lifestyle intervention

Onset of Puberty and Cardiovascular Risk Factors in Untreated Obese Children and Adolescents

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