Using NIH-ADOPT Process to Characterize Adolescents with Obesity and Prediabetes

Abstract

ObjectivesObesity and youth-onset type 2 diabetes (T2D) are both increasing in adolescents in the United States. To identify the behavioral, biological, psychosocial, and environmental characteristics that lead to obesity, the Accumulating Data to Optimally Predict Obesity Treatment (ADOPT) Core Measures Project, supported by the National Institutes of Health (NIH), recommends that these criteria are assessed in obesity research. Our objectives were to assess ADOPT criteria in our Dietary Intervention for Glucose tolerance In Teens (DIG IT), a randomized controlled trial (RCT) that involves an evaluation of health-coaching for prevention of youth-onset T2D.MethodsBoys and girls, ages 10–21 years and body mass index (BMI) > 85th percentile, were recruited into the ongoing DIG IT study. Baseline characteristics on behavior included diet and physical activity; on biology included BMI Z-scores and hemoglobin A1c (HgA1c); on psychology included emotional eating and binge eating; and on environment included parent/guardian's self-rating of their overall health; all per methods published in our protocol paper. Descriptive statistics include proportions, means and standard deviations.ResultsWe characterized baseline data on 59 participants with 61% female; age, 16.0 ± 2.8 years; BMI Z score, 2.3 ± 0.4; sagittal abdominal diameter (SAD), 23 ± 5 cm; fasting glucose, 92.3 ± 7.4 mg/dL and 49% meeting the criteria of pre-diabetes. From ADOPT criteria we highlighted several factors that promote risk of obesity and T2D including 53% consuming >10% of added sugar/day; 91% consuming <3 ounces of whole grains/day; 68% having sedentariness >10 hours/day, HgA1c of 5.5 ± 0.3, 40% of parent/guardian's self-rated overall health as fair, 65% parent/guardian rating of how often child complains of limiting food portions as sometimes or often, 46% of parent/guardian rating how often child binge eats as sometimes or often.ConclusionsWithin the ADOPT criteria, in the DIG IT population of adolescents, we identified several risk factors that promote obesity and T2D. Such risk factors may be targeted in family-based intervention programs to prevent youth-onset T2D.Funding SourcesIndiana Clinical and Translational Sciences Institute (NIH, UL1TR002529), McKinley Education Foundation, Showalter Research Trust.