The Effect of Healthy Lifestyle Strategies on the Management of Insulin Resistance in Children and Adolescents with Obesity: A Narrative Review

Abstract

Childhood obesity is characterized by an increased risk of several metabolic derangements including insulin resistance (IR). The strongest recommendations to prevent obesity and related complications are a balanced and adequate diet and practicing physical activity from early childhood. In this review, we propose to present the effects of healthy lifestyle strategies, including physical exercise and dietary approaches, on the management of IR and related metabolic derangements. All types of exercise (aerobic, resistance and combined training) effectively reduce IR in pediatric patients with obesity; it seems that aerobic and combined training stimulate greater improvements in IR compared to resistance training. Balanced normocaloric or hypocaloric dietary approaches are also valid strategies to address IR; it is not possible to assess the long-term impact of varying macronutrients on cardiometabolic risk. The glycemic index/load evaluation is a useful dietary approach to glucose metabolism control. Similarly, they should adopt the principle of the Mediterranean diet. Randomized studies with longer monitoring are needed to define the benefits of nutritional supplementation on IR. Considering that healthy style acquisition could track to later ages, programs of healthy lifestyle starting with children offer a better preventive strategy to preserve metabolic control and children’s health.

Effects of Endurance Exercise Intensities on Autonomic and Metabolic Controls in Children with Obesity: A Feasibility Study Employing Online Exercise Training

“…In this paper, we observed that only the volume of exercise due to structured moderate-to-vigorous intensity exercise was associated with improved cardiac autonomic control, reduced systolic arterial pressure, and improved auxologic and metabolic parameters. Of particular interest is the reduction in the HOMA-IR index, which suggested reduced insulin resistance after training, confirming the relevant influence of different types of exercise on insulin resistance [ 66 ]. In contrast, we observed only a slight change in the auxologic parameters, such as BMI z-score and TMI, considering that the MET count also included METs linked to simple walking for more than 10 min.…”

Association of serum total IgE and allergen-specific IgE with insulin resistance in adolescents: an analysis of the NHANES database

“…A possible explanation may be that adolescents with seafood allergies, such as shrimp, may not meet healthy dietary pattern requirements, such as the Mediterranean (Med) dietary pattern. Calcaterra et al [ 37 ] suggested that adopt the principle of the Med diet was beneficial to several metabolic derangements including IR in adolescents. Nevertheless, the specific mechanisms that being allergic to rye grass, white oak, or peanut showed a potential protect effect on IR, whereas being allergic to shrimp had the opposite effect are needed to be further clarified.…”

Exergames to Limit Weight Gain and to Fight Sedentarism in Children and Adolescents with Obesity

“…Recently, several studies have shown that PA plays a crucial role in the management of OB in children and adolescents. In fact, PA can help to reduce body weight, improve body composition, and decrease insulin resistance, as well as strengthen self-esteem and improve the overall quality of life in this population [ 34 , 35 , 36 , 37 , 38 ]. Moreover, positive effects on mental health, including reducing symptoms of anxiety and depression [ 39 ], body mass index (BMI), BMI z-score, and body fat percentage in children and adolescents with OB have been associated with PA practice [ 40 , 41 , 42 ], with positive effects on the severity of OB and future adverse complications also being observed.…”