Fiber and exercise in the treatment of obese adolescents.

The changes in body weight, body fat, lean body mass, and the efficiency index were studied in a sample of 80 obese males and females undergoing four different treatments, using two treatment components: an increase in dietary fiber, and energy expenditure through exercise. In both sexes there was a significant effect of exercise upon body weight and an improvement in the efficiency index. There was also a significant interaction between fiber and exercise in girls, but not in boys. This suggests that the eventual effect of dietary fiber is heightened by exercise, as corroborated by significant differences in some of the groups.

Risk factors in childhood diabetes mellitus.

The quotients total cholesterol/HDL-cholesterol and free fatty acid/albumin in serum were examined in various groups of diabetic patients and the changes of the quotients induced by various forms of physical activity were then registered. Both total cholesterol/HDL-cholesterol and free fatty acid/albumin were increased in patients with unsatisfactory control of diabetes. Low albumin levels were only seen in cases with very poor control or in cases afflicted by complications. Increased muscular activity unvariably led to a fall in the value of total cholesterol/HDL-cholesterol while in children with adequate control but performing little physical exercise the quotient of free fatty acid/albumin was low and total cholesterol/HDL-cholesterol was increased. In addition to the quotient of total cholesterol/HDL-cholesterol also the quotient of free fatty acid/albumin is a sensitive indicator of the diabetic condition.

Simultaneous occurrence of diabetes mellitus and coeliac disease.

Subtotal villous atrophy in the proximal jejunum was observed in six patients affected by juvenile diabetes. Introduction of gluten free diet invariably led to clinical improvement, in the four patients in whom also rebiopsy was performed the jejunal mucosa exhibited improvement. In all cases gluten sensitive enteropathy was diagnosed after the onset of diabetes. Marked stunting in growth, strikingly labile carbohydrate tolerance, pronounced proneness to hypoglycaemia or development of Mauriac's syndrome were the symptoms pointing to coeliac disease. Protracted diarrhoea was seen only in two patients, pronounced deceleration in weight development occurred in none of the six children. In four patients out of six the presence of both HLA B8 and DR3 antigens was demonstrated, in a fifth patient only DR3 was present; this suggests a common genetic background of the simultaneous occurrence of the two disorders. Untreated coeliac disease aggravates preexisting diabetes. The importance of early recognition of latent coeliac disease is stressed.

Prevention of adult cardiovascular disease in obese children.

An investigation was carried out to establish the risk factors of cardiovascular disease among obese children. Among 173 obese children 38% were endangered in respect of cardiovascular disease. The frequency of hyperlipoproteinaemia was near to 20%. It is considered necessary to separate these children from the group of obese children and to treat them according to the outlined aspects.

The position of the diabetic child in society.

A total of 108 diabetic children and 153 controls has been examined by explorative methods and questionnaires. According to the results the relationship between the diabetic child and his surroundings is not satisfactory. The sporting possibilities of the diabetic child are scanty, often without reason. All this may be in relation with the erroneous knowledge on diabetes of the child and his environment. The diabetic children familiar with their disease are in a more advantageous position. In consequence diabetic children need more attention and care. Well-trained experts and teams have to direct their way of life.