You may have thought that insulin resistance was something only adults need to worry about, but unfortunately that is not the case.
What causes insulin resistance in children?
Obesity is the leading cause of insulin resistance in children and adolescents. Other causes include prolonged use of medications such as corticosteroids, growth hormone therapy and some rare genetic disorders. Puberty is also associated with an increase in insulin resistance; however this typically improves once hormones settle down.
In Australia around 1 in 4 children aged 5-14 were overweight (17%) or obese (7.7%) (1).
These high rates are linked to lifestyle factors such as increased intakes of high calorie foods with little nutritional value and high sugar intakes, as well as little to no physical activity combined with increased sedentary behaviours which includes a lot of screen time.
Although we don’t know exactly how prevalent insulin resistance is within overweight/obese children and adolescents, some studies indicate that it could be as high as 40% (2).
So, what is insulin resistance?
Put simply insulin resistance means cells within the body aren’t listening to the signals the hormone insulin is making.
When we eat carbohydrate containing foods our body breaks this down into glucose. The role of insulin is to move the glucose from our blood stream into our cells. In the case of insulin resistance, the cells essentially ignore the insulin and don’t take in the glucose, meaning that blood glucose levels don’t go down like they’re supposed to – instead they continue to rise after the meal. The thing is, a high blood glucose level tells our pancreas to make more insulin, and so it continues to make more insulin even though the cells are still ignoring the first lot. So, we end up with high insulin levels to do a job that should only take a small amount of insulin. Eventually, the cells become more and more resistant leading to high insulin and high blood glucose levels.
High insulin levels are associated with weight gain, high blood pressure and an increased risk of cardiovascular disease.
Insulin resistance also means that your pancreas is working extra hard to make all that extra insulin and this can in turn lead to it burning out – the cells that produce insulin become damaged and less insulin can be made. It’s at this stage that insulin resistance can lead to type 2 diabetes, which is an inability to produce enough insulin to keep blood glucose levels under control.
Signs of insulin resistance in children
Common signs of insulin resistance include:
- Abdominal obesity
- Dark skin patches typically on the back of the neck, elbows, knees, knuckle or armpits (known as acanthosis nigricans).
- High blood pressure
- High blood glucose levels
- Increased appetite
If you are at all concerned about your child’s health please discuss this with your paediatrician or GP.
What can you do?
The best approach to tackling insulin resistance is physical activity and a healthy balanced diet.
Exercise is shown to increase insulin sensitivity. Encourage your child to get active. Find a sport or activity that they are really keen to try and likely to enjoy. Try to make family time on the weekends about being outdoors and active, whether that be walking, riding or a trip to the local playground.
Make an effort to also include incidental exercise wherever possible. This could be choosing to walk or ride to school instead of driving or walking to friend’s houses for playdates.
Make the focus on enjoyment and your child is more likely to want to keep at it.
Don’t cut our carbs
While insulin resistance does mean that you will need to be mindful of carbohydrates, your child should continue to enjoy them as part of a balanced diet. This is the body’s preferred energy source, and growing bodies need it for healthy development. Aim for whole foods like fruit and vegetables, whole grain breads and cereals. These all contain carbohydrates as well as being excellent sources of fibre and essential vitamins and minerals. A diet high in fibre has been shown to lower insulin resistance. Milk and yoghurt also contain carbohydrates as well as calcium, which is essential for healthy bones. Going for plain, unsweetened versions are your best bet.
Try to avoid highly processed foods as these tend to be high in calories and have added sugar, but little nutritional value by way of vitamins and minerals. This article here explains the difference to the types of sugars found in foods and which ones you should and shouldn’t avoid.
Reducing the amount of added sugar in your child’s diet may seem daunting, but this shows some simple swaps to go from a day of high sugar to a day of no added sugar.
Our paediatric dietitian Michelle Bulman can help make positive changes to your child’s diet.
- Australian Institute of Health and Welfare. (2020). Australia’s children. Retrieved from https://www.aihw.gov.au/reports/children-youth/australias-children
- van der Aa MP, Fazeli Farsani S, Knibbe CA, de Boer A, van der Vorst MM. Population-Based Studies on the Epidemiology of Insulin Resistance in Children. J Diabetes Res. 2015;2015:362375. doi:10.1155/2015/362375