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28-08-2018 | Diet | Review | Article

Dietary Interventions and Type 2 Diabetes in Youth: a Fresh Look at the Evidence

Journal: Current Nutrition Reports

Authors: William B. Perkison, Joel A. Adekanye, Marcia C. de Oliveira Otto

Publisher: Springer US

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Abstract

Purpose of Review

The incidence of type 2 diabetes among children and adolescents has sharply increased, highly influenced by prevalence of obesity in youth. Here, we provide an overview of the pathogenesis of diabetes, and summarize recent dietary interventions investigating effects of diet on metabolic risk factors in overweight and obese youth.

Recent Findings

Seven dietary interventions were identified randomly assigning participants to weekly or bi-weekly dietary counseling sessions over 12–24-week period, with mixed results. Four interventions showed significant reductions in fasting insulin and insulin resistance levels relative to baseline concentrations ranging from 26 to 50%.

Summary

Recent evidence is mixed, with four studies showing improvements to insulin concentrations and insulin resistance in obese children and adolescents associated with energy restriction and/or change to carbohydrate consumption. Further work is needed to investigate long-term effects of dietary factors including carbohydrate quality and energy restriction on metabolic health and diabetes prevention early in life.
Literature
1.
Hillier TA, Pedula KL. Complications in young adults with early-onset type 2 diabetes: losing the relative protection of youth. Diabetes Care. 2003;26(11):2999–3005.CrossRef
2.
Reinehr T. Type 2 diabetes mellitus in children and adolescents. World J Diabetes. 2013;4(6):270–81.CrossRef
3.
Mayer-Davis EJ, Lawrence JM, Dabelea D, Divers J, Isom S, Dolan L, et al. Incidence trends of type 1 and type 2 diabetes among youths, 2002-2012. N Engl J Med (Boston). 2017;375(15):1419–28.CrossRef
4.
Copeland KC, Silverstein J, Moore KR, Prazar GE, Raymer T, Shiffman RN, et al. Management of newly diagnosed type 2 diabetes mellitus (T2DM) in children and adolescents. Pediatrics. 2013;131(2):364–82.CrossRef
5.
Bloomgarden ZT. Type 2 diabetes in the young: the evolving epidemic. Diabetes Care. 2004;27(4):998–1010.CrossRef
6.
Schwingshackl L, Missbach B, Konig J, Hoffmann G. Adherence to a Mediterranean diet and risk of diabetes: a systematic review and meta-analysis. Public Health Nutr. 2015;18(7):1292–9.CrossRef
7.
Otto MC, Afshin A, Micha R, Khatibzadeh S, Fahimi S, Singh G, et al. The impact of dietary and metabolic risk factors on cardiovascular diseases and type 2 diabetes mortality in Brazil. PLoS One. 2016;11(3):e0151503.CrossRef
8.
Afshin A, Micha R, Khatibzadeh S, Mozaffarian D. Consumption of nuts and legumes and risk of incident ischemic heart disease, stroke, and diabetes: a systematic review and meta-analysis. Am J Clin Nutr. 2014;100(1):278–88.CrossRef
9.
Esposito K, Maiorino MI, Bellastella G, Chiodini P, Panagiotakos D, Giugliano D. A journey into a Mediterranean diet and type 2 diabetes: a systematic review with meta-analyses. BMJ Open. 2015;5(8):e008222.CrossRef
10.
Artz E, Freemark M. The pathogenesis of insulin resistance in children: metabolic complications and the roles of diet, exercise and pharmacotherapy in the prevention of type 2 diabetes. Pediatr Endocrinol Rev. 2004;1(3):296–309.PubMed
11.
Defronzo RA. Banting lecture. From the triumvirate to the ominous octet: a new paradigm for the treatment of type 2 diabetes mellitus. Diabetes. 2009;58(4):773–95.CrossRef
12.
DeFronzo RA, Abdul-Ghani MA. Preservation of beta-cell function: the key to diabetes prevention. J Clin Endocrinol Metab. 2011;96(8):2354–66.CrossRef
13.
Sacks FM. Major potential of diet treatment for type 2 diabetes. Curr Diab Rep. 2008;8(4):249–50.CrossRef
14.
Solomon TP, Haus JM, Kelly KR, Rocco M, Kashyap SR, Kirwan JP. Improved pancreatic beta-cell function in type 2 diabetic patients after lifestyle-induced weight loss is related to glucose-dependent insulinotropic polypeptide. Diabetes Care. 2010;33(7):1561–6.CrossRef
15.
Mizokami-Stout K, Cree-Green M, Nadeau KJ. Insulin resistance in type 2 diabetic youth. Curr Opin Endocrinol Diabetes Obes. 2012;19(4):255–62.CrossRef
16.
Narasimhan S, Weinstock RS. Youth-onset type 2 diabetes mellitus: lessons learned from the TODAY study. Mayo Clin Proc. 2014;89(6):806–16.CrossRef
17.
Davis JN, Ventura EE, Weigensberg MJ, Ball GD, Cruz ML, Shaibi GQ, et al. The relation of sugar intake to beta cell function in overweight Latino children. Am J Clin Nutr. 2005;82(5):1004–10.CrossRef
18.
DeFronzo RA, Abdul-Ghani M. Assessment and treatment of cardiovascular risk in prediabetes: impaired glucose tolerance and impaired fasting glucose. Am J Cardiol. 2011;108(3 Suppl):3B–24B.CrossRef
19.
Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28(7):412–9.CrossRef
20.
Wallace TM, Levy JC, Matthews DR. Use and abuse of HOMA modeling. Diabetes Care. 2004;27(6):1487–95.CrossRef
21.
