Pediatric Research | 2021
Science for Kids: Effects of low-glycemic index diet on plasma adipokines in childhood obesity
Abstract
INTRODUCTION In both the developing and developed world, childhood obesity has become an epidemic. In the United States, between the years 2017 and 2018, the prevalence of obesity was 19.3% in children aged 2–19 years, which affected approximately 14.4 million children and adolescents. Increase in obesity may be due to changes in lifestyle, including diet, physical activity, and built-in living environments. Interesting electronic gadgets for kids that keeps them glued to the screen, less exercise and physical play, staying at home, and processed foods including sugary beverages are some of the reasons that have led to this epidemic. Obesity increases the risk for health problems such as sleep apnea, swelling of joints, and metabolic syndrome, which is a combination of hypertension, high blood sugar levels and diabetes, and increased levels of blood lipids. Metabolic syndrome increases lifetime risk for heart attack, stroke, and type II diabetes. Therefore, childhood obesity can lead to longterm health issues and decrease children’s productivity and lifespan. The fat cells, otherwise called adipocytes, release adipokines, which are cell signaling proteins. Adipokines have a large role in the metabolism of muscles, liver, and other organs. Adiponectin, leptin, visfatin, and resistin are adipokines that have been investigated in this study of obese children. Insulin is a hormone that allows the cells of the body to accept and break down glucose, or sugar, for energy for the body. When the body builds a resistance to insulin, the body has higher amounts of sugar in the blood since the insulin is not doing its job. The body produces more insulin to counter insulin resistance, which is detrimental to the system. Adiponectin increases insulin sensitivity. Leptin suppresses appetite and allows for higher energy expenditure; however, high leptin levels in obesity are associated with leptin resistance. Visfatin acts in a similar manner as insulin, by helping the body break down glucose for energy; however, there is no clear evidence that visfatin has any correlation to insulin resistance. Resistin which is a cytokine, a protein important for cell signaling released by fat cells, may cause inflammation. Obesity prevention and treatment require changes in lifestyle such as healthier diets and increased physical activity. Typically, physicians recommend a low-fat, high-fiber diet for obese children. Another important factor in the diet is the glycemic index (GI, ranges from 1 to 100), which rates foods containing carbohydrates on how much they boost blood sugar. Foods that have an index of 100 boosts blood sugar by 100% and are equivalent to pure sugar. Foods like vegetables and fruits, which contain complex carbohydrates and fiber, have a low GI and might help obese children. In this study, the control group follows a conventional diet advised by doctors with low fat and high fiber content. The intervention is a low-GI diet for 6 months and the authors investigated the effects of low-GI diet on adipokines in obese children.