A 2 year physical activity and dietary intervention attenuates the increase in insulin resistance in a general population of children: the PANIC study

Autor: Panu Karjalainen, Soren Brage, Taisa Sallinen, Juuso Väistö, Ursula Schwab, Tomi Laitinen, Niina Lintu, Jarmo Jääskeläinen, Tuomas O. Kilpeläinen, Sonja Soininen, Timo A. Lakka, Aino-Maija Eloranta, Kai Savonen, Santtu Mikkonen, Virpi Lindi, Anna Viitasalo, Tuomo Tompuri, Mustafa Atalay, Theresia M. Schnurr, Eero A. Haapala, David E. Laaksonen
Přispěvatelé: Lakka, Timo A [0000-0002-9199-2871], Lintu, Niina [0000-0002-5456-1490], Väistö, Juuso [0000-0001-7026-5934], Viitasalo, Anna [0000-0002-7861-7217], Sallinen, Taisa [0000-0003-2769-6338], Haapala, Eero A [0000-0001-5096-851X], Tompuri, Tuomo T [0000-0003-3748-7580], Soininen, Sonja [0000-0002-2082-8652], Schnurr, Theresia M [0000-0002-6573-4959], Mikkonen, Santtu [0000-0003-0595-0657], Atalay, Mustafa [0000-0001-8999-1426], Kilpeläinen, Tuomas O [0000-0002-8349-3028], Brage, Soren [0000-0002-1265-7355], Apollo - University of Cambridge Repository
Rok vydání: 2020
Předmět:
Blood Glucose
Male
Endocrinology
Diabetes and Metabolism
medicine.medical_treatment
Physiology
physical activity
lean body mass
ruokavaliot
Body fat percentage
HOMA-IR
law.invention
Body Mass Index
glukoosi
0302 clinical medicine
Randomized controlled trial
law
Insulin
Body Size
030212 general & internal medicine
glucose
Child
Children
intervention
education.field_of_study
Body movement
interventiotutkimus
Fasting
Sedentary time
body fat
Lean body mass
Body fat
Body Composition
Female
fyysinen aktiivisuus
insulin
Population
sedentary time
030209 endocrinology & metabolism
lapset (ikäryhmät)
Intervention
insuliini
Article
03 medical and health sciences
Insulin resistance
children
Heart rate
Internal Medicine
medicine
Humans
education
Exercise
kehonkoostumus
business.industry
Physical activity
medicine.disease
Diet
Glucose
Insulin Resistance
business
diet
Zdroj: Diabetologia
Lakka, T A, Lintu, N, Väistö, J, Viitasalo, A, Sallinen, T, Haapala, E A, Tompuri, T T, Soininen, S, Karjalainen, P, Schnurr, T M, Mikkonen, S, Atalay, M, Kilpeläinen, T O, Laitinen, T, Laaksonen, D E, Savonen, K, Brage, S, Schwab, U, Jääskeläinen, J, Lindi, V & Eloranta, A-M 2020, ' A 2 year physical activity and dietary intervention attenuates the increase in insulin resistance in a general population of children : the PANIC study ', Diabetologia, vol. 63, pp. 2270-2281 . https://doi.org/10.1007/s00125-020-05250-0
DOI: 10.1007/s00125-020-05250-0
Popis: Aims/hypothesis We studied for the first time the long-term effects of a combined physical activity and dietary intervention on insulin resistance and fasting plasma glucose in a general population of predominantly normal-weight children. Methods We carried out a 2 year non-randomised controlled trial in a population sample of 504 children aged 6–9 years at baseline. The children were allocated to a combined physical activity and dietary intervention group (306 children at baseline, 261 children at 2-year follow-up) or a control group (198 children, 177 children) without blinding. We measured fasting insulin and fasting glucose, calculated HOMA-IR, assessed physical activity and sedentary time by combined heart rate and body movement monitoring, assessed dietary factors by a 4 day food record, used the Finnish Children Healthy Eating Index (FCHEI) as a measure of overall diet quality, and measured body fat percentage (BF%) and lean body mass by dual-energy x-ray absorptiometry. The intervention effects on insulin, glucose and HOMA-IR were analysed using the intention-to-treat principle and linear mixed-effects models after adjustment for sex, age at baseline, and pubertal status at baseline and 2 year follow-up. The measures of physical activity, sedentary time, diet and body composition at baseline and 2 year follow-up were entered one-by-one as covariates into the models to study whether changes in these variables might partly explain the observed intervention effects. Results Compared with the control group, fasting insulin increased 4.65 pmol/l less (absolute change +8.96 vs +13.61 pmol/l) and HOMA-IR increased 0.18 units less (+0.31 vs +0.49 units) over 2 years in the combined physical activity and dietary intervention group. The intervention effects on fasting insulin (regression coefficient β for intervention effect −0.33 [95% CI −0.62, −0.04], p = 0.026) and HOMA-IR (β for intervention effect −0.084 [95% CI −0.156, −0.012], p = 0.023) were statistically significant after adjustment for sex, age at baseline, and pubertal status at baseline and 2 year follow-up. The intervention had no effect on fasting glucose, BF% or lean body mass. Changes in total physical activity energy expenditure, light physical activity, moderate-to-vigorous physical activity, total sedentary time, the reported consumption of high-fat (≥60%) vegetable oil-based spreads, and FCHEI, but not a change in BF% or lean body mass, partly explained the intervention effects on fasting insulin and HOMA-IR. Conclusions/interpretation The combined physical activity and dietary intervention attenuated the increase in insulin resistance over 2 years in a general population of predominantly normal-weight children. This beneficial effect was partly mediated by changes in physical activity, sedentary time and diet but not changes in body composition. Trial registration ClinicalTrials.gov NCT01803776
Databáze: OpenAIRE
Externí odkaz: