1
overweight and obese children were more likely to say their body size was too big compared to normal weight children (OR¼7.7 and 30.6, respectively). Overweight and obese children were also more likely than normal weight children to respond noto Do you like the way you look now?(OR¼2.4 and 7.8, respectively). BMI z-score was associated with lower scores for global self-concept (b¼-1.3), intellectual and school status (b¼-1.5), and physical appearance and attributes (b¼-1.3). The poor self-concept and body size dissatisfaction of Cree children with excess weight may lead to disordered eating or psychological outcomes such as depression. The psychosocial implications of obesity in First Nations children may be as important as chronic disease considerations. 238 Early Overnutrition Impairs Arginine Responsivity in Diabetes- Susceptible Swiss Webster Mice MARIA M. GLAVAS * , JESSICA K. FOX, XIAOKE HU, JAMES D. JOHNSON, TIMOTHY J. KIEFFER Vancouver, BC Childhood obesity and rapid early growth increase the risk for type 2 diabetes. Such early overnutrition can be modelled in mice by reducing litter size, which results in rapid weight gain, hyper- insulinemia and hyperleptinemia in early life. We have previously demonstrated that such chronic postnatal overnutrition (CPO) in Swiss Webster mice signicantly increases susceptibility to dia- betes, characterized by profound hyperglycemia and subsequent beta-cell failure. In the present studies we examined whether CPO mice exhibit altered responsivity to glucose and/or arginine in isolated islets prior to the onset of hyperglycemia. Litters from Swiss Webster mice were culled to 3 (CPO) or 10 (control, CTR) pups shortly after birth and maintained on a moderate fat (25 kcal%) diet. At 11 weeks of age islets were iso- lated from non-diabetic mice and perifused with 3 and 20 mmol/L glucose followed by 15 mmol/L arginine, for measurement of insulin responsivity. Total pancreatic insulin content was measured in a separate cohort by insulin ELISA. Both CTR and CPO mice exhibited similar insulin secretion in response to 3 and 20 mmol/L glucose. In contrast, whereas CTR mice showed a dramatic insulin response to arginine, CPO mice failed to respond. Total pancreatic insulin content did not differ between CTR and CPO mice. Thus, CPO mice exhibit impaired responsivity to arginine, but not glucose, in isolated islets. This impaired amino acid responsivity prior to the development of diabetes may contribute to their increased susceptibility to diabetes. 239 Withdrawn 240 Sustainable Childhood Obesity Prevention Through Community Engagement (SCOPE): A Qualitative Study BONNIE MCINTOSH * , AMELIA DALY, LOUISE MASSE, JOAN WHARF HIGGINS, PATTI-JEAN NAYLOR, SHAZHAN AMED Vancouver, BC; Victoria, BC Rates of childhood obesity are on the rise and as a result, so are the number of children and youth with type 2 diabetes. SCOPE is a community-based participatory research (CBPR) project aimed at preventing childhood obesity by supporting community-driven action. The objective of this study was to describe community perspectives on SCOPE's rst phase of implementation in two pilot cities in British Columbia (BC) e Prince George (PG) and Abbotsford (AB). Qualitative methods were implemented to obtain perspectives about SCOPE from two groups: SCOPE community coordinators and community stakeholders. Participants were recruited via email and/or by telephone. Coordinators completed a telephone interview. Stake- holders completed a telephone interview and/or a questionnaire. Of 17 participants, 2 were community coordinators and 15 were community stakeholders. Coordinators and stakeholders similarly interpreted SCOPE as a childhood obesity prevention program focused on community engagement that raises awarenessabout childhood obesity and engages all sectors of a community.Overall, the project was valued by participants; particularly, related to its role in facilitating partnerships, providing evidence-based resources, and contributing funding. Participants similarly described barriers to achieving healthy lifestyles including those related to the built environment, and social, behavioural, and economic obstacles. Participants expressed positive perspectives regarding SCOPE's CBPR approach and felt that the project is sustainable. Study results indicate that SCOPE is a valued and successful CBPR project that has had a positive impact on supporting childhood obesity prevention at the community level. Further, it has a strong potential to be sustainable and applicable to other BC cities. 241 Process Evaluation of a BC Initiative: Sustainable Childhood Obesity Prevention Through Community Engagement (SCOPE) AMELIA C. DALY * , BONNIE MCINTOSH, LOUISE MASSE, JOAN WHARF HIGGINS, PATTI-JEAN NAYLOR, SHAZHAN AMED Vancouver, BC; Victoria, BC SCOPE focuses on the prevention of childhood obesity through community based participatory research (CBPR) and demonstrates the need for more up-streamapproaches. SCOPE was piloted in two cities in British Columbia (BC), Prince George (PG) and Abbotsford (AB). SCOPE's objective was to use an integrated community approach to develop a BC model of childhood obesity prevention that focuses on multi-sectoral engagement and supports community- based, community-driven action facilitated by best evidence. Process evaluation of SCOPE included tracking community engagement (CE) activities and collecting data using surveys, website analytics, budget tracking, quarterly reports, meeting minutes, and qualitative reporting. The results yielded a total of 234 CE activities: 63% in AB, 30% in PG, and 7% at the central SCOPE ofce. Most CE activities occurred in person (84%). SCOPE engaged multiple sectors including: education (23%), media (7%), private business (9%), and non- governmental organizations (35%). Extensive CE activities in pilot cities led to the establishment of multi-sector, collaborative part- nerships, which subsequently led to sustainable community-led action that leveraged existing community strengths. For example, in AB, SCOPE partnered with the local health authority and today, all public health nurses administering 12-month immunizations teach young families about healthy behaviours using an evidence-based health message. In PG, a leadership training program called Kids Helping Kidsresulted from a partnership between SCOPE, the City of PG and Action School BC!. SCOPE, using a CBPR approach, has been effective in establishing multi-sector engagement and collaborative partnerships that build on existing community strengths and resources to ensure a sustainable outcome. 242 Effect of Modest Weight Loss on Long-term Health Outcomes in Patients Newly Diagnosed with Type 2 Diabetes Mellitus (T2DM) in Canada PIERRE JOHANSEN, ANNA R. TESCHEMAKER, NICOLE C. BRAZIER * , CHERYL NESLUSAN, MICHAEL WILLIS Lund, Sweden; Raritan, NJ; Toronto, ON Being overweight adversely affects health outcomes in patients with T2DM, therefore, weight management is a cornerstone of treatment. The objective of this study was to examine the impact of modest weight reduction on long-term health outcomes for Abstracts / Can J Diabetes 36 (2012) S24eS76 S69

