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In summary, a significant reduction of IR in all sex and age groups with a pronounced effect in girls was observed for non-diabetic children with overweight and obesity after multidisciplinary intervention.
To rule out masked impaired glucose tolerance or diabetes in participants without OGTT, we analyzed the effect of treatment in the subgroup of participants who underwent OGTT. Furthermore, treatment effects were equal, indicating no difference between participants with OGTT and the whole sample Table S 4.
Two-thirds of participants analyzed and included in analysis both before and after intervention decreased CRP levels within the program. In total, CRP levels were effectively reduced by 1. Sex-specific analysis revealed lower levels in girls than in boys, after intervention 2.
There was a not-significant trend in ANC to a decrease by 0. When we studied adipokines as additional markers of metaflammation, leptin was significantly reduced by 2. Adiponectin was significantly increased by 0. This increase was also existent in both genders, but girls had 0.
Effect of multidisciplinary intervention on biomarkers of metaflammation.
Discussion The program was successful in the short-term treatment of childhood obesity by improving body composition. The dropout rate of 17. Thus, the efficacy of the 5 months program was respectable compared to similar studies.
Of course, the majority of participants were still obese after completion of the program.
BMI in adolescence correlates with BMI in adulthood and is a strong predictor of glucose utilization in early adulthood 30. Childhood obesity also increases the risk of diabetes and abdominal obesity in adulthood independently of each other 31, and insulin resistance amplifies the risk for metabolic syndrome in adulthood 4.
Certainly, the changed lifestyle must be continued in order to maintain or enhance the effects long-term.
By providing measurable body improvements and communication with other children affected by obesity, the program might have been a motivational factor for continued lifestyle improvement.
There is recent evidence that weight-loss after behavioral intervention programs can be maintained long-term, and compared to untreated controls, a 3 months program has sustained impact on biometrics and physical activity after 1 year 12, 32, 33.
To promote ongoing profound changes in diet, physical exercise and behavior, we offered easily accessible continuing classes for the children after the program.
We, however, did not identify a major predictor for treatment response in our cohort. In particular, no effect of gender, age, or migratory background was observed.
The design of our intervention program showed similarities and differences to other comparable programs. Like other, we considered family integration as crucial, especially in children, who are more dependent on their family than adolescents 34, 35.
Before every session, body fat percentage was measured by bioimpedance analysis, giving the participants objective feedback about the current body composition.
According to the nutritionist's subjective experience, this was one of the main motivators for adhering to their recommendations. Theaters then would have to purchase the headsets that narrate films for the blind and glasses that provide the closed-captioning for the deaf, at an additional cost.