title: Dietary risk factors for the development of insulin resistance in adolescent girls: a 3-year prospective study.
abstract: OBJECTIVE
  Identifying risk factors for insulin resistance in adolescence could provide valuable information for early prevention. The study sought to identify risk factors for changes in insulin resistance and fasting blood glucose levels.
  
  
  METHODS
  Prospective cohort of girls participating in the National Heart, Lung, and Blood Institute Growth and Health Study.
  
  
  METHODS
  Adolescent girls (n 774) assessed at the ages of 16-17 and 18-19 years. Over a 3-year period, measurements of fasting blood glucose and insulin and serum cotinine were taken, and dietary intake (3 d food diary), smoking status and physical activity levels were self-reported.
  
  
  RESULTS
  Improvements in homeostasis model assessment of insulin resistance (HOMA-IR) were associated with increases in the percentage of energy intake from polyunsaturated fats (β = -3·33, 95% CI -6·28, -0·39, P = 0·03) and grams of soluble fibre (β = -5·20, 95% CI -9·81, -0·59, P = 0·03) between the ages of 16-17 and 18-19 years; with similar findings for insulin. Transitioning into obesity was associated with an increase in insulin (β = 6·34, 95% CI 2·78, 9·91, P < 0·001) and HOMA-IR (β = 28·77, 95% CI 8·13, 49·40, P = 0·006). Serum cotinine concentrations at 16-17 years, indicating exposure to tobacco, were associated with large increases (β = 15·43, 95% CI 6·09, 24·77, P < 0·001) in fasting blood glucose concentrations.
  
  
  CONCLUSIONS
  Increases in the percentage of energy from polyunsaturated fat and fibre, and avoidance of excess weight gain and tobacco exposure, could substantially reduce the risk of insulin resistance in late adolescence.
authors.affiliation: 1 Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement, School of Medicine, Cardiff University, Heath Park, Cardiff CF14 4YS, UK.
authors.forename: James
authors.initials: J
authors.lastname: White
authors.affiliation: 2 Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK.
authors.forename: Russell
authors.initials: R
authors.lastname: Jago
authors.affiliation: 2 Centre for Exercise, Nutrition & Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK.
authors.forename: Janice L
authors.initials: JL
authors.lastname: Thompson
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism; D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D003367:Cotinine / Q000097:blood; D004032:Diet; D015930:Diet Records; D004043:Dietary Fiber / Q000008:administration & dosage*; D002149:Energy Intake; D005215:Fasting; D005231:Fatty Acids, Unsaturated / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D016014:Linear Models; D009043:Motor Activity; D015596:Nutrition Assessment; D009765:Obesity / Q000097:blood / Q000517:prevention & control; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D004043:Dietary Fiber; D005231:Fatty Acids, Unsaturated; D007328:Insulin; D003367:Cotinine