Background

Obesity, prediabetes, and type 2 diabetes (T2D) disproportionately affect Hispanics and individuals of low socioeconomic status; however, no large studies have examined prevalence of prediabetes in low-income minority children <12 y and the American Diabetes Association (ADA) has no testing recommendations specifically for children. This study aims to examine effects of TX Sprouts, a nutrition, gardening and cooking cluster-randomized controlled trial, on fasting plasma glucose (FPG) and prediabetes in primarily low-income Hispanic 3rd-5th grade children.

Methods

Sixteen Austin area schools were randomized to the TX Sprouts intervention (n=8 schools) or control (n=8 schools). Intervention schools received a teaching garden and 18 nutrition, gardening, and cooking lessons, taught weekly during school hours over one year. Control schools received the program the following school year. FPG and glycated hemoglobin (HbA1c) were analyzed from an optional fasting blood sample. Prediabetes was determined using ADA cutoffs (FPG: 100-125 mg/dL and/or HbA1c: 5.7-6.4%). Mixed effects regressions, accounting for cluster effect, will analyze changes in FPG and prediabetes between intervention and control groups.

Results

Of 3,137 consented students, 1067 students had complete baseline clinical measures and blood draws (mean age 9.3 years, 53% female, 69% Hispanic, 71% free/reduced lunch program). Approximately 51% of children had overweight/obesity and 27% were classified as prediabetic. Data collection will be completed in May 2019, and intention-to-treat effects will be analyzed this summer. We expect 700 students (~65%) to have complete post-intervention blood data.

Conclusions

This is the first trial to examine effects of a large school-based nutrition, gardening, and cooking intervention on prediabetes in primarily low-income, Hispanic children. Results will help inform testing recommendations for prediabetes and T2D in young children and shape future interventions for combating pediatric prediabetes.