A 2 year physical activity and dietary intervention attenuates the increase in insulin resistance in a general population of children : the PANIC study
Lakka, T. A., Lintu, N., Väistö, J., Viitasalo, A., Sallinen, T., Haapala, E. A., Tompuri, T. T., Soininen, S., Karjalainen, P., Schnurr, T. M., Mikkonen, S., Atalay, M., Kilpeläinen, T. O., Laitinen, T., Laaksonen, D. E., Savonen, K., Brage, S., Schwab, U., Jääskeläinen, J., . . . Eloranta, A.-M. (2020). A 2 year physical activity and dietary intervention attenuates the increase in insulin resistance in a general population of children : the PANIC study. Diabetologia, 63(11), 2270-2281. https://doi.org/10.1007/s00125-020-05250-0
Julkaistu sarjassa
DiabetologiaTekijät
Päivämäärä
2020Tekijänoikeudet
© 2020 the Authors
Aims/hypothesis
We studied for the first time the long-term effects of a combined physical activity and dietary intervention on insulin resistance and fasting plasma glucose in a general population of predominantly normal-weight children.
Methods
We carried out a 2 year non-randomised controlled trial in a population sample of 504 children aged 6–9 years at baseline. The children were allocated to a combined physical activity and dietary intervention group (306 children at baseline, 261 children at 2-year follow-up) or a control group (198 children, 177 children) without blinding. We measured fasting insulin and fasting glucose, calculated HOMA-IR, assessed physical activity and sedentary time by combined heart rate and body movement monitoring, assessed dietary factors by a 4 day food record, used the Finnish Children Healthy Eating Index (FCHEI) as a measure of overall diet quality, and measured body fat percentage (BF%) and lean body mass by dual-energy x-ray absorptiometry. The intervention effects on insulin, glucose and HOMA-IR were analysed using the intention-to-treat principle and linear mixed-effects models after adjustment for sex, age at baseline, and pubertal status at baseline and 2 year follow-up. The measures of physical activity, sedentary time, diet and body composition at baseline and 2 year follow-up were entered one-by-one as covariates into the models to study whether changes in these variables might partly explain the observed intervention effects.
Results
Compared with the control group, fasting insulin increased 4.65 pmol/l less (absolute change +8.96 vs +13.61 pmol/l) and HOMA-IR increased 0.18 units less (+0.31 vs +0.49 units) over 2 years in the combined physical activity and dietary intervention group. The intervention effects on fasting insulin (regression coefficient β for intervention effect −0.33 [95% CI −0.62, −0.04], p = 0.026) and HOMA-IR (β for intervention effect −0.084 [95% CI −0.156, −0.012], p = 0.023) were statistically significant after adjustment for sex, age at baseline, and pubertal status at baseline and 2 year follow-up. The intervention had no effect on fasting glucose, BF% or lean body mass. Changes in total physical activity energy expenditure, light physical activity, moderate-to-vigorous physical activity, total sedentary time, the reported consumption of high-fat (≥60%) vegetable oil-based spreads, and FCHEI, but not a change in BF% or lean body mass, partly explained the intervention effects on fasting insulin and HOMA-IR.
Conclusions/interpretation
The combined physical activity and dietary intervention attenuated the increase in insulin resistance over 2 years in a general population of predominantly normal-weight children. This beneficial effect was partly mediated by changes in physical activity, sedentary time and diet but not changes in body composition.
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Julkaisija
SpringerISSN Hae Julkaisufoorumista
0012-186XAsiasanat
Julkaisu tutkimustietojärjestelmässä
https://converis.jyu.fi/converis/portal/detail/Publication/41792401
Metadata
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Lisätietoja rahoituksesta
Open access funding provided by University of Eastern Finland (UEF) including Kuopio University Hospital. The PANIC study has been supported financially by grants from Ministry of Education and Culture of Finland, Ministry of Social Affairs and Health of Finland, Research Committee of the Kuopio University Hospital Catchment Area (State Research Funding), Finnish Innovation Fund Sitra, Social Insurance Institution of Finland, Finnish Cultural Foundation, Foundation for Paediatric Research, Diabetes Research Foundation in Finland, Finnish Foundation for Cardiovascular Research, Juho Vainio Foundation, Paavo Nurmi Foundation, Yrjö Jahnsson Foundation, and the city of Kuopio. The work of SB was funded by the UK Medical Research Council (MC_UU_12015/3) and the NIHR Biomedical Research Centre in Cambridge (IS-BRC-1215-20014). ...Lisenssi
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The effects of a 2-year physical activity and dietary intervention on plasma lipid concentrations in children : the PANIC Study
Eloranta, Aino-Maija; Sallinen, Taisa; Viitasalo, Anna; Lintu, Niina; Väistö, Juuso; Jalkanen, Henna; Tompuri, Tuomo T.; Soininen, Sonja; Haapala, Eero A.; Kiiskinen, Sanna; Schnurr, Theresia M.; Kilpeläinen, Tuomas O.; Mikkonen, Santtu; Savonen, Kai; Atalay, Mustafa; Brage, Soren; Laaksonen, David E.; Lindi, Virpi; Ågren, Jyrki; Schwab, Ursula; Jääskeläinen, Jarmo; Lakka, Timo A. (Springer, 2021)Purpose: We studied the effects of a physical activity and dietary intervention on plasma lipids in a general population of children. We also investigated how lifestyle changes contributed to the intervention effects. ... -
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Effects of 2‐year dietary and physical activity intervention on cognition in children : a nonrandomized controlled trial
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Haapala, Eero A.; Väistö, Juuso; Ihalainen, Johanna K.; Tomaselli González, Claudia; Leppänen, Marja H.; Veijalainen, Aapo; Sallinen, Taisa; Eloranta, Aino-Maija; Ekelund, Ulf; Schwab, Ursula; Brage, Soren; Atalay, Mustafa; Lakka, Timo A. (Taylor & Francis, 2022)We investigated the associations of physical activity (PA), sedentary time (ST), and diet quality with biomarkers of inflammation in 390 children (192 girls, 198 boys) aged 6-8 years. PA energy expenditure (PAEE), light ... -
Scaling up a school-based intervention to increase physical activity and reduce sedentary behaviour in children : protocol for the TransformUs hybrid effectiveness–implementation trial
Koorts, Harriet; Timperio, Anna; Lonsdale, Chris; Ridgers, Nicola D.; Lubans, David R.; Della Gatta, Jacqueline; Bauman, Adrian; Telford, Amanda; Barnett, Lisa; Lamb, Karen E.; Lander, Natalie; Lai, Samuel K.; Sanders, Taren; Arundell, Lauren; Brown, Helen; Wilhite, Katrina; Salmon, Jo (BMJ Publishing Group, 2023)Introduction Efficacious programmes require implementation at scale to maximise their public health impact. TransformUs is an efficacious behavioural and environmental intervention for increasing primary (elementary) school ...
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