Diabetes Dateline
Winter 2011
School-based Intervention Lowers Obesity
Rate in Children at Risk for Diabetes
Researchers recently announced results
from the HEALTHY clinical trial, led
by the National Institute of Diabetes and
Digestive and Kidney Diseases (NIDDK). The
3-year study, conducted in middle schools with a
high enrollment of minority youth from low-income
families, found that a school-based intervention
could lower the obesity rate in students
at highest risk for type 2 diabetes—those who
started out overweight or obese in sixth grade.
However, schools that implemented the intervention
did not differ from comparison schools
in the study’s primary outcome—the prevalence
of overweight and obesity combined.
Type 2 diabetes is an emerging health problem
in youth, particularly minority youth, being
driven by the obesity epidemic. The HEALTHY
study’s results were published in the July 29, 2010,
issue of The New England Journal of Medicine.
The intervention included changes in school
food services; longer, more intense periods of
physical education; and classroom activities to
promote behavior change. 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
United States. Half of the schools implemented
the program, and the other half served as comparison
schools.
When students were first evaluated in sixth
grade, about half were overweight or obese.
Many had other risk factors for type 2 diabetes,
such as a first-degree relative with diabetes, large
waist size, and elevated blood glucose and insulin
levels. By the end of the study, the number of
overweight and obese students had declined
by 4 percent in both comparison and program
schools. One possible explanation for this result
is that comparison schools may have independently
implemented healthful changes to the school environment because of increased awareness about the problem of childhood obesity fostered by the study.
Program schools outperformed comparison schools in several areas. Among children in the study who started out overweight or obese in the sixth grade, children in program schools had 21 percent lower odds of being obese at the end of the study than similar students in comparison schools, a statistically significant difference. The percentage of children with waist size above the 90th percentile was lower in program schools than in comparison schools. Insulin levels were also lower in program schools. High insulin levels or a large waist increase the risk of developing type 2 diabetes, independent of body weight. High insulin levels reflect insulin resistance, the first step on the path to type 2 diabetes.
“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., M.A.C.P., director of the NIDDK.
Visit the HEALTHY study’s website, www.healthystudy.org, and www2.niddk.nih.gov/Research/ClinicalResearch/HEALTHY/QandA for additional information about the study.
The NIDDK has easy-to-read booklets and fact sheets about diabetes. For more information or to obtain copies,
www.diabetes.niddk.nih.gov.
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NIH Publication No. 11–4562
January 2011
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