Costa Cintia S, Campagnolo Paula D B, Lumey L H, Vitolo Marcia R
1Graduate Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre,Porto Alegre, RS, 90050170,Brazil.
2School of Health,Universidade do Vale do Rio dos Sinos,São Leopoldo, RS, 93022000,Brazil.
Br J Nutr. 2017 Jan;117(1):134-141. doi: 10.1017/S0007114516004578. Epub 2017 Jan 18.
Education interventions that stimulate complementary feeding practices can improve the nutritional status of children and may protect against future chronic diseases. We assessed the long-term effectiveness of dietary intervention during the 1st year of life on insulin resistance levels, and investigated the relationship between insulin resistance and weight changes over time. A randomised field trial was conducted among 500 mothers who gave birth to full-term infants between October 2001 and June 2002 in a low-income area in São Leopoldo, Brazil. Mother-child pairs were randomly assigned to intervention (n 200) and control groups (n 300), and the mothers in the intervention group received dietary counselling on breast-feeding and complementary feeding of their children during the 1st year of life. Fieldworkers blinded to assignment assessed socio-demographic, dietary and anthropometric data during follow-up at ages 1, 4 and 8 years. Blood tests were performed in 305 children aged 8 years to measure fasting serum glucose and insulin concentrations and the homoeostasis model assessment index of insulin resistance (HOMA-IR). At the age of 8 years, the intervention group showed no changes in glucose and insulin concentrations or HOMA-IR values (change 0·07; 95 % CI -0·06, 0·21 for girls; and change -0·07; 95 % CI -0·19, 0·04 for boys) compared with study controls. Insulin resistance was highly correlated, however, with increases in BMI between birth and 8 years of age. Although this dietary intervention had no impact on glucose profile at age 8 years, our findings suggest that BMI changes in early childhood can serve as an effective marker of insulin resistance.
促进辅食添加的教育干预措施可改善儿童营养状况，并可能预防未来的慢性疾病。我们评估了出生后第一年饮食干预对胰岛素抵抗水平的长期效果，并调查了胰岛素抵抗与随时间变化的体重之间的关系。2001年10月至2002年6月期间，在巴西圣 Leopoldo 的一个低收入地区，对500名足月分娩婴儿的母亲进行了一项随机现场试验。母婴对被随机分配到干预组（n = 200）和对照组（n = 300），干预组的母亲在其孩子出生后的第一年接受了关于母乳喂养和辅食添加的饮食咨询。对分组不知情的现场工作人员在1岁、4岁和8岁随访期间评估了社会人口统计学、饮食和人体测量数据。对305名8岁儿童进行了血液检测，以测量空腹血清葡萄糖和胰岛素浓度以及胰岛素抵抗的稳态模型评估指数（HOMA-IR）。在8岁时，与研究对照组相比，干预组的葡萄糖和胰岛素浓度或HOMA-IR值没有变化（女孩变化0.07；95%CI -0.06，0.21；男孩变化-0.07；95%CI -0.19，0.04）。然而，胰岛素抵抗与出生至8岁期间BMI的增加高度相关。虽然这种饮食干预对8岁时的血糖状况没有影响，但我们的研究结果表明，幼儿期BMI的变化可作为胰岛素抵抗的有效指标。
