Dietary restriction in obese children and its relation with eating behavior, fibroblast growth factor 21 and leptin: a prospective clinical intervention study

Abstract

BackgroundObesity is significant problem involving eating behavior and peripheral metabolic conditions. The effect of carbohydrate and fat restriction on appetite regulation, fibroblast growth factor 21 (FGF21) and leptin in children has not been defined. Our objective was to compare the effect of both diets.MethodsOne hundred and twenty children with body mass index (BMI) higher than the equivalent of 30 kg/m2 for an adult, as corrected for gender and age were randomly assigned to (n = 60) a low-carbohydrate (L-CHO) diet or (n = 60) a low-fat (L-F) diet for 2 months. Fifty-three (88.3 %) subjects on the low-carbohydrate-diet and 45 (75 %) on the low-fat diet completed the study. Anthropometric measures, leptin and FGF21 levels were measured before and after the intervention. Comparison of the data for both of the diet groups was carried out using the t-test for independent variables. Intragroup comparisons before and after of each of the dietary treatments were performed using ANOVA for repeated measures. Factors associated with FGF21, leptin levels and satiety, were analyzed by multiple regression.ResultsAfter both of the diets, weight, leptin, food responsiveness, and enjoyment of food significantly decreased and high density lipoprotein cholesterol (HDL) increased, but FGF21 decreased. Before and after both of the interventions FGF21 was associated with triglycerides. Before the diet, satiety was associated with lower screen time (p < 0.04) and insulin levels (p < 0.05).ConclusionsBoth dietary restrictions improved the metabolic and hormonal parameters of obese children. FGF21 is an indicator of a beneficial metabolic response in younger children. After 2 months an adaptation of the eating behavior to food restriction was observed.

Searching for Evidence of an Anti-Inflammatory Diet in Children: A Systematic Review of Randomized Controlled Trials for Pediatric Obesity Interventions With a Focus on Leptin, Ghrelin, and Adiponectin

“…These studies were less likely than the others to result in significant intervention versus control group differences in BMI (2/7 studies found group differences), indicating that the control group's dietary modification was similar to the intervention group's dietary modification (Jensen et al, 2014;Wang et al, 2015). For example, the low-carbohydrate, lowfat, and ketogenic diets were equally effective in yielding significant pre-/postintervention reductions in BMI and leptin, and results did not vary by dietary content (Ibarra-Reynoso et al, 2015;Jensen et al, 2014;Partsalaki et al, 2012). The normocaloric diets (whole grain, DASH, and high-protein breakfast) did not result in a significant change in BMI from baseline, though the whole-grain diet resulted in a significant reduction in leptin after intervention (Hajihashemi et al, 2014;Saneei et al, 2014;Wang et al, 2015).…”

“…Leptin was measured in 18 of the 25 studies listed in the tables. Researchers found a significant pre-/postintervention decrease in leptin in 11 of the studies listed in the tables (Abd El-Kader et al, 2013;Ackel-D'Elia et al, 2014;Balagopal et al, 2005;Balagopal et al, 2010;Damaso et al, 2014;De Piano et al, 2012;Elloumi et al, 2009;Hajihashemi et al, 2014;Ibarra-Reynoso et al, 2015;Kelishadi et al, 2008;Park et al, 2007;Shalitin et al, 2009). In one study (Hajihashemi et al, 2014), leptin in the not-whole-grain control group increased significantly from baseline.…”

“…To strengthen the analysis, we categorized studies by comparison group. In seven studies, researchers compared one type of nutrition intervention versus another, with or without a nondiet intervention control group (Galhardo et al, 2012;Hajihashemi, Azadbakht, Hashemipour, Kelishadi, & Esmailzadeh 2014;Ibarra-Reynoso et al, 2015;Jensen et al, 2014;Partsalaki, Karvela, & Spiliotis, 2012;Saneei, Hashemipour, Kelishadi, & Esmaillzadeh 2014;Wang, Yang, Lu, & Mu 2015). These studies were less likely than the others to result in significant intervention versus control group differences in BMI (2/7 studies found group differences), indicating that the control group's dietary modification was similar to the intervention group's dietary modification (Jensen et al, 2014;Wang et al, 2015).…”

Fibroblast Growth Factor 21 and the Adaptive Response to Nutritional Challenges

“…However, unlike the murine model, in obese patients, a KD does not increase FGF21 serum levels [99] and even decreases its levels when a KD is combined with low calorie intake [100]. Similarly, in obese children, a low carbohydrate diet (LCD) (50% carbohydrates) reduces FGF21 circulating levels [101].…”

Effects of dietary restriction on metabolic and cognitive health

“…This effect was associated with low triglyceride serum levels, revealing that DR can improve metabolic parameters in obesity. (43) Additionally, a randomized, controlled clinical study was performed that assessed the effects of CR in non-obese adults, and revealed a significant weight loss accompanied with a decrease in systemic oxidative stress and ageing biomarkers, even 2 years after the dietary intervention. (44) For decades, the effects of CR in the ageing brain and the development of neurodegenerative diseases have been a topic of intense study.…”