Sonographic Markers Are Useful for Detection of Early Vascular Deterioration in Children with Overweight/Obesity: Effect of a 1-Year Combined Nutritional Education and Physical Exercise Program

Abstract

As in adults, childhood obesity is associated with several metabolic disorders; however, there is little information regarding complex obesity-derived complications such as hepatic steatosis or endothelial dysfunction at early ages. Therefore, the objective of the present study was to analyze the effect of a nutritional and physical exercise program on obesity comorbidities in the form of subclinical atherosclerosis and non-alcoholic fatty liver in young children. A total of 148 children completed the study. For nine months (one academic year), children carried out a nutritional and physical activity program of 3 h/week. Anthropometric, clinical, liver ultrasound and carotid intima-media thickness (cIMT) parameters were evaluated. Our results showed that the program significantly improved anthropometrical parameters, especially regarding BMI and body fat (p < 0.001 and p = 0.004, respectively). The effect on metabolic parameters was limited, although a significant reduction on triglycerides was observed (p = 0.009). The education program had a great influence on the echogenic parameters, since the percentage of children with light steatosis decreased from 35% to 4% at the end of the study. In addition, cIMT also decreased significantly in both groups, although there was no statistically significant differences between groups. In conclusion, detection of early complications of obesity through sonographic parameters may allow early intervention, as in the present study, to prevent obesity co-morbidities in children.

Dietary Assessment for Weight Management and Health Maintenance

“…However, little information is available on complex obesity-related complications such as hepatic steatosis or endothelial dysfunction early in life. In this paper, we confirmed that sonographic markers are adequate for determining liver and carotid intima-media thickness (cIMT) parameters in children [15]. If we consider that these techniques are non-invasive and relatively accessible from an economic point of view, their use can help not only to prevent alterations, but also to develop dietary interventions aimed at reducing cardiovascular risks.…”

“…For instance, in children, the reliability of skinfolds limits the applicability of these techniques. In this issue, we have examined the utility of sonographic markers for assessing the early markers of cardiovascular impairment [15]. In our view, these data hold significant importance for the prevention of obesity-related diseases in children.…”