ESPE Abstracts

Background: The prevalence of childhood obesity is high worldwide and predisposes to adult obesity and metabolic disorders. Many dietary approaches have been proposed to reduce this prevalence, but no single diet has proven to be superior to others in terms of long-term weight loss maintenance in children.

Objective and hypotheses: To evaluate and compare long-term body weight changes among obese children and adolescents who had lost at least 10% of their initial weight with either a ketogenic (very-low carbohydrate) or a hypocaloric diet after 6.83±1.7 years.

Method: 38 obese children and adolescents after weight loss intervention with a ketogenic (55.26%) or hypocaloric diet (44.73%) between 2005 and 2010 were reassessed. BMI SDS was calculated at baseline (BMI SDS 0), after the weight loss (BMI SDS 1) and after approximately 6.8 years(BMI SDS 2). Differences were assessed according to type of diet, gender and difficulty to retain the weight loss.

Results: The ketogenic children started older (14.87±2.92 vs 12.87±2.79, P=0.039), had higher BMI SDS than the hypocaloric children (2.92±0.76 vs 2.37±0.58, P=0.019) and 71.4% were morbidly obese (BMI SDS>2.5). All children significantly decreased their BMI SDS 1 with a similar fold change (0.64). Assessment of BMI SDS according to time, type of diet or difficulty in retaining weight loss, revealed that BMI SDS decrease was irrespective of diet type or difficulty. All children decreased their BMI SDS by 0.4 in the last 6.8 years and this decrease was significant for those on the ketogenic diet (2.26±0.81 vs 1.8±1.22, P=0.005), except for two children that underwent bariatric surgery. Most of the children that followed the hypocaloric diet (75%) are currently lean or overweight BMI SDS (<2) and showed no differences according to difficulty.

Conclusion: Our data reveals the importance of life style intervention in childhood obesity. A BMI SDS decrease of approximately 0.5 is of great importance and can be retained and decreased further into young adulthood irrespective of the diet followed.