Objective: Obesity and type 2 diabetes have emerged as critical health issues among Latino youth. Although both conditions manifest early in life, very few diabetes prevention programs have been developed to specifically meet the needs of this population. The authors describe the development, implementation, and metabolic impact of a culturally informed, community-based diabetes prevention program for obese Latino youth. Methods: A lifestyle education program was developed to address the health needs of Latino youth served by a community-based medical clinic. The program consisted of group education sessions delivered to children and their families to address nutrition, physical activity, family roles and responsibilities, and self-esteem. The metabolic impact of the program was evaluated by assessing body mass index (BMI), high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, total cholesterol, triglycerides, glucose, and insulin. Results: On entry, the prevalence of risk factors among the 102 youth (mean BMI, 30.4 ± 4.9 kg/m2) was substantial (68.6% with low HDL cholesterol, 32.1% with elevated triglycerides, 9.4% with impaired fasting glucose, 39.4% with elevated total cholesterol, 43.0% with elevated LDL cholesterol, and 60.6% with hyperinsulinemia). The 50 youth who returned after the program for follow-up measurements exhibited significant health improvements, including a 3.8% reduction in BMI; 5.4% and 8.6% decreases in total and LDL cholesterol, respectively; a 9.3% increase in HDL cholesterol; and a 24.0% decrease in fasting insulin (all P values < .05). Conclusions: These promising findings suggest that a community-based diabetes prevention program for obese Latino youth is a feasible strategy for improving health in this high-risk population. Further studies are warranted to examine whether similar programs can be implemented in diverse communities and settings.
OgdenCLCarrollMDFlegalKM. High body mass index for age among US children and adolescents, 2003-2006. JAMA. 2008;299(20):2401-2405.
2.
WhitakerRCOrzolSM. Obesity among US urban preschool children: relationships to race, ethnicity, and socioeconomic status. Arch Pediatr Adolesc Med. 2006;160(6):578-584.
3.
GoranMIBergmanRNAvilaQ. Impaired glucose tolerance and reduced β-cell function in overweight Latino children with a positive family history for type 2 diabetes. J Clin Endocrinol Metab. 2004;89(1):207-212.
4.
CruzMLWeigensbergMJHuangTTBallGShaibiGQGoranMI. The metabolic syndrome in overweight Hispanic youth and the role of insulin sensitivity. J Clin Endocrinol Metab. 2004;89(1):108-113.
NarayanKMBoyleJPThompsonTJSorensenSWWilliamsonDF. Lifetime risk for diabetes mellitus in the United States. JAMA. 2003;290(14):1884-1890.
7.
KnowlerWCBarrett-ConnorEFowlerSE. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346(6):393-403.
8.
AckermannRTFinchEABrizendineEZhouHMarreroDG. Translating the Diabetes Prevention Program into the community: the DEPLOY pilot study. Am J Prev Med. 2008;35(4):357-363.
9.
FranksPWHuangTTBallG. Lifestyle intervention for type 2 diabetes risk reduction: using the Diabetes Prevention Program to inform new directions in pediatric research. Can J Diabetes. 2007;31(3):242-251.
10.
HuangTTKGoranMI. Prevention of type 2 diabetes in young people: a theoretical perspective. Pediatr Diabetes. 2003;4:38-56.
11.
American Diabetes Association. Type 2 diabetes in children and adolescents. Pediatrics. 2000;105(3):671-680.
12.
ZimmetPAlbertiGKaufmanF. The metabolic syndrome in children and adolescents. Lancet. 2007;369(9579):2059-2061.
13.
National Cholesterol Education Program. Highlights of the report of the Expert Panel on Blood Cholesterol Levels in Children and Adolescents. Pediatrics. 1992;89(3):495-501.
14.
McLaughlinTAbbasiFChealKChuJLamendolaCReavenG. Use of metabolic markers to identify overweight individuals who are insulin resistant. Ann Intern Med. 2003;139(10):802-809.
15.
PagliassottiMJGaylesECHillJO. Fat and energy balance. Ann N Y Acad Sci. 1997;827:431-448.
16.
SummerbellCDWatersEEdmundsLDKellySBrownTCampbellKJ. Interventions for preventing obesity in children. Cochrane Database Syst Rev. 2005(3):CD001871.
17.
SummerbellCDAshtonVCampbellKJEdmundsLKellySWatersE. Interventions for treating obesity in children. Cochrane Database Syst Rev. 2003(3):CD001872.
18.
FloresGFuentes-AfflickEBarbotO. The health of Latino children: urgent priorities, unanswered questions, and a research agenda. JAMA. 2002;288(1):82-90.
19.
The HEALTHY Study Group. Risk factors for type 2 diabetes in a sixth-grade multiracial cohort: the HEALTHY study. Diabetes Care. 2009;32(5):953-955.
20.
OlveraNBushJASharmaSVKnoxBBSchererRLButteNF. BOUNCE: a community-based mother-daughter healthy lifestyle intervention for low-income Latino families. Obesity (Silver Spring). 2010;18(suppl 1):S102-S104.
21.
JohnstonCATylerCMcFarlinBK. Weight loss in overweight Mexican American children: a randomized, controlled trial. Pediatrics. 2007;120(6):e1450-e1457.
22.
TylerCJohnstonCAMadhukarMForeytJP. Practical strategies for treating obesity in Mexican Americans. Obesity Manag. 2005;1(6):247-250.
23.
HackieMBowlesC. Maternal perception of their overweight children. Public Health Nursing. 2007;24(6):538-546.
24.
ContentoIRBaschCZybertP. Body image, weight, and food choices of Latina women and their young children. J Nutr Educ Behav. 2003;35(5):236-248.
25.
StettlerNElliottMRKallanMJAuerbachSBKumanyikaSK. High prevalence of overweight among pediatric users of community health centers. Pediatrics. 2005;116(3):e381-e388.
26.
FloresGAbreuMOlivarMAKastnerB. Access barriers to health care for Latino children. Arch Pediatr Adolesc Med. 1998;152(11):1119-1125.
27.
Position of the American Dietetic Association: individual-, family-, school-, and community-based interventions for pediatric overweight. J Am Diet Assoc. 2006;106(6):925-945.
28.
ZerhouniEAAlvingB. Clinical and translational science awards: a framework for a national research agenda. Transl Res. 2006;148(1):4-5.
29.
EconomosCDIrish-HauserS. Community interventions: a brief overview and their application to the obesity epidemic. J Law Med Ethics. 2007;35(1):131-137.
