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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EThe HEALTHY study enrolled 6th grade students from 42 middle schools and followed them through 8th grade (n=4603). Schools were randomized 1:1 to either control (observation only) or a comprehensive intervention program that was conducted by teachers and school officials that targeted nutrition, physical activity, and personal behavior [The HEALTHY Study Group. \u003Cem\u003EInternatl J Obesity\u003C\/em\u003E 2009].\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes Mellitus\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EPrevention \u0026amp; Screening\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EObesity\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EPediatric Nutrition\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EThe HEALTHY study, a name that was selected by the targeted middle school student population, was initiated after a pilot investigation in 2003 documented a high prevalence of risk factors for diabetes in 8th grade students in the United States [\u003Cem\u003EDiabetes Care\u003C\/em\u003E 2006]. Indeed, of the 1740 subjects who were observed, 49% had a body mass index (BMI) \u2265 the 85\u003Csup\u003Eth\u003C\/sup\u003E percentile (the cutoff for overweightness and obesity); 40.5% had fasting blood glucose (FPG) \u2265100 mg\/dl; and 36.2% had fasting insulin \u226530 \u03bcU\/ml, suggesting that middle schools could be logical venues for population-based efforts to prevent or delay the onset of type 2 diabetes mellitus (T2DM).\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EAs described by Kathryn Hirst, PhD, George Washington University Biostatistics Center, Rockville, MD, the HEALTHY study enrolled 6\u003Csup\u003Eth\u003C\/sup\u003E grade students from 42 middle schools and followed them through 8\u003Csup\u003Eth\u003C\/sup\u003E grade (n=4603). School eligibility required a \u226550% minority student body and\/or \u226550% of students who were eligible for free\/reduced rate lunch. Schools were randomized 1:1 to either control (observation only) or a comprehensive intervention program that was conducted by teachers and school officials that targeted nutrition, physical activity, and personal behavior [The HEALTHY Study Group. \u003Cem\u003EInternatl J Obesity\u003C\/em\u003E 2009].\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EAt baseline, subjects were assessed for physical measurements and fasting blood was drawn to determine FBG, insulin, HbA1C, and lipids; self-reports of diet, exercise, and quality of life were also collected. The same data were collected at the end of study following two and a half years of HEALTHY intervention delivery. Primary endpoints for the study included measures of adiposity, glucose, and insulin.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EGary D. Foster, PhD, Temple University, Philadelphia, PA, reported the primary results of the study [The HEALTHY Study Group. \u003Cem\u003EN Engl J Med\u003C\/em\u003E 2010]. For BMI \u226585\u003Csup\u003Eth\u003C\/sup\u003E percentile (defined as overweight and obese categories), the changes that were observed for the intervention versus control group were not statistically significant, though significance was seen for BMI z-scores (p=0.04; \u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E). Average waist circumference and FBG were not significantly different; however, significant differences were observed for fasting insulin levels (p=0.04) as well as for reductions in measures for the most at-risk individuals: BMI \u226595\u003Csup\u003Eth\u003C\/sup\u003E percentile (\u2212 5.5% vs \u22123.8%; p=0.05) and waist circumference \u0026gt; 90\u003Csup\u003Eth\u003C\/sup\u003E percentile (\u22128.1% vs \u22125.9%; p=0.04) for intervention versus control, respectively.\u003C\/p\u003E\u003Cdiv id=\u0022T1\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/11407\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/11407\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/11407\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-6\u0022 class=\u0022first-child\u0022\u003EBMI (Overall Sample).\u003C\/p\u003E\n         \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-7\u0022\u003EIn reporting the HEALTHY secondary endpoints for cardiovascular disease risk factors and fitness, Marsha D. Marcus, PhD, University of Pittsburgh, Pittsburgh, PA, referenced data from 2003, which determined that roughly 4% of all adolescents and nearly 30% of overweight adolescents in the United States meet the criteria for metabolic syndrome \u2013 the constellation of metabolic dysfunctions that are associated with obesity [Cook et al. \u003Cem\u003EArch Pediatr Adolesc Med\u003C\/em\u003E 2003].\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003EThere were no significant differences in abnormal lipids in intervention versus control. Overall, there was no difference in level of hypertension; however, the intervention showed significant improvements in measures of hypertension for male African-American (p=0.002) and male Caucasian students (p=0.045) but not for male Hispanics.\u003C\/p\u003E\u003Cp id=\u0022p-9\u0022\u003ELevels of physical activity were low at baseline and remained so at the end of the study, suggesting that the HEALTHY intervention had a negligible effect in this population.\u003C\/p\u003E\u003Cp id=\u0022p-10\u0022\u003EHEALTHY investigators commented that while the intervention did not meet its primary endpoint of altering the combined prevalence of being overweight or obese, it did have moderate effects on obesity and other important risk factors for T2DM.\u003C\/p\u003E\u003Cp id=\u0022p-11\u0022\u003EFor further details and access to the intervention program materials that were used in the HEALTHY study, go to \u003Ca href=\u0022http:\/\/www.healthystudy.org\u0022\u003Ehttp:\/\/www.healthystudy.org\u003C\/a\u003E.\u003C\/p\u003E\u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/10\/6\/38\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022The editors would like to thank the many members of the American Diabetes Association presenting faculty who generously gave their time to ensure the accuracy and quality of the articles in this publication.\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-1614646370\u0022 data-figure-caption=\u0022The editors would like to thank the many members of the American Diabetes Association presenting faculty who generously gave their time to ensure the accuracy and quality of the articles in this publication.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure1\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/10\/6\/38\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/10\/6\/38\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure1\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/10\/6\/38\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/11403\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\n            \u003Cp id=\u0022p-12\u0022 class=\u0022first-child\u0022\u003EThe editors would like to thank the many members of the American Diabetes Association presenting faculty who generously gave their time to ensure the accuracy and quality of the articles in this publication.\u003C\/p\u003E\n         \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2010 MD Conference Express\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/10\/6\/38.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nzlwcd\u0022\u003E\u003C\/script\u003E\n\u003Cscript 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