PARÂMETROS DIETÉTICOS ASSOCIADOS AO FENÓTIPO DE RESISTÊNCIA À INSULINA EM ADOLESCENTES: CONSÓRCIO RPS, SÃO LUÍS

Abstract

Adolescence is a period of development that encompasses a wide range of changes and is seen as a crucial window of opportunity for shaping lifelong health, especially with regard to insulin resistance (IR). IR is a common part of the pathophysiology of multiple cardiometabolic diseases and there is a need for attention to this condition in the face of the increasing prevalence of DM2 in adolescents and young adults. Although insulin resistance and the changes that accompany it have a multifactorial origin, adolescent food consumption and some specific dietary components appear to be an important modifiable risk factor in this process. This dissertation therefore aims to investigate the association of dietary parameters with the Insulin Resistance Phenotype in adolescents. This is a cross-sectional study developed using data from the second follow-up of the RPS Consortium cohort, São Luís (n = 1 874), in which the outcome was the latent variable Insulin Resistance Phenotype, formed by three indicators: Triglycerides/HDL ratio, Triglycerides-Glycemia Index and VLDL level. A theoretical model stratified by sex, including Socioeconomic Status, the dietary parameters of carbohydrate and saturated fat intake, and obesity as a mediator in association with the outcome in adolescents were analyzed using Structural Equation Models. The results showed that the consumption of added sugars greater than 25g had a direct risk effect in boys (Standardized Coefficient – SC = 0.093; p = 0.015) and girls (SC = 0.100; p = 0.018) for Insulin Resistance Phenotype. Consumption of more than 10% of the total energy value from saturated fats was also associated with the Insulin Resistance Phenotype in boys (SC = 0.071; p = 0.027) and girls (SC = 0.117; p < 0.001). The other parameters were not associated with the outcome in adolescents. The findings show that consumption of added sugars and saturated fats above the international recommendations explained insulin resistance in adolescents, regardless of obesity. Dietary interventions aimed at strengthening international recommendations among young people should be encouraged in order to prevent the risk of diabetes in the future.