Graduate Program in Public Health, Faculty of Health Sciences, University of Brasília, Campus Universitário Darcy Ribeiro S/N, Asa Norte, Brasília 70910-900, Brazil.
Int J Environ Res Public Health. 2022 Aug 24;19(17):10551. doi: 10.3390/ijerph191710551.
The objective of this study was to use ERICA data from adolescents from Brazilian public schools to investigate the role of school feeding in insulin resistance markers. Public school students (12-17 years old) with available biochemical examinations were selected. Adolescents answered a self-administered questionnaire, and contextual characteristics were obtained through interviews with principals. A multilevel mixed-effects generalized linear model was performed at the contextual and individual levels with each insulin resistance marker (fasting insulin, HOMA-IR, and blood glucose levels). A total of 27,990 adolescents were evaluated (50.2% female). The prevalence of (1) altered insulin was 12.2% (95% CI; 11.1, 13.5), (2) high HOMA-IR was 24.7% (95% CI; 22.8, 26.7), and (3) high blood glucose was 4.6% (95% CI; 3.8, 5.4). School feeding was positively associated with an insulin resistance marker, decreasing by 0.135 units of HOMA-IR (95% CI; -0.19, -0.08), 0.469 μU/L of insulin levels (95% CI; -0.66, -0.28), and 0.634 mg/dL of blood glucose (95% CI; -0.87, -0.39). In turn, buying food increased blood glucose by 0.455 mg/dL (95% CI; 0.16, 0.75). School feeding was positively associated with insulin resistance variables, demonstrating the potential of planned meals in the school environment to serve as a health promoter for the adolescent population.
本研究的目的是利用巴西公立学校青少年的 ERICA 数据，探讨学校供餐对胰岛素抵抗标志物的作用。选择有生化检查结果的公立学校学生（12-17 岁）。青少年回答了一份自我管理问卷，通过与校长的访谈获得了背景特征。在个体和群体水平上进行了多水平混合效应广义线性模型，每个胰岛素抵抗标志物（空腹胰岛素、HOMA-IR 和血糖水平）都进行了分析。共评估了 27990 名青少年（50.2%为女性）。（1）胰岛素改变的患病率为 12.2%（95%CI；11.1, 13.5），（2）高 HOMA-IR 的患病率为 24.7%（95%CI；22.8, 26.7），（3）高血糖的患病率为 4.6%（95%CI；3.8, 5.4）。学校供餐与胰岛素抵抗标志物呈正相关，使 HOMA-IR 降低 0.135 个单位（95%CI；-0.19, -0.08），胰岛素水平降低 0.469 μU/L（95%CI；-0.66, -0.28），血糖降低 0.634 mg/dL（95%CI；-0.87, -0.39）。相反，购买食物使血糖升高 0.455 mg/dL（95%CI；0.16, 0.75）。学校供餐与胰岛素抵抗变量呈正相关，这表明学校环境中计划膳食有可能成为青少年群体的健康促进因素。
