Ingram School of Nursing, McGill University, Montreal, Canada.
Departments of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada.
J Nutr. 2018 Nov 1;148(11):1838-1844. doi: 10.1093/jn/nxy189.
Identifying dietary factors that determine insulin sensitivity and secretion in children entering puberty may provide valuable information for the early prevention of type 2 diabetes.
We assessed whether macronutrients and food groups are longitudinally associated with insulin sensitivity and secretion over a 2-y period in children with a family history of obesity, and whether associations differ by level of adiposity.
Data were derived from the Quebec Adipose and Lifestyle Investigation in Youth (QUALITY) Study, an ongoing prospective cohort including 630 children recruited at ages 8-10 y, with ≥1 obese parent, and followed 2 y later (n = 564). The intake of macronutrients and foods was assessed at baseline using three 24-h dietary recalls. At age 10-12 y, insulin sensitivity was assessed by the Matsuda Insulin Sensitivity Index (ISI) and the homeostatic model assessment of insulin resistance. Insulin secretion was assessed by the ratio of the area under the curve of insulin to the area under the curve of glucose at 30 min and at 120 min of an oral-glucose-tolerance test. Multivariable linear regression models were fitted for each dietary factor while adjusting for age, sex, puberty, physical activity, screen time, total energy intake, and percentage of body fat; and interaction terms between dietary factors and percentage of body fat were tested.
Saturated fat intake was associated with a 1.95% lower (95% CI: -3.74%, -0.16%) Matsuda ISI, whereas vegetable and fruit intake was associated with a 2.35% higher (95% CI: 0.18%, 4.52%) Matsuda ISI 2 y later. The association of saturated fat intake with insulin sensitivity was most deleterious among children with a higher percentage of body fat (P-interaction = 0.023). Other than fiber intake, no longitudinal associations between dietary intake and insulin secretion were found.
Lowering saturated fat and increasing vegetable and fruit intakes during childhood may improve insulin sensitivity as children enter puberty. This study was registered at www.clinicaltrials.gov as NCT03356262.
确定进入青春期的儿童中决定胰岛素敏感性和分泌的饮食因素，可能为 2 型糖尿病的早期预防提供有价值的信息。
我们评估了在有肥胖家族史的儿童中，宏量营养素和食物组是否与 2 年内的胰岛素敏感性和分泌呈纵向相关，以及这些关联是否因肥胖程度而异。
数据来自魁北克青少年脂肪与生活方式研究（QUALITY），这是一项正在进行的前瞻性队列研究，纳入了 630 名 8-10 岁、至少有 1 位肥胖父母的儿童，2 年后（n=564）再次进行随访。使用 3 次 24 h 膳食回忆法评估基线时的宏量营养素和食物摄入。在 10-12 岁时，通过 Matsuda 胰岛素敏感性指数（ISI）和稳态模型评估的胰岛素抵抗来评估胰岛素敏感性。通过口服葡萄糖耐量试验 30 min 和 120 min 时胰岛素曲线下面积与血糖曲线下面积的比值评估胰岛素分泌。在调整年龄、性别、青春期、体力活动、屏幕时间、总能量摄入和体脂百分比后，对每个饮食因素进行多变量线性回归模型拟合；并测试饮食因素与体脂百分比之间的交互项。
饱和脂肪摄入量与 Matsuda ISI 降低 1.95%（95%CI：-3.74%，-0.16%）相关，而蔬菜和水果摄入量与 Matsuda ISI 增加 2.35%（95%CI：0.18%，4.52%）相关，2 年后。在体脂百分比较高的儿童中，饱和脂肪摄入量与胰岛素敏感性的关联最为有害（P 交互=0.023）。除了纤维摄入外，没有发现饮食摄入与胰岛素分泌之间存在纵向关联。
在儿童进入青春期期间，降低饱和脂肪和增加蔬菜和水果的摄入量可能会改善胰岛素敏感性。本研究在 www.clinicaltrials.gov 注册，编号为 NCT03356262。
