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Published on: January 7, 2018
Development of insulin resistance and its relation to diet in the obese child
Ramón Cañete1, Mercedes Gil-Campos, Concepción M Aguilera
1Unit of Paediatric Endocrinology, Reina Sofia University Hospital, Cordoba, Spain.
Insights
Childhood obesity is rising, with many obese children showing insulin resistance (IR). Dietary factors and hormonal changes from adipose tissue significantly contribute to the development of IR in youth.
Area of Science:
- Pediatric Endocrinology
- Metabolic Syndrome
- Nutritional Science
Background:
- Global rise in youth obesity rates.
- Approximately 30% of obese children exhibit insulin resistance (IR) and metabolic abnormalities.
- IR in childhood obesity is a growing public health concern.
Purpose of the Study:
- To review mechanisms of IR development in obese children.
- To explore links between IR and dietary factors in pediatric and adolescent populations.
- To update understanding of IR pathogenesis in youth.
Main Methods:
- Literature review of studies on childhood obesity and IR.
- Analysis of endocrine and metabolic pathways involved in IR.
- Examination of dietary influences on adiposity and IR.
Main Results:
- Increased plasma free fatty acids (FFA) and intracellular LC acyl-CoA are linked to early IR.
- A new endocrine paradigm highlights adipose tissue hormones and cytokines regulating lipid metabolism, preceding metabolite changes.
- Excessive caloric intake exacerbates IR; hypocaloric diets reduce it.
- Dietary factors like high animal protein, saturated/trans/n-6 fats, high carb-to-fat ratio, high glycemic, and low-fiber diets worsen adiposity and IR.
Conclusions:
- Adipose tissue endocrine dysfunction plays a crucial role in early IR development in obese children.
- Dietary patterns significantly influence the onset and progression of IR in youth.
- Interventions targeting caloric intake and diet composition are vital for managing childhood IR.
Abstract:
The incidence rate of obesity in youth has continued to increase worldwide and about 30% of obese children display insulin resistance (IR) and other metabolic abnormalities. The present study reviews the mechanisms for development of IR in the obese child and possible links between IR and dietary factors in childhood and adolescence. Although increased concentrations of plasma free fatty acids (FFA) and their counter part at intracellular level, long-chain acyl-coenzyme A (LC acyl-CoA), have been related to the early onset of IR in childhood obesity, a new endocrine paradigm states that adipose tissue secretes a wide variety of hormones and cytokines that regulate lipid energy metabolism. These hormonal changes precede any changes in metabolites such as FFA and glucose and appear to be associated with early IR in childhood. Excessive caloric intake increases IR in children; opposite, substantial reduction of overweight achieved by a hypocaloric diet decreases it. Elevated consumption of animal protein, particularly in early life, as well as diets rich in saturated, trans, and n-6 polyunsaturated fatty acids, and diets with a high carbohydrate to fat ratio, besides a high glycaemic and low-fiber diet also appear to exacerbate adiposity and IR.
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