Working with children to help prevent the development of diabetes type 2

South LondonMetabolic and Endocrine
Start Date: 1 Jan 2013 End Date: 30 Sep 2019

Type 2 diabetes has its origins in childhood

Researchers at St George's, University of London, have shown that type 2 diabetes in people of South Asian and African-Caribbean descent has its origins in childhood.

Their research has illustrated that blood levels of glucose and insulin are higher in children of Indian, Pakistani and Bangladeshi families living in the UK than they are in their white peers. Children of African-Caribbean origin also have elevated glucose and insulin levels in their blood.

An elevated insulin level is a sign that cells are becoming resistant to its action. The pancreas then produces more of the hormone in a bid to help move glucose out of the bloodstream.

Understanding and addressing these patterns in childhood could help to prevent type 2 diabetes in future years, says Professor Peter Whincup, a professor of epidemiology at St George's. Adults of South Asian and African-Caribbean origin who live in the UK have a greater risk of developing type 2 diabetes than white Europeans: adults of South Asian descent are at least three times more likely than their white counterparts and the risk is about twice as high for adults of African-Caribbean descent.

The CHASE Study

Professor Whincup led the Child Heart and Health Study in England (CHASE) that investigated the origins of type 2 diabetes with the help of approximately 5,000 nine and 10-year-old children recruited through primary schools – mostly in London but also in The Midlands. The children were weighed and measured, gave blood samples and provided information about their lifestyle and diet.

Using data collected in CHASE, Professor Whincup and his colleagues have shown that diet and physical activity in childhood play important roles in the emerging risk of type 2 diabetes.

How diet can influence the risk of type 2 diabetes

Children who eat more calories are more likely to have higher glucose levels in their blood and elevated insulin levels.

Researchers discovered that children who consume the highest amount of energy also tend to consume more high energy-dense food like biscuits, sweets, crisps and cheese. Energy density is the amount of energy – or calories – found in each gram of food. Fruit and vegetables and foods that are high in fibre – such as wholegrain bread and some breakfast cereals – are foods with low energy density.

‘These findings tie in with another important observation, that children who eat breakfast regularly – particularly a breakfast cereal high in fibre content – appear to have lower type 2 diabetes risk,’ says Professor Whincup.  

He and his colleagues are carrying out further analyses of data from the CHASE Study data to find out more about how children’s diet can influence the risk of developing type 2 diabetes. The team is studying the effect of low vitamin D, low vitamin C and food from particular sources (from takeaway restaurants, for example). Researchers are also investigating the relationship between diet, sleeping patterns and type 2 diabetes risk.

Investigating whether eating a higher fibre breakfast cereal will reduce the risk

The CLAHRC team wanted to build on their earlier results by finding out if a simple change to the diet of primary school children – such as eating a high fibre, low energy dense cereal for breakfast – could help reduce their longer-term risk of developing type 2 diabetes.

They are worked with primary school children, their families and their teachers to determine what effect a change of this nature could have.

The initial findings have shown that reducing energy intake and eating a high fibre breakfast cereal are likely to reduce long-term type 2 diabetes risk. With the support of funding from the Wellcome Trust, the research team are now planning a formal evaluation of interventions to increase cereal fibre intake in children and to assess the effects on overall fibre intake and insulin resistance.

Professor Peter Whincup