Childhood obesity is associated with significant health consequences. Obesity-related low-grade inflammation is a potential trigger of early vascular damage in children. Therefore, treatment of childhood overweight and obesity is necessary. Three multidisciplinary treatment trajectories have been developed for overweight children in cooperation with Gelderse Vallei Hospital (GVH) in Ede. In the Pro- and Anti-Inflammatory Marker (PAIM) study, obesity-related low-grade inflammation is investigated in overweight and obese children participating in one of the treatment trajectories facilitated by GVH.
The prevalence of childhood overweight and obesity is increasing dramatically, becoming one of the most alarming public health issues. Even in childhood, obesity often occurs with other risk factors for cardiovascular disease, such as increased blood pressure, adverse changes in serum lipoproteins, and hyperinsulinemia. Obesity-related low-grade inflammation, and subsequently increased generation of oxidative stress,are potential triggers of early vascular damage in children. Visceral adipose tissue (VAT) and its adipose tissue resident macrophages produce many pro-inflammatory cytokines. These cytokine changes induce insulin resistance and play a major role in the pathogenesis of endothelial dysfunction and subsequent atherosclerosis. More and more evidence suggest that low-grade inflammation predicts an increased risk of chronic disease and promotes its progression. The association between diet, physical activity and obesity is well established, and between obesity and inflammation. Less data is available to allow us to elucidate how physical activity/fitness or dietary patterns may have a direct effect on inflammation. Understanding the interplay between physical activity, cardiorespiratory fitness and fatness in any comprehensive approach may be of importance to reducing cardiovascular disease risk in young people.
Besides abovementioned cardiovascular consequences, obese children and adolescents and their families are at risk for psychological and social adjustment problems.
The aim of the PAIM study is to explore the relationship between pro- and anti-inflammatory markers and BMI z-score during the intervention and maintenance programmes for overweight / obesity in GVH. Furthermore, the association of low-grade inflammation with physical activity and cardiorespiratory fitness is being addressed. All overweight / obese children participating in a one-year intervention programme of GVH followed by a maintenance programme of two years are requested to participate in this longitudinal observational study.