ESPE Abstracts (2019) 92 P2-128

Is one year of Diet and Physical Activity Program for Obese Children Enough to Revert the Metabolic Disorders?

Beatriz Garcia Cuartero 1,2, Concepcion Garcia Lacalle2, Veronica Sanchez Escudero2, Laura Sanchez Salado2, Maria Martin Garcia3, Ignacio Ara Royo3, Amparo Gonzalez Vergaz2

1Ramon y Cajal University Hospital, Madrid, Spain. 2Severo Ochoa University Hospital, Leganés, Spain. 3 Genud Toledo Castilla La Mancha University, Toledo, Spain

Objetives: To analyse clinical and laboratory characteristics of an obese pediatric population.

To assess their response to specific program consisting in modification of their nutritional habits and physical activity .

Material and Methods: Obese patients completed a year of group therapy with nutritional education and physical activity. We analysed at the beggining and after a year anthropometry and body composition by bioimpedance (Tanita 33 TB), blood pressure, insulin, glycaemia, lipids and adiponectin. Metabolic syndrome (MS) was diagnosed according to IDF. Information regarding nutritional habits and physical activity was obtained with questionnaire. Data was analysed with SPSS 19.

Results: 68 patients (54.4% women),mean age of 10,26 (+/−2,89) years were admitted in the study, 46,4% in puberty, BMI of 27,56 (+/− 3,95), SD 4,24 (+/− 1,5). 10 patients were diagnosed of MS and 13 of steatosis.

After a year, mean age 11,5 (+/− 2,9) years, 70,6% in puberty,BMI of 27,65 kg/m2, SD 3,58 (+/− 1,7). 14 % normal weight. 9 patients MS (66,6% male), and 5 of these from the begining.

An improvement in the quality of mediaterranean diet and health habits was observed. There was decrease in sedentary activities (hour/day): from 3,3(+/−2) to 2,7 (+/− 1,7) ( P<0,001) and increase in physical activity 2,5 hours/week (P<0,001).

We observed statistical significant improvement of SD of the BMI (P<0,0001), an increase in lean mass (Kg) from 36,03 (+/− 11,37) to 41,49 (+/−13,17) (P<0,003) and reduction in percentage of lean mass from 37,38 (+/− 5,75) to 35,58 (+/− 10,19). However, global increase in waist circumference was noticed from 85,39 (+/− 10,19) to 87,51 (+/− 11,8) (P< 0,015).

There was reduction in levels of adiponectin from 9,51 (+/−4,63) to 8,27 (+/− 4,72) (P<0,0001) and increase in basal glycemia from 93,03 (+/−6,94) to 96,87 (+/−9,47) (P<0,009), which is above 100 mg/dl in 30,9% of the children after a year of follow-up.

None of the patients with MS presented hypertension or diabetes. 3 of them had glucose intolerance but with normal OGTT after a year.

Despite a decrease in insulin levels after a year follow-up, they were still high.

HOMA and TG/C-HDL indexes decreased without significant statistical differences.

Conclusions: Basal glycemia was increase after intervention. The program is effective in achieving improvement of healthy habits and to reduce degree of obesity, although it has not accomplished a decrease in abdominal adipose tissue. One year of study has not been enough to revert completely MS.

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