Abstract
Evidence of the role that dietary carbohydrates (total carbohydrates, dietary fiber, total sugars, dietary glycemic index (GI) and glycemic load (GL)) exerts on insulin levels in adolescents is controversial. Thus, the aim of this study was to assess the association between dietary carbohydrates and insulin resistance in adolescents from Chiapas, México. A cross-sectional study was conducted in 217 adolescents. Sociodemographic, anthropometric, dietary and biochemical data were obtained. Total carbohydrates, dietary fiber, total sugars, dietary GI and GL were calculated from 24 h recalls. Two validated cut-off points for the homeostasis model assessment of insulin resistance (HOMA-IR) were used as surrogates of insulin resistance. Fasting insulin levels ≥ 14.38 μU/mL were considered as abnormal. Multivariate logistic regression models were fitted to assess the association between tertiles of dietary carbohydrates and insulin resistance or hyperinsulinemia. In our study, adolescents with the highest dietary fiber intake had lower odds of HOMA-IR > 2.97 (OR = 0.34; 95% CI: 0.13–0.93) when adjusted for sex, age, body fat percentage and saturated fatty acids intake. No significant associations were found for the rest of the carbohydrate variables. In summary, high-fiber diets reduce the probability of insulin resistance in adolescents from marginalized areas of Chiapas, México.
Highlights
Insulin resistance is a fundamental component of Type 2 diabetes mellitus (T2DM) etiology and is related to a wide range of diseases such as hypertension, hyperlipidemia and polycystic ovarian disease [1]
The median of homeostasis model assessment of insulin resistance (HOMA-IR) in our study was 1.8 units, which is similar to values previously reported for similar aged adolescents in México [36,37]
Another study conducted in 292 adolescents (12–15 years) from Coahuila, México, found a higher proportion (46%) of insulin resistance [37]
Summary
Insulin resistance is a fundamental component of Type 2 diabetes mellitus (T2DM) etiology and is related to a wide range of diseases such as hypertension, hyperlipidemia and polycystic ovarian disease [1]. Diet is a modifiable factor that can prevent or predispose to insulin resistance. The effect of carbohydrate intake on insulin resistance has been scarcely studied in adolescents. Observational studies have found higher insulin sensitivity in youth with diets high in dietary fiber [2] and whole-grain intake [3]. High total sugar intake has been linked to increased insulin resistance in girls and adolescents [4], this association remains controversial [5]. High GI diets during puberty have been associated with increased insulin resistance in adulthood [10]. Low GI diets can produce significant decreases in the homeostasis model assessment of insulin resistance (HOMA-IR) in children and adolescents [11]
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