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Abstracts / Can J Diabetes 36 (2012) S24eS76 S69

overweight and obese children were more likely to say their bodysize was too big compared to normal weight children (OR¼7.7 and30.6, respectively). Overweight and obese children were also morelikely than normal weight children to respond “no” to ‘Do you likethe way you look now?’ (OR¼2.4 and 7.8, respectively). BMI z-scorewas associated with lower scores for global self-concept (b¼-1.3),intellectual and school status (b¼-1.5), and physical appearanceand attributes (b¼-1.3). The poor self-concept and body sizedissatisfaction of Cree children with excess weight may lead todisordered eating or psychological outcomes such as depression.The psychosocial implications of obesity in First Nations childrenmay be as important as chronic disease considerations.

238

Early Overnutrition Impairs Arginine Responsivity in Diabetes-Susceptible Swiss Webster MiceMARIA M. GLAVAS*, JESSICA K. FOX, XIAOKE HU, JAMES D. JOHNSON,TIMOTHY J. KIEFFERVancouver, BC

Childhood obesity and rapid early growth increase the risk fortype 2 diabetes. Such early overnutrition can be modelled in miceby reducing litter size, which results in rapid weight gain, hyper-insulinemia and hyperleptinemia in early life. We have previouslydemonstrated that such chronic postnatal overnutrition (CPO) inSwiss Webster mice significantly increases susceptibility to dia-betes, characterized by profound hyperglycemia and subsequentbeta-cell failure. In the present studies we examined whether CPOmice exhibit altered responsivity to glucose and/or arginine inisolated islets prior to the onset of hyperglycemia.

Litters from Swiss Webster mice were culled to 3 (CPO) or 10(control, CTR) pups shortly after birth and maintained ona moderate fat (25 kcal%) diet. At 11 weeks of age islets were iso-lated from non-diabetic mice and perifused with 3 and 20 mmol/Lglucose followed by 15 mmol/L arginine, for measurement ofinsulin responsivity. Total pancreatic insulin content was measuredin a separate cohort by insulin ELISA.

Both CTR and CPO mice exhibited similar insulin secretion inresponse to 3 and 20mmol/L glucose. In contrast, whereas CTRmiceshowed a dramatic insulin response to arginine, CPO mice failed torespond. Total pancreatic insulin content did not differ between CTRand CPO mice. Thus, CPO mice exhibit impaired responsivity toarginine, but not glucose, in isolated islets. This impaired amino acidresponsivity prior to the development of diabetesmay contribute totheir increased susceptibility to diabetes.

