Abstract
(1) Background and aims: Obesity and high body max index (BMI) have been linked to elevated levels of inflammation serum markers such as C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-alpha), adiponectin, and resistin. It has been described that adipose tissue presents a high production and secretion of these diverse pro-inflammatory molecules, which may have local effects on the physiology of the fat cell and also systemic effects on other organs. Our aim was to evaluate the impact that lifestyle modifications, following a Mediterranean Diet (MedDiet) program and physical activity (PA) training, would have on inflammatory biomarkers in a metabolically healthy prepubertal population with obesity (MHOPp) from Malaga (Andalusia, Spain). (2) Methods: 144 MHOPp subjects (aged 5–9 years) were included in this study as they met ≤1 of the following criteria: waist circumference and blood pressure ≥ 90 percentile, triglycerides > 90 mg/dL, high-density lipoprotein cholesterol (HDL-c) < 40 mg/dL, or impaired fasting glucose (≥100 md/dL). Selected subjects followed a personalized intensive lifestyle modification. Anthropometric measurements, inflammation biomarkers, and adipokine profile were analyzed after 12 and 24 months of intervention. (3) Results: 144 MHOPp participants (75 boys—52% and 69 girls—48%; p = 0.62), who were 7.8 ± 1.4 years old and had a BMI 24.6 ± 3.3 kg/m2, were included in the study. After 24 months of MedDiet and daily PA, a significant decrease in body weight (−0.5 ± 0.2 SD units; p < 0.0001) and BMI (−0.7 ± 0.2 SD units; p < 0.0001) was observed in the total population with respect to baseline. Serum inflammatory biomarkers (IL-6, TNF-alpha, and CRP) after 24 months of intervention were significantly reduced. Adipokine profile (adiponectin and resistin) did not improve with the intervention, as adiponectin levels significantly decreased and resistin levels increased in all the population. Inflammatory biomarkers and adipokine profile had a significant correlation with anthropometric parameters, body composition, and physical activity. (4) Conclusions: After 24 months of lifestyle modification, our MHOPp reduced their Z-score of BMI, leading to an improvement of inflammatory biomarkers but inducing deterioration in the adipokine profile, which does not improve with MedDiet and physical activity intervention. An adequate education within the family about healthier habits is necessary to prevent and reduce an excessive increase in obesity in childhood.
Highlights
Obesity and overweight are the abnormal or the excessive fat accumulation, as defined by the World Health Organization (WHO)
This study is a cross-sectional study of a MHOPp (4–9 years aged) that included participants of both sexes during a total period of 24 months
The purpose of this study was to determine whether adherence to Mediterranean Diet (MedDiet) and regular physical activity (PA) promote modifications in serum inflammatory biomarkers and adipokines levels after 12 and 24 months of lifestyle modification
Summary
Obesity and overweight are the abnormal or the excessive fat accumulation, as defined by the World Health Organization (WHO). The prevalence of overweight and obesity in children and adolescents has increased from 4% in 1975 to more than 18% in 2016 [1]. The main cause of obesity is a consumed/expended calories imbalance, other factors can be involved. There is a trend towards consuming energy-dense foods, usually high in free sugars and fat, which is accompanied by a decrease in physical activity, mainly caused by changes in social and environmental factors [2,3]. The prevalence of obesity in childhood and youth population has become a public health challenge because of its increasing rate and the presence of several physical and psychosocial comorbidities
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