Rates of Type 2 diabetes, a disease once only found in adults, have been steadily rising in children for years. If unchecked, it can have serious health effects for children, including higher risks of heart and blood-vessel disease, nonalcoholic fatty liver disease, skin problems, and damage to the nerves, kidneys, eyes and feet.
But a national study chaired by Gary Foster at Temple University's Center for Obesity Research and Education — and just published in the online version of the New England Journal of Medicine — has found that school-based interventions can help reduce various risk factors for Type 2 diabetes in children.
The HEALTHY Study, funded by the National Institutes of Health, was a three-year, nationwide investigation that assessed the effects of a school-based approach to preventing risk factors for Type 2 diabetes among more than 4,600 students in grades six to eight from 42 middle schools.
Half of the schools were intervention schools that followed HEALTHY's guidelines for activity levels and food offerings in cafeterias, vending machines and at school events, and the other half of schools acted as the controls.
Each intervention school provided its students with:
· Healthier food choices that were high in fiber and low in fat;
· More fruits and vegetables;
· Water or low-fat milk;
· A minimum of 225 minutes of physical-education class every 10 days, and;
· Communication campaigns and educational programs that promoted long-term healthy behaviors.
Researchers said that they were surprised to learn that by the end of the study, there was a 4 percent reduction in the combined rates of overweight and obesity at both intervention and control schools. While pleased with the unexpected finding, they noted that further analyses will need to be done to determine why the rates of overweight and obesity also improved in control schools.
"Participation in studies may lead to improved health outcomes for participants, even when they don't receive the intervention," said Foster, director of CORE. "For example, at the start of the HEALTHY study, parents of children at both control and intervention schools were given feedback about their body-mass index and other risk factors for Type 2 diabetes, which could have influenced behavior."
Despite similar decreases in the combined rates of overweight and obesity in intervention and control schools, children in intervention schools had greater reductions in obesity, BMI z-scores (BMI that is closer to the norm for a child's age and gender), waist-circumference measurements and fasting insulin levels than did children in control schools.
"Obese children are at the greatest risk for developing metabolic abnormalities," said Foster. "Reducing the rates of obesity in this high-risk group can have profound effects on their risk of developing diabetes."