Bienestar: A School-Based Diabetes and Obesity Prevention Program

An Evidence-Based Practice

Description

The Bienestar Health Program was developed to reduce or prevent type 2 diabetes mellitus in low-income children. High levels of modifiable risk factors associated with type 2 diabetes mellitus have been reported in low-income children and especially among low-income Mexican-American children. Latino children tend to store more belly fat, consume less dietary fiber, fewer fruits and vegetables and engage in physical activity less than their African American or non-Hispanic white peers. Culturally relevant intervention programs are needed to curb the rising rates of diabetes among Mexican-American youth.

The Bienestar Health Program consists of a health class and physical education curriculum, a family program, a school cafeteria program, and an after-school health club. The health curriculum covers nutrition, physical activity, self-esteem, self-control, and diabetes. The physical education curriculum promotes an active lifestyle and the after-school program promotes leisure time physical activity. Bienestar involves the child's entire community in the program by offering cooking classes for the parents and educating cafeteria staff and after-school caretakers to encourage lower-fat, higher fiber snacks. All materials are produced in Spanish.

Goal / Mission

The objectives of Bienestar are to decrease dietary saturated fat intake, increase dietary fiber intake, and increase physical activity among low-income Mexican-American elementary and middle school children.

Impact

Statistically significant increases fitness scores and dietary fiber intakes levels among low-income, Mexican-American fourth-graders. A second randomized control trial conducted from 6th to 8th grade showed reductions in various indexes of adiposity.

Results / Accomplishments

Findings from a randomized controlled trial showed that the program statistically significantly increased fitness scores and dietary fiber intakes levels among low-income, Mexican-American fourth-graders. Moreover, the trial found decreased fasting capillary glucose levels after the children participated in the Bienestar program. Because fasting capillary glucose is a measure of blood sugar, this finding suggests that the present risk of developing type 2 diabetes was decreased after participation in Bienestar.

A second randomized control trial conducted from 6th to 8th grade showed a reduction in BMI z scores, percentage of students with waist circumference at or above the 90th percentile, fasting insulin levels (P=0.04 for all comparisons), and prevalence of obesity (P=0.05). Both intervention and control schools saw a decrease in the combined prevalence of overweight and obesity.

These findings may reduce the risk of childhood-onset type 2 diabetes.

About this Promising Practice

Primary Contact
Roberto P. TreviƱo, MD
Social and Health Research Center
1302 S St Mary's St
San Antonio, TX 78210
rptrevino07@msn.com
http://www.sahrc.org/
Categories
Health / Diabetes
Health / Children's Health
Health / Exercise, Nutrition, & Weight
Organization(s)
Social and Health Research Center, Texas
Source
National Institutes of Health-National Institute of Diabetes and Digestive and Kidney Disease
Location
Texas
For more details
http://archpedi.ama-assn.org/cgi/content/full/158/...
http://www.nejm.org/doi/full/10.1056/NEJMoa1001933
Target Audience
Children, Families, Racial/Ethnic Minorities