title: Evaluation of two dietary treatments in obese hyperinsulinemic adolescents.
abstract: Hyperinsulinemia increases the risk of cardiovascular disease in obese children. Only a few treatments are available to decrease insulin resistance. The reduction of hyperinsulinemia by dietary means would be a simple, physiologic and economic way to reduce the risk of metabolic disease.
  
  
  OBJECTIVE
  To compare the effects of two low-energy diets on serum insulin concentrations and weight loss in obese hyperinsulinemic adolescents.
  
  
  METHODS
  Eighty-six randomly assigned insulin-resistant obese adolescents completed a 16 week calorie-restricted diet. The experimental diet had a reduced glycemic index designed to evoke a low insulin response (LIR), with carbohydrates and proteins ingested in separate meals. The control diet was a conventional (CD) with similar proportions (60%, 20% and 20%). Variables studied were blood glucose and insulin concentrations after an oral glucose load, body mass index, waist circumference, and insulin resistance (homeostasis model assessment, HOMA).
  
  
  RESULTS
  Mean weight [+/- Standard Deviation (SD)] was significantly reduced after the LIR (-0.53 +/- 0.5) and the CD (-0.54 +/- 0.4), but a greater decrease of waist circumference (cm) was observed after the LIR (-9.1 +/- 4.8 vs. -6.6 +/- 4.6, p = 0.02). Fasting insulin concentrations (-17.9 +/- 27.9 vs. -9.4 +/- 14.8, p = 0.01) and HOMA dropped significantly more after the LIR than after the CD (-3.5 +/- 4.9SD vs. -2.4 +/- 1SD, p < 0.0001).
  
  
  CONCLUSIONS
  The LIR diet reduces serum insulin concentrations and waist circumference more than conventional treatment and appears to be a promising alternative to a conventional diet in insulin-resistant obese adolescents. Long-term follow-up is needed to evaluate the maintenance of weight loss and metabolic parameters.
authors.affiliation: Department of Nutrition, Hospital de Pediatría JP Garrahan, Combate de los Pozos 1881, Buenos Aires, Argentina. mlarmeno@gmail.com
authors.forename: Marisa Laura
authors.initials: ML
authors.lastname: Armeno
authors.forename: Andrea Gabriela
authors.initials: AG
authors.lastname: Krochik
authors.forename: Carmen Sylvia
authors.initials: CS
authors.lastname: Mazza
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D001835:Body Weight; D031204:Caloric Restriction / Q000379:methods*; D002648:Child; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D004044:Dietary Proteins / Q000008:administration & dosage; D005260:Female; D038321:Glycemic Index; D006801:Humans; D006946:Hyperinsulinism / Q000178:diet therapy* / Q000378:metabolism; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008297:Male; D009765:Obesity / Q000178:diet therapy* / Q000378:metabolism; D040242:Risk Reduction Behavior
chemical_list: D001786:Blood Glucose; D004040:Dietary Carbohydrates; D004044:Dietary Proteins; D007328:Insulin