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By: Kaitlin Deason And Confidential Group Members FCS 682 . Fall 2011

Obesity and Type II Diabetes in Youth Are weight management programs effective for reducing the risk of type II diabetes in children ages 5-19?. By: Kaitlin Deason And Confidential Group Members FCS 682 . Fall 2011. Research Question.

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By: Kaitlin Deason And Confidential Group Members FCS 682 . Fall 2011

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  1. Obesity and Type II Diabetes in Youth Are weight management programs effective for reducing the risk of type II diabetes in children ages 5-19? By: Kaitlin Deason And Confidential Group Members FCS 682 . Fall 2011

  2. Research Question Are weight management programs effective in reducing T2DM in children ages 5-19?

  3. Review • Based on current literature • Obesity is associated with the development of T2DM • Obesity affects some communities more than other • Obesity shown to increase both impaired glucose tolerance and insulin insensitivity, which are definite precursors for T2DM. • Lifestyle changes including increased physical activity and weight loss were shown to reverse, delay, and or prevent T2DM in children.

  4. Review Cont. • Currently many programs aimed at reducing childhood obesity, and thereby T2DM. • According to number of children continuing to be diagnosed with T2DM that not enough is being done. • Still a huge need for additional widespread, population targeting, successful, weight management programs that incorporate a variety of healthy lifestyle factors in combination with education in order to prevent and reduce the number of children with type II diabetes in the United States.

  5. Review Cont. • Approximately 16.9% of children and adolescence are obese • The prevalence of childhood T2DM ranges from .19 - 49.4 out of every 1000 • Factors contributing to childhood obesity • Obesity, sedentary lifestyles, family history, high-risk ethnicity groups, and insulin resistance • Obese children are at risk for T2DM • retinopathy, neuropathy, and cardiovascular and renal disease • 40% of children who are obese at age 7 become obese adolescents, and 75% of adolescents who are obese become obese adults

  6. hypothesis • The purpose is to determine the effects of an afterschool exercise program on weight loss and concurrent reduction in risk of type II Diabetes Mellitus • Hypothesis: An afterschool program with an exercise component will improve weight loss outcomes in children, and thus result in a lower risk of developing T2DM

  7. Design • The study has Pre-test, Post-test, True Experimental research design • Participants: randomly assigned using Simple Random Sampling to either a treatment or control group R O X O R O O

  8. Sampling • Population: Participants from elementary schools (K-6) • Stratified Random Sampling • Subgroups: African Americans, Latinos, and Caucasians • Childhood obesity is more prevalent in minority groups such as African Americans and Latinos

  9. Procedure and Research material • Written consent will be obtained • All collected data will be confidential • Trained medical staff will perform clinical examination • Trained staff will collect Height, Weight, and waist circumference using calibrated instruments • Body mass index (BMI) will be calculated • Blood sampling will be performed in fasting status • Blood samples will be analyzed for triglycerides, LDL and HDL cholesterol, fasting glucose, and insulin

  10. Variables • Dependent variables: BMI and Waist circumference: ratio continuous variables • Independent variable: having or not having the organized physical activity

  11. Statistical Analysis • Goal: Compare the mean of anthropometric measurement in the control group and the treatment group • t-test measures the tendency of relationship between the 35-40 minutes of organized exercises and BMI/waist circumference measurement in elementary school children • control and treatment groups have homogeneity of variance • t-test is robust and is the inferential statistics • 2used to determine the magnitude of the difference between organized exercises and anthropometric measurements • Cohen’s effect

  12. Conclusion • Hypothesis: An afterschool exercise program on weight loss and concurrent reduction in risk of type II Diabetes Mellitus • Research design: Pre-test, Post-test, True Experimental • Sampling: Simple Random Sampling • Population: Participants from elementary schools (K-6) • Statistical method: t-test

