OSPEL: Overweight and obeSity in Paediatric population in Luxembourg

Background

The worldwide increasing number of youth having overweight, obesity and associated comorbidities needs an improvement of diagnostic, treatment and prevention

Objectives

Objective  Diagnostic

• Development of easy-to-use, reliable  and inexpensive tools to assess visceral adiposity, major risk factor of early cardiometabolic diseases in youth.

• Investigation of the relationship between cardiometabolic risk factors and lower limbs fat.

• Better prediction of cardiometabolic, inflammatory and adipokine profiles. 

Objective Treatment

• Development of a group therapy of obesity. Intensive approach, nutritional education, physical exercise, self-esteem improvement and parental involvement.

• Comparison of the group therapy versus the individual therapy usually applied for obesity management in youth (involving outpatient visits to the paediatrician supported sometimes by nutritional education).

Objective Prevention

• Investigation of the health indicators and psychosocial characteristics predicting drop-out from group/individual therapy in children and adolescents.

• Better understanding of the mechanisms behind the development of metabolic abnormalities in obesity, by investigating the role played by lifestyle habits.

Participants 

205 boys and girls (7-17 y) with excess weight frequenting the Diabetes & Endocrinology Care Paediatrics Clinic, Centre Hospitalier de Luxembourg

Methods

Physical examination, biology

• Anthropometry: Height, weight, BMI, abdominal and limb adiposity measures

• Dual-energy X-ray absorptiometry, DEXA: Body fat at measurement

• Magnetic resonance imaging, MRI: Visceral adiposity measurement

• Biological assessment: Fasting glucose, fasting insulin, HDL-cholesterol, triglycerides, C-reactive protein (CRP), leptin, adiponectin and resistin 

Group therapy

• Three 3-hour sessions per week, 4 months

• Theoretical and practical educational sessions on nutrition

• Psychological support sessions for self-esteem improvement

• Non competitive physical activities focused on enjoyment

Questionnaires

• Perceived health, quality of life, lifestyle behaviour and body image assessed through the Health Behaviour in School-aged Children (HBSC) questionnaire

• Psychosocial variables assessed by the Strengths and Difficulties Questionnaire (SDQ)

Main Results

 In diagnostic

• Anthropometric prediction of visceral adiposity is improved by the subtraction of subcutaneous fat from the total abdominal fat in youth (Samouda H et al. Pediatr Diabetes. 2017; 18:399-404).

• Leg fat is protective for cardiometabolic  risk during childhood (Samouda H et al. Pediatr Diabetes. 2016; 17: 300-8).

• Adding anthropometric measures of regional adiposity to BMI improves prediction in youth of cardiometabolic, inflammatory and adipokine profiles (Samouda H et al. BMC Pediatr. 2015; 15: 168).

In Treatment

• At the end of the program (4 months), intensive group therapy were more efficient than individual therapy in terms of weight loss, body image satisfaction, quality of life and lifestyle changes (Samouda H et al. Final study report for the attention of the Ministry of Health. Mars 2010). 

In Prevention

• The continued attendance in obesity treatment can be successfully predicted by age, weight status and body dissatisfaction (Pit-Ten Cate IM et al. BMJ Open. 2017).

• Significant association observed between metabolically unhealthy obesity and low moderate to vigorous physical activity, during an ordinary week (Samouda H et al. Submitted to Paediatric Diabetes).

Public Health Implication

• Implementation of a dedicated program of weight management in the hospital.

OSPEL Study - Obesity in Luxembourg NutriHealth Group

“In the frame of OSPEL study, we developed and evaluated a therapeutic program for overweight and obesity management in youth. The OSPEL obesity management program is currently used as a basis for the implementation of a dedicated national medical network for weight management in children, at the hospitals”, states Hanen Samouda, PhD, NutriHealth Group.

Partners

• Centre Hospitalier de Luxembourg

• Kannerklinik

• Hôpitaux Robert Schuman

• Commune de Strassen

• Fonds National de la Recherche

• Ministère de l’Enseignement Supérieur et de la Recherche

• Ministère de la Santé

• Direction de la Santé

• Ministère des Sports 

• Institut National du Sport

• Luxembourg Institute of Health