Current Diabetes Reports

, Volume 13, Issue 1, pp 63–71 | Cite as

Lessons Learned From the HEALTHY Primary Prevention Trial of Risk Factors for Type 2 Diabetes in Middle School Youth

  • Marsha D. Marcus
  • Kathryn Hirst
  • Francine Kaufman
  • Gary D. Foster
  • Tom Baranowski
Pediatric Type 2 Diabetes (PS Zeitler, Section Editor)


The HEALTHY trial was designed to take a primary prevention approach to risk factors for type 2 diabetes in youth, primarily obesity. The study involved over 6,000 students at 42 middle schools across the U.S. Half received an integrated intervention program of components addressing the school food environment, physical education, lifestyle behaviors, and promotional messaging. The intervention was designed to be more comprehensive than previous efforts, and the research was amply funded. Although the primary objective of reducing the percentage of overweight and obesity in schools that received the intervention program, as compared with control schools, was not obtained, key secondary outcomes indicated an intervention effect. In retrospect, senior investigators involved in the study’s design, conduct, and analysis discuss weaknesses and strengths and offer recommendations for future research efforts that address prevention of childhood obesity from a public health perspective.


Obesity Metabolic risk Cardiovascular risk Prevention School-based health promotion Preadolescence Cluster design trial Diabetes HEALTHY 



We wish to thank the administration, faculty, staff, students, and their families at the middle schools and school districts that participated in the HEALTHY study.

This work was completed with funding from NIDDK/NIH Grants U01-DK61230, U01-DK61249, U01-DK61231, and U01-DK61223, with additional support from the American Diabetes Association.

HEALTHY intervention materials are available for download at


Conflicts of interest: M.D. Marcus has received a subcontract from George Washington University (part of a Cooperative agreement from NIDDK) and has been on the Scientific Advisory Board for United Health Care. K. Hirst has received grant support from NIDDK; also, travel to study meetings was covered; the NIDDK grant covered all activity, including committee work and data analysis, but not under a fee but under a cost-reimbursable grant. F. Kaufman has received grant support from NIDDK; also, travel to study meetings was covered. G.D. Foster has received grant support from NIH/NIDDK; also, travel to study meetings was covered; he has received salary support from a grant and has been on the Scientific Advisory Board for United Health Group, ConAgra Food, Tate and Lyle. T. Baranowski received grant support from NIDDK; also, travel to study meetings was covered; he also serves on the Publications and Presentations Committee for the HEALTHY trial (NIDDK).


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of outstanding importance

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Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  • Marsha D. Marcus
    • 1
  • Kathryn Hirst
    • 2
  • Francine Kaufman
    • 3
  • Gary D. Foster
    • 4
  • Tom Baranowski
    • 5
  1. 1.University of Pittsburgh School of MedicinePittsburghUSA
  2. 2.George Washington University Biostatistics CenterRockvilleUSA
  3. 3.Children’s Hospital Los AngelesLos AngelesUSA
  4. 4.Temple University Center for Obesity Research and EducationPhiladelphiaUSA
  5. 5.Baylor College of Medicine Children’s Nutrition Research CenterHoustonUSA

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