Randomized Control Trial to Improve Adiposity and Insulin Resistance in Overweight Latino Adolescents

Davis, Jaimie N.; Kelly, Louise A.; Lane, Christianne J.; Ventura, Emily E.; Byrd-Williams, Courtney E.; Alexandar, Katharine A.; Azen, Stanley P.; Chou, Chih Ping; Spruijt‐Metz, Donna; Weigensberg, Marc J.; Berhane, Kiros; Goran, Michael I.

doi:10.1038/oby.2009.19

Cited by 95 publications

(138 citation statements)

References 35 publications

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“…Eleven studies did not provide pubertal status in ausableformforouranalysisbecause:(1) it was not reported at all 23,24,26,27,[38][39][40]53 ; (2) it was reported in a range of stages 34 ; or (3) it was reported for the entire sample. 22 Fail Safe-N The number of unpublished or unretrieved null effects that would diminish the significance of observed effects to P , .05 was estimated as the fixed effects fail-safe N. A fail-safe N 1 represents the relative sample size of 1 additional effect that would be needed to lower the average ES to a nonsignificant value. A fail-safe N + represents the minimal number of additional null effects from multiple studies of average sample size needed to reach a similar null conclusion.…”

Section: Homogeneity Of Resultsmentioning

confidence: 99%

“…29 IR was calculated by using fasting levels of insulin and glucose by using the homeostasis model assessment (HOMA) technique in each study included in this analysis. 22,25,31,32,[34][35][36][37][38][39][40][41] A decrease in fasting insulin levels or IR among participants in exercise interventions resulted in a positive ES. Two authors (M.V.F.…”

Section: Es Calculationmentioning

confidence: 99%

“…Eleven studies did not provide pubertal status in ausableformforouranalysisbecause:(1) it was not reported at all 23,24,26,27,[38][39][40]53 ; (2) it was reported in a range of stages 34 ; or (3) it was reported for the entire sample. 22,32 The initial regression model based on baseline BMI (k = 28) was significant (R 2 = 0.15, b = 0.38, z = 2.25, P , .05). Gender (k = 27) and pubertal status (k = 16) were not independently associated with the effect of exercise on fasting insulin in the age range of our analysis (R 2 = 0.07, b = 0.26, z = 1.44 and R 2 = 0.08, b = -0.28, z = -1.18, respectively; all P .…”

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confidence: 99%

“…A flowchart of study selection is provided in Fig 1. Manual searches revealed 5 additional publications. [22][23][24][25][26][27] Six articles reported fasting insulin measurements as median and interquartile range (25th-75th percentile), reported data in change scores from baseline, or did not report either premeasurement or postmeasurement data. A request for missing data was sent to each of the corresponding authors.…”

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confidence: 99%

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Exercise and Insulin Resistance in Youth: A Meta-Analysis

et al. 2014

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BACKGROUND AND OBJECTIVES: The prevalence of obesity and diabetes is increasing among children, adolescents, and adults. Although estimates of the efficacy of exercise training on fasting insulin and insulin resistance have been provided, for adults similar estimates have not been provided for youth. This systematic review and meta-analysis provides a quantitative estimate of the effectiveness of exercise training on fasting insulin and insulin resistance in children and adolescents.METHODS: Potential sources were limited to peer-reviewed articles published before June 25, 2013, and gathered from the PubMed, SPORTDiscus, Physical Education Index, and Web of Science online databases. Analysis was limited to randomized controlled trials by using combinations of the terms adolescent, child, pediatric, youth, exercise training, physical activity, diabetes, insulin, randomized trial, and randomized controlled trial. The authors assessed 546 sources, of which 4.4% (24 studies) were eligible for inclusion. Thirty-two effects were used to estimate the effect of exercise training on fasting insulin, with 15 effects measuring the effect on insulin resistance. Estimated effects were independently calculated by multiple authors, and conflicts were resolved before calculating the overall effect. RESULTS:Based on the cumulative results from these studies, a small to moderate effect was found for exercise training on fasting insulin and improving insulin resistance in youth (Hedges' d effect size = 0.48 [95% confidence interval: 0.22-0.74], P , .001 and 0.31 [95% confidence interval: 0.06-0.56], P , .05, respectively). CONCLUSIONS:These results support the use of exercise training in the prevention and treatment of type 2 diabetes. Pediatrics 2014;133:e163-e174 Mr Fedewa conceptualized and designed the study, conducted the initial analysis, and drafted the initial manuscript; Dr Gist coded and analyzed effects and reviewed and revised the initial manuscript; Dr Evans assisted with conceptualizing and designing the study and reviewed and revised the initial manuscript; Dr Dishman assisted with conceptualizing and designing the study, performed additional statistical analysis, and critically reviewed and revised the initial manuscript; and all authors approved the final manuscript as submitted. The global prevalence of pediatric type 2 diabetes mellitus (T2DM) has paralleled the rise in obesity, increasing steadily since the late 1970s. 1 This endocrine disorder is caused by a combination of peripheral insulin resistance (IR) in muscle and adipose tissue and inadequate insulin secretion from the pancreas, eventually resulting in a relative insulin deficiency. 2 Early dysfunction in b-cell activity and cellular IR appear long before manifestation of the signs and symptoms of T2DM. 3 Deterioration of peripheral insulin sensitivity and b-cell dysfunction can be observed as the disease progresses in youth at risk for developing metabolic syndrome and T2DM. 4 Puberty is marked by a decrease in physical activity 5 and an incr...

