News Author: Laurie Barclay, MD

April 7, 2006 — Long-term, biannual dietary intervention reduces risk for insulin resistance in 9-year-old children, according to the results of a randomized study reported in the April issue of Diabetes Care.

"Insulin resistance, defined as an inadequate metabolic response to plasma insulin at normal concentrations, is promoted by obesity and high intake of saturated fat, and up to 30% of overweight or obese individuals develop insulin resistance," write Tuuli Kaitosaari, MD, from the University of Turku in Finland, and colleagues from the Special Turku Coronary Risk Factor Intervention Project for Children (STRIP) study. "Preventing obesity and sedentary lifestyle and supporting a healthy lifestyle are important preventive measures, particularly if started in childhood."

In this study, healthy 7-month-old infants (n = 1062) were randomized to the intervention (n = 540) and control groups (n = 522). The intervention consisted of biannual individualized counseling sessions for each child's family, aimed at minimizing children's exposure to known environmental risk factors for atherosclerosis. At 9 years of age in a random subgroup of 78 intervention children and 89 control children, a homeostasis model assessment of insulin resistance (HOMA-IR) index, serum lipids, blood pressure, and weight for height were determined.

Compared with the control children, the intervention children consumed less total fat (P = .002) and saturated fat (P < .0001) and had a lower HOMA-IR index (P = .02). Saturated fat intake was significantly correlated with HOMA-IR. Multivariate analyses revealed that the study group, but not saturated fat intake or other determinants of HOMA-IR (serum triglyceride concentration, weight for height, and systolic blood pressure), was significantly associated with HOMA-IR.

"This suggests that the beneficial effect of intervention on insulin sensitivity was largely, but not fully, explained by the decrease in saturated fat intake," the authors write. "The long-term biannual dietary intervention decreases the intake of total and saturated fat and has a positive effect on insulin resistance index in 9-year-old children."

The authors suggest that development of insulin resistance and possibly also atherosclerosis may be delayed or prevented by introducing relevant dietary and lifestyle habits in early childhood.

"Further follow-up studies with continuing counseling sessions in our trial will show whether the observed beneficial effects of intervention will continue over puberty into early adulthood," the authors conclude.

The Juho Vainio Foundation; the Yrjö Jahnsson Foundation; the Finnish Cardiac Research Foundation; the Foundation for Pediatric Research, Finland; the Academy of Finland; the Sigrid Juselius Foundation; the Turku University Foundation; the Finnish Cultural Foundation, City of Turku; EVO funds of Turku University Central Hospital; and the Raisio Group Research Foundation supported this study.

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