A 2 year physical activity and dietary intervention attenuates the increase in insulin resistance in a general population of children: the PANIC study
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A 2 year physical activity and dietary intervention attenuates the increase in insulin resistance in a general population of children : the PANIC study. / Lakka, Timo A; Lintu, Niina; Väistö, Juuso; Viitasalo, Anna; Sallinen, Taisa; Haapala, Eero A; Tompuri, Tuomo T; Soininen, Sonja; Karjalainen, Panu; Schnurr, Theresia M; Mikkonen, Santtu; Atalay, Mustafa; Kilpeläinen, Tuomas O; Laitinen, Tomi; Laaksonen, David E; Savonen, Kai; Brage, Soren; Schwab, Ursula; Jääskeläinen, Jarmo; Lindi, Virpi; Eloranta, Aino-Maija.
In: Diabetologia, Vol. 63, 2020, p. 2270-2281.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - A 2 year physical activity and dietary intervention attenuates the increase in insulin resistance in a general population of children
T2 - the PANIC study
AU - Lakka, Timo A
AU - Lintu, Niina
AU - Väistö, Juuso
AU - Viitasalo, Anna
AU - Sallinen, Taisa
AU - Haapala, Eero A
AU - Tompuri, Tuomo T
AU - Soininen, Sonja
AU - Karjalainen, Panu
AU - Schnurr, Theresia M
AU - Mikkonen, Santtu
AU - Atalay, Mustafa
AU - Kilpeläinen, Tuomas O
AU - Laitinen, Tomi
AU - Laaksonen, David E
AU - Savonen, Kai
AU - Brage, Soren
AU - Schwab, Ursula
AU - Jääskeläinen, Jarmo
AU - Lindi, Virpi
AU - Eloranta, Aino-Maija
PY - 2020
Y1 - 2020
N2 - 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.TRIAL REGISTRATION: ClinicalTrials.gov NCT01803776 Graphical abstract.
AB - 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.TRIAL REGISTRATION: ClinicalTrials.gov NCT01803776 Graphical abstract.
U2 - 10.1007/s00125-020-05250-0
DO - 10.1007/s00125-020-05250-0
M3 - Journal article
C2 - 32816094
VL - 63
SP - 2270
EP - 2281
JO - Diabetologia
JF - Diabetologia
SN - 0012-186X
ER -
ID: 248028256