Inflammation in obese children and adolescents: Association with psychosocial stress variables and effects of a lifestyle intervention

• Published in: Brain, behavior, and immunity Vol. 98; pp. 40 - 47
• Main Authors: Verbiest, I., Michels, N., Tanghe, A., Braet, C.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01.11.2021
• Subjects: Adolescent; Body Mass Index; C-reactive protein; Child; Children and adolescents; Humans; Inflammation; Life Style; Lifestyle intervention; Obesity; Pediatric Obesity - complications; Pediatric Obesity - therapy; Psychosocial stress variables; Stress, Psychological; Weight Loss; Obesity; Children and adolescents; Inflammation; C-reactive protein; Psychosocial stress variables; Lifestyle intervention
• ISSN: 0889-1591; 1090-2139
• DOI: 10.1016/j.bbi.2021.07.020

•C-reactive protein is related with psychosocial variables in obese youth (7–19y).•Eating behavior and attachment anxiety are positively related to C-reactive protein.•A lifestyle intervention resulted in decreased C-reactive protein values.•Baseline attachment avoidance is related to less C-reactive protein decrease. Obesity in childhood and adolescence is a complex health issue that has detrimental effects on the physical and psychological health of the youngster, both in the short and long term. A characteristic of obesity is the associated chronic low-grade inflammation which can result in insulin resistance. Previous research suggested that biomarkers referring to such increased inflammation may help in understanding resistance to weight loss. Whether and how psychosocial factors are related with inflammation remains to be proven. The current study consisted of 594 children and adolescents (7–19 years), of whom 480 had follow-up data, who enrolled for a ten-month inpatient multidisciplinary obesity treatment consisting of healthy food routines, physical activities and psychological treatment. The purpose of the study was to explore (1) the relationship between inflammation and psychosocial stress variables (i.e., depressive symptoms, eating behavior, concerns about eating/shape/weight, insecure parent-child attachment) (correlational and multiple regression analysis), (2) whether a lifestyle intervention for obese youngsters results in decreased C-reactive protein (CRP) values (paired t-test) and (3) which psychosocial variables influence this CRP change as indication of treatment success (multiple regression analysis with change in BMI as control variable). Results showed that the psychosocial stress variables emotional eating, external eating and attachment anxiety are related to higher CRP values. Our data further suggested that a lifestyle intervention decreases the CRP values. This significant reduction in blood inflammatory marker was besides being influenced by weight loss also dependent on psychosocial variables, more specific on self-reported attachment avoidance, as this latter was related to less CRP decrease.