Journal
JOURNAL OF PEDIATRICS
Volume 152, Issue 5, Pages 612-617Publisher
MOSBY-ELSEVIER
DOI: 10.1016/j.jpeds.2007.12.036
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Funding
- Intramural NIH HHS [Z01 HD000641-12, Z99 HD999999, Z01 HD000641] Funding Source: Medline
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Objective To examine the relationship between energy intake during a buffet meal and indexes of insulin dynamics in overweight children. Study design Ninety-five nondiabetic, overweight (body mass index >= 95th percentile) children (age 10.3 +/- 1.4 years) selected lunch from a 9835-kcal buffet eaten ad libitum after an overnight fast. The associations between energy intake and measures of insulin dynamics, in the postabsorptive state and during a 2-hour hyperglycemic clamp, were determined. Covariates in the statistical model included race, sex, skeletal age, fat-free mass, fat mass, socioeconomic status, and number of foods in the buffet rated as acceptable. Results Energy intake was positively associated with the fasting homeostasis model assessment for insulin resistance index (beta = 0.24, P = .042), fasting insulin/glucose ratio (beta = 0.24, P = .044), first-phase insulin (beta = 0.23, P = .032), and first-phase C-peptide (beta = 0.21, P = .046); energy intake was negatively associated with clamp-derived insulin sensitivity (beta = -0.29, P = .042). Each 10% decrease in clamp-derived insulin sensitivity predicted a 27-kcal greater energy intake. Conclusions Insulin resistance and hyperinsulinemia are associated with greater energy intake after an overnight fast in overweight children. These associations suggest mechanisms whereby insulin resistance may contribute to excessive weight gain in children.
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