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Open Access Research

Insulin sensitivity affects propensity to obesity in an ethnic-specific manner: results from two controlled weight loss intervention studies

Barbara A Gower15*, Jessica A Alvarez13, Nikki C Bush14 and Gary R Hunter2

Author Affiliations

1 Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, USA

2 Department of Human Studies, University of Alabama at Birmingham, Birmingham, AL, 35294, USA

3 Current address: Division of Endocrinology, Diabetes & Lipids, Emory University School of Medicine, Atlanta, GA, 30322, USA

4 Current address: Endocrine Research Unit, Mayo Clinic, Rochester, MN, 55905, USA

5 Department of Nutrition Sciences, University of Alabama at Birmingham, 423 Webb Building, 1675 University Blvd, Birmingham, AL, 35294-3360, USA

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Nutrition & Metabolism 2013, 10:3  doi:10.1186/1743-7075-10-3

Published: 8 January 2013

Abstract

Background

Risk for obesity differs with ethnicity/race and is associated with insulin sensitivity (SI), insulin responsiveness, and dietary glycemic load (GL). The objective of this study was to test the hypotheses that, 1) obesity-prone, normal weight, African-American (AA) women would be more insulin sensitive than BMI-matched, never overweight AA women; 2) increased adiposity over time would be associated with greater baseline SI and higher dietary GL in AA but not European-American (EA) women; and 3) increased adiposity over time would be predicted by SI in women with high but not low acute insulin response to glucose (AIRg).

Methods

Two controlled weight loss interventions were conducted involving overweight (BMI 25.0-29.9 kg/m2) premenopausal AA and EA women. The first included matching with normal-weight (BMI <25.0 kg/m2) controls following weight loss, and then comparing SI. The second included a 1-year follow-up of weight-reduced participants to identify predictors of change in %body fat. Main outcome measure in the first study was insulin sensitivity (SI) as assessed with intravenous glucose tolerance test (IVGTT), and in the second study was change in %fat, as assessed with DXA, over one year. AIRg was assessed during IVGTT, and free-living diet was determined by food record.

Results

In the first study, formerly overweight AA women were 43% more insulin sensitive than BMI-matched never overweight AA (P < 0.05). In the second study, SI was positively associated with change in %fat over 1 year only in AA women (P < 0.05) and women with high AIRg (P < 0.05). In addition, AA who were insulin sensitive and who consumed a higher GL diet tended to gain greater %fat (P = 0.086 for diet x SI interaction). In both studies, AA women had higher AIRg (P < 0.001) than EA women.

Conclusions

Formerly overweight (obesity-prone) AA women were more insulin sensitive than never overweight AA women, a quality that may predispose to adiposity, particularly when combined with a high GL diet. This ethnicity/race-specific effect may be due to high insulin responsiveness among AA.

Keywords:
Glycemic index; Diet; Insulin secretion; Acute insulin response