The question:

What is the influence of enhanced physical activity levels and enhanced primary school movement education on biomarkers associated with control of blood sugar and fats?

Physical activity levels have fallen dramatically in recent decades around the world, with changes in lifestyle, and increased mechanisation in the home and in the workplace. The consequences of these changes are widespread, and include major impacts on obesity, and a number of diseases, such as diabetes. The prevalence of type 2 diabetes is rising rapidly across the globe. Traditionally, type 2 diabetes has been considered a disease of the middle-aged and older adult. However in recent times, the age of onset has decreased and cases of type 2 diabetes in adolescents and children have been reported worldwide. The incidence of type 2 diabetes in young people is increasing in parallel with overweight and obesity.

In adults, a number of studies have demonstrated the protective effect of regular physical activity against the development of type 2 diabetes. Two landmark studies from the USA and Finland demonstrated that regular physical activity (at least 150 minutes per week), along with dietary changes, reduced the risk of developing type 2 diabetes by 58% in people with impaired glucose tolerance.

Research of this nature does not yet exist in young people; however observational data have indicated a strong link between physical activity levels and insulin resistance (a key metabolic precursor of the development of type 2 diabetes) in children, indicating that measurements of glucose and insulin metabolism are key components of an interventional involving physical activity.

Glucose tolerance status is most accurately measured by an oral glucose tolerance test (OGTT). However, this involves fasting overnight, two blood tests, 2 hours apart, and having a glucose drink (which can induce nausea).

A good alternative is to estimate insulin sensitivity using fasting blood glucose and insulin levels. We will also be measuring indicators of cardiovascular disease including blood triglycerides (fats), cholesterol (HDL and LDL fractions) and glycated haemoglobin, an indicator of persistently high blood sugar levels.