Effect of a successful intensive lifestyle program on insulin sensitivity and glucose tolerance in obese youth

OBJECTIVE—To evaluate the impact on glucose metabolism of a lifestyle program (the Yale Bright Bodies Program) for obese children.RESEARCH DESIGN AND METHODS—Thirteen Bright Bodies and ten clinic-care control subjects who were part of a large randomized clinical trial had 75-g oral glucose tolerance tests at the beginning and end of the 12-month study.RESULTS—Bright Bodies subjects had significantly greater decreases in weight, BMI, and body fat than clinic-care subjects, and the Bright Body subjects’ changes in body composition were accompanied by marked improvements in insulin sensitivity (P = 0.009) and glucose tolerance (P = 0.04).CONCLUSIONS—An intensive lifestyle program that successfully reduces body weight and body fat can markedly improve insulin sensitivity and glucose metabolism in obese youth.In an attempt to respond to the childhood obesity epidemic, we developed Yale''s Bright Bodies weight-management program, a family-based lifestyle intervention that includes nutrition education, exercise, and behavior modification. Its efficacy was validated by a 12-month randomized clinical trial (RCT) with more than 170 overweight children and adolescents. In this RCT, Bright Bodies subjects had significant improvements in BMI and body composition, including a 9.2-kg difference in change in total body fat versus that in the clinic-care control group (1). To examine the impact of the Bright Bodies program on insulin sensitivity and glucose metabolism in obese children, a randomly selected subset of subjects from both groups underwent an oral glucose tolerance test (OGTT) at the beginning and end of the 12-month study.