Multicomponent intervention effect on cardiometabolic risk factors among overweight/obese Brazilian children: a mediation analysis

Abstract

To verify whether percentage of body fat, physical fitness, physical activity and calorie intake mediates the multicomponent intervention effect on cardiometabolic risk factors in overweight/obese children, and present the relative contribution of each mediator. This is an intervention study, developed with 35 overweight/obese school-aged children (control group = 17 and intervention group = 18), aged between 7 and 13 years (9.05 ± 1.90). A 12-week multicomponent intervention was performed, consisting of physical exercise, nutritional education sessions and parental support. The following variables were evaluated at baseline and post-intervention: anthropometric measures and percentage of body fat, physical fitness, physical activity assessed by accelerometer, total calorie intake and biochemical assays. For statistical analysis, generalized linear models were used. The intervention effect on glucose was mediated by percentage of body fat (24%), muscular fitness (22%) and total calorie intake (40%). The same was observed for alanine aminotransferase (ALT), with a mediation proportion of 26, 31 and 35%, respectively, as well as for HDL-C (percentage of body fat − 30%, muscular fitness − 30% and total calorie intake − 33%); while vigorous physical activity mediated the intervention effect on glucose (40%), HDL-C (39%) LDL-C (43%) and total cholesterol (37%). Interventions strategies should focus on reducing percentage of body fat and calorie intake, and enhancing muscular fitness and vigorous physical activity to achieve effective changes on cardiometabolic risk factors.