Favorable Effect of Short-Term Lifestyle Intervention on Human Paraoxonase-1 Activity and Adipokine Levels in Childhood Obesity

Objective: The prevalence of obesity is increasing in adult and child populations throughout the world. Childhood obesity has a great impact on adult cardiovascular morbidity and mortality; treatment of this pathological state is important given the significant health consequences. We investigated the effect of short-term lifestyle changes on the alteration of human serum paraoxonase-1 (PON1) activities, leptin, adiponectin, E-selectin, and asymmetric dimethylarginine (ADMA) as atherogenic and antiatherogenic factors in obese children. PON1 protects lipoproteins against oxidation by hydrolyzing lipid peroxides in oxidized low density lipoprotein (LDL) and therefore may protect against atherosclerosis. Methods: A total of 23 white obese and overweight children (age, 11.43 +/- 1.78 years; 8 girls, 15 boys) participated in a 2-week-long lifestyle camp based on a diet and exercise program. Overweight and obesity were defined according to the national body mass index (BMI) reference tables for age and sex. Results: After a 2-week-long supervised diet and aerobic exercise program, obese children had significantly lower leptin (55.02 +/- 33.42 ng/ml vs 25.37 +/- 19.07 ng/ml; p < 0.0001), ADMA (0.68 +/- 0.15 mu mol/l vs 0.55 +/- 0.16 mu mol/l; p < 0.01), and E-selectin levels (67.19 +/- 30.35 ng/ml vs 46.51 +/- 18.40 ng/ml; p < 0.0001), whereas they had significantly higher PON1 paraoxonase activity (110.48 +/- 72.92 U/l vs 121.75 +/- 93.48 U/l; p < 0.05) besides the antiatherogenic alteration of the lipid profile and significant weight change (70.32 +/- 19.51 kg vs 67.01 +/- 18.75 kg, p < 0.0001; BMI, 28.95 +/- 5.05 kg/m(2) vs 27.43 +/- 4.82 kg/m(2), p < 0.0001). Adiponectin and PON1 arylesterase activity did not change significantly. Conclusions: Our investigation suggests that modifications in dietary habits and physical activity induce antiatherogenic changes in childhood obesity. These findings emphasize the major role of primary prevention and nonpharmaceutical treatment of childhood obesity through lifestyle changes based on diet and increased physical activity.