Insulin resistance status: predicting weight response in overweight children.
OBJECTIVE
To assess the relationship between insulin resistance and body mass index (BMI) z score associated with dietary modification that focuses on limiting sweetened beverage consumption in overweight children.


METHODS
A retrospective cohort study conducted between July 1, 2004, and April 28, 2006.


METHODS
Community-based primary care practices treating children.


METHODS
Forty-five children (aged < or =18 years) at or above the 95th percentile of BMI for age and sex. Intervention Children and parents were instructed by a dietitian regarding caloric reduction and modification of sweetened beverage intake.


METHODS
Insulin resistance at baseline was calculated from fasting insulin and glucose levels (ie, homeostatic model assessment [HOMA]) and change in BMI z score from baseline to 12-week follow-up.


RESULTS
Change in BMI z score in response to a decrease in sweetened beverages correlated (Pearson product moment correlation coefficient = 0.42; P < .01) with baseline insulin resistance. Those with a decrease in or an unchanged BMI z score had significantly greater insulin resistance than those whose BMI z score increased (mean [SD] HOMA, 6.2 [4.2] vs 2.6 [2.0], P < .01). Linear regression confirmed that HOMA was a significant predictor of change in BMI z score when controlling for age, race, and sex.


CONCLUSIONS
Among overweight children in primary care practices, a significant relationship was found between insulin resistance and the change in BMI z score associated with a dietitian-mediated intervention that includes a focus on decreasing sweetened beverage consumption. Estimating insulin resistance may inform dietary recommendations for overweight children.
Cummings
Doyle M
DM
Department of Family Medicine, Brody School of Medicine at East Carolina University, 600 Moye Blvd, Greenville, NC 27834, USA. cummingsd@ecu.edu
Henes
Sarah
S
Kolasa
Kathryn M
KM
Olsson
John
J
Collier
David
D
D000293:Adolescent; D001628:Beverages / Q000009:adverse effects*; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D015444:Exercise / Q000502:physiology; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007333:Insulin Resistance; D008019:Life Style; D008297:Male; D009765:Obesity / Q000453:epidemiology* / Q000517:prevention & control*; D050177:Overweight / Q000453:epidemiology / Q000517:prevention & control; D010865:Pilot Projects; D011237:Predictive Value of Tests; D015995:Prevalence; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D015431:Weight Loss
D001786:Blood Glucose