title: Insulin resistance is improved in overweight African American boys but not in girls following a one-year multidisciplinary community intervention program.
abstract: OBJECTIVE
  To assess potential for effectiveness, in a non-randomized pilot study, of a community-based lifestyle intervention program to reduce the risk for type 2 diabetes mellitus in overweight African American (AA) children.
  
  
  METHODS
  Sample of 165 9-11 year-old AA children with body mass index (BMI) >85th percentile were recruited from local recreational sites, schools and churches. Participants self-selected to attend one of two study sites, blinded to the specifics of the intervention administered at each site. The intervention group received a programmatically focused 2-week summer camp with once-a-week community-based exercise, nutrition, and behavioral modification sessions, and their families were invited to monthly nutrition educational sessions. Control group participants received a 2-week conventional YMCA summer camp and their families received nutrition and physical activity education material through the mail. Baseline assessment and 1-year follow-up were conducted in collaboration with the YMCA of the East Bay and Children's Hospital Oakland, CA, with 109 participants (66%) having pre/post data.
  
  
  RESULTS
  After one-year of intervention, treatment boys showed a drop in homeostasis model assessment of insulin-resistance (HOMA-IR) (-0.58 vs +0.17; p = 0.003), fasting glucose (Gf, mg/dL) (mean change: -2.9 vs +0.4; p = 0.126) and fasting insulin (If, microU/mL) (-2.2 vs +0.7; p = 0.009) compared to control boys, after accounting for baseline differences and pubertal stage of the child. Treatment girls had similar changes to the control girls in HOMA-IR (-0.02 vs -0.17; p = 0.66), Gr (-0.3 vs +1.4; p = 0.29) and If (+0.03 vs +0.17; p = 0.57).
  
  
  CONCLUSIONS
  After one year, this community-based intervention program effectively improved insulin resistance and thus reduced risk for type 2 diabetes mellitus in overweight AA boys but did not change the risk in girls compared to control children.
authors.affiliation: The Dr Robert C and Veronica Atkins Center for Weight and Health, University of California, Berkeley, CA, USA.
authors.forename: Aarthi
authors.initials: A
authors.lastname: Raman
authors.forename: Lorrene D
authors.initials: LD
authors.lastname: Ritchie
authors.forename: Robert H
authors.initials: RH
authors.lastname: Lustig
authors.forename: Mark D
authors.initials: MD
authors.lastname: Fitch
authors.forename: Mark L
authors.initials: ML
authors.lastname: Hudes
authors.forename: Sharon E
authors.initials: SE
authors.lastname: Fleming
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D015992:Body Mass Index; D002648:Child; D002662:Child Health Services; D003153:Community Health Services; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006266:Health Education; D006801:Humans; D007333:Insulin Resistance; D008019:Life Style; D008297:Male; D050177:Overweight / Q000453:epidemiology / Q000378:metabolism* / Q000628:therapy*; D010865:Pilot Projects; D015995:Prevalence; D012307:Risk Factors; D040242:Risk Reduction Behavior; D012727:Sex Characteristics; D017678:Sex Distribution; D016896:Treatment Outcome