| Abstract | Porast pretilosti u djece i adolescenata jedan je od glavnih javnozdravstvenih problema današnjice. Cilj istraživanja bio je utvrditi učinak nutritivne intervencije na smanjenje tjelesne mase i poboljšanje specifičnih pokazatelja metaboličkih komplikacija pretilosti u djece i adolescenata iz različitog obiteljskog okruženja (mjesto stanovanja, bračno stanje roditelja, zaposlenost i stupanj obrazovanja roditelja, braća i sestre). U istraživanje je bilo uključeno 100 ispitanika s postavljenom dijagnozom pretilosti (Ž=50, M=50), prosječne dobi (12,61±1,90 godina), tjelesne mase (84,30±17,74 kg), indeksa tjelesne mase (31,18±4,17 kg/m2) odnosno percentila indeksa tjelesne mase (98,38±1,26 percentila). Ispitanici su u sklopu petodnevnog strukturiranog multidisciplinarnog programa s naglaskom na nutritivnu intervenciju, bili podijeljeni u skupine s obzirom na predadolescentsku i adolescentsku dob. Kontrolni pregledi provodili su se jednom mjesečno prvih 6 mjeseci, a potom svaka 2 mjeseca do kraja istraživanja (24 mjeseca). Istraživanje je ukupno završilo 62 % ispitanika. Za procjenu prehrambenih i životnih navika koristio se validirani upitnik; za određivanje tjelesne visine, tjelesne mase, opsega struka i opsega bokova korištene su standardne antropometrijske metode te standardne biokemijske metode za određivanje ukupnog kolesterola, HDL kolesterola, LDL kolesterola i triglicerida, test oralnog opterećenja glukozom, inzulina, aspartat-aminotransferaze, alanin-aminotransferaze, gama-glutamil-transferaze. Tijekom razdoblja praćenja 30,64 % ispitanika smanjilo je indeks tjelesne mase. Nakon 12 mjeseci značajno se smanjio ukupan kolesterol (p=0,016), LDL kolesterol (p=0,005), povećao HDL kolesterol (p=0,044) te smanjila glukoza na tašte (p=0,009), aspartat-aminotransferaza (p=0,007), alanin-aminotransferaza (p=0,005) i gama-glutamil-transferaza (p=0,030). Ujedno, zabilježeno je značajno smanjenje sistoličkog arterijskog tlaka nakon 24 mjeseca (p=0,005). Nutritivna intervencija koja uključuje edukaciju djece i adolescenata te njihovih roditelja/staratelja, uz provođenje prilagođene mediteransko-redukcijske dijete, ima značajan učinak na antropometrijske i biokemijske parametre te kardiometaboličke indikatore rizika. |
| Abstract (english) | The rise of obesity in children and adolescents nowadays is one of the major public health problems. The aim of this study was to determine the effect of nutritional intervention on weight loss and improvement of specific metabolic complications indicators of obesity in children and adolescents from different family environments (place of residence, parents marital status, parents employment and education level, brothers and sisters). The study included 100 subjects with obesity diagnosis (F=50, M=50), mean age (12.61±1.90 years), body weight (84.30±17.74 kg), body mass index (31,18±4,17 kg/m2) that is body mass index percentile (98.38 ±1.26 percentile). Subjects were divided into groups based on preadolescent and adolescence age, as a part of a five-day structured multidisciplinary program with emphasis on nutritional intervention. Control examinations were performed once a month for the first 6 months, and then every 2 months until the end of the study (24 months). A total of 62 % of respondents completed the study. A validated questionnaire was used to assess dietary and lifestyle habits; standard biochemical methods for total cholesterol, HDL cholesterol, LDL cholesterol and triglycerides, oral glucose tolerance test, insulin, aspartate aminotransferase, alanine aminotransferase, gamma glutamyl transferase and standard anthropometric methods to determine body height, body weight, waist circumference and hip circumference. During the follow-up period, 30.64 % respondents reduced their body mass index. After 12 months, total cholesterol (p=0.016) and LDL cholesterol (p=0.005) descreased and HDL cholesterol (p=0.044) increased. Values of fasting glucose (p=0.009), aspartate aminotransferase (p=0.007), alanine aminotransferase (p=0.005) and gamma glutamyl transferase (p=0.030) also descreased. At the same time, a significant decrease in systolic arterial blood pressure was recorded after 24 months (p=0.005). Nutritional intervention that includes education of children and adolescents and their parents/guardians, with included Mediterranean-reduction diet, has significant effect on anthropometric and biochemical parameters and cardiometabolic risk indicators. |
