Abstract
BackgroundThe Atherogenic Index of Plasma is a predictive biomarker of atherosclerosis in adults but there is a lack of studies in paediatric population aimed at evaluating the longitudinal changes of the AIP and of the cardiometabolic blood profile related to nutritional interventions. The aim of this study was to compare the effect of individual- versus collective-based nutritional-lifestyle intervention on the Atherogenic Index of Plasma in schoolchildren with obesity.MethodsOne-hundred sixty-four children aged 6–12 years with Body Mass Index z-score > 2 referred to the Paediatric Obesity Clinic, San Paolo Hospital, Milan, Italy, were consecutively enrolled and randomized to undergo to either an individual- (n = 82) or a collective- (n = 82) based intervention promoting a balanced normo-caloric diet and physical activity. In addition, the individual intervention included a tailored personalized nutritional advice and education based on the revised Coventry, Aberdeen, and London-Refined taxonomy. Both at baseline and after 12 months of intervention, dietary habits and anthropometric measures were assessed, a fasting blood sample were taken for biochemistry analysis.ResultsThe participation rate at 12 months was 93.3% (n = 153 patients), 76 children in the individual-intervention and 77 children in the collective intervention. At univariate analysis, mean longitudinal change in Atherogenic Index of Plasma was greater in the individual than collective intervention (− 0.12 vs. − 0.05), as well as change in triglyceride-glucose index (− 0.22 vs. − 0.08) and Body Mass Index z-score (− 0.59 vs. − 0.37). At multiple analysis, only change in Body Mass Index z-score remained independently associated with intervention (odds ratio 3.37).ConclusionIn children with obesity, an individual-based nutritional and lifestyle intervention, including techniques from the CALO-RE taxonomy, could have an additional beneficial effect over a collective-based intervention, although the actual size of the effect remains to be clarified.Trial Registration Clinical Trials NCT03728621
Highlights
Obesity rates have risen rapidly worldwide over the past few decades [1, 2] and obesity is currently one of the most serious global public health burdens [3]
The Atherogenic Index of Plasma (AIP) is a major indicator of the size of pre- and anti-atherogenic lipoprotein particles. It is today considered both a predictive biomarker of atherosclerosis risk in adults [9, 10] and a better indicator than others lipid variables in assessing cardiovascular risk [11, 12], associated with obesity [13]. In both overweight and obese children, nutritional interventions are a crucial step recommended by the international guidelines to profitably manage obesity [4, 14] because those could result in improvement in the status of obesity [15,16,17] and cardiometabolic blood profile [15, 18]
Preliminary analysis disclosed no difference in any baseline anthropometric, dietary or biochemistry variable between children who completed the trial and those did not
Summary
Obesity rates have risen rapidly worldwide over the past few decades [1, 2] and obesity is currently one of the most serious global public health burdens [3]. The Atherogenic Index of Plasma (AIP) is a major indicator of the size of pre- and anti-atherogenic lipoprotein particles It is today considered both a predictive biomarker of atherosclerosis risk in adults [9, 10] and a better indicator than others lipid variables in assessing cardiovascular risk [11, 12], associated with obesity [13]. In both overweight and obese children, nutritional interventions are a crucial step recommended by the international guidelines to profitably manage obesity [4, 14] because those could result in improvement in the status of obesity [15,16,17] and cardiometabolic blood profile [15, 18]. The aim of this study was to compare the effect of individualversus collective-based nutritional-lifestyle intervention on the Atherogenic Index of Plasma in schoolchildren with obesity
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