A new study hopes to reach out to youth at risk for Type 2 diabetes and related cardiovascular disease through an exercise intervention that will put them back on the road to good health.
Lexi Howard, 13, is focused on leg lifts as she works out in the Exercise & Health Psychology Lab in the Faculty of Health Sciences. Howard is a participant in a study focused on reducing risk factors for Type 2 diabetes and related cardiovascular disease.
Researchers from The University of Western Ontario have teamed up with the London Health Sciences Centre Children’s Hospital on a clinical research study called “REACH: Reduction of Adolescent Factors for Type 2 Diabetes and Diabetes-related Cardiovascular Disease.”
It focuses on comparing changes in lifestyle with diet and exercise programs in at-risk youth aged 10-16 with similar lifestyle changes made in combination with the use of metformin medication, a pill that makes the body’s insulin work more effectively. Only a randomized group of participants (one in two) will be given metformin.
The study participants have a body mass index that is greater than the 95th percentile for their age group and gender, which is calculated based on their weight divided by their height.
Cheril Clarson, section head, Paediatric Endocrinology at the Children’s Hospital and associate professor in Western’s Department of Paediatrics at Schulich School of Medicine & Dentistry, is the principal investigator.
In this unique study researchers follow the progress of participants over two years, incorporating physical activity, pharmacology, counseling by a social worker and dietician, and parental involvement. The goal is to reduce the body mass index, as well as evaluate the reduction of risks, the effects of intensive exercise and behavioural training, as well as the added effect of metformin.
With the rate of childhood obesity on the rise and the increased risks factors for developing Type 2 diabetes and diabetes-related cardiovascular disease, this study aims to reverse the tide for those at risk and generate the confidence and knowledge to improve their health.
“That’s a very vulnerable age. Most young kids are active by nature and when they get to that age they are making choices whether to be active. It sets the tone for how active they are going to be as an adult,” says Harry Prapavessis, study researcher and director of the Exercise & Health Psychology Lab in the Faculty of Health Sciences.
Participants are involved in a graduated exercise program, beginning with 12 weeks of moderate or vigorous exercise in the lab. They are also involved in a weekly group session focusing on behaviour changing skills, where the youth are taught how to use what they learn in their daily routines. They are also encouraged to set goals and discuss barriers to participating in physical activity.
As the study progresses, participants are weaned off the structured exercise program held in the lab and encouraged to exercise in their own environment. They also receive a membership with a local community fitness facility.
“For the first 12 weeks they get fit while they are here and after that they have the energy and they have the fitness level to actually engage in all of the sports and activities they want for an extended period of time and actually do it well,” says Justine Wilson, master’s student in Kinesiology and member of the research team.
The first wave spanned the summer months and the study is now in its second wave. They are currently recruiting teens for a January start for a third wave.
The study spans a two-year period, allowing researchers to examine the long-term efficacy of lifestyle intervention program aimed at reducing risk factors for Type 2 Diabetes and cardiovascular disease. There is currently limited data evaluating the long-term effects of such programs – most childhood obesity studies focus on a six month intervention.
“This is really about lifestyle change. It’s really trying to give them skills that they feel they can do activity on a day-in, day-out basis,” says Prapavessis. “This is a stepping stone to doing things out in your environment and in your community.”
Maggie Watson, research co-ordinator for the study at the Children’s Hospital, hopes participants will take the skills they learn “and incorporate it into their lives forever.”
Part of this challenge is including parents, who are often primarily responsible for grocery shopping and food preparation.
“We always try to engage families to be supportive in the coaching of the child,” adds Watson, noting this includes attending appointments with the dietician and social worker.
Learn more
Find out about the study or how to participate by contacting research coordinator Maggie Watson at 519-639-237 or e-mail [email protected].
To participate, families must be committed for a two-year period. Parents and children will be pre-screened to evaluate whether they meet the criteria for the study.