Background: Despite extensive evidence in adults that lifestyle modification, including a healthy diet, may prevent the onset of type 2 diabetes, studies examining the impact of chronic dietary exposures on insulin dynamics in at-risk children are lacking.
Objective and hypotheses: To assess how dietary intake predicts insulin sensitivity and secretion over a 2-year period in children with a family history of obesity.
Method: Data stem from the QUebec Adipose and Lifestyle InvesTigation in Youth (QUALITY) cohort, consisting of 630 children recruited at age 810 years, based on a family history of obesity. Macronutrients (including %carbohydrates, %fat, %saturated fat, %protein, fiber, sugar-sweetened beverages) were assessed at baseline using three non-consecutive 24-h dietary recalls. Insulin sensitivity, assessed by Matsuda Index, and insulin secretion, assessed by the ratio of the AUC of insulin:glucose at 30 min (AUC30) and at 120 min (AUC120) after an oral glucose tolerance test, were carried out both at baseline and 2 years later. Physical activity (PA) was evaluated by 7d accelerometry and fitness by peak oxygen consumption (VO2peak), percent fat mass by DXA. Regression analysis with smoothing splines for non-linearity were used and models were minimally adjusted for age, sex, PA, fitness, screen time, adiposity, season and pubertal stage. We accounted for missing data using multiple imputation.
Results: Saturated fat intake was deleterious to insulin sensitivity over time: for every 1% increase in baseline saturated fat intake, Matsuda index decreased by 1.6% (95% CI =−3.2, −0.06) 2 years later, even after adjusting for other lifestyle habits and adiposity. No dietary component predicted any measure of insulin secretion after adjusting for PA, fitness, screen time and adiposity.
Conclusion: Interventions that aim to lower saturated fat intake in children may be beneficial to prevent later development of type 2 diabetes in youth with a family history of obesity.
10 - 12 Sep 2016
European Society for Paediatric Endocrinology