Study Shows Schools Can Reduce Obesity and Other Risks For Type 2 Diabetes

The New England Journal of Medicine recently published findings from a study funded by the National Institute of Diabetes and Digestive & Kidney Diseases, a branch of the National Institute of Health. Known as the HEALTHY Trial, the study spanned three years in seven cities. It was designed to reduce the risk for type 2 diabetes among middle-school children whose race or ethnic group and socioeconomic status placed them at high risk. A whopping 50% of the study population was at or above the 85th percentile for BMI at the beginning of the study.

Students in the intervention schools received increased physical education, improved food offerings in the cafeteria/vending/school stores and a classroom-based program. Parents at all participating schools (intervention or comparison) were given written feedback on student health screenings and were notified if their children were found to be at high risk for diabetes.

Some of the study’s findings are encouraging and some quite unexpected. Most interesting was a decrease in the combined prevalence of overweight and obesity in both the intervention and control schools, with no significant difference between the two. The reasons for this finding are unclear. Investigators speculate that when comparison-school parents were informed of their children’s risk, they may have made healthy changes on their own, or that comparison schools may have made independent changes in the school environment. Both of these reasons seem plausible. And since comparison schools were given yearly monetary incentives totaling $12,000 (see NIDDK study protocol), they likely made improvements in physical education and/or food offerings. It’s unfortunate that a school environmental scan was not conducted to capture the changes to help us better understand.

The intervention schools did have a greater impact on a subgroup of students. By the end of the study, intervention students who were overweight or obese at the beginning of the study had a 21% lower rate of obesity than their counterparts in comparison schools.

This study suggests that school-based screening tied to parental notification could become an effective strategy for reducing the incidence of overweight and obesity in children, including children from lower socioeconomic and high-risk families. This and many other encouraging findings from this comprehensive study provide evidence that investing in physical education, nutrition education and school meals pays big dividends. Schools provide a unique venue for teaching children the concept of energy balance and the importance of healthy lifestyles. Passage of a strong child nutrition bill is a strong step toward those goals.