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Journal of Pediatric Endocrinology and Metabolism

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Evaluation of two dietary treatments in obese hyperinsulinemic adolescents

1 / Andrea Gabriela Krochik 1 / Carmen Sylvia Mazza1

1Department of Nutrition, Hospital de Pediatría JP Garrahan, Combate de los Pozos 1881, Buenos Aires, Argentina

Corresponding author: Marisa Laura Armeno, Rondeau 3029, CP 1262, Buenos Aires, Argentina Phone/Fax: +5411-3965-7230

Citation Information: Journal of Pediatric Endocrinology and Metabolism. Volume 24, Issue 9-10, Pages 715–722, ISSN (Online) 2191-0251, ISSN (Print) 0334-018X, DOI: 10.1515/JPEM.2011.291, August 2011

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Hyperinsulinemia increases the risk of cardiovascular disease in obese children. Only a few treatments are available to decrease insulin resistance. The reduction of hyperinsulinemia by dietary means would be a simple, physiologic and economic way to reduce the risk of metabolic disease.

Objective: To compare the effects of two low-energy diets on serum insulin concentrations and weight loss in obese hyperinsulinemic adolescents.

Materials and methods: Eighty-six randomly assigned insulin-resistant obese adolescents completed a 16 week calorie-restricted diet. The experimental diet had a reduced glycemic index designed to evoke a low insulin response (LIR), with carbohydrates and proteins ingested in separate meals. The control diet was a conventional (CD) with similar proportions (60%, 20% and 20%). Variables studied were blood glucose and insulin concentrations after an oral glucose load, body mass index, waist circumference, and insulin resistance (homeostasis model assessment, HOMA).

Results: Mean weight [±Standard Deviation (SD)] was significantly reduced after the LIR (–0.53±0.5) and the CD (–0.54±0.4), but a greater decrease of waist circumference (cm) was observed after the LIR (–9.1±4.8 vs. –6.6±4.6, p=0.02). Fasting insulin concentrations (–17.9±27.9 vs. –9.4±14.8, p=0.01) and HOMA dropped significantly more after the LIR than after the CD (–3.5±4.9SD vs. –2.4±1SD, p<0.0001).

Conclusions: The LIR diet reduces serum insulin concentrations and waist circumference more than conventional treatment and appears to be a promising alternative to a conventional diet in insulin-resistant obese adolescents. Long-term follow-up is needed to evaluate the maintenance of weight loss and metabolic parameters.

Keywords: dietary treatments; insulin resistance; obese adolescents.

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