Effect of a Family-Based Intervention on Nutrient Biomarkers, Desaturase Enzyme Activities, and Cardiometabolic Risk Factors in Children with Overweight and Obesity

Abstract

Background Developing dietary strategies to prevent excess weight gain during childhood is critical to stem the current obesity epidemic and associated adverse cardiometabolic consequences. Objectives We aimed to assess how participation in a family-based weight-management intervention affected nutrient biomarkers and cardiometabolic risk factors (CMRFs) in children (7–12 y old; n = 321) with baseline BMI z score (BMIz) ≥85th percentile. Methods This was a secondary analysis from a randomized-controlled, parallel-arm clinical trial. Families of children, recruited from a largely Hispanic population, were assigned to Standard Care (SC; American Academy of Pediatrics overweight/obesity recommendations), or SC + Enhanced Program (SC + EP; 8 skill-building cores, monthly support sessions, targeted diet/physical activity strategies). Nutrient biomarkers (plasma carotenoids, fat-soluble vitamins, RBC fatty acid profiles, desaturase indexes) and CMRFs were measured in archived blood samples collected at baseline and the end of the 1-y intervention. Results Children in both groups had significantly lower trans fatty acid and higher pentadecylic acid (15:0), PUFA n–3, and β-carotene concentrations, indicative of decreased hydrogenated fat and increased dairy, vegetable oil, fish, and fruit/vegetable intake, respectively. Similar changes were seen in de novo lipogenesis and desaturase indexes, as well as CMRFs (BMIz, lipid profile, inflammation, adipokines, liver enzymes) in both groups. Using multiple logistic regression, increase in carotenoids and decrease in endogenously synthesized SFA, MUFA, PUFA n–6, and desaturase indexes were associated with improvements in BMIz, blood pressure, lipid profile, glucose metabolism, inflammatory biomarkers, adipokines, and liver enzymes. Trans fatty acids were associated with improvements in BMIz, glucose metabolism, and leptin, with less favorable effects on inflammatory markers and adiponectin. Conclusions Providing targeted family-based behavioral counseling, as part of SC, can help overweight/obese children adopt healthier eating patterns that are associated with modest improvements in BMIz and several CMRFs. Limited additional benefit was observed with SC + EP. These results provide critical data to design subsequent interventions to increase the impact of family-based obesity prevention programs. This trial was registered at clinicaltrials.gov as NCT00851201.

Spillover Effects of a Family-Based Childhood Weight-Management Intervention on Parental Nutrient Biomarkers and Cardiometabolic Risk Factors

“…Detailed descriptions of the family-based management trial (NCT00851201 registered on clinicaltrials.gov), including design, intervention, and primary outcomes in the children, have been previously published ( 30 , 31 ). This study focused on the parents ( n = 205) of participating children (aged 7–12 y with baseline BMI z score ≥85th percentile) who had an archived fasting plasma, serum, and RBC sample at both baseline and end of the 1-y intervention.…”

“…Available CMRF data for the parents from the primary clinical trial ( 31 ) and ancillary study ( 30 ) were divided into 7 broad categories: BMI, blood pressure (systolic and diastolic), glucose metabolism (fasting glucose and insulin), lipid profile [total cholesterol (TC), LDL cholesterol, HDL cholesterol, triglycerides (TGs)], markers of inflammation [high-sensitivity C-reactive protein (hsCRP), TNF-α, IL-6], vascular adhesion [E-selectin, P-selectin, soluble intercellular adhesion molecule (sICAM)] and coagulation (thrombomodulin), and adipokines (leptin and adiponectin).…”

“…Using the latter approach, we have documented that providing targeted family-based behavioral counseling as part of standard care (American Academy of Pediatrics overweight/obesity recommendations) ( 31 ) can help children with overweight/obesity adopt healthier eating patterns that are associated with modest improvements in BMI z score (BMI score standardized for age and sex) and several cardiometabolic risk factors (CMRFs) ( 30 ). The majority of parents who participated in this intervention were female (94% mothers) and nearly all of them (92%) had a BMI that classified them as being in the overweight or obese categories.…”

Pediatric obesity: prevention is better than care

“…Family-based intervention programs have been associated with a significant improvement in adiposity measures and cardiometabolic risk profile. Moreover, children in the intervention group displayed a healthier eating pattern compared to control group [ 58 – 61 ].…”