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dc.contributor.authorLakka,Timo A.
dc.contributor.authorLintu, Niina
dc.contributor.authorVäistö, Juuso
dc.contributor.authorViitasalo, Anna
dc.contributor.authorSallinen, Taisa
dc.contributor.authorHaapala, Eero A.
dc.contributor.authorTompuri, Tuomo T.
dc.contributor.authorSoininen, Sonja
dc.contributor.authorKarjalainen, Panu
dc.contributor.authorSchnurr, Theresia M.
dc.contributor.authorMikkonen, Santtu
dc.contributor.authorAtalay, Mustafa
dc.contributor.authorKilpeläinen, Tuomas O.
dc.contributor.authorLaitinen, Tomi
dc.contributor.authorLaaksonen, David E.
dc.contributor.authorSavonen, Kai
dc.contributor.authorBrage, Soren
dc.contributor.authorSchwab, Ursula
dc.contributor.authorJääskeläinen, Jarmo
dc.contributor.authorLindi, Virpi
dc.contributor.authorEloranta, Aino-Maija
dc.date.accessioned2020-08-26T10:26:17Z
dc.date.available2020-08-26T10:26:17Z
dc.date.issued2020
dc.identifier.citationLakka, 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. <i>Diabetologia</i>, <i>63</i>(11), 2270-2281. <a href="https://doi.org/10.1007/s00125-020-05250-0" target="_blank">https://doi.org/10.1007/s00125-020-05250-0</a>
dc.identifier.otherCONVID_41792401
dc.identifier.urihttps://jyx.jyu.fi/handle/123456789/71510
dc.description.abstractAims/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.en
dc.format.mimetypeapplication/pdf
dc.languageeng
dc.language.isoeng
dc.publisherSpringer
dc.relation.ispartofseriesDiabetologia
dc.rightsCC BY 4.0
dc.subject.otherbody fat
dc.subject.otherchildren
dc.subject.otherdiet
dc.subject.otherglucose
dc.subject.otherHOMA-IR
dc.subject.otherinsulin
dc.subject.otherintervention
dc.subject.otherlean body mass
dc.subject.otherphysical activity
dc.subject.othersedentary time
dc.titleA 2 year physical activity and dietary intervention attenuates the increase in insulin resistance in a general population of children : the PANIC study
dc.typearticle
dc.identifier.urnURN:NBN:fi:jyu-202008265651
dc.contributor.laitosLiikuntatieteellinen tiedekuntafi
dc.contributor.laitosFaculty of Sport and Health Sciencesen
dc.contributor.oppiaineLiikuntalääketiedefi
dc.contributor.oppiaineBiomekaniikkafi
dc.contributor.oppiaineSports and Exercise Medicineen
dc.contributor.oppiaineBiomechanicsen
dc.type.urihttp://purl.org/eprint/type/JournalArticle
dc.description.reviewstatuspeerReviewed
dc.format.pagerange2270-2281
dc.relation.issn0012-186X
dc.relation.numberinseries11
dc.relation.volume63
dc.type.versionpublishedVersion
dc.rights.copyright© 2020 the Authors
dc.rights.accesslevelopenAccessfi
dc.subject.ysoruokavaliot
dc.subject.ysolapset (ikäryhmät)
dc.subject.ysoinsuliini
dc.subject.ysofyysinen aktiivisuus
dc.subject.ysokehonkoostumus
dc.subject.ysointerventiotutkimus
dc.subject.ysoglukoosi
dc.format.contentfulltext
jyx.subject.urihttp://www.yso.fi/onto/yso/p3790
jyx.subject.urihttp://www.yso.fi/onto/yso/p4354
jyx.subject.urihttp://www.yso.fi/onto/yso/p8422
jyx.subject.urihttp://www.yso.fi/onto/yso/p23102
jyx.subject.urihttp://www.yso.fi/onto/yso/p26989
jyx.subject.urihttp://www.yso.fi/onto/yso/p32625
jyx.subject.urihttp://www.yso.fi/onto/yso/p18742
dc.rights.urlhttps://creativecommons.org/licenses/by/4.0/
dc.relation.doi10.1007/s00125-020-05250-0
jyx.fundinginformationOpen 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).


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