Improved insulin sensitivity and body composition, irrespective of macronutrient intake, after a 12 month intervention in adolescents with pre-diabetes; RESIST a randomised control trial
Improved insulin sensitivity and body composition, irrespective of macronutrient intake, after a 12 month intervention in adolescents with pre-diabetes; RESIST a randomised control trial
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DOI：
10.1186/s12887-014-0289-0
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发表时间：
2014-11-25
期刊：
影响因子：
2.4
通讯作者：
Cowell, Chris T.
中科院分区：
文献类型：
--
作者：
Garnett, Sarah P.;Gow, Megan;Cowell, Chris T.
背景：饮食中较高的蛋白质与碳水化合物的比例可能会增强体重减轻，改善身体成分和心脏代谢风险，包括成人的葡萄糖稳态。这项随机对照试验的目的是确定两种结构化生活方式干预措施（膳食常量营养素含量不同）对青少年胰岛素敏感性和身体成分的功效。我们假设中等碳水化合物（能量的 40-45%）、增加蛋白质（25-30%）的饮食比高碳水化合物饮食（55-60%）、中等蛋白质（15%）的饮食更能有效改善肥胖、胰岛素抵抗青少年的预后。方法：在澳大利亚悉尼的两家医院招募了具有糖尿病前期和/或胰岛素抵抗临床特征的 10-17 岁肥胖儿童。在基线时，青少年服用二甲双胍并随机接受两种能量限制饮食中的一种。干预措施包括定期与营养师联系和监督身体活动计划。结果包括 12 个月时通过口服葡萄糖耐量试验测量的胰岛素敏感性指数和通过双能 X 射线吸收测定法测量的身体成分。 结果：在招募的 111 名青少年中，85 名 (77%) 完成了干预。以第 95 个百分位百分比表示的 BMI 下降了 6.8% [95% CI: -8.8 至 -4.9]，ISI 增加了 0.2 [95% CI: 0.06 至 0.39]，体脂百分比下降了 2.4% [95% CI: -3.4 至 -1.3]。任何时候饮食组之间的结果都没有显着差异。结论：当使用二甲双胍和运动计划治疗时，结构化的低能量饮食（高碳水化合物或中等碳水化合物并增加蛋白质）可以在有 2 型糖尿病风险的肥胖青少年中实现临床显着改善。
Background: A higher protein to carbohydrate ratio in the diet may potentiate weight loss, improve body composition and cardiometabolic risk, including glucose homeostasis in adults. The aim of this randomised control trial was to determine the efficacy of two structured lifestyle interventions, differing in dietary macronutrient content, on insulin sensitivity and body composition in adolescents. We hypothesised that a moderate-carbohydrate (40-45% of energy), increased-protein (25-30%) diet would be more effective than a high-carbohydrate diet (55-60%), moderate-protein (15%) diet in improving outcomes in obese, insulin resistant adolescents.Methods: Obese 10-17 year olds with either pre-diabetes and/or clinical features of insulin resistance were recruited at two hospitals in Sydney, Australia. At baseline adolescents were prescribed metformin and randomised to one of two energy restricted diets. The intervention included regular contact with the dietician and a supervised physical activity program. Outcomes included insulin sensitivity index measured by an oral glucose tolerance test and body composition measured by dual-energy x-ray absorptiometry at 12 months.Results: Of the 111 adolescents recruited, 85 (77%) completed the intervention. BMI expressed as a percentage of the 95th percentile decreased by 6.8% [95% CI: -8.8 to -4.9], ISI increased by 0.2 [95% CI: 0.06 to 0.39] and percent body fat decreased by 2.4% [95% CI: -3.4 to -1.3]. There were no significant differences in outcomes between diet groups at any time.Conclusion: When treated with metformin and an exercise program, a structured, reduced energy diet, which is either high-carbohydrate or moderate-carbohydrate with increased-protein, can achieve clinically significant improvements in obese adolescents at risk of type 2 diabetes.