2010 (Oct) Canadian Diabetes Association Annual Conference, poster presentation by BRAID Research

1. The Next Generation of Diabetes:The Next Generation of Diabetes:
Children at Risk inChildren at Risk in DriftpileDriftpile First Nation, AlbertaFirst Nation, Alberta
Kelli RalphKelli Ralph--Campbell, Richard T.Campbell, Richard T. OsterOster, Ellen L., Ellen L. TothToth, BRAID Diabetes Research Group, University of Alberta, Edmonton, BRAID Diabetes Research Group, University of Alberta, Edmonton, AB;, AB;
Trina Scott, PauletteTrina Scott, Paulette CampiouCampiou, Florence, Florence WillierWillier,, DriftpileDriftpile First Nation, AB;First Nation, AB; KarieKarie Quinn, Nutrition byQuinn, Nutrition by KarieKarie, Grande Prairie, AB, Grande Prairie, AB
Abstract
The BRAID-Kids project began in Driftpile First Nation in March 2009, in response to screening
data from our earlier longitudinal BRAID1 study that showed obesity, overweight and pre-diabetes
prevalence of 56%, 15% and 32% (respectively) amongst the Community’s children. BRAID-Kids is
researching whether working with families and addressing the effects of colonization (i.e. loss of self-
esteem, pride, and sense of identity) can improve the ability of First Nations families to live healthy
lifestyles.
Clinical and anthropometric measurements (blood glucose, hemoglobin A1c, body mass index,
blood pressure, weight, height, waist circumference) and fitness tests (20-metre multi-stage shuttle
run) are undertaken for children (ages 5-15) at six-month intervals.
Children (with their parent/guardian) also complete a food frequency questionnaire. BRAID-
Kids aims to improve children’s physical activity and dietary choices through two means: 1) Direct: an
in-school prevention curriculum; and, 2) Indirect: a tradition-based “Cree Pride” program aimed at
parents/guardians, with the goal of impacting the home environment.
Clinical, anthropometric and fitness results have been worrisome, consistent with (perhaps
worse than) similar results in James Bay, Quebec (Downs, 2006). Many children with normal weight
still had central adiposity (waist circumference >/=85th percentile, NHANES III criteria), putting them at
greater risk for diabetes and cardiovascular disease. The first set of results-over-time (six months)
has shown no improvements.
Challenges have included difficulty implementing Cree Pride, and lack of “buy-in” by teachers
for the prevention curriculum; we are reconceptualising aspects of the project to address these.
1Believing we can Reduce Aboriginal Incidence of Diabetes
2BRAID-Kids received funding support from the Lawson Foundation.
Dr. Ellen L. Toth,
BRAID Medical Lead
Some families report having changed theirSome families report having changed their
eating habits because of what they learnedeating habits because of what they learned
from BRAIDfrom BRAID--Kids dietetic teaching.Kids dietetic teaching.
20-m shuttle run test:
The Next Generation of Diabetes:The Next Generation of Diabetes:The Next Generation of Diabetes:The Next Generation of Diabetes:The Next Generation of Diabetes:The Next Generation of Diabetes:The Next Generation of Diabetes:The Next Generation of Diabetes:The Next Generation of Diabetes:The Next Generation of Diabetes:The Next Generation of Diabetes:The Next Generation of Diabetes:The Next Generation of Diabetes:The Next Generation of Diabetes:The Next Generation of Diabetes:The Next Generation of Diabetes:The Next Generation of Diabetes:The Next Generation of Diabetes:The Next Generation of Diabetes:The Next Generation of Diabetes:The Next Generation of Diabetes:The Next Generation of Diabetes:The Next Generation of Diabetes:The Next Generation of Diabetes:The Next Generation of Diabetes:The Next Generation of Diabetes:The Next Generation of Diabetes:The Next Generation of Diabetes:The Next Generation of Diabetes:The Next Generation of Diabetes:The Next Generation of Diabetes:The Next Generation of Diabetes:The Next Generation of Diabetes:The Next Generation of Diabetes:The Next Generation of Diabetes:The Next Generation of Diabetes:The Next Generation of Diabetes:
BRAID-Kids builds on the success of the Kahnawake
Schools Diabetes Prevention Project1, Sandy Lake
Diabetes Prevention Project2, and the Pima Action /
Prima Pride project3:
References:
1. KSDPP: Macaulay AC, et al. The Kahnawake Schools Diabetes Prevention Project: intervention, evaluation, and
baseline results of a diabetes primary prevention program with a Native community in Canada. Prev Med.
1997;26(6):779-90.
2. Sandy Lake: Saksvig BI, et al. A pilot school-based healthy eating and physical activity intervention improves diet, food
knowledge, and self-efficacy for Native Canadian children. J Nutr, 2005;135:2392-2398.
3. Pima Pride: Narayan KM, et al. Randomized clinical trial of lifestyle interventions in Pima Indians: A pilot study.
Diabetic Med, 198;15:66-72.
4. Blood Pressure: The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children
and Adolescents. Pediatrics, 2004;114:555-576.
5. Waist circumference percentiles: Katzmarzyk, PT. Waist circumference percentiles for Canadian youth 11–18y of age.
Eur J Clin Nutr, 2004;58: 011–1015.
6. Central adiposity: NHANESIII
7. 20-m multistage shuttle run: Leger L, et al. Aerobic capacity of 6 to 17-year-old Quebecois - 20 meter shuttle run test
with 1 minute stages. Can J Appl Sport Sci, 1984;9:64-69.
8. Relative fitness: Downs SM, et al. Central adiposity and associated lifestyle factors in Cree children. Appl Physiol Nutr
Metab, 2008;33(3):476–482.
9. James Bay Cree: Downs et al., 2008.
10. Weight classification: Organizational Principles to Guide and Define the Child Health Care System and/or Improve the
Health of All Children. Pediatrics, August 2003;112(2):424-430.
The run time improved between pilot andThe run time improved between pilot and
baseline for 10 children. For these children,baseline for 10 children. For these children,
run times improved by an average of 29.3run times improved by an average of 29.3
seconds (range: 8seconds (range: 8--107 seconds).107 seconds).