Source: CORNELL UNIVERSITY submitted to NRP
RURAL OBESITY, NEW YORK
Sponsoring Institution
National Institute of Food and Agriculture
Project Status
COMPLETE
Funding Source
SPECIAL GRANT
Reporting Frequency
Annual
Accession No.
0206800
Grant No.
2006-34517-17088
Cumulative Award Amt.
(N/A)
Proposal No.
2006-06188
Multistate No.
(N/A)
Project Start Date
Sep 15, 2006
Project End Date
Sep 14, 2007
Grant Year
2006
Program Code
[WH]- (N/A)
Recipient Organization
CORNELL UNIVERSITY
(N/A)
ITHACA,NY 14853
Performing Department
NUTRITIONAL SCIENCES
Non Technical Summary
Obesity often leads to diabetes and its associated illness and death. The purpose of this research is to determine if a lifestyle intervention program can reduce the progression toward diabetes among overweight individuals with impaired glucose tolerance.
Animal Health Component
100%
Research Effort Categories
Basic
(N/A)
Applied
100%
Developmental
(N/A)
Classification

Knowledge Area (KA)Subject of Investigation (SOI)Field of Science (FOS)Percent
7046010101025%
7046010117025%
7246010101025%
7246010117025%
Knowledge Area
724 - Healthy Lifestyle; 704 - Nutrition and Hunger in the Population;

Subject Of Investigation
6010 - Individuals;

Field Of Science
1010 - Nutrition and metabolism; 1170 - Epidemiology;
Goals / Objectives
The objective of the proposed research is to determine whether a lifestyle intervention program, similar to the lifestyle intervention used in the Diabetes Prevention Program, can be effective in reducing the incidence of diabetes among overweight individuals with elevated fasting blood glucose values in the 'real world' setting of the rural area served by Bassett Healthcare.
Project Methods
A two-phase program is proposed. In the first phase, a 20-week behavioral weight loss program (Lifestyle Challenge Program) will be implemented among overweight individuals served at Bassett Hospital. The purpose of this phase is to evaluate the feasibility and logistics of using this program in the rural communities served by this hospital system. In the second phase, the Lifestyle Challenge Program will be implemented in 10 of the rural sites served by Bassett Healthcare and not in 10 others (randomly assigned). Individuals in the control sites will receive usual care (standard advice on weight loss and exercise). To be eligible for this study, individuals must be overweight and have a fasting blood glucose value between normal and diabetic. Blood lipds, weight, height, blood pressure and resting pulse rate will be assessed at baseline. Six months after the beginning of the intervention, all subjects will provide a second fasting blood sample to determine if this intervention is more effective than usual care in slowing the progression toward diabetes in these at-risk individuals. In addition, change in the participants' blood lipid values, weight, blood pressure and resting pulse will be assessed.

Progress 09/15/06 to 09/14/07

Outputs
The project recently completed the first year of a planned 3-year program. The intervention is a program we have termed 'Challenge Diabetes', which is based on the Lifestyle Challenge Program. The program is similar to that used in the Diabetes Prevention Program, modified slightly to be more practical in a small-office, rural setting. In the first year, the major activities were planning, designing educational materials, handouts etc., and conducting a pilot study. This pilot study was held and completed in Bassett's main outpatient clinic in Cooperstown, NY. We recruited 15 subjects (12 women, 3 men, aged 40 to 65 y). All were overweight with a mean body mass index (+/- S.D.) in the obese range (33.7 +/- 6.7 kg/m squared) and an elevated fasting blood glucose concentration (98 +/- 9 mg/dL).

Impacts
As expected, there was a high dropout rate from the program; only 5 subjects (3 women, 2 men) completed all 20 weeks. However, those who completed the program were quite successful, with a mean weight loss of 7.4 +/- 7.1 kg (range 2.8-19.8 kg). Blood pressure fell quite markedly in these subjects with a mean drop of 17 +/- 12 mm Hg systolic and 10 +/- 9 mm Hg diastolic. Laboratory values (blood glucose, insulin, HbA1c, lipids, etc.), both on those who completed the program and those who did not, are pending analysis. As a result of experience and knowledge gained from the first year of the study, changes will be made to the program as we move into the second year. The biggest change is that the program will be shortened to 16 weeks, but 4 sessions will be added at 3-month intervals after completion of the program. Details of each individual session have also been modified based on feedback from the participants.

Publications

  • No publications reported this period