A study led by a professor at Arizona State University published in the Journal of the American Medical Association
Derek Barra’s eating plan was fairly simple. Whatever his mother, Miriam, put on the plate, he ate – sometimes as many as four servings.
Between meals, he would eat unhealthy snacks, sodas, or juices that were high in sugar.
Bara can still throw away the food. He’s 15 years old, after all. But the Valley teen makes wiser decisions to feed the teen’s appetite, and drink water instead of soda—with Dr. Bieber sometimes – and eat more vegetables and fruits.
Miriam also helps cook with less oil and encourages Derek and her other kids to get their sugar from fruit instead of candy.
They fell off the wagon sometimes, but they also learned what to eat, and most importantly, they learned how to eat.
“We are very aware of what we are eating,” Miriam said through an interpreter. “You have stuck this information with us.”
These healthy choices – and the education needed to change habits – are exactly what Gabriel ChaibiD., a professor at Arizona State University’s Edson School of Nursing and Health Innovation, he hoped to achieve when he launched a program six years ago to help Latino Valley children, ages 12 to 18, who were at high risk of developing diabetes.
The results of the study, which was boosted in 2021 by a $3.3 million grant from the National Institute of Diabetes and Digestive and Kidney Diseases, were published this week in the Journal of the American Medical Association.
Among the results:
- There was a 10% improvement in glucose tolerance (a measure of how children process sugar) after 12 months.
- There was a 37% increase in insulin sensitivity (a measure of how well the body uses insulin) after six months.
- The children in the study reported a 10% increase in their weight-related quality of life after 12 months.
“What we learned is that these children, when you provide them with access to preventive services, they can do a better job,” said Al-Shuaibi, the principal investigator on the project.
The study was driven by data from the Centers for Disease Control and Prevention that showed Hispanic children are 1.5 to 1.7 times more likely to develop diabetes than white children, Al-Shaibi said.
“We designed a study that said, ‘You know, we appreciate that there are inequalities in society,'” Al-Shaibi said. “And these inequalities are not only related to the wealthy or the have-nots, but these kids also have a really hard time accessing traditional health care services.”
The program, which involved 117 families from across the valley, was a collaborative effort between Arizona State University, Valley of the Sun YMCA and St.
Dual Focus: Education and Exercise.
“The real key is how I implement this in my daily life,” said Micah Olson, M.D., medical director of the Type 2 Diabetes Program at Phoenix Children’s Hospital and co-author and study co-author. And that’s not easy, especially in the environment we live in today, where calories come in so cheap and it’s hard to move our bodies the way we’re used to.
“So the hypothesis of the study was: Can we present this information in a way that is culturally focused and presented by teachers who speak the language culturally and that would be more effective in getting children and families to make the kind of changes we are asking them to make, compared to what we can do in the clinic rooms medical?”
Parents and their children make their way to the downtown Phoenix YMCA once a week to do physical exercise, learn how to make better food choices, and modify and track their behavior. The exercise programs were designed by YMCA trainers, bilingual health educators and dietitians from St. Vincent and Phoenix Children’s Hospital were on hand to help families who did not speak English.
“All of this is delivered in the community, through the community, for the community,” Al-Shuaibi said. “We think this is unique because it isn’t,” Come to our clinic at Arizona State University. It is, ‘We will move the research to the community where it can best be carried out.’
Families were given tasks, which included handing out vouchers to Food City and having to find ingredients for a healthy meal for less than $5 a person.
“This becomes their duty,” Al-Shuaibi said. “Can you go out and shop and make a healthy meal on this budget? This was eye-opening for some of these families.”
The following week, families talked about the healthy meal they had prepared and how they were surprised to be able to do it on a budget.
It is all delivered in society, by society, by society.
Gabriel Al-Shibi, Professor at the Edison School of Nursing and Health Innovation
“We also made it a bit competitive,” said Elvia Leech, director of the Ivy Family Wellness Center in Saint Vincent de Paul. We’d tell them, “It has to be delicious, but it has to be cost-effective.” Then whoever gets the least cost wins the prize or the game. They came up with really great examples that highlight that you don’t have to eat really expensive foods in order to be healthy.”
The families were also given healthy recipes that they could cook.
“It gave me a sense of nutrition, like certain things I wasn’t supposed to eat often and how to eat a balanced diet,” Myriam Barra said.
Libby Coral, director of operations for the YMCA, said the families’ shared experiences have brought them together in a way that individual diet, exercise and nutrition programs cannot.
“They really developed that sense of community,” Coral said. “We had these groups of families and children who had the same issues and could learn from each other and support each other. They built friendships and relationships that went beyond the program itself.”
Al-Shuaibi hopes that the study will have benefits for future generations. Kids who exercise and develop healthy eating habits today will be the parents who teach their kids these behaviors tomorrow. To do its part, the YMCA gave all 117 families in the study a free six-month membership.
“We know that these types of diseases run in families,” Al-Shuaibi said. “If you are a child whose parents have diabetes, you are more likely to develop diabetes. But we also know that prevention and behaviors run in families. If your parents are active, you are more likely to be active and so on.”
Although the study is complete, the work is not. Al-Shaibi and his team received an additional round of funding to continue the research and target entire families over the next five years.
“We’re trying to have a bigger impact,” he said. “It can be the mother, the father, the cousins, the grandparents, everyone who lives in the house.”
Top photo: Program participants after a YMCA fitness class.
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