A Mediterranean-style Breakfast and Postprandial Lipid Disorders in Obese Pre-adolescents and Adults
Condition: Obesity
MeSH terms: Lipid Metabolism Disorders
Study type: Interventional

Summary: 
      Obesity has a major impact on the development of cardiovascular disease and other related
      conditions and it is of particular concern in children. The prevalence of childhood
      overweight and obesity in Spain is among the highest in the European continent. Childhood
      obesity has been associated with diseases that were thought to apply only to adults, such as
      the metabolic syndrome. Insulin resistance is the most important risk factor in subjects with
      severe obesity, which together with visceral obesity, exacerbates postprandial
      triglyceridemia, increasing cardiovascular risk.

      In this context, the investigators hypothesize that the postprandial lipid metabolism is also
      impaired in obese pre-adolescents, as it is in obese adults. This includes not only
      exacerbated postprandial triglyceridemia, but also impaired levels of inflammation markers.
      In addition, the investigators hypothesize that the lipid and protein composition of
      postprandial chylomicrons and chylomicron remnants are also altered in obese children when
      compared with their normal-weight counterparts, and that these postprandial lipoproteins
      induce foam cell formation differently. The investigators also believe that a
      Mediterranean-style meal can help to normalize the altered postprandial lipid metabolism in
      obese adolescents.
    

Detailed description: 
      Excess of body weight has led the World Health Organization to call it a global epidemic.
      Obesity has a major impact on the development of cardiovascular disease and other related
      conditions and it is of particular concern in children.

      The prevalence of childhood overweight and obesity in Spain is among the highest in the
      European continent. The health consequences of obesity in children are not as evident as in
      adults, but childhood obesity has been associated with diseases that were thought to apply
      only to adults, such as the metabolic syndrome. Insulin resistance is the most important risk
      factor in subjects with severe obesity, which together with visceral obesity, exacerbates
      postprandial triglyceridemia, increasing cardiovascular risk.

      However, this has not been appropriately studied in children for the moment. The excellent
      results of previous projects carried out by our research group have shown the beneficial
      properties of olive oil on health, being the main ingredient of the Mediterranean Diet,
      including an improved postprandial lipid pattern.

      In this context, our hypothesis is that the postprandial lipid metabolism is also impaired in
      obese pre-adolescents, as it is in obese adults. This includes not only exacerbated
      postprandial triglyceridemia, but also impaired levels of inflammation markers. In addition,
      we hypothesize that the lipid and protein composition of postprandial chylomicrons and
      chylomicron remnants are also altered in obese children when compared with their
      normal-weight counterparts, and that these postprandial lipoproteins induce foam cell
      formation differently, as well as a different release of inflammation markers by macrophages.
      However, it is also part of our hypothesis, that a Mediterranean-style meal,administrated as
      a breakfast can help to normalize the altered postprandial lipid metabolism in obese
      children.

      With this aim, we will carry out a dietary intervention study with a randomized, crossover
      design in a single meal, in order to measure changes in the postprandial lipid metabolism in
      pre-adolescents and adults affected by obesity and to compare the effect of a
      Mediterranean-style breakfast. Chylomicron remnants will be isolated from blood serum and
      will be fully characterized. These particles will be incubated with monocyte cell lines to
      determine their effect on cellular lipid metabolism and the production of inflammatory
      factors. In addition, the influence of obesity in the composition and structure of the plasma
      membrane will also be assessed. The results will generate knowledge about the pathophysiology
      of obesity in children and will contribute to the dietary recommendations for weight
      maintenance in this population. Furthermore, it will provide information on the development
      of atherosclerosis during the postprandial period, which may begin at very young ages.
    

Intervention name(s): Mediterranean-style breakfast; Western-style breakfast
Intervention type(s): Dietary Supplement; Dietary Supplement
Intervention description(s): The experimental meal will be administered early in the morning as breakfast, "Cardioliva" olive oil, bread (2 slices), tomatoes (half piece), fruit juice (200 mL), skim milk (150 mL). The amount of fat administered will be the equivalent to 0.75 g per kg of body weight.; The experimental meal will be administered early in the morning as breakfast, containing butter, bread 82 slices), chocolate milk (200 mL). The amount of fat administered will be the equivalent to 0.75 g per kg of body weight.
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: Double (Participant, Care Provider)
Primary purpose: Prevention
Keywords: Obesity; Adolescence; Lipid metabolism; Mediterranean diet; Chylomicron; Macrophages