IMPROVING METABOLIC FITNESS IN OBESE PERSONS

肥胖的青少年在以后的非胰岛素发展的高风险 依赖性糖尿病（NIDDM）和其他代谢性疾病， 肥胖这项建议的目的，是推行一项以学校为本的 干预计划，以改变该组的生活方式， 代谢健康和降低代谢疾病的风险。我们定义 最佳代谢适应性，因为没有代谢和生化风险 与肥胖相关的因素，如葡萄糖耐受不良，胰岛素 抵抗力、高血压和高脂血症。干预将是 通过现有的、非常成功的学校诊所实施 位于一所种族混合的高中。学校诊所的工作人员， 谁将协助该项目，在工作中有经验， 对少数民族学生的需求敏感。我们将研究两组 肥胖的高中生在第一个队列中， 将提供干预，随后是1.5年的参与， 一个同伴辅导项目在第二个队列中，2年的强化治疗 将只提供干预。两个队列的受试者将 亚伯拉罕林肯高中（ALHS）的肥胖学生。对照受试者 将从另外两所拥有校本诊所的高中招募。 为期2年的强化干预（对两个队列进行）将 包括营养和体育活动指导， 行为改变，关注心理和情绪问题。我们 将制定正式的课程（由参与者提供主要投入） 可以纳入普通课程。同时我们 将与ALHS的食品服务人员合作，以提高质量， 学校餐体育活动干预旨在帮助 学生从事更少的久坐活动，并发展一种热爱 体力活动。参与者将接触到许多终身 在落基山脉地区流行的活动，包括徒步旅行，骑自行车， 还有滑雪该计划的有效性将根据以下方面进行评估： 行为的持续变化，代谢健康的优化，以及 改善社会心理问题。该计划的重点不是在 体重和参与者将不鼓励频繁评估 体重减轻。然而，身体脂肪含量的显著减少是 预期最后，该程序已经开发，以便它可以 利用现有资源永久纳入ALHS，包括 学校诊所。这将通过让学生和 教师参与课程发展。肥胖学生需要 更密集的干预可以通过学校得到进一步的帮助- 基于诊所我们提出的干预计划可以纳入 全国数百所学校中的任何一所都有学校诊所。

Obese adolescents are at high risk for later development of non-insulin dependent diabetes (NIDDM) and other metabolic diseases associated with obesity. The objective of this proposal is to implement a school-based intervention program to modify lifestyle in this group to optimize metabolic fitness and reduce the risk of metabolic diseases. We define optimum metabolic fitness as an absence of metabolic and biochemical risk factors associated with obesity, such as glucose intolerance, insulin resistance, hypertension, and hyperlipidemia. The intervention will be implemented through an existing, highly successful school-based clinic located in a racially-mixed high school. The school-based clinic staff, who will assist with the project, are experienced in working with, and are sensitive to, the needs of minority students. We will study two cohorts of obese high school students. In the first cohort, 2 years of intensive intervention will be provided, followed by 1.5 years of participating in a peer tutoring program. In the second cohort, 2 years of intensive intervention alone will be provided. Participants in both cohorts will be obese students at Abraham Lincoln High School (ALHS). Control subjects will be recruited from 2 other high schools having school-based clinics. The 2-year intensive intervention (administered to both cohorts) will involve instruction in nutrition and physical activity, assistance with behavior change, and attention to psychosocial and emotional problems. We will develop a formal curriculum (with major input from participants) which can be incorporated into the general curriculum. Simultaneously, we will work with the food service staff of ALHS to improve the quality of school meals. The physical activity intervention is designed to help students engage in fewer sedentary activities and to develop a love of physical activity. Participants will be exposed to many lifetime activities popular in the Rocky Mountains Region, including hiking, biking and skiing. The effectiveness of the program will be evaluated in terms of sustained changes in behavior, optimization of metabolic fitness, and improvement of psychosocial problems. The focus of the program is not on body weight and participants will be discouraged from frequent evaluations of weight loss. However, significant reductions in body fat content are expected. Finally, the program has been developed so that it can be incorporated permanently into ALHS using existing resources, including the school-based clinic. This will be facilitated by having students and teachers participate in curriculum development. Obese students who require more intensive intervention can receive further help through the school- based clinic. The intervention program we propose can be incorporated into any of the hundreds of schools nationwide which have school-based clinics.