Tuesday, October 23, 2012
Higher levels of activity, lower BMI may help to protect them against Type 2 diabetes, even if they gain weight as adults
Old Order Amish children are much more physically active and three times less likely to be overweight than non-Amish children, which may provide them with some long-term protection against developing Type 2 diabetes, University of Maryland School of Medicine researchers report in the journal Diabetes Care.
The researchers found that Amish children in Lancaster County, Pa., spent an additional 34 minutes a day in light physical activity, plus another 53 additional minutes a day in moderate to vigorous activity compared to non-Amish white children living nearby on Maryland's rural Eastern Shore. The amount of moderate to vigorous activity, which is important to cardiovascular health, was twice that of the non-Amish children. The level of physical activity was inversely correlated to their BMI, or body mass index, which is a measurement of body fat based on a person's height and weight.
"We know from our earlier research that Amish adults are just as overweight as non-Amish Americans of European origin, but they have half the incidence of Type 2 diabetes," says Soren Snitker, M.D., Ph.D., the study's senior author and an associate professor of medicine and pediatrics at the University of Maryland School of Medicine. "This study suggests that the Amish gain their excess weight relatively late in life, which may decrease their long-term risk of developing the disease." The number of years someone is obese is a risk factor for diabetes, irrespective of the person's age and current BMI. Higher levels of physical activity and lower BMI are both protective against diabetes, Dr. Snitker says. Obesity is a major risk factor for Type 2 diabetes.
Dr. Snitker says that while it is unrealistic to imagine that the general public will adopt the Amish lifestyle in its entirety, the study results underscore the need for parents to encourage their children to be more physically active. "We may be able to learn something from the attitudes of the Amish," he says. “Whether children are physically active or not depends a lot on choices their parents make. Do they facilitate physically demanding activities for their children or do they allow them to spend long hours playing electronic games or watching television?"
E. Albert Reece, M.D., Ph.D., M.B.A., vice president for medical affairs at the University of Maryland and the John Z. and Akiko K. Bowers Distinguished Professor and dean of the University of Maryland School of Medicine, says, "As America's children become increasingly overweight, they become more vulnerable to diseases such as Type 2 diabetes. The incidence of diabetes among our young people is rising at an alarming rate. This study by Dr. Snitker and his colleagues offers clear evidence of the benefits of exercise and maintaining a healthy body weight as reflected in the body mass index calculation."
The Old Order Amish in Lancaster County, Pa., trace their ancestry back 14 generations to a small group of Anabaptist Christians who came to Pennsylvania from Europe in the mid-1700s. They don't drive cars or have electricity in their homes and eschew many of the trappings of modern life.
The researchers compared data from 270 Old Order Amish children, ages 8 to 19, from Lancaster County and 229 children from Maryland's Eastern Shore. They measured the children's physical activity by having them wear a device to track their body movement, which allowed them to calculate how much energy they burned as a result of their activity.
Typical Amish children's activities include walking to school, playing with their friends, and performing chores.
"The Amish lifestyle affects the whole family, involving Old Order Amish (OOA) children in household or farming chores from an early age," the researchers note. "OOA children also seem to spend a substantial amount of time in outdoor play with their siblings and neighbors, facilitated by the large size of the OOA Amish nuclear family. OOA children do not use computers or electronic games, nor do they watch television. OOA children attend one-room school houses and almost always go outside for recess. Even the youngest OOA students use active transportation to get to school, generally walking in a group." By comparison, non-Amish children "almost universally" travel to school and other destinations by bus or car, the researchers say.
The lead authors of the article are Kristen G. Hairston, M.D., M.P.H. and Julie D. Ducharme, M.D., who are both recent graduates of the fellowship program in endocrinology and metabolism at the University of Maryland School of Medicine.
The research was funded by grants from the National Institutes of Health (P30 DK072488, T32 AG000219, K01 AG2278), the Geriatric Research and Education Clinical Center at the Baltimore Veterans Administration Medical Center, the U.S. Centers for Disease Control and the American Diabetes Association (ADA). The journal Diabetes Care is an ADA publication.
The study is one of a number of studies conducted by University of Maryland School of Medicine researchers using data collected from the Old Order Amish in Pennsylvania. Alan R. Shuldiner, M.D., associate dean for personalized medicine and director of the Program in Personalized and Genomic Medicine at the School of Medicine, and a co-author of this study, operates an Amish research clinic in Lancaster Pa. Over the past 20 years, he and his research team have conducted more than a dozen studies with the Amish, looking for genes that may cause common diseases, such as diabetes, osteoporosis and cardiovascular disease.
Kristen G. Hairston, MD, MPH; Julie D. Ducharme, MD; Margarita S. Treuth, PhD; Wen-Chi Hsueh, MD; Ania M. Jastreboff, MD, PhD; Kathy A. Ryan, MS; Xiaolian Shi, MS; Braxton D. Mitchell, PhD; Alan R. Shuldiner, MD; Soren Snitker, MD, PhD
About the University of Maryland School of Medicine
Established in 1807, the University of Maryland School of Medicine is the first public medical school in the United States, and the first to institute a residency-training program. The School of Medicine was the founding school of the University of Maryland and today is an integral part of the 11-campus University System of Maryland. On the University of Maryland's Baltimore campus, the School of Medicine serves as the anchor for a large academic health center which aims to provide the best medical education, conduct the most innovative biomedical research and provide the best patient care and community service to Maryland and beyond.