Diet Determines Features of the Metabolic Syndrome in 6- to 14-Year-Old Children

Abstract

Background/Objectives: Insulin resistance (IR) and hypertension are common in overweight children, and the adipocyte-derived hormones resistin, adiponectin, and leptin may modulate IR and blood pressure (BP). Few data exist in children on dietary determinants of IR, BP, or leptin, and no data exist on dietary determinants of resistin and adiponectin. Therefore, the objective of this study was to investigate dietary determinants of IR, BP, resistin, adiponectin, and leptin concentrations, as well as the interrelationship among these variables, in normal and overweight children. Subjects/Methods: In 6- to 14-year-old Swiss children (n=79), nutritional intake was assessed using two 24-hour-recalls and a one-day dietary record. Body mass index (BMI), body fat percentage (BF%), waist/hip ratio (W/H ratio), BP, glucose, insulin, resistin, adiponectin, and leptin were determined. IR was calculated using the quantitative insulin sensitivity check index (QUICKI). Results: BMI, BF%, and W/H ratio were significant predictors of leptin and insulin, QUICKI, and systolic BP, but not resistin or adiponectin. Of the overweight and obese children, 40 % were diagnosed pre-hypertensive or hypertensive. Total energy, fat, saturated fat, and protein intakes were significant predictors of fasting insulin and QUICKI, and total fat, saturated fat, and monounsaturated fat intakes were significant predictors of systolic BP, independent of BMI standard deviation score (BMI-SDS) and age. There were no associations between these dietary factors and leptin, adiponectin, or resistin. Conclusion: In children, dietary macronutrient composition is a predictor of IR and systolic BP, but not resistin, adiponectin, or leptin concentrations. Resistin and adiponectin concentrations are not correlated with IR or BP in this age range.

Longitudinal associations of lifestyle factors and weight status with insulin resistance (HOMA-IR) in preadolescent children: the large prospective cohort study IDEFICS

“…In the IDEFICS baseline survey, a low amount of physical activity was shown to be associated with a cluster of CVD risk factors including IR [13]. In accordance with the evidence from our analysis, a few other studies published data on the association of dietary factors like intake of total energy, total fat or saturated fat with IR in children and adolescents [11, 12]. …”

“…weight status [8], measures of central and peripheral adiposity [9, 10], dietary factors such as intake of total fat or saturated fat [11, 12], physical inactivity [13], poor physical fitness [14], low or high birth weight for gestational age [7, 15], and maternal factors like gestational diabetes [16] or unbalanced maternal nutrition [17]. Nevertheless, in children, population-based epidemiological data on the determinants of IR are still rare and mostly available from cross-sectional studies.…”

Low Physical Activity Level and Short Sleep Duration Are Associated with an Increased Cardio-Metabolic Risk Profile: A Longitudinal Study in 8-11 Year Old Danish Children

“…Quality of fat intake has been proposed to be important in the etiology of cardiovascular diseases [29] and intake of saturated fatty acids has been found to be positively associated with insulin levels and systolic blood pressure in children [50]; however, adjusting for intake of dietary fat quality only changed the beta-coefficients slightly. Instead, the prospective associations between movement behaviours and the MetS-score became non-significant after controlling for FMI, indicating that adiposity partly explains the reported associations.…”

Central Adiposity, Systemic Inflammation, and the Metabolic Syndrome

“…Results indicated that this inflammatory index was predictive of changes in CRP levels, and that it may represent an additional indirect method of determining risk of MetS in the context of food intake [48••]. Recently, macronutrient intake (total energy, total protein, saturated fat) was found to predict features of MetS in children 6 to 14 years of age [49]. Thus, the importance of adherence to the general dietary recommendations for preventing or reducing the risk of MetS (adequate intake of omega-3 fatty acids; high intake of fruits, vegetables, grains, and nuts; and low intake of saturated fats and trans fats) must be stressed for individuals of all ages.…”