Study Supports School-Based Diabetes Prevension Strategies

A recent Temple University study has found that a school-based approach can be effective in reducing rates of type 2 diabetes. It was conducted by Temple's Center for Obesity Research and Education (CORE) with National Institutes of Health funding and published in the online version of the New England Journal of Medicine.

The three-year, nationwide study assessed the effects of a school-based approach to preventing risk factors for type 2 diabetes among more than 4,600 students in grades 6-8 from 42 middle schools with predominantly Hispanic and African-American children from low-income households, most of whom were eligible for free or reduced-priced lunches. Schools with these populations were specifically chosen because rates of type 2 diabetes are much higher among minorities and low-income populations.

Half of the schools were intervention schools that followed Healthy Study’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 they were surprised to learn that by the end of the study, there was a four 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," says CORE Director Gary Foster. "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 (BMI) 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," Foster notes. "Reducing the rates of obesity in this high-risk group can have profound effects on their risk of developing diabetes."