title: Long-term follow-up of cardiovascular disease risk factors in children after an obesity intervention.
abstract: BACKGROUND
  Data concerning the long-term improvement of cardiovascular disease (CVD) risk factors after an obesity intervention in children are limited.
  
  
  OBJECTIVE
  We studied changes in weight status and CVD risk factors in children in an intervention program and evaluated whether these changes were sustained 1 y after the end of the intervention.
  
  
  METHODS
  We analyzed changes in the SD score (SDS) of body mass index [BMI; in kg/m2 (SDS-BMI)], blood pressure (BP), lipids, and homeostasis model assessment index of insulin resistance (HOMA-IR) over the course of 2 y in 240 obese (BMI > 97th percentile) children aged 6-14 y (x age: 10.4 y; x BMI: 26.9). Of these 240 children, 203 participated in a 1-y intervention program of physical exercise, nutrition education, and behavior therapy. We compared these children with 37 obese children who underwent no intervention and with 12 normal-weight children of the same age and sex.
  
  
  RESULTS
  Obese children had significantly (P < 0.05) higher BP, HOMA-IR, and insulin, triacylglycerol, and LDL-cholesterol concentrations and lower HDL-cholesterol concentrations than did normal-weight children. Twenty-nine children dropped out of the intervention. Only in the 126 children who reduced their SDS-BMI did BP (8% and 12% decreases in systolic and diastolic BP, respectively), lipids (12% and 5% decreases in triacylglycerol and LDL cholesterol, respectively; 7% increase in HDL cholesterol), insulin (13% decrease), and HOMA-IR (17% decrease) improve significantly (P < 0.05). Reduction in SDS-BMI and all benefits regarding CVD risk factors were sustained 1 y after the end of the intervention in the children whose SDS-BMI decreased.
  
  
  CONCLUSIONS
  Long-term multidisciplinary intervention led to a reduction in SDS-BMI in most of the obese children 1 y after the end of the intervention. Reduction in SDS-BMI was accompanied by an improvement in CVD risk factors.
authors.affiliation: Vestische Hospital for Children and Adolescents, University of Witten/Herdecke, Datteln, Germany. t.reinehr@kinderklinik-datteln.de
authors.forename: Thomas
authors.initials: T
authors.lastname: Reinehr
authors.forename: Gideon
authors.initials: G
authors.lastname: de Sousa
authors.forename: André Michael
authors.initials: AM
authors.lastname: Toschke
authors.forename: Werner
authors.initials: W
authors.lastname: Andler
mesh_terms: D000293:Adolescent; D001521:Behavior Therapy; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D016022:Case-Control Studies; D002648:Child; D053198:Child Nutrition Sciences / Q000193:education*; D015444:Exercise / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007333:Insulin Resistance; D008055:Lipids / Q000097:blood; D008137:Longitudinal Studies; D008297:Male; D009765:Obesity / Q000097:blood / Q000150:complications / Q000178:diet therapy / Q000628:therapy*; D012307:Risk Factors; D015431:Weight Loss / Q000502:physiology*
chemical_list: D008055:Lipids