Infancy-Onset Dietary Counseling of Low-Saturated-Fat Diet Improves Insulin Sensitivity in Healthy Adolescents 15–20 Years of Age

Abstract

OBJECTIVEWe reported previously that low-saturated-fat dietary counseling started in infancy improves insulin sensitivity in healthy children 9 years of age. The aim of this study was to evaluate the effect of lifelong dietary counseling on insulin sensitivity in healthy adolescents between 15 and 20 years of age. In addition, we examined dietary fiber intake and the polyunsaturated fatty acid (PUFA) + monounsaturated (MUFA)-to-saturated fatty acid (SFA) ratio in the intervention and control adolescents and the association of these dietary factors with homeostasis model of insulin resistance (HOMA-IR).RESEARCH DESIGN AND METHODSThe study comprised adolescents participating in the randomized, controlled Special Turku Coronary Risk Factor Intervention Project (STRIP) study, which aims to guide the study participants toward a diet beneficial for cardiovascular health. HOMA-IR was assessed annually between 15 and 20 years of age (n = 518; intervention, n = 245; control, n = 273), along with diet, BMI, pubertal status, serum cotinine concentrations, and physical activity. Dietary counseling was given biannually during the follow-up.RESULTSHOMA-IR was lower (7.5% on average) in the intervention group than in the control group between 15 and 20 years of age (P = 0.0051). The intervention effect was similar in girls and boys. The PUFA+MUFA-to-SFA ratio was higher (P < 0.0001) and the dietary fiber (g/MJ) intake was higher (P = 0.0058) in the intervention group compared with the control group. There was no association between the PUFA+MUFA-to-/SFA ratio and HOMA-IR, whereas dietary fiber intake (g/MJ) was associated with HOMA-IR in girls (P < 0.0001).CONCLUSIONSDietary counseling initiated in infancy and maintained until 20 years of age was associated with improved insulin sensitivity in adolescents.

Metabolic Syndrome From Adolescence to Early Adulthood

“…6 The intervention aimed to guide the study participants toward a diet beneficial for cardiovascular health. The personalized dietary counseling was safe for the children's growth and development 7 and led to lower low-density lipoprotein cholesterol concentrations and blood pressure in the intervention group, 8,9 improved insulin sensitivity, 10 increased ideal cardiovascular health, 11 and enhanced endothelial function. 12 We have previously reported preliminary data from the STRIP study that the intervention may reduce the clustering of overweight-related cardiometabolic risk factors between the ages of 5 to 15 years, suggesting a beneficial effect on the risk of MetS.…”

“…Plasma glucose was analyzed by a hexokinase method (Glucose Olympus System Reagent, Olympus, Ireland; interassay coefficient of variation, 1.8%). 10 Triglycerides were analyzed with the colorimetric glycerol-3-phospate oxidase p-aminophenazone method (Merck, Darmstadt, Germany) with an automatic Olympus AU400 analyzer. 8 Serum total cholesterol concentration was analyzed with a fully enzymatic cholesterol oxidase-p-aminophenazone method (Merck).…”

“…10 In this analysis, we therefore investigated whether the association of intervention with MetS persisted after the inclusion of insulin in the analysis. When insulin was added to the model, the intervention effect on MetS (mod_IDF80/20) was only slightly diluted (intervention versus control group: RR, 0.62; 95% CI, 0.43-0.91; P=0.02).…”

Longitudinal child-oriented dietary intervention: Association with parental diet and cardio-metabolic risk factors. The Special Turku Coronary Risk Factor Intervention Project

“…Details of the insulin and glucose analyses have been reported previously. 4 Related to the available food record data between the child's ages of 9-19 years, the cardio-metabolic risk factor data were also used during this period. Additionally, for total and low-density lipoprotein cholesterol the entire available data beginning from the child's age of 7 months or 5 years, respectively, were used.…”

“…3 Dietary changes during childhood have additionally been associated with improved insulin sensitivity, 4 lower blood pressure 5 and improved cardiovascular health as determined by the American Heart Association. 6 These results are in line with previous intervention studies in children with similar objectives to influence diet to improve cardio-metabolic health.…”