Research article
Six-Year Change in Youth Physical Activity and Effect on Fasting Insulin and HOMA-IR

https://doi.org/10.1016/j.amepre.2008.07.007Get rights and content

Background

There is a shortage of longitudinal data analyzing associations between physical activity and indicators of insulin resistance among children and adolescents after accounting for adiposity change. To guide future prevention efforts, data were used from the Danish arm of the European Youth Heart Study to examine these issues.

Methods

Participants were 384 students in Grade 9 (aged 15 years) from the municipality of Odense, Denmark, who participated in surveys in 1997 and 2003. Physical activity was monitored for at least 3 days by accelerometer, and mean counts per minute (CPM) and minutes >3000 CPM per day were obtained. Blood samples were collected, and levels of fasting insulin, fasting glucose, and homeostasis model of assessment of insulin resistance (HOMA-IR) were obtained. Data were analyzed in 2008.

Results

Physical activity declined from 45 minutes >3000 CPM in 1997 to 35 minutes >3000 CPM in 2003. Longitudinal regression analyses showed that a change in minutes >3000 CPM was negatively associated with fasting insulin levels (z=−2.47, p=0.014) and HOMA-IR (z=−2.31, p=0.021) in 2003. Similar findings were found when CPM was used as the physical activity variable. Results demonstrated that a 6-year decline in physical activity was associated with higher insulin and HOMA-IR levels.

Conclusions

The 6-year change in the volume of physical activity engaged in by adolescents aged 15 years was negatively associated with fasting insulin and HOMA-IR. Preventing an age-related decline in physical activity may be an effective means of preventing youth insulin resistance.

Section snippets

Background

It has been estimated that in 2006, 22 million children in the European Union (EU) were overweight, and of these, 5 million children were obese.1 It is also estimated that more than 27,000 European children have type 2 diabetes, and more than 400,000 have impaired glucose levels.2 As the prevalence of childhood obesity within the EU is expected to rise by more than 1 million cases per year,1 the number of insulin-resistant youth is also likely to increase. To prevent future type 2 diabetes, it

Participants

Data are from the Danish arm of the European Youth Heart Study (EYHS). The sampling frame has been discussed in detail elsewhere,12, 13 but in 1997 students in Grade 3 were recruited from a sample of schools in the municipality of Odense, Denmark. The sample was stratified by the SES of the area. Data were initially collected on 590 3rd-grade students (310 girls) in 1997. In 2003, a second survey was completed in which all the original participants, then in Grade 9, were invited to participate

Results

Participant characteristics are shown in Table 1. Of the 384 participants, 216 (56.3%) lived in a household with a university graduate. The mean BMI increased from 17.2 in 1997 to 21.2 in 2003. Mean minutes >3000 CPM were 45.6 minutes in 1997 and 35.1 minutes in 2003. Independent sample t-tests indicated larger 2003 waist circumferences among boys (75.94 cm vs 72.96 cm, t=−3.84, p<0.001); higher 2003 glucose levels among boys (5.16 mmol/l vs 4.89 mmol/l, t=−6.67, p<0.001); higher activity among

Discussion

The physical activity levels of Danish adolescents declined from when they were aged 9 to when they were aged 15, and this decline was associated with adverse changes in participants' fasting insulin and HOMA-IR levels when aged 15. These findings are among the first to document in a longitudinal study what has previously been suspected based on data in cross-sectional studies,11, 27 and they support the promotion of physical activity among youth as a means of maintaining desirable metabolic

Conclusion

This paper has provided further cross-sectional and new longitudinal data on the association between physical activity and indicators of insulin resistance among Danish adolescents aged 15 years. Reductions in physical activity between ages 9 and 15 were associated with higher fasting insulin levels and HOMA-IR levels. New programs that focus on stemming the age-related decline in physical activity are likely to be an effective means of preventing insulin resistance.

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