Key result
Pediatric weight reduction is associated with cardiometabolic improvements, including ~0.7-kg loss per 1-mg/dL HDL increase.
Why the study?
Excess body weight in children is linked to multiple immediate and long-term medical comorbidities, but the degree of weight reduction associated with cardiometabolic changes is unclear.
Does weight reduction improve cardiometabolic outcomes in overweight and obese children?
Systematic Review
Does weight reduction improve cardiometabolic outcomes in overweight and obese children?
Weight reduction in overweight and obese children is associated with significant improvements in cardiometabolic markers, particularly HDL, systolic blood pressure, and triglycerides.
Modest weight loss improves SBP, HDL, and triglycerides in obese children; supports targeting small BMI reductions in management and future trials.
BACKGROUND: Excess body weight in children is associated with multiple immediate and long-term medical comorbidities. We aimed to identify the degree of reduction in excess body weight associated with cardiometabolic changes (lipid panel, liver function tests, systolic blood pressure (SBP), diastolic blood pressure, glycosylated hemoglobin, and fasting blood glucose) in overweight and obese children. METHODS: We conducted a comprehensive search of MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, and Scopus through February 12, 2015. We included randomized controlled trials and cohort studies that evaluated interventions to treat pediatric obesity (medication, surgery, lifestyle, and community-based interventions) with ≥ a 6-month follow-up. We used a random effects meta-regression approach to assess the association between body mass index (BMI)/weight and cardiometabolic changes. RESULTS: (P = .04) in BMI. A 1-mg/dL increase in HDL was significantly associated with a 0.74-kg decrease in weight (P = .02). A 1-mg/dL decrease in triglycerides was significantly associated with a 0.1-kg decrease in weight (P = .03). The remaining associations were not statistically significant. CONCLUSIONS: Weight reduction in children is associated with significant changes in several cardiometabolic outcomes, particularly HDL, SBP, and triglycerides. The magnitude of improvement may help in setting expectations and may inform shared decision-making and counseling.
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Rajjo et al. (2016) conducted a systematic review in overweight and obese children. Weight reduction was evaluated on cardiometabolic changes (lipid panel, liver function tests, blood pressure, glycosylated hemoglobin, fasting blood glucose). Weight reduction in overweight and obese children was significantly associated with cardiometabolic improvements, including a 0.74-kg weight decrease per 1-mg/dL increase in HDL (P=0.02).
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