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


METHODS
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.
Balagopal
Prabhakaran
P
Nemours Children's Clinic, Mayo Clinic and Mayo School of Medicine, University of Florida, Jacksonville 32207, USA. bbalagop@nemours.org
George
Donald
D
Patton
Norman
N
Yarandi
Hossein
H
Roberts
William L
WL
Bayne
Edward
E
Gidding
Samuel
S
D000293:Adolescent; D000704:Analysis of Variance; D015992:Body Mass Index; D001835:Body Weight; D002097:C-Reactive Protein / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000453:epidemiology; D008076:Cholesterol, HDL / Q000378:metabolism; D008078:Cholesterol, LDL / Q000378:metabolism; D018752:Diet, Fat-Restricted; D016002:Discriminant Analysis; D015444:Exercise; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D006801:Humans; D007249:Inflammation / Q000517:prevention & control*; D007333:Insulin Resistance / Q000502:physiology; D015850:Interleukin-6 / Q000378:metabolism*; D008019:Life Style; D008297:Male; D009765:Obesity / Q000378:metabolism*; D012307:Risk Factors; D013997:Time Factors
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D015850:Interleukin-6; D005340:Fibrinogen; D002097:C-Reactive Protein