title: Comparison of two diets of varying glycemic index on carotid subclinical atherosclerosis in obese children.
abstract: Childhood obesity is associated with an increased carotid intima-media thickness (IMT) and stiffness. Increased carotid wall thickening and rigidity are considered markers of subclinical atherosclerosis. The aim of the present study was to test the effect of two hypocaloric diets of varying glycemic index on weight loss and markers of subclinical atherosclerosis in obese children. Seventy consecutive obese children attending the Outpatient Weight Clinic of the Department of Pediatrics were invited to participate in an intensive dietary protocol. Twenty-six accepted and were randomly assigned to two different groups: the first group followed a hypocaloric low-glycemic index diet and the second a hypocaloric high-glycemic index diet. Anthropometric measures and biochemical tests were performed in all children. Quantitative B-mode ultrasound scans were used to measure intima-media thickness (IMT) and diameters of the common carotid artery. Considering both groups together, at 6 months, body mass index decreased from 28.3 +/- 3.1 to 25.8 +/- 3.3 kg/m(2), systolic blood pressure from 119 +/- 12 to 110 +/- 11 mmHg (P< 0.001), diastolic blood pressure from 78 +/- 8 to 74 +/- 7 mmHg (P< 0.001), IMT from 0.48 +/- 0.05 to 0.43 +/- 0.07 mm (P< 0.001), stiffness from 3.57 +/- 1.04 to 2.98 +/- 0.94 mm (P = 0.002), and high-sensitivity C-reactive protein from 1.5 +/- 0.9 (values log transformed) to 0.4 +/- 1.1 (P < 0.001). No differences were detectable in fasting serum triglycerides, total cholesterol, and high-density lipoprotein cholesterol. Insulin resistance (calculated by the HOmeostatic Model Assessment index [HOMA] score) significantly reduced only in the low-glycemic-index diet group (P < 0.04). In conclusion, this study confirms a benefit of hypocaloric diets on carotid IMT and stiffness in obese children and demonstrates, for the first time, an amelioration of insulin sensitivity in obese children after a low-glycemic index diet. These results justify the advice to obese children to follow a low-glycemic index diet in order to improve their cardiometabolic profile.
authors.affiliation: Department of Internal Medicine, A. Cardarelli Hospital, Via A Cardarelli 9, 80131 Naples, Italy. lelliann@libero.it
authors.forename: Arcangelo
authors.initials: A
authors.lastname: Iannuzzi
authors.forename: Maria Rosaria
authors.initials: MR
authors.lastname: Licenziati
authors.forename: Maria
authors.initials: M
authors.lastname: Vacca
authors.forename: Donata
authors.initials: D
authors.lastname: De Marco
authors.forename: Giorgio
authors.initials: G
authors.lastname: Cinquegrana
authors.forename: Marco
authors.initials: M
authors.lastname: Laccetti
authors.forename: Alessandro
authors.initials: A
authors.lastname: Bresciani
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Covetti
authors.forename: Gabriella
authors.initials: G
authors.lastname: Iannuzzo
authors.forename: Paolo
authors.initials: P
authors.lastname: Rubba
authors.forename: Mario
authors.initials: M
authors.lastname: Parillo
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D002340:Carotid Artery Diseases / Q000178:diet therapy* / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002648:Child; D004038:Diet, Reducing; D004548:Elasticity; D005260:Female; D038321:Glycemic Index; D006801:Humans; D007333:Insulin Resistance; D008055:Lipids / Q000097:blood; D008297:Male; D009765:Obesity / Q000150:complications / Q000178:diet therapy* / Q000378:metabolism / Q000503:physiopathology; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography; D055105:Waist Circumference
chemical_list: D015415:Biomarkers; D008055:Lipids; D002097:C-Reactive Protein