Social programs are implemented far more often than they're tested. Here's one that was -- a study to see if improved school food, more physical activity time and classes about healthy living actually improved the health of students.
Some might be tempted to say -- "Of course they would. What a waste of government money." But things don't always turn out the way one would think: My favorite example of this was a well-meaning attempt to improve behavior of delinquent kids by putting them in group therapy together. (The kids' behavior, if anything, got worse ... perhaps because they befriended each other.)
This investigation, known as the HEALTHY study, involved eight medical centers and 42 schools (for a total of 4,603 students) at seven sites around the U.S. -- locally, UC Irvine was one of the research centers. It enrolled schools with disproportionate numbers of kids known to be at higher risk for diabetes because of ethnic or socioeconomic reasons. About 54% of the children were Hispanic; 18% were black.
At the study start at the beginning of sixth grade, baseline health was measured -- BMI, waist circumference, fasting blood glucose and insulin. Assessments were done again three years later, at the end of eighth grade.
Half the schools -- the controls -- got a bit of money to put toward food and physical activity changes of the schools' own choosing, but that was it.
The other half were given a fairly intensive program over three years including:
--lower-fat foods, more fruits and vegetables, only milk, water or juice as beverages -- implemented school-wide, meaning in cafeterias, snack bars, vending machines, etc.;
--225 minutes or more moderate-to-vigorous exercise for each 10-day period;
--a classroom learning program covering health education, behavior change skills, campaigns and healthy messages in school, as well as newsletters sent to parents to encourage parental support of healthful behaviors at home.
The results -- well, they weren't as crashing as one might hope, but they were better than other interventions of this type have been, the authors say.
The main measure was a reduction in rates of overweight and obese kids. There was no statistically significant difference between rates at the two types of schools. Both went down.The scientists wonder whether the very fact that the kids were all measured got the "control" schools to take some kind of action. But they don't really know why this happened.
There weren't any statistically significant differences in fasting glucose levels either.
There were some differences, though. At the schools with intensive interventions:
1) Fasting insulin levels decreased more
2) BMI scores decreased more
3) Percentages of kids with waist circumferences above the 90th percentile decreased more
4) Rates of obesity (as opposed to overweight and obesity added together) decreased more in the group of kids who were obese or overweight at the study start. (There was a 21% difference.) Since half the kids in the study were in this category, that's not so shabby.
All these things might contribute to a lower risk of diabetes among the kids, the scientists concluded.
The study was funded by the National Institutes of Health and American Diabetes Assn.; findings were reported Sunday at a meeting of the American Diabetes Assn. going on now in Orlando, Fla., and will be published in the New England Journal of Medicine.
Photo: Kids working out in a school gym (not one of the schools in the study). More physical activity was part of a multi-pronged school intervention that may lower diabetes risk.
Credit: Ken Hively / Los Angeles Times