Impact of the Bienestar School-Based Diabetes Mellitus Prevention Program on Fasting Capillary Glucose Levels

Abstract

Objective-To evaluate the impact of a school-based diabetes mellitus prevention program on lowincome fourth-grade Mexican American children.Design-A randomized controlled trial with 13 intervention and 14 control schools. Setting-Elementary schools in inner-city neighborhoods in San Antonio, Tex.Participants-Eighty percent of participants were Mexican American and 94% were from economically disadvantaged households. Baseline and follow-up measures were collected from 1419 (713 intervention and 706 control) and 1221 (619 intervention and 602 control) fourth-grade children, respectively. Intervention-The Bienestar Health Program consists of a health class and physical education curriculum, a family program, a school cafeteria program, and an after-school health club. The objectives are to decrease dietary saturated fat intake, increase dietary fiber intake, and increase physical activity.Main Outcome Measures-The primary end point was fasting capillary glucose level, and the secondary end points were percentage of body fat, physical fitness level, dietary fiber intake, and dietary saturated fat intake. Fasting capillary glucose level, bioelectric impedance, modified Harvard step test, three 24-hour dietary recalls, weight, and height were collected at baseline and 8 months later.Results-Children in the intervention arm attended an average of 32 Bienestar sessions. Mean fasting capillary glucose levels decreased in intervention schools and increased in control schools after adjusting for covariates (−2.24 mg/dL [0.12 mmol/L]; 95% confidence interval, −6.53 to 2.05 [−0.36 to 0.11 mmol/L]; P = .03). Fitness scores (P = .04) and dietary fiber intake (P = .009) significantly increased in intervention children and decreased in control children. Percentage of body fat (P = .56) and dietary saturated fat intake (P = .52) did not differ significantly between intervention and control children.

Provision of healthy school meals does not affect the metabolic syndrome score in 8–11-year-old children, but reduces cardiometabolic risk markers despite increasing waist circumference

“…This indicates that the study population was highly representative of Danish children. Furthermore, the study had a very low dropout rate, mainly due to reasons not related to the study and the completion rate of 76 % for the primary outcome for all the three visits was in line with the 72 -86 % reported in earlier trials (9,15,17) . The observation that dropouts were more likely to be from households with low educational background compared with children who completed the study might reflect lower personal resources, problems in understanding the study instructions or lesser familiarity with the NND school meals (23) .…”

“…The results of the present study are strengthened by a considerable sample size and a high participation rate (82 %) compared with the 59 -74 % in other school intervention trials (9,15,17) . The baseline diet of the children in the present study was in line with the representative Danish National Dietary Surveys (4) , and the prevalence of overweight and obesity corresponded to the level found in a recent Danish cohort (60) .…”

Outcomes From a Culturally Tailored Diabetes Prevention Program in Hispanic Families From a Low-Income School

“…These changes are comparable to those reported for other diabetes prevention efforts in schools [15][16][17][18] ; however, these more comprehensive studies saw additional positive changes in other health outcomes such as aerobic fitness, body fat, and fasting glucose. [15][16][17][18] The total cost per class for the HHSH program without evaluation, including health educator time, child care, food, and program materials was $415. For 10 weeks, this was a total cost of $4150, amounting to $51 per family for the program.…”

Design of the OPUS School Meal Study: A randomised controlled trial assessing the impact of serving school meals based on the New Nordic Diet

“…Although the clinical measurements included an overnight fast, a whole-body scan, and a blood sample in a setting where the children were not accompanied by their parents, >97% of the children scheduled were examined at each laboratory truck visit. This number is higher than the 74% reported in the intervention schools in the study by Trevino et al [13] but comparable to the 98% reported by the Healthy Study Group [19], two American trials.…”