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Randomized controlled trial to improve adiposity, inflammation, and insulin resistance in obese African-American and Latino youth
Hasson RE, Adam TC, Davis JN, Kelly LA, Ventura EE, Byrd-Williams CE, Toledo-Corral CM, Roberts CK, Lane CJ, Azen SP, Chou CP, Spruijt-Metz D, Weigensberg MJ, Berhane K, Goran MI
Obesity 2012 Apr;20(4):811-818
clinical trial
4/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

The purpose of this study was to examine ethnic differences in the metabolic responses to a 16-week intervention designed to improve insulin sensitivity (SI), adiposity, and inflammation in obese African-American and Latino adolescents. A total of 100 participants (African Americans n = 48, Latino n = 52; age 15.4 +/- 1.1 years, BMI percentile 97.3 +/- 3.3) were randomly assigned to interventions: control (C; n = 30), nutrition (N; n = 39, 1x/week focused on decreasing sugar and increasing fiber intake), or nutrition strength training (NST; n = 31, 2x/week). The following were measured at pre-and postintervention: strength, dietary intake, body composition (dual-energy x-ray absorptiometry/magnetic resonance imaging) and glucose/insulin indexes (oral glucose tolerance test (OGTT)/intravenous glucose tolerance test (IVGTT)) and inflammatory markers. Overall, N compared to C and NST reported significant improvements in SI (16.5% versus 32.3% versus 6.9% respectively, p < 0.01) and disposition index (DI: 15.5% versus 14.2% versus 13.7% respectively, p < 0.01). NST compared to C and N reported significant reductions in hepatic fat fraction (HFF: 27.3% versus 4.3% versus 0% respectively, p < 0.01). Compared to N, NST reported reductions in plasminogen activator inhibitor-1 (PAI-1) (38.3% versus 1.0%, p < 0.01) and resistin (18.7% versus 11.3%, p = 0.02). There were no intervention effects for all other measures of adiposity or inflammation. Significant intervention by ethnicity interactions were found for African Americans in the N group who reported increases in total fat mass, 2-h glucose and glucose incremental areas under the curve (IAUC) compared to Latinos (p's 0.05). These interventions yielded differential effects with N reporting favorable improvements in SI and DI and NST reporting marked reductions in HFF and inflammation. Both ethnic groups had significant improvements in metabolic health; however some improvements were not seen in African Americans.

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