  13. Questions/Comments ?

  14. References • Birch, L. (2006). Child feeding practices and the etiology of obesity. Obesity, 14(3), 343-344. • Centers for Disease Control and Prevention. (2011). Overweight and obesity. Defining childhood overweight and obesity. Retrieved from http://www.cdc.gov/obesity/ childhood/defining.html • DeBoer, M. D. (2011) Ethnicity, obesity and metabolic syndrome: implications on assessing risk and targeting intervention. Expert Review of Endocrinology & Metabolism 6(2), 279-290. • Ghergherechi, R., Tabrizi, A. (2010). Prevalence of impaired glucose tolerance and insulin resistance among obese children and adolescents. Therapeutics and Clinical Risk Management,6, 345-349. • Gray, A., Smith, C. (2003). Fitness, dietary intake, and body mass index in urban Native American youth. Journal of the American Dietetic Association, 103, 1187-1191 • Hannon, T. S, Roa, G., & Arslanian, S. A. (2005). Childhood obesity and type 2 diabetes mellitus. Pediatrics, 116, 473- 480. • Kempf, K., Rathmann, W., & Herder, C. (2008). Impaired glucose regulation and type 2 diabetes in children and adolescents. Diabetes Metabolism Research and Reviews, 24, 427-437. • Knowler, W., Barrett-Connor, E., Fowler, S., Hamman, R., Lachin, J., Walker, E., & Nathan, D. (2002). Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. New England Journal of Medicine, 346, 393-403. • Lipton, R. B., Drum, M., Burnet, D., Rich, B., Cooper, A., Baumann, E., & Hagopian, W. (2005). Obesity at the onset of diabetes in an ethnically diverse population of children: what does it mean for epidemiologists and clinicians? Pediatrics, 115, 553-560. • Liu, L.L., Lawrence, J.M., Davis, C., Liese, A.D., Pettitt, D.J., Pihoker, C., Dabelea, D., Hamman, R., Waitzfelder, B., & Kahn, H.S. (2010). Prevalence of overweight and obesity in youth with diabetes in USA: the SEARCH for Diabetes in Youth. Pediatric Diabetes, 11: 4–11 • O’Malley, G., Santoro, N., Northrup, V., D’Adanmo, E., Shaw, M., Eldrich, S., & Caprio, S. (2010). High normal fasting glucose level in obese youth: a marker for insulin resistance and beta cell dysregulation. Diabetologia, 53, 1199-1209. doi:10.1007/s00125-010-1693-0

  15. References Cont. • Ondrak, K. S., McMurray, R. G., Battaglini, C. L., Evenson, K. R., & Harrell, J. S. (2009). The relationship between changes in weight status and insulin resistance in youth. International Journal of Pediatric Endocrinology, 1-7. doi:10.1155/2009/862061 • Savoye, M., Berry, D., Dziura, J., Shaw, M., Serrecchia, J., Barbetta, G., Rose, P., Lavietes, S., & Caprio, S. (2005). Anthropometric and psychosocial changes in obese adolescents enrolled in a weight management program. Journal of the American Dietetic Association, 105(3), 364-370. doi: 10.1016/j.jada.2004.12.009 • Savoye, M., Shaw, M., Dziura, J., Tamborlane, W. V., Rose, R., Guandalini, C., Goldberg Gell, R., Burgert, T. S., Cali, A. M., Weiss, R., Caprio, S. (2007). Effects of weight management program on body composition and metabolic parameters in Overweight Children. Journal of the American Medical Association, 297(24), 2697-2704. • Sinha, R., Fisch, G., Teague, B., Tamberlane, W. V., Banyas, B., Allen, K., … & Caprio, S. (2002). Prevalence of impaired glucose tolerance among children and adolescents with marked obesity. New England Journal of Medicine, 346, 802-810. • Sullivan, P., Morrato, E., Ghushchyan V., Wyatt, H., & Hill, J. (2005). Obesity, inactivity, and the prevalence of diabetes and diabetes-related cardiovascular comorbities in the U.S., 2000-2002. Diabetes Care, 28(7), 1599-603. • The HEALTHY Study Group. (2010). A school-based intervention for diabetes risk reduction. The New England Journal of Medicine, 363, 443-453. • Traviño, R. P., Fogt, D. L., Wyatt, T. J., Leal-Vasques, L., Sosa, E. & Woods, C. (2008). Diabetes risk, low fitness, and energy insufficiency levels among children from poor families. Journal of the American Dietetic Association, 108(11), 1846-1853. • U.S. Department of Health and Human Services (2000). Healthy People 2010. 2nd ed. With Understanding and Improving Health and Objectives for Improving Health. Washington, DC: U.S. Retrieved from http://www.healthypeople.gov/2010/Document/tableofcontents. htm#under • Urrutia-Rojas, X., & Menchaca, J. (2006). Prevalence of risk for type 2 diabetes in school children. Journal of School Health, 76(5), 189-194. • Yeung, E. H., Zhang, C., Buck Louis, G. M., Willett, W. C., & Hu, F. B. (2010). Childhood Size and Life Course Weight Characteristics in Association With the Risk of Incident Type 2 Diabetes. Diabetes Care, 33:1364-1369

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