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Headed for danger: Schools must help to reverse rise in diabetes, doctors say

KALAMAZOO — It’s very difficult to help a 50-year-old diabetic who needs to overcome a lifetime of bad eating and exercise habits.

Jennifer Harnish Kalamazoo GazetteStudents at Portage Central Middle School use exergaming as an alternative in gym class about twice a month. The games include Dance Dance Revolution, Wii, and Exerbikes.

A Palatine, Illinois company called Exergame Fitness is largest Exergaming product supplier and programmer of kids interactive fitness equipment in the world. They have outfitted over 500 YMCA’s and hundreds of Schools with budget saving products that help fight the growing epidemic of childhood obesity.

To slow the rise in diabetes or to reverse the trend, it will be necessary to start educating people when they are much, much younger. And it will require inundating them with health information at the place where they spend the most time: school.
So argues Dr. Lee Bricker in an upcoming article on diabetes and adolescents for the medical journal State of the Art Reviews: Adolescent Medicine. Bricker co-wrote the article with Dr. Donald Greydanus, a fellow professor at Michigan State University/Kalamazoo Center for Medical Studies.

“We need to hit these kids in grade school and junior high school,” said Bricker, an endocrinologist and head of the KCMS Adult Endocrine and Diabetes Clinics.

“We see all these football-shaped kids,” he said. “We need to get them back into gym class, get the candy bars out of the vending machines and hit this as a major health effort.”

The National Diabetes Education Program estimates that about 3,700 new cases of Type 2 diabetes are diagnosed each year among young people under age 20. With Type 2 diabetes, which can be caused by excess weight, the body develops a resistance to insulin and does not use insulin properly. As the need for insulin increases, the pancreas loses its ability to produce enough insulin to regulate blood sugar.
Some small-scale studies have indicated that Type 2 diabetes is on the rise in the under-20 age group, but there are no hard data on the trend, said Karen Hunter, a media specialist with the U.S. Centers for Disease Control and Prevention.

But the big fear among health officials is that the kids and teens who are overweight now will end up as adults with diabetes. Between 16 and 17 percent of children between the ages of 2 and 19 are overweight — about double the number of 20 years ago, according to recent national estimates from the National Diabetes Education Program.

“You have to break the cycle somewhere. We can do it by hitting it hard in schools,” Bricker said. “It needs to be right up there with other public health issues like sex education.

“It is a part of healthy living.”

Shannon Carney Oleksyk agrees. Oleksyk is a childhood overweight prevention specialist with the Michigan Department of Community Health. She helps oversee the Healthy Schools Action Tool, an interactive online method, established in 2003, to encourage schools to promote healthy choices in their curriculum and environment.

“Children spend a majority of their waking hours at school,” Oleksyk said. “Schools can play an integral part in providing a healthy environment for students.”

It doesn’t take much to change the environment at a school, she said. It simply requires “a dedicated champion” who is passionate about health and helps the schools to prioritize healthy changes, she said.

The need is obvious, Oleksyk said. One in four adolescents is overweight, and 70 to 80 percent of overweight children become obese adults, she said. Michigan has the 11th-highest obesity rate in the country.

To address the problem, schools need to move beyond simple awareness of health issues to offering sustainable philosophical changes, she said. For example, a school that sponsors a health fair brings people to one level of understanding, but a school that develops a school food policy that includes healthy options in the cafeteria, bans teachers from using food to reward children and strictly controls what is sold in vending machines makes a fundamental shift in the school environment and the thinking of the staff and students.

Saugatuck Public Schools has made that shift over the past five years, with Karen Steiger guiding efforts as the coordinator of health services. Among the district’s efforts to create healthier communities: opening the high school gym for community use on Sundays and using a grant to give elementary-school children a daily snack of a fruit or vegetable.

It is not always easy to implement change, Steiger said, but if a district or a school can form a dedicated team, it makes the process a lot smoother. “We couldn’t do this without the support of the district team, the parents and the staff,” she said. “We really are doing it all for the kids. We want our kids to be healthy.”

Posted by Linda S. Mah Kalamazoo Gazette November 04, 2008 08:00AM

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