title: Randomized controlled trial to improve adiposity, inflammation, and insulin resistance in obese African-American and Latino youth.
abstract: The purpose of this study was to examine ethnic differences in the metabolic responses to a 16-week intervention designed to improve insulin sensitivity (SI), adiposity, and inflammation in obese African-American and Latino adolescents. A total of 100 participants (African Americans: n = 48, Latino: n = 52; age: 15.4 ± 1.1 years, BMI percentile: 97.3 ± 3.3) were randomly assigned to interventions: control (C; n = 30), nutrition (N; n = 39, 1×/week focused on decreasing sugar and increasing fiber intake), or nutrition + strength training (N+ST; n = 31, 2×/week). The following were measured at pre- and postintervention: strength, dietary intake, body composition (dual-energy X-ray absorptiometry/magnetic resonance imaging) and glucose/insulin indexes (oral glucose tolerance test (OGTT)/intravenous glucose tolerance test (IVGTT)) and inflammatory markers. Overall, N compared to C and N+ST reported significant improvements in SI (+16.5% vs. -32.3% vs. -6.9% respectively, P < 0.01) and disposition index (DI: +15.5% vs. -14.2% vs. -13.7% respectively, P < 0.01). N+ST compared to C and N reported significant reductions in hepatic fat fraction (HFF: -27.3% vs. -4.3% vs. 0% respectively, P < 0.01). Compared to N, N+ST reported reductions in plasminogen activator inhibitor-1 (PAI-1) (-38.3% vs. +1.0%, P < 0.01) and resistin (-18.7% vs. +11.3%, P = 0.02). There were no intervention effects for all other measures of adiposity or inflammation. Significant intervention by ethnicity interactions were found for African Americans in the N group who reported increases in total fat mass, 2-h glucose and glucose incremental areas under the curve (IAUC) compared to Latinos (P's < 0.05). These interventions yielded differential effects with N reporting favorable improvements in SI and DI and N+ST reporting marked reductions in HFF and inflammation. Both ethnic groups had significant improvements in metabolic health; however some improvements were not seen in African Americans.
authors.affiliation: Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
authors.forename: Rebecca E
authors.initials: RE
authors.lastname: Hasson
authors.forename: Tanja C
authors.initials: TC
authors.lastname: Adam
authors.forename: Jaimie N
authors.initials: JN
authors.lastname: Davis
authors.forename: Louise A
authors.initials: LA
authors.lastname: Kelly
authors.forename: Emily E
authors.initials: EE
authors.lastname: Ventura
authors.forename: Courtney E
authors.initials: CE
authors.lastname: Byrd-Williams
authors.forename: Claudia M
authors.initials: CM
authors.lastname: Toledo-Corral
authors.forename: Christian K
authors.initials: CK
authors.lastname: Roberts
authors.forename: Christianne J
authors.initials: CJ
authors.lastname: Lane
authors.forename: Stanley P
authors.initials: SP
authors.lastname: Azen
authors.forename: Chih-Ping
authors.initials: CP
authors.lastname: Chou
authors.forename: Donna
authors.initials: D
authors.lastname: Spruijt-Metz
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Weigensberg
authors.forename: Kiros
authors.initials: K
authors.lastname: Berhane
authors.forename: Michael I
authors.initials: MI
authors.lastname: Goran
mesh_terms: D015502:Absorptiometry, Photon; D050154:Adiposity; D000293:Adolescent; D001741:Black or African American; D001823:Body Composition; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D005951:Glucose Tolerance Test; D006630:Hispanic or Latino; D006801:Humans; D007249:Inflammation / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control* / Q000628:therapy; D007333:Insulin Resistance; D008297:Male; D044623:Nutrition Therapy / Q000379:methods; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control* / Q000628:therapy; D055070:Resistance Training / Q000379:methods; D014481:United States / Q000453:epidemiology