Effects of nutrition education and exercise in obese children: the Ho-Chunk Youth Fitness Program

Abstract

Background: Type 2 diabetes is increasingly common, primarily because of increases in the prevalence of a sedentary lifestyle and obesity. This is even more apparent in certain minority populations, such as Native Americans. Whether the risk of type 2 diabetes can be decreased by interventions that affect the lifestyles of children at high risk is not known.

Methods: The Ho-Chunk Youth Fitness Project, aimed at dietary and exercise instruction and intervention, consists of 38 native (Ho-Chunk Tribe, Wisconsin) and non-native children (ages 6-18 years). Children underwent evaluation including medical exam, nutrition, exercise assessment, metabolic testing of fasting plasma insulin, plasma glucose, plasma cholesterol, and percent body fat before and after a 24-week intervention. Intervention consisted of twice weekly classes with supervision for both nutrition and exercise.

Results: Mean fasting plasma insulin decreased from 22 +/- 7.7 microIU/ml to 11 +/- 6 microIU/ml (normal < 15 microIU/ml) after 24 weeks of training (P < 0.05). Percent body fat (30.2 +/- 6.4%), glucose (91 +/- 9 mg/dL), and total cholesterol (182 +/- 22 mg/dL) remained unchanged during this time.

Conclusions: Risks for insulin resistance and type 2 diabetes, as measured by fasting insulin (an indirect measurement of insulin sensitivity in obese children), can be decreased by supervised nutrition and exercise intervention. Furthermore, hyperinsulinemia in overweight children can be reduced without decreasing body fat.