Effect of self‐esteem, diet and physical activity strategies on the risk factors for Type 2 diabetes mellitus (T2DM) in overweight African American children

Based on their geographical location, 102 overweight 9–10 y/o African American (AA) children (BMI >85 th %) were recruited into a high‐intensity intervention (HII; higher integrated efforts to improve diet, physical activity (PA) and self‐esteem) or low‐intensity intervention group (LII) to assess the risk factors for T2DM and the effect of a community intervention trial on these factors. Fasting glucose (G f ) and insulin (I f ) were measured both at baseline (yr0) and after 1 year of intervention (yr1), and were used to determine insulin sensitivity (S I ; QUICKI) and pancreatic function (HOMA‐B%) along with body fatness, diet intake, PA patterns, physical fitness (VO 2 max), self‐esteem, family health and family environment. Adjusting for gender, age, Tanner (self‐assessed), socioeconomic index and family history of diabetes, multivariate regression analysis showed that at yr0, BMI z‐score (β = −0.024; p<0.001) and measures of PA levels (METs .min −1 .day −1 , β = 0.014, p= 0.008) correlated with indices of S I ; while BMI z‐score (β =47.28; p =0.04) and VO 2 max correlated with HOMA‐B% (β =10.24, p =0.01). At yr1, the HII showed a significant improvements in G f (p<0.001) and QUICKI (p =0.017) compared to the LII, after accounting for yr0 differences. The decrease in I f and HOMA‐B% in the HII after yr1 did not reach statistical significance. In this population of high BMI, AA children, greater BMI z‐score and lower PA and fitness correlated with S I and HOMA‐B% at yr0 and the HII exhibited improvement in S I after yr1.