ESPE Abstracts

Background/Aim: Leucocyte telomere length (LTL) is a robust marker of biological aging and is associated with obesity and cardiometabolic risk factors even in childhood and adolescence. The aim of the present study was to assess the effect of a structured, comprehensive, multidisciplinary, personalized, lifestyle intervention program of healthy diet and physical exercise on LTL in children and adolescents with overweight and obese.

Materials and Methods: Five hundred (n = 508) children and adolescents (239 males, 269 females; 282 prepubertal, 226 pubertal), aged 10.14 ± 0.13 years were recruited to participate in the study. Participants were classified as obese (n = 267, 52.6%), overweight (n = 174, 34.2%) or of normal BMI (n = 67, 13.2%) according to the IOTF cut-off points and were studied prospectively for one year. All subjects followed a structured, comprehensive, multidisciplinary, personalized, lifestyle intervention program of healthy diet and physical exercise, with frequent clinical and laboratory evaluation. LTL was measured using quantitative real-time PCR and telomeric restriction fragments (TRF) at the beginning of the study and following 12 months of intervention. In addition, success of the intervention was assessed by employing two criteria: i) The change (improvement) of IOTF category, and ii) The change of BMI z-score by 0,6. Secondary measures were metabolic and hormonal parameters that are known to change in obesity.

Results: Following 12 months of intervention, there was a significant decrease of BMI z-score (1.72±0.06; P < 0.01). In 193 subjects (47.42%) the IOTF category improved, while in 175 subjects (42.99%) the BMI z-score decreased by 0.6. In all subjects, LTL increased significantly after 1 year of the lifestyle interventions (LTL_baseline: 1.35±0.01, LTL_{12 months}: 1.41±0.01, P < 0.01), irrespective of gender, pubertal status or BMI. Waist circumference was the best negative predictor of LTL at initial assessment. The implementation of the lifestyle interventions also resulted in a significant improvement in clinical (BMI, BMI z-score and waist to height ratio) and body composition indices of obesity, inflammatory markers, hepatic enzymes, HbA1C, QUICKI index, and lipid profile in all participants.

Conclusion: Our findings suggest that a comprehensive, multidisciplinary, personalized, lifestyle intervention program is associated with increased LTL in children and adolescents with overweight and obesity. Furthermore, the increase in LTL may be associated with a favorable metabolic profile and decreased morbidity later in life.