Lifestyle intervention in obese children is associated with a decrease of the metabolic syndrome prevalence.

BACKGROUND: Weight loss is the appropriate approach to reduce the obesity-related health risk. However, the effect of lifestyle interventions on the metabolic syndrome prevalence has been rarely studied in obese children.
METHODS: We analyzed changes of weight status, 2h glucose levels from oral glucose tolerance tests (oGTT), fasting glucose, lipids, blood pressure, and the prevalence of metabolic syndrome in relation to a 1-year outpatient lifestyle intervention in 288 obese children (45% male; mean age 12.5 years, mean SDS-BMI 2.48). These data were compared to 186 obese children without intervention with similar distributions of age, gender, and weight status.
RESULTS: Lifestyle intervention led to a significant decrease of SDS-BMI (mean -0.22; 95%CI -0.18 to -0.26), while SDS-BMI increased significantly in children without intervention (mean +0.15; 95%CI +0.13 to +0.18). Children with lifestyle intervention had a significant decrease of metabolic syndrome prevalence (from 19% to 9%; definition according to IDF) and an improvement of waist circumference, blood pressure, and 2h glucose values in the oGTT in contrast to obese children without intervention. The degree of weight loss was significantly associated with the amount of improvement of the components of the metabolic syndrome. Particularly, the children with a SDS-BMI reduction >0.5 showed an improvement of all components of the metabolic syndrome.
CONCLUSIONS: Lifestyle intervention led to weight loss and an improvement of the metabolic syndrome and its components. Degree of weight loss was associated with the improvement of the prevalence of metabolic syndrome and its components.