Mediterranean-style diet reduces metabolic syndrome components in obese children and adolescents with obesity

Abstract

Background: The beneficial effects of the Mediterranean diet have been amply proven in adults with cardiovascular risk factors. The effects of this diet have not been extensively assessed in pediatric populations with obesity, insulin resistance (IR) and metabolic syndrome (MetS). The aim of this study was to assess the efficacy of the Mediterranean style diet (MSD) to decrease cardiovascular risk factors in children and adolescents with obesity.

Methods: Participants were randomly assigned to a MSD rich in polyunsaturated fatty acids, fiber, flavonoids and antioxidants (60% of energy from carbohydrate, 25% from fat, and 15% from protein, (n = 24); or a standard diet (55% of carbohydrate, 30% from fat and 15% from protein, (n = 25), the caloric ingest was individualized. At baseline and 16-week of intervention, the glucose, triglycerides (TG), total cholesterol (TC), HDL-C, LDL-C were measured as well as the body composition and anthropometric data. The diet compliance was determined by the 24-hour recalls.Paired Student's t and Macnemar's test were used to compare effects in biochemical, body composition, anthropometric, and dietary variables.

Results: The MSD group had a significantly decrease in BMI, lean mass, fat mass, glucose, TC, TG, HDL-C and LDL-C. (p < 0.05); the diet compliance increased consumption of omega 9 fatty acids, zinc, vitamin E, selenium, and decreased consumption of saturated fatty acids (p < 0.05). The standard diet group decrease in glucose levels and frequency of glucose >100 mg/dL (p < 0.05).

Conclusion: The MSD improves the BMI, glucose and lipid profile in children and adolescents with obesity and any MetS component.

Figure 1

Changes in metabolic syndrome (MetS) frequency according to diet type.Mediterranean-style diet (MSD) - MetS presented as frequency, difference at baseline and at 16 weeks follow-up was analyzed using McNemar related-samples test (p = 0.003). Standard diet (SD)- MetS presented as frequency, difference at baseline and at 16 weeks follow-up was analyzed using McNemar related-samples test (p = 0.999).

Figure 2

Dietary consumption of zinc and vitamin E according to the type of diet.Mediterranean-style diet (MSD) – Zinc and vitamin E are expressed as mean (mg), the difference in consumption at baseline and 16 weeks follow-up was analyzed with a paired t test (p = 0.001, p < 0.001 respectively). Standard diet (SD) – Zinc and vitamin E are expressed as mean (mg), the difference in consumption at baseline and 16 weeks was analyzed with a paired t test (p = 0.446, p = 0.880 respectively).

Figure 3

Dietary consumption of omega 9 fatty-acids, selenium, vitamin C according to the type of diet.Mediterranean style diet (MSD) – Omega 9 fatty acids (g), selenium (μg), and vitamin C (mg) are expressed as mean, the difference in consumption at baseline and 16 weeks follow-up was analyzed with a paired t test (p = 0.021, p < 0.001, p = 0.037 respectively). Standard diet (SD) – Omega 9 fatty acids (g), selenium (μg), and vitamin C (mg) are expressed as mean, the difference in consumption at baseline and 16 weeks follow-up was analyzed with a paired t test (p = 0.330, p = 0.490, p = 0.435 respectively).