An intervention in middle schools lowered the obesity rate in students at highest risk for type 2 diabetes, those who started out overweight or obese in sixth grade, an NIH-funded study has found. However, schools that implemented the program did not differ from comparison schools in the study's primary outcome—the prevalence of overweight and obesity combined—which had declined 4 percent in both groups of schools by the end of the three-year study.
The goal of the HEALTHY Study was to determine whether changes in school food services; longer, more intense periods of physical education; and classroom activities to promote behavior change would lower risk factors for type 2 diabetes. Conducted from the beginning of the sixth grade to the end of the eighth, the study involved 4,600 students attending 42 middle schools in seven areas of the country. Schools were randomly assigned to implement the program or serve as a comparison school.
"The study shows that a school-based program can help lower obesity and certain risk factors for type 2 diabetes in youth at high risk for the disease," said Griffin P. Rodgers, M.D., director of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
Researchers were surprised to find that the number of overweight and obese students had declined in comparison schools as well as program schools. "The decline in the number of overweight and obese children in comparison schools was a welcome but unexpected finding," said study chair and lead author Gary D. Foster, Ph.D., of Temple University, Philadelphia. "Future analyses will try to clarify the reasons for the improvement in these schools. For example, we'll look at the comparison schools to see if they made healthy changes to the school environment because of increased awareness about the problem of childhood obesity."
The intervention significantly lowered the obesity rate among children whose body mass index, or BMI, was initially at the 85th percentile or more. In children, overweight is defined as a BMI at the 85th to 94th percentile for their age and sex; obesity is defined as a BMI at the 95th percentile or more. BMI is a measurement of weight in relation to height.
Students in program schools who were overweight or obese in the sixth grade had 21 percent lower odds of being obese by the end of the eighth grade compared with students in control schools. Nationally, about one-third of children are overweight or obese, but in schools participating in the study, half of students were overweight or obese in sixth grade.
"Decreasing the number of obese children can have profound effects on diabetes risk in young people, since obese youth are at greatest risk of metabolic abnormalities," Foster said.
At the end of the study, 35 percent of children in both intervention and comparison schools with a BMI in the 95th percentile or greater had high insulin readings, compared with 2 percent of students whose BMI was less than the 85th percentile.
The program also lowered average levels of fasting insulin and the number of students with a waist at or over the 90th percentile in students in intervention schools compared with comparison schools. A high blood level of insulin after an overnight fast and a large waist increase the risk of developing type 2 diabetes, independent of body weight. However, the two groups did not differ in mean glucose levels or the percentage of students with elevated fasting glucose. A higher-than-normal level of fasting blood sugar indicates a greater risk of developing type 2 diabetes.
The results of the HEALTHY Study appear online in the New England Journal of Medicine June 27, 2010, and coincide with presentation of the results at the 70th annual scientific sessions of the American Diabetes Association (ADA) in Orlando, Fla. The study was funded by the NIDDK, a part of the National Institutes of Health, and the ADA.
"We will only stop the diabetes epidemic if we continue to test innovative approaches to help children make healthy lifestyle choices," said Richard M. Bergenstal, M.D., president, Medicine and Science, ADA. "The HEALTHY Study shows us an effective approach that can be implemented to improve the outcomes of a large number of youth at very high risk of diabetes."
Because type 2 diabetes disproportionately affects minorities and low-income people, the study was conducted in schools with a high enrollment of minority children (54 percent Hispanic and 18 percent African-American) and youth from low-income families. About 75 percent of students were eligible for free or reduced-price meals.
At the beginning of sixth grade, many students had signs of high diabetes risk. Nearly half were overweight or obese, 16 percent had elevated fasting blood glucose levels, and nearly 7 percent had elevated fasting insulin levels. At the end of the eighth grade, students were tested for diabetes risk factors, including fasting blood levels of glucose, insulin, and lipids as well as height, weight, blood pressure, fitness level, and waist circumference.
The program consisted of
Healthier choices in the cafeteria, snack bars, class events, and vending machines (lower fat, higher fiber foods; more fruits and vegetables; and an emphasis on water, low-fat milk, and drinks with no added sugar)
Longer, more intense periods of physical activity, defined as achieving a heart rate of at least 130 beats per minute, with a target of 150 minutes or more over a 10-day period
Activities and awareness campaigns that promoted long-term healthy behaviors.
The study was conducted by researchers at the following centers:Baylor College of Medicine, Houston, Texas
Type 2 diabetes, which accounts for up to 95 percent of all diabetes cases, becomes more common with increasing age. The disease is strongly associated with obesity, inactivity, family history of diabetes, history of gestational diabetes, impaired glucose metabolism, and racial or ethnic background. The prevalence of diagnosed diabetes has more than doubled in the last 30 years, due in large part to the upsurge in obesity. For more information about diabetes, visit http://diabetes.niddk.nih.gov/index.htm.
