Abstract
BackgroundObesity is significant problem involving eating behavior and peripheral metabolic conditions. The effect of carbohydrate and fat restriction on appetite regulation, fibroblast growth factor 21 (FGF21) and leptin in children has not been defined. Our objective was to compare the effect of both diets.MethodsOne hundred and twenty children with body mass index (BMI) higher than the equivalent of 30 kg/m2 for an adult, as corrected for gender and age were randomly assigned to (n = 60) a low-carbohydrate (L-CHO) diet or (n = 60) a low-fat (L-F) diet for 2 months. Fifty-three (88.3 %) subjects on the low-carbohydrate-diet and 45 (75 %) on the low-fat diet completed the study. Anthropometric measures, leptin and FGF21 levels were measured before and after the intervention. Comparison of the data for both of the diet groups was carried out using the t-test for independent variables. Intragroup comparisons before and after of each of the dietary treatments were performed using ANOVA for repeated measures. Factors associated with FGF21, leptin levels and satiety, were analyzed by multiple regression.ResultsAfter both of the diets, weight, leptin, food responsiveness, and enjoyment of food significantly decreased and high density lipoprotein cholesterol (HDL) increased, but FGF21 decreased. Before and after both of the interventions FGF21 was associated with triglycerides. Before the diet, satiety was associated with lower screen time (p < 0.04) and insulin levels (p < 0.05).ConclusionsBoth dietary restrictions improved the metabolic and hormonal parameters of obese children. FGF21 is an indicator of a beneficial metabolic response in younger children. After 2 months an adaptation of the eating behavior to food restriction was observed.
Highlights
Obesity is significant problem involving eating behavior and peripheral metabolic conditions
The children had a mean age of 9.8 ± 1.6 years, a mean body mass index (BMI) of 28.1 ± 3.6 kg/m2, a mean waist-hip ratio (WHR) of 0.96 ± 0.05, and a mean percent body fat of 41.01 ± 3.46
Factors associated with the fibroblast growth factor 21 (FGF21) levels Using the multiple regression procedure, we found that before the diet, FGF21 was positively associated with total cholesterol, triglycerides and BMI
Summary
Obesity is significant problem involving eating behavior and peripheral metabolic conditions. The effect of carbohydrate and fat restriction on appetite regulation, fibroblast growth factor 21 (FGF21) and leptin in children has not been defined. Childhood obesity is a health problem that is difficult to manage because the obesogenic environment hinders long-term adherence to a diet. Carbohydrate or lipid restrictions have been used extensively with limited long-term results. Carbohydrate restriction offers a satisfactory weight loss and improvement of adiponectin levels [2]. Lipid restriction may improve cardiometabolic risk factors such as triglycerides, low density lipoprotein cholesterol (LDL) and insulin levels [3]. Lipid restriction may improve Homeostatic Model Assessment- Insulin Resistance (HOMA-IR) scores, and leptin and proinflammatory cytokines levels regardless of body weight [4]
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