ASU partners with community agencies to prevent diabetes in Latino teens

March 5, 2013

About 20 Latino teenagers who live near the Downtown Phoenix campus are starting a journey this month that ASU researchers hope will lead them to better long-term health.

They are the first group enrolled in a five-year research study that will eventually involve about 160 obese teens, pulling together the resources of ASU’s Southwest Interdisciplinary Research Center (SIRC), the Lincoln Family Downtown YMCA and the St. Vincent de Paul Virginia G. Piper Medical and Dental Clinic. Download Full Image

Funded by a $1.2 million award from the National Institutes of Health, the "ASU Every Little Step Counts" study will examine the effects of a community-based diabetes prevention program for Latino adolescents, with the goal of reducing obesity-related health disparities in this population.

The stakes are high: the Center for Disease Control estimates that up to 50 percent of all Latino youth born in the year 2000 will develop Type 2 diabetes in their lifetime, an alarming statistic that could lead to other severe health and societal consequences. Latino youth have the highest rates of metabolic syndrome, which includes insulin resistance, obesity and elevated glucose levels or “prediabetes.”

“This is a vulnerable population, many which are uninsured or underserved, and we learned that the inner-city clinics are inundated with adults who have diabetes,” says Gabriel Shaibi, principal investigator of the study, SIRC faculty research affiliate and assistant professor in the College of Nursing and Health Innovation and the School of Nutrition and Health Promotion. “It became clear that prevention programs for youth were needed.

“A strength of the program is that it is culturally grounded to meet the needs of Latino youth and families," Shaibi adds. "It was developed largely by the community, to be delivered in the community. Given the community focus, word about the program has spread through churches, schools and health fairs. ASU research faculty and staff work alongside health educators from the St. Vincent de Paul clinic and exercise trainers from the Y.

“We have worked in partnership with the community from the start, which will allow us to more readily speed up the translation of our research findings into the real world.”

In the past 10 years Arizona has experienced the largest statewide increase – 45.3 percent -- in the number of children and adolescents who are overweight or obese. Latinos represent about a third of Arizona’s population.

Several previous studies by Shaibi have shown that lifestyle changes including improvements in nutrition habits and physical activity, can increase insulin sensitivity and lower cardiovascular risk factors such as cholesterol in youth – even without significant weight loss.

The 14- to 16-year-olds in the current study participate in structured exercise and games as well as nutrition education at the YMCA for 12 weeks, followed by monthly support meetings for them and their parents. They’ll be provided with a one-year membership to the Y to encourage regular exercise. At the end of a year, they’ll return to ASU to see whether health improvements have been sustained.

“A critical part of their development is instilling healthy behaviors as they build their independence,” says Shaibi. “There are a lot of factors that influence their health behaviors and choices, so we help them develop support systems from their friends and family. A key factor in success is helping the kids build social support and skills, exposing them to the YMCA and its philosophy. Many of the kids live near the Y but have never utilized the facility.”

Parents are often the biggest proponents of the program, as diabetes often runs in the family so parents realize their children are at risk. The project uses bilingual lay health educators, or promotoras, to deliver the diabetes prevention education to families.

“Parents are extremely excited when offered an opportunity they have never been offered before to benefit the overall health of their kids,” says Saray Vera, health education coordinator at the St. Vincent clinic. “They are anxious and eager to get their kids started on the program. Partnering with ASU on this project is extremely valuable to us, and we are eternally grateful and honored to work with the institution.”

Co-investigators from ASU include two professors from the College of Nursing and Health Innovation, Colleen Keller and Darya McClain. Researchers hope the program may serve as a foundation for future large-scale interventions.

Kerri O’Brien, senior vice president for healthy living at the YMCA, says teaching healthy living habits to youth and their families can help them be successful in making lifestyle changes for the long term. The partnership with ASU makes their outreach all the stronger.

“This program can lead to communities of people leading more productive and enjoyable lives,” she says. “Getting there will take time, energy and focus, but every little step counts.”

The NIH study is part of a larger $6.3 million research award to the Southwest Interdisciplinary Research Center at ASU from the National Institute of Minority Health and Health Disparities.

ASU researcher finds exercise may be intervention for Down syndrome

March 5, 2013

Marcus Santellan’s aunt says he’s more talkative at home, using longer sentences, now that he’s in an exercise program at Arizona State University. The young man with Down syndrome (DS) is helping ASU researchers find out whether intense, assisted exercise can improve cognitive, motor and emotional functioning in adolescents with DS.

Marcus swings his legs down from the motorized bike with a groan after a half-hour session, but he’s exhilarated. He is one of eight participants who come to the Tempe and Downtown Phoenix campuses three times a week to work out on a bike. Another eight have already completed the study. Download Full Image

Katy Lichtsinn, an ASU kinesiology senior who acts as his cheerleader and mentor, warns his aunt that Marcus might be tired after pedaling at 110 rpm.

“I’m not tired,” says Marcus, taking a gulp from a water bottle. “But I can’t feel my legs.”

Persons with DS, a chromosomal condition that affects about 400,000 children born in the United States, have broad cognitive impairment and physical characteristics that limit their ability to perform functional tasks of daily living. To date, there have been few, if any, behavioral interventions that have been shown to bring about improvement in their functioning.

Shannon D.R. Ringenbach, an associate professor of kinesiology in the School of Nutrition and Health Promotion, hopes to show that Assisted Cycle Therapy has the potential to improve the lives of people with DS. She has received a $150,000 grant from the Eunice Shriver National Institute of Child Health and Human Development to conduct the study.

A smaller pilot study she carried out two years ago revealed that adolescents with DS improved their speed of information processing and manual dexterity, even after one Assisted Cycle Therapy session. The same was not true after one voluntary exercise session, since people with DS tend toward sedentary behavior and have reduced strength.

An innovation in Ringenbach’s approach is the use of a specialized stationary bicycle with a motor, so participants exercise faster. Assisting in the research are about 15 ASU undergraduates and one doctoral student, who monitor the participants carefully and urge them on. Participants are tested periodically on their functional behaviors, manual dexterity, executive function and depression.

“It’s really remarkable that by doing this kind of exercise, they begin to think faster,” says Ringenbach. “We believe they develop new brain cells. We don’t know yet how long it will last. But it has the potential to dramatically change the quality of their lives. With early intervention in children with Down syndrome, it’s possible it could improve their IQ.”

Exercise has been shown to improve cognitive, physical and mental health in people with Parkinson’s disease. 

Marcus’ aunt, Georgina Rosas, has been caring for him along with her sister since he was six months old. He graduated from Tempe High School last year, and has been active in Special Olympics. Rosas enrolled him in the ASU study in hopes it would help him think a little faster. She wishes there were more interventions for people with DS.

“A lot of Down syndrome children are smart and able to learn to do things, but they get left behind, in the research,” she says. “He is well loved, with two devoted aunts. But it’s nice to have people at the university who are looking into this.”

Participants’ families tell Ringenbach that their children enjoy the program a great deal. They are talking and interacting more, their moods are better, and they’d like the program to continue. She hopes to extend her research by developing a motorized bike for smaller children, and perhaps to develop a program for individuals with DS at the downtown YMCA.