Lifestyle-only intervention attenuates the inflammatory state associated with obesity: a randomized controlled study in adolescents.

Author: Balagopal P, George D, Patton N, Yarandi H, Roberts WL, Bayne E, Gidding S

Author affiliation: Nemours Children's Clinic, Mayo Clinic and Mayo School of Medicine, University of Florida, Jacksonville 32207, USA. bbalagop@nemours.org

Publication date & source: 2005.03, J Pediatr., 146(3):342-8.

Publication type: Clinical Trial; Randomized Controlled Trial; Research Support, Non-U.S. Gov't

OBJECTIVES: The primary goals were to understand the relationship among the inflammatory factors, C-reactive protein (CRP), interleukin-6 (IL-6), and fibrinogen, and indices of obesity in normoglycemic, insulin-resistant adolescents and to investigate the impact of a lifestyle-only intervention on these nontraditional risk factors for cardiovascular disease (CVD). STUDY DESIGN: Randomized controlled lifestyle-only intervention study in adolescents. Of the 21 adolescents studied, 15 obese subjects (body mass index [BMI] = 37.6 +/- 3.3 kg/m 2 ) were randomized to either a lifestyle intervention program or usual care. The lean controls were studied only at baseline. Analysis of variance (ANOVA) for repeated measures was used to study intervention effect and t test, one-way ANOVA, and discriminant function analysis for baseline comparisons. RESULTS: The intervention group maintained weight, whereas the control group gained weight (P = .02). A redistribution of body composition and a decrease in insulin resistance were observed. Elevated circulating concentrations of CRP, fibrinogen, and IL-6 were significantly reduced (all P <or=.02) in response to intervention, but not in controls. CONCLUSIONS: Modest lifestyle-only change in previously sedentary obese adolescents redistributes the parameters of body composition in the absence of weight loss and reverses, at least in part, the inflammatory state in association with an improvement of insulin resistance.