New Study Seeks to Lower Diabetes Risk in Youth
As schools across the country reopen their doors this fall, hundreds
of sixth graders in 42 middle schools will begin taking part in
a study sponsored by the National Institutes of Health (NIH). The
HEALTHY study will determine if changes in school food services
and physical education (PE) classes, along with activities that
encourage healthy behaviors, lower risk factors for type 2 diabetes,
an increasingly common disease in youth.
“The alarming rise in obesity and type 2 diabetes in all age groups
poses a major public health crisis for this country. This important
study is one component of a multi-faceted research agenda to address
this dual epidemic, which threatens the health of our youth and
the vitality of our health care system,” said NIH Director Elias
A. Zerhouni, M.D.
Participating schools will be randomly assigned to a program group,
which implements the changes, or to a comparison group, which continues
to offer food choices and PE programs typically seen in middle
schools across the country. Students in the program group will
have
- healthier choices from the cafeteria and vending machines (e.g.,
lower fat foods, more fruits and vegetables, and drinks with no
added sugar)
- longer, more intense periods of physical activity, and
- activities and awareness campaigns that promote long-term healthy
behaviors.
After 2.5 years, all students will be tested for diabetes risk
factors, including blood levels of glucose, insulin, and lipids.
They will also be measured for fitness level, blood pressure, height,
weight, and waist circumference.
“The school environment can have a profound effect on the behavior
and health of young people. From this study we hope to learn if
better food options, improvements in physical activity programs,
and education about eating better and moving more result in healthier
kids and a lower risk of type 2 diabetes,” said study chair Gary
Foster, Ph.D., of Temple University.
The study is being conducted by researchers at
- Baylor College of Medicine, Houston, TX
- University of California at Irvine, CA
- University of No rth Carolina at Chapel Hill, NC
- Oregon Health and Science University, Portland, OR
- Temple University, Philadelphia, PA
- University of Pittsburgh Medical Center, Pittsburgh, PA
- University of Texas Health Science Center at San Antonio, TX
- George Washington University, Washington, D.C. (Coordinating
Center)
In planning the HEALTHY study, researchers relied on the results
of six pilot studies. In one such study, about half of eighth graders
in 12 schools were overweight or at risk for overweight. Few had
diabetes, but about 41 percent had abnormally high readings of
fasting blood glucose, pointing to a much higher risk of developing
type 2 diabetes.
Type 2 diabetes is closely linked to being overweight, inactive,
and having a family history of diabetes. Nearly two-thirds of U.S.
adults are overweight or obese, with a body mass index (BMI) of
25 or more. Among youth 2 to 19 years old, 17 percent are overweight
(i.e., have a BMI at the 95th percentile or more for their age
and sex) — triple the rate in 1980. About the same percentage
of youth have a BMI between the 85th and 95th percentile for their
age and sex, putting them at risk for becoming overweight.
Type 1 diabetes, which affects up to 1 million people in the United
States, develops when the body's immune system destroys the insulin-producing
beta cells of the pancreas. This form of diabetes usually strikes
children and young adults, who need several insulin injections
a day or an insulin pump to survive. The HEALTHY study is aimed
at preventing type 2 diabetes. Other NIH-funded studies are trying
to prevent type 1 diabetes in centers nationwide: http://www.nih.gov/news/pr/jun2006/niddk-09.htm.
The longer a person has diabetes, the greater the chances of developing
serious damage to the eyes, nerves, heart, kidneys, and blood vessels. “We're
already seeing kids in their late teens with early complications
from type 2 diabetes,” said Francine Kaufman, M.D., director of
the Comprehensive Childhood Diabetes Center at the Childrens Hospital
Los Angeles, where type 2 diabetes accounts for more than 20 percent
of new childhood diabetes cases. “As a society, we need to address
the obesity epidemic if we’re going to have any success containing
the rising rate of type 2 diabetes in kids. A logical place to
start is in our schools.”
Once seen only in adults, type 2 diabetes has been rising steadily
in youth. While there are no national data on the prevalence of
type 2 diabetes in youth, clinics around the country are reporting
that more young people, especially from minority groups, are developing
the disease. Studies in Cincinnati, Los Angeles, San Antonio, and
other cities conclude that cases of type 2 diabetes in youth have
risen dramatically since 1994, when less than 5 percent of new
childhood diabetes cases were type 2. By 1999, type 2 diabetes
accounted for 8 to 45 percent of new childhood diabetes cases,
varying by geographic location. Some diabetes centers are now seeing
more new cases of type 2 diabetes than type 1.
Nearly 21 million people in the United States — 7 percent of the
population — have diabetes, the most common cause of blindness,
kidney failure, and amputations in adults and a major cause of
heart disease and stroke. Type 2 diabetes accounts for up to 95
percent of all diabetes cases in adults, and about one-third of
those affected don’t know they have it. The prevalence of type
2 diabetes has risen dramatically in the last 30 years, due mostly
to the upsurge in obesity. In addition, at least 54 million U.S.
adults age 20 and older have pre-diabetes, which independently
raises the risk of developing type 2 diabetes and cardiovascular
disease.
Results from the HEALTHY study are expected in 2009. Sponsored
by the National Institute of Diabetes and Digestive and Kidney
Diseases (NIDDK), the study is part of a broad research initiative,
called STOPP T2D (Studies to Treat or Prevent Pediatric Type 2
Diabetes), which seeks to improve the treatment and prevention
of type 2 diabetes in youth. The American Diabetes Association
(ADA) co-sponsors the HEALTHY study, and the Institute for Public
Health and Water Research supports the study through a grant to
the ADA.
The NIH has undertaken a rigorous research agenda to enhance new
research in areas of greatest scientific opportunity. [http://www.obesityresearch.nih.gov/About/strategic-plan.htm]
The NIH also sponsors We Can! — Ways to Enhance
Children’s Activity and Nutrition, a program to prevent childhood
obesity, which encourages parents and children to adopt healthy
eating habits, increase physical activity, and reduce leisure “screen
time.” 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.
The NIDDK, a component of the NIH, conducts and supports research
in diabetes and other endocrine and metabolic diseases; digestive
diseases, nutrition, and obesity; and kidney, urologic and hematologic
diseases. Spanning the full spectrum of medicine and afflicting people
of all ages and ethnic groups, these diseases encompass some of the
most common, severe, and disabling conditions affecting Americans.
For more information about NIDDK and its programs, see 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. |