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Western News at The University of Western Ontario Reaching out to youth at risk
A new study hopes to reach out to youth at risk for Type 2 diabetes and relatedcardiovascular disease through an exercise intervention that will put them back on theroad to good health.
Lexi Howard, 13, is focused on leg lifts as she works out in the Exercise & HealthPsychology Lab in the Faculty of Health Sciences. Howard is a participant in a studyfocused on reducing risk factors for Type 2 diabetes and related cardiovascular disease.
Researchers from The University of Western Ontario have teamed up with theLondon Health Sciences Centre Children's Hospital on a clinical research study called"REACH: Reduction of Adolescent Factors for Type 2 Diabetes and Diabetes-relatedCardiovascular Disease." It focuses on comparing changes in lifestyle with diet and exercise programs in at-riskyouth aged 10-16 with similar lifestyle changes made in combination with the use ofmetformin medication, a pill that makes the body's insulin work more effectively. Only arandomized group of participants (one in two) will be given metformin.
The study participants have a body mass index that is greater than the 95th percentilefor their age group and gender, which is calculated based on their weight divided bytheir height.
Cheril Clarson, section head, Paediatric Endocrinology at the Children's Hospital andassociate professor in Western's Department of Paediatrics at Schulich School ofMedicine & 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 anddietician, and parental involvement. The goal is to reduce the body mass index, as wellas evaluate the reduction of risks, the effects of intensive exercise and behaviouraltraining, as well as the added effect of metformin.
With the rate of childhood obesity on the rise and the increased risks factors fordeveloping Type 2 diabetes and diabetes-related cardiovascular disease, this studyaims to reverse the tide for those at risk and generate the confidence and knowledge toimprove their health.
"That's a very vulnerable age. Most young kids are active by nature and when they getto that age they are making choices whether to be active. It sets the tone for how activethey are going to be as an adult," says Harry Prapavessis, study researcher and directorof the Exercise & Health Psychology Lab in the Faculty of Health Sciences.
Participants are involved in a graduated exercise program, beginning with 12 weeksof moderate or vigorous exercise in the lab. They are also involved in a weekly groupsession focusing on behaviour changing skills, where the youth are taught how touse what they learn in their daily routines. They are also encouraged to set goals anddiscuss barriers to participating in physical activity.
As the study progresses, participants are weaned off the structured exercise programheld in the lab and encouraged to exercise in their own environment. They also receivea membership with a local community fitness facility.
"For the first 12 weeks they get fit while they are here and after that they have theenergy and they have the fitness level to actually engage in all of the sports andactivities they want for an extended period of time and actually do it well," says JustineWilson, 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-termefficacy of lifestyle intervention program aimed at reducing risk factors for Type 2Diabetes and cardiovascular disease. There is currently limited data evaluating thelong-term effects of such programs – most childhood obesity studies focus on a sixmonth intervention.
"This is really about lifestyle change. It's really trying to give them skills that they feelthey can do activity on a day-in, day-out basis," says Prapavessis. "This is a steppingstone to doing things out in your environment and in your community." Maggie Watson, research co-ordinator for the study at the Children's Hospital, hopesparticipants 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 forgrocery shopping and food preparation.
"We always try to engage families to be supportive in the coaching of the child," addsWatson, noting this includes attending appointments with the dietician and socialworker.
� Find out about the study or how to participate by contacting research coordinator Maggie Watson at 519-639-237 or e-mail.
� 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 thestudy.
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Source: http://communications.uwo.ca/western_news/stories/2009/November/reaching_out_to_youth_at_risk.pdf

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