Children and adolescents with poorly controlled type 1 diabetes mellitus (T1DM) are at risk for decreased bone mass. Growth hormone (GH) and its mediator, IGF-1, promote skeletal growth. Recent observations have suggested that children and adolescents with T1DM are at risk for decreased bone mineral acquisition. We examined the relationships between metabolic control, IGF-1 and its binding proteins (IGFBP-1, -3, -5), and bone mass in T1DM in adolescent girls 12–15 yr of age with T1DM (n = 11) and matched controls (n = 10). Subjects were admitted overnight and given a standardized diet. Periodic blood samples were obtained, and bone measurements were performed. Serum GH, IGFBP-1 and -5, glycosylated hemoglobin (HbA1c), glucose, and urine magnesium levels were higher and IGF-1 values were lower in T1DM compared with controls (p < 0.05). Whole body BMC/bone area (BA), femoral neck areal BMD (aBMD) and bone mineral apparent density (BMAD), and tibia cortical BMC were lower in T1DM (p < 0.05). Poor diabetes control predicted lower IGF-1 (r2 = 0.21) and greater IGFBP-1 (r2 = 0.39), IGFBP-5 (r2 = 0.38), and bone-specific alkaline phosphatase (BALP; r2 = 0.41, p < 0.05). Higher urine magnesium excretion predicted an overall shorter, lighter skeleton, and lower tibia cortical bone size, mineral, and density (r2 = 0.44–0.75, p < 0.05). In the T1DM cohort, earlier age at diagnosis was predictive of lower IGF-1, higher urine magnesium excretion, and lighter, thinner cortical bone (r2 ≥ 0.45, p < 0.01). We conclude that poor metabolic control alters the GH/IGF-1 axis, whereas greater urine magnesium excretion may reflect subtle changes in renal function and/or glucosuria leading to altered bone size and density in adolescent girls with T1DM.

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We evaluated a 12-week recreation center-based healthy lifestyle intervention for 30 obese home-dwelling young adults (YA) with intellectual disabilities. Three cohorts participated: YA only, YA and parents, and parents only. The YA cohorts received a nutrition/exercise intervention; parents focused on modeling healthy lifestyle behaviors. Outcomes included YA blood, nutrition, anthropometric, and fitness measures at pre, post, and 3-month follow-up. Compared with wait-list controls, the YA-only cohort improved immediately postintervention in blood pressure (BP), weight, and balance (p < .05). At 3-month follow-up, no intervention was consistently superior; overall reductions in weight, BP, hip circumference, and exercise barriers were obtained (p < .05). Linear and curvilinear changes from baseline to 3 months after the intervention varied by outcome and participant. Participants with Down syndrome lost less weight.

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BACKGROUND Elementary teachers have the potential to influence children's eating habits. This study examined teacher views and practices regarding nutrition education. METHODS An online survey was administered to K‐6 teachers (N = 628) in 55 public elementary schools in a large city in the western United States. Three indices were created based on responses. Indices included: (1) attitudes and beliefs about nutrition education; (2) self‐efficacy regarding nutrition education; and (3) personal health behaviors. Relationships between indices, classroom practices, and teacher characteristics were tested. Teacher comments were categorized into themes. RESULTS Most teachers agreed they can make a difference in the eating behaviors of their students (68%). Correlations between hours of nutrition taught and teachers' attitudes and beliefs (r = .37, p < .01), nutrition self‐efficacy (r = .38, p < .01), and personal health practices (r = .15, p < .01) were weak, yet statistically significant. Number of years teaching was inversely related to frequency of food rewards (r = −119, p < .01). Few teachers (21%) agreed they have support to teach nutrition in the classroom. CONCLUSION Teachers understand the importance of nutrition education but provision is limited by competing demands. Teachers suggest tailored nutrition materials, qualified nutrition personnel, and school stakeholder support to promote nutrition education.