GENUD (Growth, Exercise, Nutrition and Development) Research Group, Department of Physiotherapy and Nursing, Faculty of Health Sciences, University of Zaragoza, Avenida Domingo Miral s/n, CP, 50009 Zaragoza, Spain.
Br J Nutr. 2013 Nov;110(10):1919-25. doi: 10.1017/S0007114513001153. Epub 2013 Apr 19.
Emerging data indicate that higher levels of insulin resistance (IR) are common among children and adolescents and are related to cardiometabolic risk; therefore, IR requires consideration early in life. In addition, there is a lack of conclusive evidence regarding the role of dietary nutrients on IR. The Healthy Lifestyle in Europe by Nutrition in Adolescence Cross-Sectional Study (HELENA-CSS) was conducted in European adolescents aged 12·5–17·5 years. A total of 637 participants with valid homeostasis model assessment (HOMA) index data and who completed at least a 2 d 24 h dietary recall were included in the study (60% of the total HELENA-CSS sample). There were two dietary indices calculated, with the only difference between them being the inclusion or not of physical activity (PA). Markers of IR such as HOMA and the quantitative insulin sensitivity check index (QUICKI) were calculated. Pubertal status, BMI and cardiorespiratory fitness (CRF) were measured as potential confounders. The dietary index including PA was inversely associated with HOMA and directly with the QUICKI in females, but not in males, after adjusting for pubertal status, centre, BMI and CRF. In conclusion, the present study indicates that considering PA as part of the dietary index is of relevance as the resulted index is inversely related to IR independently of potential confounders including CRF. Overall, these findings suggest that intervention studies aimed at preventing IR in young people should focus on increasing the quality of the diet and also on including an optimal PA level in healthy adolescents.
新出现的数据表明，胰岛素抵抗（IR）在儿童和青少年中较为常见，且与心血管代谢风险相关；因此，IR 需要在生命早期就引起重视。此外，关于膳食营养素对 IR 的作用还缺乏确凿的证据。欧洲青少年营养与生活方式横断面研究（HELENA-CSS）在 12.5-17.5 岁的欧洲青少年中进行。共有 637 名参与者具有有效的稳态模型评估（HOMA）指数数据，并至少完成了 2 天 24 小时膳食回忆，他们被纳入了这项研究（HELENA-CSS 总样本的 60%）。计算了两个膳食指数，它们之间唯一的区别是是否包含体力活动（PA）。计算了胰岛素抵抗的标志物，如 HOMA 和定量胰岛素敏感性检查指数（QUICKI）。青春期状态、BMI 和心肺适能（CRF）被测量为潜在的混杂因素。在调整了青春期状态、中心、BMI 和 CRF 后，包含 PA 的膳食指数与女性的 HOMA 和 QUICKI 呈负相关，而与男性的 HOMA 和 QUICKI 不相关。总之，本研究表明，将 PA 作为膳食指数的一部分考虑是相关的，因为所得指数与 IR 呈负相关，独立于包括 CRF 在内的潜在混杂因素。总体而言，这些发现表明，旨在预防年轻人 IR 的干预研究应侧重于提高饮食质量，并在健康青少年中纳入最佳的 PA 水平。
