Research Institute of Child Nutrition, Dortmund, Germany.
Int J Obes (Lond). 2012 Nov;36(11):1463-71. doi: 10.1038/ijo.2011.241. Epub 2012 Jan 17.
Puberty is a so-called critical period for overweight development and is characterized by physiological insulin resistance during mid-puberty. This study addressed the hypothesis that habitual consumption of a diet inducing higher levels of postprandial glycemia or insulinemia during puberty may have an unfavorable effect on the body composition in young adulthood.
Multivariate regression analysis was performed on 262 participants of the Dortmund Nutritional and Anthropometric Longitudinally Designed Study with at least two 3-day weighed dietary records during puberty (baseline: girls 9-14 years; boys 10-15 years) and anthropometric measurements in young adulthood (18-25 years). A published dietary glycemic index was assigned to each carbohydrate-containing food. Similarly, each food was assigned a food insulin index (insulinemic response to a 1 MJ portion of food relative to 1 MJ of glucose) using 121 values measured at Sydney University.
Dietary glycemic index or glycemic load during puberty was not related to body composition in young adulthood. In contrast, a higher dietary insulin index and a higher dietary insulin load during puberty were associated with higher levels of percentage of body fat (%BF) in young adulthood, even after adjustment for early life, socioeconomic and nutritional factors; %BF in energy-adjusted tertiles of dietary insulin index were 22.9 (95% confidence intervals (CI): 21.6, 24.1), 24.5 (23.2, 25.7), 24.7 (23.5, 25.9) %, P (for trend)=0.01; %BF in energy-adjusted tertiles of dietary insulin load were 22.8 (95% CI: 21.5, 24.0), 24.5 (23.2, 25.7), 24.8 (23.6, 26.0) %, P (for trend)=0.01. Adjustment for baseline %BF attenuated these relationships (P (for trend)=0.1 and=0.08, respectively). Dietary insulin demand was not related to body mass index.
This study suggests a prospective adverse influence of dietary insulin demand during puberty on %BF in young adulthood. Postprandial increases in insulinemia rather than increases in glycemia appear to be implicated in an unfavorable development of body composition.
青春期是超重发展的所谓关键时期，其特点是青春期中期出现生理性胰岛素抵抗。本研究提出了这样一个假设，即在青春期习惯性地摄入能引起更高餐后血糖或胰岛素水平的饮食，可能对成年早期的身体成分产生不利影响。
对多特蒙德营养和人体测量纵向设计研究的 262 名参与者进行了多变量回归分析，这些参与者在青春期至少有两次为期 3 天的称重饮食记录（基线：女孩 9-14 岁；男孩 10-15 岁），并在成年早期（18-25 岁）进行了人体测量。为每一种含碳水化合物的食物分配了一个已发表的饮食血糖指数。同样，使用悉尼大学测量的 121 个值，为每一种食物分配了食物胰岛素指数（相对于 1 兆焦耳的葡萄糖，食物引起的胰岛素反应）。
青春期的饮食血糖指数或血糖负荷与成年早期的身体成分无关。相反，青春期较高的饮食胰岛素指数和饮食胰岛素负荷与成年早期更高的体脂百分比（%BF）水平相关，即使在调整了早期生活、社会经济和营养因素后也是如此；在能量调整的饮食胰岛素指数三分位数中，%BF 分别为 22.9（95%置信区间（CI）：21.6，24.1）、24.5（23.2，25.7）、24.7（23.5，25.9）%，P（趋势）=0.01；在能量调整的饮食胰岛素负荷三分位数中，%BF 分别为 22.8（95%CI：21.5，24.0）、24.5（23.2，25.7）、24.8（23.6，26.0）%，P（趋势）=0.01。调整基础%BF 减弱了这些关系（P（趋势）分别为 0.1 和 0.08）。饮食胰岛素需求与体重指数无关。
本研究表明，青春期饮食胰岛素需求对成年早期%BF 有前瞻性的不利影响。餐后胰岛素血症的增加而不是血糖的增加似乎与身体成分的不利发展有关。