239

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240

Sustainable Childhood Obesity Prevention Through CommunityEngagement (SCOPE): A Qualitative StudyBONNIE MCINTOSH*, AMELIA DALY, LOUISE MASSE,JOAN WHARF HIGGINS, PATTI-JEAN NAYLOR, SHAZHAN AMEDVancouver, BC; Victoria, BC

Rates of childhood obesity are on the rise and as a result, so are thenumber of children and youth with type 2 diabetes. SCOPE isa community-based participatory research (CBPR) project aimed atpreventingchildhoodobesitybysupportingcommunity-drivenaction.The objective of this studywas to describe community perspectives onSCOPE's first phase of implementation in two pilot cities in BritishColumbia (BC) e Prince George (PG) and Abbotsford (AB).

Qualitative methods were implemented to obtain perspectivesabout SCOPE from two groups: SCOPE community coordinators andcommunitystakeholders. Participantswererecruitedviaemail and/or

by telephone. Coordinators completed a telephone interview. Stake-holders completed a telephone interview and/or a questionnaire.

Of 17 participants, 2 were community coordinators and 15 werecommunity stakeholders. Coordinators and stakeholders similarlyinterpreted SCOPE as a childhood obesity prevention programfocused on community engagement that “raises awareness” aboutchildhood obesity and “engages all sectors of a community.”Overall,theprojectwasvaluedbyparticipants; particularly, related to its rolein facilitating partnerships, providing evidence-based resources,and contributing funding. Participants similarly described barriersto achieving healthy lifestyles including those related to the builtenvironment, and social, behavioural, and economic obstacles.Participants expressed positive perspectives regarding SCOPE'sCBPR approach and felt that the project is sustainable.

Study results indicate that SCOPE is a valued and successful CBPRproject that has had a positive impact on supporting childhoodobesity prevention at the community level. Further, it has a strongpotential to be sustainable and applicable to other BC cities.

241

Process Evaluation of a BC Initiative: Sustainable ChildhoodObesity Prevention Through Community Engagement (SCOPE)AMELIA C. DALY*, BONNIE MCINTOSH, LOUISE MASSE,JOAN WHARF HIGGINS, PATTI-JEAN NAYLOR, SHAZHAN AMEDVancouver, BC; Victoria, BC

SCOPE focuses on the prevention of childhood obesity throughcommunity based participatory research (CBPR) and demonstratestheneed formore “up-stream” approaches. SCOPEwaspiloted in twocities in British Columbia (BC), Prince George (PG) and Abbotsford(AB). SCOPE's objective was to use an integrated communityapproach to develop aBCmodel of childhoodobesity prevention thatfocuses on multi-sectoral engagement and supports community-based, community-driven action facilitated by best evidence. Processevaluation of SCOPE included tracking community engagement (CE)activities and collecting data using surveys,website analytics, budgettracking, quarterly reports, meeting minutes, and qualitativereporting. The results yielded a total of 234 CE activities: 63% in AB,30% in PG, and 7% at the central SCOPE office. Most CE activitiesoccurred inperson (84%). SCOPE engagedmultiple sectors including:education (23%), media (7%), private business (9%), and non-governmental organizations (35%). Extensive CE activities in pilotcities led to the establishment of multi-sector, collaborative part-nerships, which subsequently led to sustainable community-ledaction that leveraged existing community strengths. For example, inAB, SCOPE partnered with the local health authority and today, allpublic health nurses administering 12-month immunizations teachyoung families about healthy behaviours using an evidence-basedhealth message. In PG, a leadership training program called ‘KidsHelpingKids’ resulted froma partnership between SCOPE, the City ofPG and Action School BC!. SCOPE, using a CBPR approach, has beeneffective in establishing multi-sector engagement and collaborativepartnerships that build on existing community strengths andresources to ensure a sustainable outcome.

242

Effect of Modest Weight Loss on Long-term Health Outcomes inPatients Newly Diagnosed with Type 2 Diabetes Mellitus (T2DM)in CanadaPIERRE JOHANSEN, ANNA R. TESCHEMAKER, NICOLE C. BRAZIER*,CHERYL NESLUSAN, MICHAEL WILLISLund, Sweden; Raritan, NJ; Toronto, ON

Being overweight adversely affects health outcomes in patientswith T2DM, therefore, weight management is a cornerstone oftreatment. The objective of this study was to examine the impact ofmodest weight reduction on long-term health outcomes for