Tompkins Connie L, Moran Kelsey, Preedom Stephanie, Brock David W
Department of Rehabilitation and Movement Sciences, University of Vermont, 106 Carrigan Drive, 310D Rowell, Burlington, VT 05405-0068, USA.
Curr Diabetes Rev. 2011 May;7(3):164-70. doi: 10.2174/157339911795843096.
Childhood obesity is a significant, worldwide, public health problem. Coinciding with the increasing prevalence of obesity in youth, Type 2 diabetes has emerged as a critical health condition in this population. In the U.S. alone, approximately 215,000 U.S. youth under the age of 20 were diagnosed with diabetes, with the majority of 10-19 years old diagnosed with Type 2 diabetes. Additionally, the exact number of youth that may have Type 2 diabetes yet remain undiagnosed is unknown. Increasing physical activity to encourage weight loss among youth may reduce the incidence of Type 2 diabetes in youth; however, several recent studies reported positive associations between physical activity and components of Type 2 diabetes without weight loss in youth. These findings support previous studies in adults which observed physical activity-induced improvements in insulin dynamics without changes in body fat. The purpose of this review was to identify studies which examined the effect of physical activity without dietary intervention on markers of insulin resistance in overweight and obese youth. These studies provide strong evidence that physical activity alone, without dietary intervention, can have a positive, significant impact on insulin resistance risk and potentially prevent the development of type 2 diabetes in overweight and obese youth. The studies reviewed provide support for future interventions to shift the focus from reducing obesity to increasing physical activity for the prevention of type 2 diabetes in obese youth.
儿童肥胖是一个重大的全球性公共卫生问题。随着青少年肥胖患病率的不断上升，2型糖尿病已成为这一人群中的关键健康状况。仅在美国，就有大约21.5万名20岁以下的美国青少年被诊断出患有糖尿病，其中大多数年龄在10 - 19岁的青少年被诊断为2型糖尿病。此外，尚不清楚可能患有2型糖尿病但仍未被诊断出来的青少年的确切人数。增加体育活动以鼓励青少年减肥可能会降低青少年2型糖尿病的发病率；然而，最近的几项研究报告了体育活动与青少年2型糖尿病各组成部分之间的正相关关系，且青少年并未减重。这些发现支持了先前针对成年人的研究，这些研究观察到体育活动可改善胰岛素动态，而体脂无变化。本综述的目的是确定那些研究体育活动（无饮食干预）对超重和肥胖青少年胰岛素抵抗标志物影响的研究。这些研究提供了强有力的证据，表明仅进行体育活动而无饮食干预，可对胰岛素抵抗风险产生积极且显著的影响，并有可能预防超重和肥胖青少年患2型糖尿病。所综述的研究为未来的干预措施提供了支持，即将重点从减少肥胖转向增加体育活动，以预防肥胖青少年患2型糖尿病。
