The Impact of the Glycemic Index, Glycemic load and the Macronutrient intake of the Diet of overweight and obese Children on Metabolic Syndrome Development

Background/Objective A significant percentage of obese children develop metabolic abnormalities. The aim of the study was to investigate whether the diet of the overweight/obese Greek children and adolescents who develop metabolic syndrome (MS) differ from the diet of those who do not concerning glycemic index (GI), glycemic load (GL) and macronutrient intake. Methods Three-day food diaries were analyzed from 96, randomly selected overweight and obese girls and boys, aged 5-16 years, regularly followed in the Obesity Clinic of the First Department of Pediatrics of the University of Athens. The diets were assessed for their total daily energy, protein, carbohydrate, fiber, fat content, GI and GL, using Food Processor ESHA-SQL 10.1. Data including: weight, height, pubertal stages, blood pressure, fasting plasma levels of total cholesterol, low-density and high-density lipoprotein cholesterol, triglycerides, glucose, insulin levels and calculated homeostasis model assessment index (HOMA), were collected. Results were analyzed per gender as a total and segregating per pubertal stage. Results In our sample of obese children, more than a third of girls and almost half of the boys had MS, with insulin resistance (HOMA) and hypertension being the most common components. Prepubertal boys with MS had a diet with a significantly greater total daily energy intake (p=0,039) and GL (p=0,032) compared to those without MS. In girls with MS there was a tendency for a greater fat intake (p=0,075), only evident in pre-pubertal girls (p=0,091). No other dietary differences were observed. Conclusion The higher GL of the diet and total daily energy intake were found to be the dietary factors significantly associated with the occurrence of MS in obese pre-pubertal boys. The diet of children at the pre-pubertal stage is suggested to be of great significance in the occurrence of MS. Larger prospective studies are needed to confirm these results.