 
Diabetes Dateline
Winter 2007
New Study Seeks to Lower Diabetes Risk in Youth
Middle Schoolers in 42 Schools to Change Eating and Physical Activity Patterns
The National Institutes of Health (NIH) has launched the HEALTHY Study in middle schools around the country to determine whether changes in school food services and physical education (PE) classes, coupled with activities that encourage healthy behavior, lower risk factors for type 2 diabetes, a growing disease among American youth. 
“The alarming rise in obesity and type 2 diabetes in all age groups poses a major public health crisis for this country,” said NIH Director Elias A. Zerhouni, M.D. “This important study is one component of a multifaceted research agenda to address this dual epidemic, which threatens the health of our youth and the vitality of our health care system.”
Hundreds of sixth graders from 42 participating middle schools will be randomly assigned to a program group that adopts the changes or to a comparison group that continues to offer food choices and PE programs typically seen in middle schools across the country.
Students in the program group will have
healthier food choices from the school cafeteria and vending machines, such as lower-fat foods, more fruits and vegetables, and drinks without added sugar longer, more intense PE classes activities and awareness campaigns that promote long-term, healthy behavior
Healthier Kids
“The school environment can have a profound effect on the behavior and health of young people,” said Study Chair Gary Foster, Ph.D., of Temple University. “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.”
In planning the HEALTHY study, researchers relied on results from six pilot studies. In one, about half of eighth graders in 12 schools were overweight or at risk for becoming overweight. Although few had diabetes, about 41 percent had fasting blood glucose values that put them at increased risk for later developing type 2 diabetes.
Seventeen percent of youth between 2 and 19 years of age are overweight––triple the 1980 rate. Studies in Cincinnati, Los Angeles, San Antonio, and other cities have shown that cases of type 2 diabetes among youth have increased dramatically since 1994, when fewer than 5 percent of new childhood diabetes cases were type 2. By 1999, type 2 diabetes already accounted for 8 to 45 percent of new childhood diabetes cases, varying by geographic location.
A study in the October 2006 issue of the journal Pediatrics reported an estimated 1.82 cases of diabetes per 1,000 youth in 2001. Among children age 9 and younger, type 1 diabetes accounted for more than 80 percent of diabetes cases, while the proportion of type 2 diabetes among youth between 10 and 19 years of age ranged from 6 to 76 percent.
Results from the HEALTHY study are expected in 2009. The study is part of a broad research initiative called “Studies to Treat or Prevent Pediatric Type 2 Diabetes” (STOPP T2D), which seeks to improve the treatment and prevention of type 2 diabetes among youth.
Researchers are conducting the HEALTHY study at the following academic institutions:
Baylor College of Medicine, Houston University of California at Irvine University of North Carolina at Chapel Hill Oregon Health and Science University, Portland Temple University, Philadelphia University of Pittsburgh Medical Center University of Texas Health Science Center at San Antonio
George Washington University, Washington, DC, is the project coordinating center.
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NIH Publication No. 07–4562
March 2007
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