Diet and exercise help improve obese adults' lipid profile. However, their effect on obese children, the aim of the present study, is poorly known. Fifty obese children were studied into 2 paired groups: group D (1,500 to 1,800 kcal diet: 55% carbohydrate, 30% fat, 15% protein), and group DE (same diet plus aerobic physical activity 1 hour/day 3 times a week). After 5 months BMI, triglycerides, total cholesterol (TC) and fractions were assessed. No change in triglycerides, TC and low-density lipoprotein cholesterol (LDL-C) levels were reported in both groups. However, high-density lipoprotein cholesterol (HDL-C) increased (+10.3%; p < 0.01) only in DE group. Screening patients with TC > 170 mg/dL, LDL-C > 110 mg/dL and HDL-C < 35 mg/dL we had: similar reduction for TC in both groups (-6.0% x -6.0%; p = NS), LDL-C reduction in both groups (-14.2% x -13.5%; p = NS), and HDL-C increase only in DE group (+10.0%; p < 0.05). CONCLUSIONS: (1) Hypocaloric diet (HD) plus exercise, rather than diet only, increase obese children's HDL-C levels irrespective of baseline levels; (2) HD only and HD plus exercise lead to TC and LDL-C reduction in obese children with TC and LDL-C above normal values.

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