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Roya Kelishadi ,MD

Results of Two Non-Pharmacological Trials for Treatment of Childhood Obesity. Roya Kelishadi ,MD Isfahan Cardiovascular Research Center Isfahan University of Medical Sciences

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Roya Kelishadi ,MD

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  1. Results of Two Non-Pharmacological Trials for Treatment of Childhood Obesity Roya Kelishadi ,MD Isfahan Cardiovascular Research Center Isfahan University of Medical Sciences Oct 29,2009

  2. Produced by: Dr.Roya Kelishadi

  3. Three-year Study on the Effects of a Trial of a Dairy-rich Diet on Body Composition, Insulin Resistance and Components of the Metabolic Syndrome among Obese Prepubescent Children Roya Kelishadi MD1, Michael B. Zemel MD,PhD2 1.Associate Professor of Pediatrics, Preventive Pediatric Cardiology Department, Isfahan Cardiovascular Research Center, Isfahan University of Medical Sciences, Isfahan, Iran 2.Professor of Nutrition and Surgery,Director, Director, The Nutrition Institute,The University of Tennessee, Knoxville, TN, USA

  4. Methods • A population-based sample of 120 obese prepubescent children • Randomly assigned to three groups of equal number. • Attending 6 consecutive monthly family-centered education sessions about healthy lifestyle

  5. Methods (Cont.) • DR: An isocaloric dairy-rich diet (>800 mg Ca/day) (DR: dairy-rich diet), • ER: A caloric restriction regimen (ER: energy-restricted), • C: and the third group received no additional recommendation (C: controls); Then they were followed up twice a year for three years.

  6. Results • The DR group had the best compliance. In all groups , body mass index- standard deviation score (BMI-SDS) and waist circumference decreased significantly after the 6-month trial, but had a sustained significant rise during the follow up period to the end of the study; however in the DR group this rise was significantly lower than the two other groups.

  7. Results (Cont.) After the 6-month trial, in all groups, • serum triglycerides (TG) and • insulin levels decreased, and • serum HDL-C level and • HOMA-R increased.

  8. We suggest that in addition to lifestyle changes, an isocaloric diet rich in dairy products may be a well-accepted regimen and can be a safe and practical strategy for weight control in young overweight children.

  9. Association of Changes in Oxidative and Pro-inflammatory States with Changes in Vascular Dysfunction after a Lifestyle Modification Trial among Obese Adolescents Roya Kelishadi MD1, Stephen R.Cook MD, MPH2 1.Associate Professor of Pediatrics, Preventive Pediatric Cardiology Department, Isfahan Cardiovascular Research Centre, Isfahan University of Medical Sciences ,Isfahan,Iran2. Associate Professor of Pediatrics, University of Rochester ,USA

  10. Objective: To assess the association of changes in • oxidative and • pro-inflammatory states with • changes in vascular dysfunction after lifestyle modification among obese youths.

  11. Methods • 6-week lifestyle intervention trial • 35 obese adolescents, • Simple obesity • No underlying disease • Not under other treatment

  12. We evaluated the relationship between changes in • anthropometric indices, • measures of insulin resistance, • C-reactive protein (CRP), • oxidized LDL (Ox-LDL) and • oxidative stress markers with changes in • carotid intima media thickness (C-IMT) and • flow mediated dilation of the brachial artery (FMD).

  13. Results: • After the trial, body mass index (BMI), waist circumference (WC), and percentage body fat reduced significantly, however participants remained overweight . • While FMD improved significantly, the improvement in C-IMT did not reach statistical significance.

  14. Results (Cont.) • The changes in BMI, WC, fat mass, ox-LDL, MDA, CRP, insulin and HOMA-IR had significant inverse correlation with the changes in mean FMD after adjustment for age and sex, • with the highest correlations documented for ox-LDL, CRP and WC, respectively.

  15. Conclusions: • Our findings suggest that enhanced oxidative damage to circulating LDL in plasma may interact with the early oxidative and pro- inflammatory state and vascular dysfunction among obese youths, and that • these early stages of pro-atherosclerotic inflammatory processes might be partially reversible by a short-term lifestyle modification, even without reaching to ideal body weight.

  16. Life style change: not an easy task!

  17. Chronic Non-communicable Diseases A Clever Person Solves A Problem, A Wise Person Avoids it [Albert Einstein] So Let’s be Wise for Prevention&Control of Overweight from Early Life!

  18. Goodhabits formed atyouthmakeallthe difference. Aristotle (384-322 BCE)

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