Evaluation of two dietary treatments in obese hyperinsulinemic adolescents.
| Autor: | Armeno ML; Department of Nutrition, Hospital de Pediatría JP Garrahan, Combate de los Pozos 1881, Buenos Aires, Argentina. mlarmeno@gmail.com, Krochik AG, Mazza CS |
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| Jazyk: | angličtina |
| Zdroj: | Journal of pediatric endocrinology & metabolism : JPEM [J Pediatr Endocrinol Metab] 2011; Vol. 24 (9-10), pp. 715-22. |
| DOI: | 10.1515/jpem.2011.291 |
| Abstrakt: | Unlabelled: Hyperinsulinemia increases the risk of cardiovascular disease in obese children. Only a few treatments are available to decrease insulin resistance. The reduction of hyperinsulinemia by dietary means would be a simple, physiologic and economic way to reduce the risk of metabolic disease. Objective: To compare the effects of two low-energy diets on serum insulin concentrations and weight loss in obese hyperinsulinemic adolescents. Materials and Methods: Eighty-six randomly assigned insulin-resistant obese adolescents completed a 16 week calorie-restricted diet. The experimental diet had a reduced glycemic index designed to evoke a low insulin response (LIR), with carbohydrates and proteins ingested in separate meals. The control diet was a conventional (CD) with similar proportions (60%, 20% and 20%). Variables studied were blood glucose and insulin concentrations after an oral glucose load, body mass index, waist circumference, and insulin resistance (homeostasis model assessment, HOMA). Results: Mean weight [+/- Standard Deviation (SD)] was significantly reduced after the LIR (-0.53 +/- 0.5) and the CD (-0.54 +/- 0.4), but a greater decrease of waist circumference (cm) was observed after the LIR (-9.1 +/- 4.8 vs. -6.6 +/- 4.6, p = 0.02). Fasting insulin concentrations (-17.9 +/- 27.9 vs. -9.4 +/- 14.8, p = 0.01) and HOMA dropped significantly more after the LIR than after the CD (-3.5 +/- 4.9SD vs. -2.4 +/- 1SD, p < 0.0001). Conclusions: The LIR diet reduces serum insulin concentrations and waist circumference more than conventional treatment and appears to be a promising alternative to a conventional diet in insulin-resistant obese adolescents. Long-term follow-up is needed to evaluate the maintenance of weight loss and metabolic parameters. |
| Databáze: | MEDLINE |
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