title: Dietary and lifestyle counselling reduces the clustering of overweight-related cardiometabolic risk factors in adolescents.
abstract: OBJECTIVE
  The aim of this study was to evaluate the impact of individualised dietary and lifestyle counselling, primarily aimed to decrease serum low-density lipoprotein cholesterol, on the clustering of overweight-related cardiometabolic risk factors in children.
  
  
  METHODS
  The 7-month-old study children were randomized either to counselling (n = 540) or control group (n = 522).
  
  
  METHODS
  The 5- to 15-year-old participants who fulfilled the international criteria were classified as overweight. Being in the highest [lowest for high-density lipoprotein (HDL) cholesterol] age- and gender-specific quintile of body mass index (BMI), blood pressure, serum triglycerides, HDL cholesterol or glucose was considered a risk factor. A cluster was defined as having high BMI and > or = 2 other risk factors.
  
  
  RESULTS
  The counselling did not reduce the prevalence of overweight in 5- to 15-year-old participants. From age 7 onwards, the proportion of children with > or = 2 risk factors was lower in the intervention than in the control group (p = 0.005). At the age of 15 years, 13.0% of girls and 10.8% of boys in the intervention group and 17.5% of girls and 18.8% of boys in the control group had the risk factor cluster (p = 0.046 for main effect of the study group). Having even one risk factor at the age of 5 years predicted the clustering of risk factors at the age of 15 years (OR: 3.8, p < 0.001).
  
  
  CONCLUSIONS
  Repeated, individualized dietary and lifestyle counselling may reduce the clustering of overweight-related cardiometabolic risk factors in adolescents even though the counselling is not intense enough to prevent overweight.
authors.affiliation: The Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland. maarit.hakanen@utu.fi
authors.forename: M
authors.initials: M
authors.lastname: Hakanen
authors.forename: H
authors.initials: H
authors.lastname: Lagström
authors.forename: K
authors.initials: K
authors.lastname: Pahkala
authors.forename: L
authors.initials: L
authors.lastname: Sillanmäki
authors.forename: M
authors.initials: M
authors.lastname: Saarinen
authors.forename: H
authors.initials: H
authors.lastname: Niinikoski
authors.forename: O T
authors.initials: OT
authors.lastname: Raitakari
authors.forename: J
authors.initials: J
authors.lastname: Viikari
authors.forename: O
authors.initials: O
authors.lastname: Simell
authors.forename: T
authors.initials: T
authors.lastname: Rönnemaa
mesh_terms: D000293:Adolescent; D001786:Blood Glucose; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003376:Counseling; D004032:Diet; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D050177:Overweight / Q000517:prevention & control*; D015995:Prevalence; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D014280:Triglycerides