Healthy eating improves metabolic outcomes in obese kids

In children and adolescents with obesity, keeping healthy diets and adhering to positive dietary behaviours appear to lead to better metabolic outcomes, according to a recent Singapore study.

“Interventions targeting the dietary intake of polyunsaturated fats and eating behaviour, such as cognitive dietary restraint, may improve metabolic health in children or adolescents with obesity,” the researchers said.

Using a 3-day food diary, intake of 52 participants enrolled in the Obesity in Singapore Children Study were assessed. Meanwhile, the Three-Factor Eating Questionnaire–Revised 18-item Version was used to assess eating behaviours across three domains: cognitive dietary restraint, emotional eating, and uncontrolled eating.

Participants were classified into two groups according to metabolic syndrome and metabolic health criteria, as determined by the International Diabetes Federation: metabolically health obesity (MHO) and metabolically unhealthy obesity (MUO).

Compared with their MHO counterparts, children and adolescents who had MUO consumed a significantly lower amount of grains (median, 0.00 vs 18.5 g; p=0.027) and polyunsaturated fats (6.26 percent vs 6.92 percent kcal; p=0.027). [Nutrients 2022;14:4796]

In terms of behaviour, MUO participants had significantly weaker cognitive restraint in eating (median, 15.0 vs 16.0; p=0.009).

“Whole grains are rich in dietary fibre, vitamins, minerals, and beneficial phytochemicals from plants, and they are recommended in dietary guidelines for healthy eating,” the researchers said, pointing out that a higher consumption of whole grains has been shown in previous studies to cut the risk of metabolic syndrome. [Nutr Res Rev 2004;17:99-110; Eur J Clin Nutr 2005;59:353-362]

“Cognitive dietary restraint is the perceived effort to limit dietary intake and higher cognitive dietary restraint is associated with a reduction in adiposity outcomes,” they noted. “Our observation of higher cognitive dietary restraint among children/adolescents with MHO may indicate an intentional dietary restriction to improve metabolic health outcomes.” [Appetite 2015;87:244-250]

Of note, the differences in diet and dietary behaviours between MUO and MHO children and adolescents remained true even when stratifying for sex. In boys and girls, consumption of healthful foods and better behavioural patterns were reported in those with MHO.

Nutrients, behaviours affect metabolic syndrome risk

Researchers then conducted logistic regression analysis to explore the impacts of specific food groups, nutrients, and behaviours on metabolic syndrome risk factors.

They found that protein intake exerted a significant protective effect against elevated blood pressure (odds ratio [OR], 0.791, 95 percent confidence interval [CI], 0.642–0.974). The same was true for calcium (OR, 0.991, 95 percent CI, 0.982–1.000) and iron (OR, 0.527, 95 percent CI, 0.309–0.899).

Cognitive dietary restraint likewise reduced the likelihood of high blood pressure (OR, 0.711, 95 percent CI, 0.523–0.966).

Moreover, participants with high polyunsaturated fat intake (OR, 0.529, 95 percent CI, 0.284–0.986) and with better cognitive dietary restraint (OR, 0.6891, 95 percent CI, 0.472–0.984) were significantly less likely to demonstrate an MUO profile.