More than two-thirds of U.S. adults age 20 and older are overweight or obese. Among youth 2 to 19 years old, about one-third have a BMI at or above the 85th percentile for their age. Once seen only in adults, type 2 diabetes has been rising steadily in youth. The SEARCH for Diabetes in Youth Study, funded by the Centers for Disease Control and Prevention and the NIH, is examining diabetes rates in youth. According to the SEARCH Study, from 2002 to 2005About 3,700 youth from less than one year of age to 19 years old were newly diagnosed with type 2 diabetes annually
The rate of new type 2 diabetes cases in youth ages 10 to 19 years was 5.3 per 100,000, with higher rates in minority populations.
The NIH sponsors We Can! Ways to Enhance Children's Activity and Nutrition— a program to prevent childhood obesity that encourages parents and children to adopt healthy eating habits, increase physical activity, and reduce leisure "screen time" to prevent childhood obesity. We Can! materials, including fact sheets, brochures and curricula for adults and children, are available at http://wecan.nhlbi.nih.gov or by calling toll-free 1-866-35-WECAN.
For media inquiries during ADA's scientific meetings (June 25-29), call the ADA press office at (407) 685-4010. After the meetings, contact Renee Cree (215) 204-6522 or email@example.com to interview Dr. Gary Foster. To interview an NIDDK spokesperson, contact (301) 496-3583 or e-mail NIDDKMedia@mail.nih.gov.
NIDDK, part of the NIH, conducts and supports basic and clinical research and research training on some of the most common, severe and disabling conditions affecting Americans. The Institute's research interests include diabetes and other endocrine and metabolic diseases; digestive diseases, nutrition, and obesity; and kidney, urologic and hematologic diseases. For more information, visit www.niddk.nih.gov.
The National Institutes of Health (NIH) — The Nation's Medical Research Agency — includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.
Resources:Information about the HEALTHY Study (NCT00458029) can be found at www.clinicaltrials.gov.
"Let's Move," First Lady Michelle Obama's campaign to end the childhood obesity epidemic in a generation http://www.letsmove.gov/
Joan Chamberlain | EurekAlert!
The personality factor: How to foster the sharing of research data
06.09.2017 | ZBW – Leibniz-Informationszentrum Wirtschaft
Europe’s Demographic Future. Where the Regions Are Heading after a Decade of Crises
10.08.2017 | Berlin-Institut für Bevölkerung und Entwicklung
Plants and algae use the enzyme Rubisco to fix carbon dioxide, removing it from the atmosphere and converting it into biomass. Algae have figured out a way to increase the efficiency of carbon fixation. They gather most of their Rubisco into a ball-shaped microcompartment called the pyrenoid, which they flood with a high local concentration of carbon dioxide. A team of scientists at Princeton University, the Carnegie Institution for Science, Stanford University and the Max Plank Institute of Biochemistry have unravelled the mysteries of how the pyrenoid is assembled. These insights can help to engineer crops that remove more carbon dioxide from the atmosphere while producing more food.
A warming planet
Our brains house extremely complex neuronal circuits, whose detailed structures are still largely unknown. This is especially true for the so-called cerebral cortex of mammals, where among other things vision, thoughts or spatial orientation are being computed. Here the rules by which nerve cells are connected to each other are only partly understood. A team of scientists around Moritz Helmstaedter at the Frankfiurt Max Planck Institute for Brain Research and Helene Schmidt (Humboldt University in Berlin) have now discovered a surprisingly precise nerve cell connectivity pattern in the part of the cerebral cortex that is responsible for orienting the individual animal or human in space.
The researchers report online in Nature (Schmidt et al., 2017. Axonal synapse sorting in medial entorhinal cortex, DOI: 10.1038/nature24005) that synapses in...
Whispering gallery mode (WGM) resonators are used to make tiny micro-lasers, sensors, switches, routers and other devices. These tiny structures rely on a...
Using ultrafast flashes of laser and x-ray radiation, scientists at the Max Planck Institute of Quantum Optics (Garching, Germany) took snapshots of the briefest electron motion inside a solid material to date. The electron motion lasted only 750 billionths of the billionth of a second before it fainted, setting a new record of human capability to capture ultrafast processes inside solids!
When x-rays shine onto solid materials or large molecules, an electron is pushed away from its original place near the nucleus of the atom, leaving a hole...
For the first time, physicists have successfully imaged spiral magnetic ordering in a multiferroic material. These materials are considered highly promising candidates for future data storage media. The researchers were able to prove their findings using unique quantum sensors that were developed at Basel University and that can analyze electromagnetic fields on the nanometer scale. The results – obtained by scientists from the University of Basel’s Department of Physics, the Swiss Nanoscience Institute, the University of Montpellier and several laboratories from University Paris-Saclay – were recently published in the journal Nature.
Multiferroics are materials that simultaneously react to electric and magnetic fields. These two properties are rarely found together, and their combined...
19.09.2017 | Event News
12.09.2017 | Event News
06.09.2017 | Event News
22.09.2017 | Medical Engineering
22.09.2017 | Physics and Astronomy
22.09.2017 | Physics and Astronomy