Pediatric and Adolescent Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy.
Pediatric Department, "Vittore Buzzi" Children's Hospital, 20154 Milan, Italy.
Nutrients. 2022 Nov 6;14(21):4692. doi: 10.3390/nu14214692.
Childhood obesity is characterized by an increased risk of several metabolic derangements including insulin resistance (IR). The strongest recommendations to prevent obesity and related complications are a balanced and adequate diet and practicing physical activity from early childhood. In this review, we propose to present the effects of healthy lifestyle strategies, including physical exercise and dietary approaches, on the management of IR and related metabolic derangements. All types of exercise (aerobic, resistance and combined training) effectively reduce IR in pediatric patients with obesity; it seems that aerobic and combined training stimulate greater improvements in IR compared to resistance training. Balanced normocaloric or hypocaloric dietary approaches are also valid strategies to address IR; it is not possible to assess the long-term impact of varying macronutrients on cardiometabolic risk. The glycemic index/load evaluation is a useful dietary approach to glucose metabolism control. Similarly, they should adopt the principle of the Mediterranean diet. Randomized studies with longer monitoring are needed to define the benefits of nutritional supplementation on IR. Considering that healthy style acquisition could track to later ages, programs of healthy lifestyle starting with children offer a better preventive strategy to preserve metabolic control and children's health.
儿童肥胖的特征是存在多种代谢紊乱的风险，包括胰岛素抵抗（IR）。预防肥胖及其相关并发症的最强建议是从儿童早期开始，保持均衡和充足的饮食以及进行身体活动。在这篇综述中，我们提出了健康生活方式策略（包括身体锻炼和饮食方法）对 IR 及相关代谢紊乱管理的影响。所有类型的运动（有氧运动、抗阻运动和综合训练）均可有效降低肥胖儿童的 IR；有氧运动和综合训练似乎比抗阻训练更能有效改善 IR。均衡的正热量或低热量饮食方法也是解决 IR 的有效策略；尚无法评估不同宏量营养素对心血管代谢风险的长期影响。血糖指数/负荷评估是控制葡萄糖代谢的一种有用的饮食方法。同样，他们应该采用地中海饮食原则。需要进行具有更长监测时间的随机研究来确定营养补充对 IR 的益处。考虑到健康的生活方式可能会持续到以后的年龄，因此从儿童时期开始的健康生活方式计划为维持代谢控制和儿童健康提供了更好的预防策略。
