title: Effect of maternal dietary counselling during the 1st year of life on glucose profile and insulin resistance at the age of 8 years: a randomised field trial.
abstract: Education interventions that stimulate complementary feeding practices can improve the nutritional status of children and may protect against future chronic diseases. We assessed the long-term effectiveness of dietary intervention during the 1st year of life on insulin resistance levels, and investigated the relationship between insulin resistance and weight changes over time. A randomised field trial was conducted among 500 mothers who gave birth to full-term infants between October 2001 and June 2002 in a low-income area in São Leopoldo, Brazil. Mother-child pairs were randomly assigned to intervention (n 200) and control groups (n 300), and the mothers in the intervention group received dietary counselling on breast-feeding and complementary feeding of their children during the 1st year of life. Fieldworkers blinded to assignment assessed socio-demographic, dietary and anthropometric data during follow-up at ages 1, 4 and 8 years. Blood tests were performed in 305 children aged 8 years to measure fasting serum glucose and insulin concentrations and the homoeostasis model assessment index of insulin resistance (HOMA-IR). At the age of 8 years, the intervention group showed no changes in glucose and insulin concentrations or HOMA-IR values (change 0·07; 95 % CI -0·06, 0·21 for girls; and change -0·07; 95 % CI -0·19, 0·04 for boys) compared with study controls. Insulin resistance was highly correlated, however, with increases in BMI between birth and 8 years of age. Although this dietary intervention had no impact on glucose profile at age 8 years, our findings suggest that BMI changes in early childhood can serve as an effective marker of insulin resistance.
authors.affiliation: 1Graduate Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre,Porto Alegre, RS, 90050170,Brazil.
authors.forename: Cintia S
authors.identifier: 0000-0002-1606-5293
authors.initials: CS
authors.lastname: Costa
authors.affiliation: 2School of Health,Universidade do Vale do Rio dos Sinos,São Leopoldo, RS, 93022000,Brazil.
authors.forename: Paula D B
authors.initials: PD
authors.lastname: Campagnolo
authors.affiliation: 3Department of Epidemiology,Mailman School of Public Health,Columbia University,New York,NY 10032,USA.
authors.forename: L H
authors.initials: LH
authors.lastname: Lumey
authors.affiliation: 4Department of Nutrition,Universidade Federal de Ciências da Saúde de Porto Alegre,Porto Alegre, RS, 90050170,Brazil.
authors.forename: Marcia R
authors.initials: MR
authors.lastname: Vitolo
mesh_terms: D000375:Aging; D001786:Blood Glucose / Q000502:physiology*; D002648:Child; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D003376:Counseling / Q000379:methods; D004032:Diet; D005260:Female; D015438:Health Behavior; D006266:Health Education / Q000379:methods; D006801:Humans; D007223:Infant; D007333:Insulin Resistance / Q000502:physiology*; D008425:Maternal Behavior; D009752:Nutritional Status
chemical_list: D001786:Blood Glucose
keywords:  HOMA-IR homoeostasis model assessment index of insulin resistance; BMI gain; Childhood; Dietary counselling; Homoeostasis model assessment index of insulin resistance; Insulin resistance; Intervention studies; Randomised controlled trials