Relationship Between Insulin Resistance–Associated Metabolic Parameters and Anthropometric Measurements With Sugar-Sweetened Beverage Intake and Physical Activity Levels in US Adolescents

Background and Hypothesis: The childhood obesity epidemic is linked with an increase in dysglycemia and type 2 diabetes (T2D) amongst youth.i Adolescence is associated with decreased levels of physical activityii, however, there is a paucity of research investigating physical activity measures and dysglycemia in youth. We hypothesize that decreased physical activity and/or increased sitting time is positively correlated with dysglycemia. Project Methods: Study participants were youth aged 10-21y with a BMI >85th percentile for age and gender. Accelerometers (activPAL) and the FELS Physical Activity Questionnaire (FELS PAQ) were used to assess objective and selfreported physical activity levels. Glucose tolerance was assessed with 2-hour oral glucose tolerance tests (OGTT). Independent t-tests were used to compare physical activity levels for participants with normal glucose tolerance (NGT) and dysglycemia. Correlation analysis was performed to evaluate relationships between measures of physical activity and OGTT measures. Results: Participants with NGT (N=27) and dysglycemia (N=26) had comparable demographics; age, race, and ethnicity. Hemoglobin A1c (HbA1c) (p =0.002), average fasting glucose (p<0.00), indices of insulin resistance (HOMA-IR) (p=.023), insulin secretion (disposition index, DI, a marker of risk for T2D) (p=.008), 2-hour-OGTT measures for glucose (p=.004) and insulin (p=.002) differed between groups. There were not group differences for objective or selfreported measures of physical activity. For the entire cohort, sitting time was positively associated with OGTT 2hr glucose (r=.38, p=.03). However, a subgroup analysis showed that the association between sitting time and OGTT 2hr glucose was significant in the dysglycemia group only (r =.64, p=.006, vs r =.016, p=.95 for NGT group). Self-reported measures of activity (Likert scores) and OGTT measures for insulin and glucose were positively correlated. Conclusion and Potential Impact: Increased sitting time is associated with impaired glucose tolerance in youth with obesity at risk for T2D. iVan der Aa MP, Fazeli Farsani S, Knibbe CA, de Boer A, van der Vorst MM. Population-Based Studies on the Epidemiology of Insulin Resistance in Children. J Diabetes Res. 2015;2015:362375. iiDumith SC, Gigante DP, Domingues MR, Kohl HW. Physical activity change during adolescence: a systematic review and a pooled analysis. International Journal of Epidemiology. 2011;40(3):685-98.

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Positive association between dietary acid load and future insulin resistance risk: findings from the Korean Genome and Epidemiology Study

Nutrition Journal ◽

10.1186/s12937-020-00653-6 ◽

2020 ◽

Vol 19 (1) ◽

Author(s):

Kyung Won Lee ◽

Dayeon Shin

Keyword(s):

Physical Activity ◽

Insulin Resistance ◽

Metabolic Acidosis ◽

Activity Levels ◽

Epidemiology Study ◽

Acid Base ◽

Resistance Risk ◽

Physical Activity Levels ◽

The Future ◽

Acid Load

Abstract Background Acid-base homeostasis is increasingly being recognized to play an important role in normal metabolic function. However, prospective studies on the relationship between diet-induced acid-base imbalance and insulin resistance among Asian populations have been limited. Thus, we investigated whether diet-induced metabolic acidosis was prospectively associated with insulin resistance risk in middle-aged and older Korean adults. Methods In total, 5406 participants from the Korean Genome and Epidemiology Study without type 2 diabetes, insulin resistance, cancer, or renal diseases at baseline examination were included in this study. To estimate diet-induced metabolic acidosis, we used potential renal acid load (PRAL) and net endogenous acid production (NEAP) scores calculated from the usual dietary intake assessed by a validated 103-item food frequency questionnaire at baseline. Multivariable Cox proportional hazard models were applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of insulin resistance incidence. Results During a mean follow-up period of 7.4 years, we documented 3449 insulin resistance cases. In the fully adjusted model, the future insulin resistance risk was significantly higher among participants in the highest quartiles of PRAL (HR: 1.30, 95% CI: 1.13–1.48, Ptrend = 0.0002) and NEAP (HR: 1.30, 95% CI: 1.14–1.49, Ptrend = 0.0008) than among those in the lowest quartiles. Associations were slightly strengthened among men, adults < 50 years old, obese participants, or those with low physical activity levels. Conclusions Our findings suggested that diet-dependent acid load was positively associated with the future development of insulin resistance, suggesting effect modification by sex, age, the presence of obesity, and physical activity levels.

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