Changes in thyroid and glycemic status and food intake in children with excess weight who were submitted for a multi-component school intervention for 16 months

Abstract

We investigated if children with excess weight who submitted to two types of intervention at school for 16 months showed improvements in thyroid and glycemic function and food intake. Children (8–11 years) with a body mass index-for-age (BMI/A) of ≥1 Z score were divided into two groups: Treatment 1 (n = 73) involved motivation to adopt healthier lifestyle; Treatment 2 (n = 103) involved performing weekly nutritional education, motivational, and physical activities at school. A semi-quantitative food frequency questionnaire was used. The delta BMI/A were similar after 16 months; Treatment 1 showed higher decrease in thyroid-stimulating hormone (TSH; median (range)): −0.45 (−3.19 to 2.17) and 0.06 (−4.57 to 1.63) mIU/L, p = 0.001), FreeT3 (−0.46 (−2.92 to 1.54) and −0.15 (−2.46 to 1.38) pmol/L, p = 0.038), and FreeT4 −1.41 (−6.18 to 3.47) and −0.90 (−4.89 to 2.96) pmol/L, p = 0.018), followed by decrease in energy intake (7304 (6806 to 7840) and 8267 (7739 to 8832) kJ, Ptreatment = 0.439, Ptime <0.001, interaction group–time p < 0.001), macronutrients and sugar. A positive correlation between FreeT3 and BMI/A, and a negative correlation with FreeT4 and insulin were found at baseline (r 0.212, p < 0.01; r −0.155, p < 0.01, respectively) and follow-up (r 0.222, p < 0.01; r −0.221, p < 0.01). The decrease in overall diet and particularly sugar intake was accompanied by a greater reduction in TSH and FreeT3 in Treatment 1, demonstrating the impact of dietary intake on thyroid function.