When 14-year-old Jared Sanchez became dangerously overweight, his primary care physician knew he would be a perfect candidate for an investigational weight loss study using the internet.

The PACE (Patient-centered Assessment and Counseling for Exercise and Nutrition) Teen Study is aimed at overweight adolescents who are at risk for Type 2 Diabetes, and their families. The program, which is still enrolling volunteers, uses web and cell phone-based prompts to urge the teens to make permanent changes in diet and behavior, without drugs, supplements or costs.

“These kids have a compelling problem with their weight. It’s not something that can be addressed in a few weeks or months,” said PACE project principal investigator Kevin Patrick, M.D., M.S., professor of Family and Preventive Medicine, University of California, San Diego School of Medicine. “The fact that Jared and his family worked on this for more than a year means it’s much more likely they have learned new skills, a new way to approach diet and activity, and they’ve practiced long enough to make this a behavioral habit.”

The program is based on a “stop light” system, giving the participants nutritional and activity-level choices according to a green, yellow or red light ranking. For example, green light foods, such as fruits and vegetables, are lowest in calories and highest in vitamins, minerals and fiber. Green light activities, such as biking or rollerblading, add the most steps to the participant’s day, thus burning more calories. Yellow and red category foods and activities have fewer benefits.

Health Coaches also send challenges via email, asking the teens to set and reach certain goals.

“Jared went online everyday to look up his activities and goals,” said Debbie Sanchez, Jared’s mother. “It was primarily up to him but the family did the activities together and also learned about nutrition. Just because it says “multigrain” doesn’t mean it’s really healthy. So we learned to read labels for fat and fiber levels to make better decisions.”

“I think it’s clear that the adolescents who are going to be most successful are the ones who have support from the people they are living with,” said PACE project co-investigator Michael Gottschalk, M.D., Ph.D., Chief, Division of Endocrinology, and associate clinical professor, Department of Pediatrics, UCSD School of Medicine. “This is an environmental change and a lot of times, it’s the environment itself that is creating part of the problem.”

An estimated 73 million Americans, one-third of the adult population, have some form of diabetes. Not long ago it was a disease seen primarily in adults over age 45, but today, the National Institutes of Health (NIH) estimates that about 177,000 young people under 20 years of age have diabetes.

Who Can Participate?

Participants must:
• Be between the ages of 12 and 16 years old
• Live in San Diego County
• Be considered overweight with at least two risk factors for Type 2 Diabetes
• Be referred to the study by a provider within either Rady’s Children’s Hospital, Children’s Primary Care Medical Group (CPCMG) or Kaiser Permanente
• Speak English
• Have access to the internet and know how to use it
• Have at least one parent willing to participate in the study with the teen

“Jared really is changed,” said Sanchez. “He is very active now. Always on the go. Movies are still ok too but he is most likely to select an activity like swimming or baseball. We are very encouraged.”

This study, funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and the National Institutes of Health, is being conducted in conjunction with the Pediatric Adolescent Endocrinology and Diabetes Clinic at Rady Children’s Hospital and Health Center, Children’s Primary Care Medical Group practices and Pediatric/Adolescent Medicine Departments at seven Kaiser Permanente sites.

About PACE

PACE research explores how web, telephone, cell phone and wireless technologies can be used to improve lifestyle behaviors.

The PACE Research Group is based at the UCSD School of Medicine, Department of Family and Preventive Medicine. PACE research is conducted by an interdisciplinary team of over 40 professionals with expertise in preventive medicine, health psychology, exercise sciences, behavioral medicine, nutrition, experimental psychology, computer sciences and engineering, media technology and graphic arts, health promotion, pediatrics, internal medicine and family medicine.

For enrollment information please call Jennifer Covin at 858-457-7282.

Source: University of California, San Diego Health Sciences