title: Dietary glycemic load, insulin load, and weight loss in obese, insulin resistant adolescents: RESIST study.
abstract: OBJECTIVE
  The optimal dietary approach for weight loss and improving insulin sensitivity in adolescents is unknown. This study aimed to explore the association between the estimated insulin demand of the diet, as measured by glycemic and insulin load, weight loss, percentage body fat and insulin sensitivity index (ISI) in obese adolescents with clinical features of insulin resistance and/or prediabetes after a 3 month lifestyle and metformin intervention.
  
  
  METHODS
  Secondary data analysis of 91 adolescents (median age 12.7 years (range 10.1-17.4) participating in a randomized controlled trial, known as RESIST; ACTRN12608000416392. Weight change between baseline and 3 months was measured by BMI expressed as percentage of the 95th centile (BMI %95). Body composition was measured by dual energy X-ray absorptiometry and ISI was determined by an oral glucose tolerance test.
  
  
  RESULTS
  Higher dietary glycemic load and insulin load were associated with less weight loss (BMI %95), adjusted for sex and pubertal stage, β = 0.0466, P = 0.007 and β = 0.0124, P = 0.040, respectively. Inclusion of total energy intake in the model explained observed associations between dietary glycemic load and insulin load and change in BMI %95. Neither dietary glycemic load nor insulin load were associated with changes in percentage body fat or ISI. Dietary glycemic index and macronutrient content (% of total energy) were not associated to changes in BMI %95, percentage body fat or ISI.
  
  
  CONCLUSIONS
  Reduced energy diet contributes to weight loss in obese, insulin resistant adolescents. Diets with a lower insulin demand were associated with a lower energy intake and may hence assist with weight loss.
authors.affiliation: Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, Australia; IEL-Nutritional Epidemiology, University of Bonn, DONALD Study at the Research Institute of Child Nutrition, Germany. Electronic address: joslowski@fke-do.de.
authors.forename: Gesa
authors.initials: G
authors.lastname: Joslowski
authors.affiliation: Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, Australia.
authors.forename: Jocelyn
authors.initials: J
authors.lastname: Halim
authors.affiliation: IEL-Nutritional Epidemiology, University of Bonn, DONALD Study at the Research Institute of Child Nutrition, Germany.
authors.forename: Janina
authors.initials: J
authors.lastname: Goletzke
authors.affiliation: Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, Australia; The Children's Hospital at Westmead Clinical School, University of Sydney, Sydney, Australia.
authors.forename: Megan
authors.initials: M
authors.lastname: Gow
authors.affiliation: The Children's Hospital at Westmead Clinical School, University of Sydney, Sydney, Australia.
authors.forename: Mandy
authors.initials: M
authors.lastname: Ho
authors.affiliation: Faculty of Science, Medicine and Health, The University of Wollongong, Australia.
authors.forename: Jimmy C-Y
authors.initials: JC
authors.lastname: Louie
authors.affiliation: IEL-Nutritional Epidemiology, University of Bonn, DONALD Study at the Research Institute of Child Nutrition, Germany.
authors.forename: Anette E
authors.initials: AE
authors.lastname: Buyken
authors.affiliation: Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, Australia; The Children's Hospital at Westmead Clinical School, University of Sydney, Sydney, Australia; Kids Research Institute at the Children's Hospital at Westmead, Sydney, Australia.
authors.forename: Chris T
authors.initials: CT
authors.lastname: Cowell
authors.affiliation: Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, Australia; The Children's Hospital at Westmead Clinical School, University of Sydney, Sydney, Australia; Kids Research Institute at the Children's Hospital at Westmead, Sydney, Australia.
authors.forename: Sarah P
authors.initials: SP
authors.lastname: Garnett
mesh_terms: D000293:Adolescent; D001823:Body Composition; D015992:Body Mass Index; D002648:Child; D004032:Diet; D002149:Energy Intake; D005951:Glucose Tolerance Test; D038321:Glycemic Index; D006801:Humans; D007004:Hypoglycemic Agents; D007328:Insulin / Q000097:blood / Q000502:physiology*; D007333:Insulin Resistance; D008019:Life Style; D008687:Metformin / Q000627:therapeutic use; D009765:Obesity / Q000178:diet therapy* / Q000628:therapy; D015431:Weight Loss
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin; D008687:Metformin
keywords: Adolescents; Glycemic load; Insulin load; Insulin resistance; Weight loss