Endocrinologie et syndrome métabolique
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Low Glycemic Index and Load, Hypo Caloric Diet as an Effective Treatment for Obesity and Hyperlipidemia in Girls with Metabolic Syndrome

Niki G. Philippas, Antonia Dastamani, Panagiota Pervanidou, Eleftheria Roma-Giannikou, George P. Chrousos, Christina Kanaka-Gantenbein

Objective: Considering the multiple complications of childhood obesity and metabolic syndrome (MS) at an early age, successful interventions are desperately needed. The aim of the study is to assess the effectiveness of a hypocaloric, low Glycemic Load (GL) and low Glycemic Index (GI) diet on the improvement of obesity and MS-related parameters.

Methods: Fifty obese girls, aged 7-16 years, were randomly recruited from the Obesity Clinic of the First Department of Pediatrics, of the University of Athens. Half of the girls were randomly prescribed a 3-month hypocaloric dietary intervention emphasizing on portion control and low GL foods, versus no intervention in the control group. The dietary advice was according to the principles of the Mediterranean diet. Physical activity was kept constant. Anthropometric measurements, fasting blood lipids, glucose and prevalence of MS were assessed before and after the 3-months.

Results: The girls in the intervention group exhibited a significant decrease in BMI, BMI z-score, waist circumference, total cholesterol and LDL compared to the control group (all p<0.05) and a 17% decrease in the incidence of MS. The decrease in total carbohydrate intake was the only dietary parameter significantly correlated to the decrease in BMI z- score in this population (p=0.049). The decrease in GI of the diet was positively correlated with a decrease in diastolic blood pressure (DBP). No other dietary components were found to be associated to the improvement of the MS parameters (p>0.05).

Conclusions: This study demonstrates the efficacy of a hypocaloric-low GI/GL diet, incorporating adequate protein and healthy fat, in improving parameters of MS in obese children and adolescents. It suggests a positive role of the reduction in total carbohydrate intake and GI to the decrease in BMI z-score and DBP respectively. Further research is needed to confirm these results in the long-term.