• Temneanu OR, Trandafir LM, Purcarea MR. Type 2 diabetes mellitus in children and adolescents: a relatively new clinical problem within pediatric practice. J Med Life. 2016;9(3):235–9. This paper reviews the latest findings in type 2 diabetes in adolescents with regards to pathogenesis, and risk factors. The paper also outlines the differences in the disease between adults and adolescents with regards to onset, progression, and complication development. PubMedPubMedCentral
22.
Simerville JA, Maxted WC, Pahira JJ. Urinalysis: a comprehensive review. Am Fam Physician. 2005;71(6):1153–62.PubMed
23.
Steinberger J, Daniels SR, American Heart Association Atherosclerosis H, Obesity in the Young C, American Heart Association Diabetes C. Obesity, insulin resistance, diabetes, and cardiovascular risk in children: an American Heart Association scientific statement from the Atherosclerosis, Hypertension, and Obesity in the Young Committee (Council on Cardiovascular Disease in the Young) and the Diabetes Committee (Council on Nutrition, Physical Activity, and Metabolism). Circulation. 2003;107(10):1448–53.CrossRef
24.
•• American Diabetes A. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2018. Diabetes Care. 2018;41(Suppl 1):S13–27. This is American Diabetes Association's most current recommended guidelines for adolescents with type 2 diabetes. Includes screening, lifestyle mangagement, pharmacologic management and transitioning to adult care. CrossRef
25.
American Diabetes A. 12. Children and adolescents: standards of medical Care in Diabetes-2018. Diabetes Care. 2018;41(Suppl 1):S126–S36.CrossRef
26.
Rodriguez BL, Fujimoto WY, Mayer-Davis EJ, Imperatore G, Williams DE, Bell RA, et al. Prevalence of cardiovascular disease risk factors in U.S. children and adolescents with diabetes: the SEARCH for diabetes in youth study. Diabetes Care. 2006;29(8):1891–6.CrossRef
27.
Truby H, Baxter K, Ware RS, Jensen DE, Cardinal JW, Warren JM, et al. A randomized controlled trial of two different macronutrient profiles on weight, body composition and metabolic parameters in obese adolescents seeking weight loss. PLoS One. 2016;11(3):e0151787.CrossRef
28.
• Visuthranukul C, Sirimongkol P, Prachansuwan A, Pruksananonda C, Chomtho S. Low-glycemic index diet may improve insulin sensitivity in obese children. Pediatr Res. 2015;78(5):567–73. Nearly 40% reduction in HOMA-IR and fasting insulin levels among youth participants following a low-GI diet only, however, further analysis suggests that higher baseline values explained the greater reduction in insulin resistance in the low-GI group. CrossRef
29.
Mirza NM, Palmer MG, Sinclair KB, McCarter R, He J, Ebbeling CB, et al. Effects of a low glycemic load or a low-fat dietary intervention on body weight in obese Hispanic American children and adolescents: a randomized controlled trial. Am J Clin Nutr. 2013;97(2):276–85.CrossRef
30.
Kirk S, Brehm B, Saelens BE, Woo JG, Kissel E, D'Alessio D, et al. Role of carbohydrate modification in weight management among obese children: a randomized clinical trial. J Pediatr. 2012;161(2):320–7 e1.CrossRef
31.
Partsalaki I, Karvela A, Spiliotis BE. Metabolic impact of a ketogenic diet compared to a hypocaloric diet in obese children and adolescents. J Pediatr Endocrinol Metab. 2012;25(7–8):697–704.PubMed
32.
Krebs NF, Gao D, Gralla J, Collins JS, Johnson SL. Efficacy and safety of a high protein, low carbohydrate diet for weight loss in severely obese adolescents. J Pediatr. 2010;157(2):252–8.CrossRef
33.
Demol S, Yackobovitch-Gavan M, Shalitin S, Nagelberg N, Gillon-Keren M, Phillip M. Low-carbohydrate (low & high-fat) versus high-carbohydrate low-fat diets in the treatment of obesity in adolescents. Acta Paediatr. 2009;98(2):346–51.CrossRef
34.
Drewnowski A, Rehm CD. Energy intakes of US children and adults by food purchase location and by specific food source. Nutr J. 2013;12:59.CrossRef
35.
• Augustin LS, Kendall CW, Jenkins DJ, Willett WC, Astrup A, Barclay AW, et al. Glycemic index, glycemic load and glycemic response: An International Scientific Consensus Summit from the International Carbohydrate Quality Consortium (ICQC). Nutr Metab Cardiovasc Dis. 2015;25(9):795–815. This article summarizes to evidence on the utility of the glycemic index, glycemic load, and glycemic response, endorsing the importance of these measures on postprandial glycemia in overall health, and the GI as a valid and reproducible method to classify carhodydrate sources. CrossRef
36.
Ludwig DS. The glycemic index: physiological mechanisms relating to obesity, diabetes, and cardiovascular disease. JAMA. 2002;287(18):2414–23.CrossRef
37.
Jakobsen MU, Dethlefsen C, Joensen AM, Stegger J, Tjonneland A, Schmidt EB, et al. Intake of carbohydrates compared with intake of saturated fatty acids and risk of myocardial infarction: importance of the glycemic index. Am J Clin Nutr. 2010;91(6):1764–8.CrossRef
38.
Barclay AW, Petocz P, McMillan-Price J, Flood VM, Prvan T, Mitchell P, et al. Glycemic index, glycemic load, and chronic disease risk--a meta-analysis of observational studies. Am J Clin Nutr. 2008;87(3):627–37.CrossRef

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