IMPROVING METABOLIC FITNESS IN OBESE PERSONS

肥胖青少年罹患非胰岛素依赖症的风险很高 依赖型糖尿病(NIDDM)和与之相关的其他代谢性疾病 肥胖。这项建议的目标是实施以学校为本的 干预计划，改变这一群体的生活方式以优化 保持新陈代谢健康，降低代谢性疾病的风险。我们定义 没有代谢和生化风险时的最佳代谢适合度 与肥胖有关的因素，如葡萄糖耐量异常、胰岛素 抵抗力、高血压和高脂血症。干预措施将是 通过现有的、非常成功的校本诊所实施 位于一所种族混杂的高中。校本诊所的工作人员， 谁将协助该项目，在工作方面经验丰富，并 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，两年的密集 将提供干预，随后将参与1.5年 一个同伴辅导计划。在第二个队列中，两年的密集 将单独提供干预。两个队列的参与者都将是 亚伯拉罕·林肯高中的肥胖学生。对照研究对象 将从另外两所拥有校本诊所的高中招募。 为期两年的强化干预(对两个队列实施)将 包括营养和体力活动方面的指导，协助 行为改变，以及对心理社会和情感问题的关注。我们 将制定一个正式的课程(参与者的主要意见) 这些课程可以纳入普通课程。同时，我们 将与ALHS的餐饮服务人员合作，提高 学校的饭菜。体力活动干预旨在帮助 学生们少参加久坐不动的活动，并培养对 体力活动。参赛者将接触到许多终身 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。该计划的有效性将从以下方面进行评估 行为的持续改变，代谢健康的优化，以及 改善心理社会问题。节目的重点不在 体重和参与者将不被鼓励经常进行评估 关于减肥的事。然而，身体脂肪含量的显著减少是 预期中。最后，开发了该程序，使其可以 使用现有资源永久并入ALHS，包括 校本诊所。这将通过让学生和 教师参与课程开发。肥胖的学生需要 更密集的干预可以通过学校获得进一步的帮助- 以诊所为基地。我们提出的干预计划可以纳入到 全国数百所设有校本诊所的学校中的任何一所。

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.