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Section: Homogeneity Of Resultsmentioning

confidence: 99%

Section: Es Calculationmentioning

confidence: 99%

“…Eleven studies did not provide pubertal status in ausableformforouranalysisbecause:(1) it was not reported at all 23,24,26,27,[38][39][40]53 ; (2) it was reported in a range of stages 34 ; or (3) it was reported for the entire sample. 22,32 The initial regression model based on baseline BMI (k = 28) was significant (R 2 = 0.15, b = 0.38, z = 2.25, P , .05). Gender (k = 27) and pubertal status (k = 16) were not independently associated with the effect of exercise on fasting insulin in the age range of our analysis (R 2 = 0.07, b = 0.26, z = 1.44 and R 2 = 0.08, b = -0.28, z = -1.18, respectively; all P .…”

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confidence: 99%

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confidence: 99%

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Exercise and Insulin Resistance in Youth: A Meta-Analysis

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“…Details of the study methods were published previously (20)(21)(22)(23). Briefly, participants were recruited through medical clinics, churches, community centers, local schools, and advertisements in Los Angeles County, CA.…”

Section: Participantsmentioning

confidence: 99%

Eating breakfast more frequently is cross-sectionally associated with greater physical activity and lower levels of adiposity in overweight Latina and African American girls

Schembre¹,

Wen²,

Davis³

et al. 2013

The American Journal of Clinical Nutrition

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Background: Eating breakfast is believed to promote a healthy body weight. Yet, few studies have examined the contribution of energy balance-related behavioral factors to this relation in minority youth. Objective: We assessed the associations between breakfast consumption and dietary intake, physical activity (PA), and adiposity before and after accounting for energy intake and PA in minority girls. Design: Cross-sectional data were obtained on body mass index (BMI), percentage body fat (measured by BodPod), dietary intake (measured with 3-d dietary records), and PA (measured with 7-d accelerometry) from 87 Latina and African American girls 8-17 y of age (75% Latina, 80% overweight). Dietary records were used to categorize girls as more frequent breakfast eaters (MF; 2 or 3 of 3 d; n = 57) or less frequent breakfast eaters (LF; 0 or 1 of 3 d; n = 30). Chi-square tests, ANCOVA, and multiple regression analyses were conducted. Mediation was assessed with a Sobel test. Results: Compared with the MF group, the LF group spent 30% less time (12.6 min/d) in moderate-to-vigorous-intensity PA (MVPA; P = 0.004) and had a higher percentage body fat (P = 0.029). MVPA accounted for 25% (95% CI: 28.8%, 58.1%; P = 0.139) of the relation between breakfast consumption and percentage body fat. We were unable to show that energy intake or MVPA was a significant mediator of the relation between breakfast consumption and adiposity in this sample. Conclusions: Evidence suggests that among predominantly overweight minority girls, MVPA, but not energy intake, was associated with both breakfast consumption and adiposity; however, a lack of power reduced our ability to detect a significant mediation effect. Other unobserved variables likely contribute to this relation. Am J Clin Nutr 2013;98:275-81.

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Culturally appropriate health education for people in ethnic minority groups with type 2 diabetes mellitus

Attridge

Creamer

Ramsden

et al. 2014

Cochrane Database of Systematic Reviews

145

154

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Culturally appropriate health education has short- to medium-term effects on glycaemic control and on knowledge of diabetes and healthy lifestyles. With this update (six years after the first publication of this review), a greater number of RCTs were reported to be of sufficient quality for inclusion in the review. None of these studies were long-term trials, and so clinically important long-term outcomes could not be studied. No studies included an economic analysis. The heterogeneity of the studies made subgroup comparisons difficult to interpret with confidence. Long-term, standardised, multi-centre RCTs are needed to compare different types and intensities of culturally appropriate health education within defined ethnic minority groups, as the medium-term effects could lead to clinically important health outcomes, if sustained.

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Randomized Control Trial to Improve Adiposity and Insulin Resistance in Overweight Latino Adolescents

Cited by 95 publications

References 35 publications

Exercise and Insulin Resistance in Youth: A Meta-Analysis

Exercise and Insulin Resistance in Youth: A Meta-Analysis

Eating breakfast more frequently is cross-sectionally associated with greater physical activity and lower levels of adiposity in overweight Latina and African American girls

Culturally appropriate health education for people in ethnic minority groups with type 2 diabetes mellitus

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