Improved Diet Quality and Nutrient Adequacy in Children and Adolescents with Abdominal Obesity after a Lifestyle Intervention

Abstract

High rates of childhood obesity require integral treatment with lifestyle modifications that achieve weight loss. We evaluated a lifestyle intervention on nutrient adequacy and diet quality in children and adolescents with abdominal obesity. A randomized controlled trial was performed on 107 participants, assigned either to a usual care group or to an intensive care group that followed a moderate hypocaloric Mediterranean diet and received nutritional education. Intake adequacy was evaluated using Dietary Reference Intakes and diet quality through the Diet Quality Index for Adolescents (DQI-A), the Healthy Lifestyle Diet-Index (HLD-I) and the Mediterranean Diet Quality Index (KIDMED). Both groups achieved a significant reduction in BMI standard deviation score (BMI-SDS), glucose and total cholesterol levels. Intake of Calcium, Iodine and vitamin D were higher in the intensive care group, with enhanced compliance with recommendations. Higher dietary scores were associated with lower micronutrient inadequacy. DQI-A and HLD-I were significantly higher in the intensive care group vs. usual care group after the treatment. In conclusion, we observed that an intensive lifestyle intervention was able to reduce BMI-SDS in children with abdominal obesity. Furthermore, participants significantly improved dietary indices getting closer to the nutritional recommendations. Therefore, these diet quality indices could be a valid indicator to evaluate micronutrient adequacy.

Associations of telomere length with two dietary quality indices after a lifestyle intervention in children with abdominal obesity: a randomized controlled trial

“…Our lifestyle intervention achieved a significant reduction in adiposity (higher than 0.25) which could reduce cardiovascular risk. In addition, we observed a greater improvement in diet quality and physical activity levels in those participants enrolled in the intervention group as has been the case in other intervention studies 27,47‐49 …”

“…In contrast, the intervention group was given a moderately hypocaloric Mediterranean diet, based on a fixed full‐day meal plan 27 . Their energy expenditure was calculated using Schofield equation (adapted to age and sex) 28 .…”

Assessment of diet quality, nutrient intake, and dietary behaviours in obese children compared to healthy children

“…The differences between the group of obese and children with normal weight amounted an average of 1000 kcal, which is 30% more calories than they required, taking into consideration their proper weight age and gender. The results of other studies also show an excess of energy in the diets of obese children [12][13][14]. The analysis of the individual components being the source of the energy excess in [12,15].…”

“…The analysis of the individual components being the source of the energy excess in [12,15]. What is interesting, also in the population of obese children from Spain it was observed that, respectively, 45% and 38% of the studied obese children had fat and carbohydrate intake levels above the norms (Acceptable Macronutrient Distribution Range-AMDR) [14]. Similar results were observed in overweight Greek children, who consumed less energy from carbohydrates and more from fat, ac-cording to AMDR [15][16][17].…”

Effectiveness of cognitive-behavioral therapy on nutrition improvement and weight of overweight and obese adolescents: A randomized controlled trial

“…Therefore, no changes in the overall energy intake were anticipated prior to study commencement. Also, according to international standards (58), it is inappropriate to reduce the energy intake in adolescents. Therefore, the focus is how to correct the pattern of food consumption.…”