ESPE Abstracts

Obesity is increasing, and the related complications are well known. Clinical Trials related with specific diets are currently lacking in paediatrics. There is an increasing interest in Mediterranean diet (MD). The Med4Youth European study* has enrolled 240, 13- to 16-year-old subjects with a BMI above the 90th percentile(WHO curves) in a multicenter randomized controlled trial (Italy, Spain and Portugal) to evaluate the effects of MD. We present the data relative to the 80 subjects enrolled in Parma, Italy, that were randomized to receive a MD or a low-fat diet (LFD) for 8 months. Dietary adherence, food diaries, physical activity, sociodemographic and quality-of-life questionnaires were used. Anthropometric, biochemical parameters, fat mass, free-fat mass and body water percentage were evaluated using bioelectrical impedance at baseline, at 2, 4 and 8 months on diet. Moreover, the patients had the opportunity to download an app through which they could keep in touch with healthcare personnel. Patients in the MD group received specific free food (bread, hummus, pomegranate juice, olive oil). Forty patients were included in each study group. During the initial 6 months of the trial, mostly after 1 and 4 months, 16 subjects dropped out in each group. Therefore, the data presented are relative to 48 subjects. After two months on diet, we observed a significant lower systolic blood pressure (SBP; P=0.006) in the MD group, and a higher pulse rate (P=0.041) in the LFD group suggesting that fitness worsened in this latter group. After 4 months, the anthropometric and biochemical data were not significantly different between the 2 groups. The children on the MD decreased their weight by 2.5%, BMI by 5.4%, Hip circumference(HC) by 2.4% with respect to measurements at baseline, whereas the subjects on the LFD presented a small increase in weight, BMI and HC. We observed a 10% decrease in the TG/HDL-C ratio in both groups. A reduction in fat mass, and an increase in fat-free mass were observed in the subjects on the MD only, although not significant, whereas a reduction in body water percentage was very clear(P=0.000). Multiple regression analyses showed that MD had a positive and significant effect on HC, waist circumference/HC ratio, SBP, and on Diastolic Blood Pressure. The 8-month follow-ups are ongoing. In conclusion, MD was more effective on BMI, body water percentage, fat distribution, and biomarkers of cardiometabolic risk compared with LFD during the first months on diet.