Supervisors info:
Ευαγγελία Χαρμανδάρη, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ, Επιβλέπουσα
Γεράσιμος Κολαΐτης, Ομότιμος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Φλώρα Μπακοπούλου, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Βελτίωση της συμπτωματολογίας άγχους και κατάθλιψης, και των καρδιομεταβολικών παραγόντων κινδύνου σε παιδιά και εφήβους με υπερβαρότητα και παχυσαρκία μετά την εφαρμογή εξατομικευμένου προγράμματος παρέμβασης στον τρόπο ζωής
Summary:
INTRODUCTION: Childhood obesity is one of the most challenging contemporary public health problems. Children and adolescents with obesity experience multiple psychosocial difficulties, such as low self-esteem, depression, anxiety, and behavioral problems. Psychosocial problems noted in youngsters with excess adiposity persist for a long time. The aim of our study was to assess symptoms of depression and anxiety in children and adolescents with overweight and obesity before and after the implementation of a comprehensive, personalized, multidisciplinary lifestyle intervention program.
METHODS: Six hundred and eleven (315 female-296 male, mean age± SD: 10.39 ± 0.10 years, 326 prepubertal and 285 pubertal) children and adolescents, aged 6-18 years, were studied prospectively and classified as having obesity (50.2%), overweight (33.5%) or normal BMI (16.2%) according to IOTF criteria. All participants entered a 12-month lifestyle intervention program that provided personalized guidance on healthy diet and physical activity to patients and their families. A multidisciplinary team evaluated all subjects at baseline and at frequent intervals thereafter. Laboratory investigations were obtained at the beginning and the end of the study. All participants completed two psychometric questionnaires, the Child’s Depression Inventory (C.D.I) and the Screen for Child Anxiety Related Disorders (S.C.A.R.E.D), aiming to evaluate depressive and anxiety symptomatology respectively.
RESULTS: After completion of the intervention, there was a statistically significant reduction in BMI and BMI z-score and improvement in inflammatory (TKE, ferritin) and cardiometabolic risk markers (HDL, LDL, Systolic Blood Pressure, HbA1C) in patients with obesity and overweight compared to baseline assessment. Moreover, a significant decrease in the anxiety score on S.C.A.R.E.D was noted in participants with obesity based on childrens´ opinion (p<0.001), as well as in all subjects independently of BMI based on parents´ opinion (p<0.003). Furthermore, a significant reduction in depression score on C.D.I. (p=0.03) was recorded in participants with obesity. Females showed a reduced response to the intervention compared to males. Furthermore, adolescents with obesity showed a significant reduction in depression and anxiety symptom scores compared to pre-intervention. Insulin resistance and metabolic syndrome parameters (Waist Circumference, Blood Pressure, Triglycerides), cortisol, PRL and LH were positive predictors of pre-intervention depressive and anxiety symptoms.
CONCLUSIONS: The implementation of a multidisciplinary, personalized lifestyle intervention program in the management of childhood obesity is extremely important to ensure physical and mental health and prevent emotional disorders. In addition, the need for early and ongoing intervention during adolescence, particularly in females, is emphasized. The improvement in mental health is likely to be mediated by an improvement in energy metabolism with subsequent improvement in neuroinflammation as a consequence of changes in diet and physical activity.
Keywords:
Childhood obesity, Mental health, Depression, Anxiety, Lifestyle intervention
