Lifestyle Modification Improves Insulin Resistance and Carotid Intima-Media Thickness in an MHO Prepubescent Population.

OBJECTIVES The aim of this study was to analyze effects of a 12-month lifestyle modification that involved a Mediterranean diet (MedDiet) and physical activity (PA) program in a population of metabolically healthy obese children (MHOCh). METHODS We included a population of MHOCh with ≤1 of the following criteria: waist circumference and blood pressure ≥90 percentile, triglycerides >150 mg/dl, HDL-c < 40 mg/dl, or impaired fasting glucose. After 12 months of intensive lifestyle modification, anthropometric measurements, glycemic and lipid profiles, adherence to the MedDiet, energy intake, PA, body composition, and carotid intima-media thickness (cIMT) were analyzed. RESULTS 131 MHOCh (70 boys and 61 girls; p = 0.65, age: 7.9 ± 1.3 years, Body Mass Index (BMI): 24.7 ± 3.5 kg/m) were included. After 12 months of intervention, a significant decrease in standard deviation (SD) units of body weight (-0.5 ± 0.1; p < 0.001) and body mass index (-0.5 ± 0.1; p < 0.001) were observed in the total population. A significant improvement in adherence to the MedDiet (+2 points) and a significant reduction in protein, fatty acids, total fat, and cholesterol intake in the entire population were observed. All participants did more moderate-vigorous PA, which led to a significant increase in lean and total mass and decrease in total fat. Significant improvements in the glycemic profile (insulin levels (-6.6 μIU/mL, p < 0.001) and HOMA index (-1.2, p < 0.001)) were observed. Participants with pathological cIMT values reduced this cardiovascular predictor to normal values. CONCLUSIONS A 12-month lifestyle modification intervention involving weight loss with MedDiet and PA in MHOCh yielded improvements in MedDiet adherence, lipid intake, moderate-vigorous PA, body composition, insulin resistance, and cIMT.