By JONEL ALECCIA, Associated Press

A new federal estimate shows a rise in prediabetes among American adolescents, a finding that is spurring concerns about the health of U.S. children — and the way Trump administration health officials are conducting research and communicating information, experts said.

In 2023, nearly 1 in 3 U.S. youngsters ages 12 to 17 had prediabetes, according to recently released data from the U.S. Centers for Disease Control and Prevention. That is far higher than a previous estimate that the condition affects about 1 in 5 kids.

There’s no question that prediabetes in U.S. youth is a serious concern. The condition puts them at risk for developing Type 2 diabetes, plus heart disease, stroke and other metabolic problems.

But scientists who study and treat diabetes noted that CDC officials released only a 600-word online summary of their new findings — not the raw data nor a peer-reviewed published paper describing how they arrived at the new figure. The agency also changed the methodology used to calculate the higher estimate without a detailed explanation.

That underscores questions about the accuracy of information being released by America’s top public health agency following widespread staff cuts in recent months, experts said.

“For any of the national health organizations now being decimated by firings (and) layoffs, I am going to be skeptical of data updates until there is transparency and clarity on the source of the data and analysis,” said Christopher Gardner, an expert in diabetes and nutrition at Stanford University.

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The new analysis used “the latest science and technologies” and “the most updated methodology as science is continually evolving,” said Melissa Dibble, a CDC spokesperson.

“These new data highlight the magnitude of prediabetes among adolescents and serve as a critical wake-up call for the nation,” Dibble said in a statement.

The new analysis relied on the long-running National Health and Nutrition Examination Survey, which collects information on demographic and health indicators via interviews, examinations and laboratory testing.

Prediabetes is a precursor to diabetes, a disease in which sugar builds up in the blood. Prediabetes is characterized by slightly elevated blood sugar levels, indicating that a person may progress to developing Type 2 diabetes.

The researchers collected data about blood sugar levels in U.S. youth — but they also changed the methodology used to analyze the information, dramatically increasing the estimate of how common prediabetes is.

The new analysis concludes that about 8.4 million U.S. adolescents — or nearly 33% — have prediabetes. That’s up from an estimate of 18% published in a 2020 peer-reviewed paper, which used the previous methodology. If the new methodology had been applied to that 2005-2016 data, the estimate would have been about 28%.

The increase from 28% to nearly 33% is not statistically significant, even though it reflects an apparent rise in prediabetes among kids, said Steven Kahn, a diabetes researcher at the UW Medicine in Seattle and editor-in-chief of the journal Diabetes Care. He said it’s concerning that CDC officials provided such limited information about the new analysis. Such findings typically have been published in the agency’s Morbidity and Mortality Weekly Report or submitted to a scientific journal for peer review and publication.

“I would like to believe it doesn’t diminish the quality of CDC data,” said Kahn. “However, because there’s no raw data to look at, none of us can look at it to better understand where these numbers are derived from and what they really mean.”

Dr. Samar Hafida, an endocrinologist and representative for the American Diabetes Association, said the new analysis “wasn’t very transparent,” but she noted that the CDC’s updated estimate generally squares with what doctors are seeing — an increase in youth with obesity and elevated blood sugar levels that put them at risk for serious future health problems.

“It could be that maybe the number slightly inflated, but I would hesitate to dismiss it,” she said.

It remains unclear what proportion of kids with prediabetes will go on to develop the disease, noted Dr. Dana Dabelea, a researcher who studies pediatric diabetes at the University of Colorado. Blood sugar levels can rise in response to developmental changes during puberty and then resolve later, she said.

Still, confirmed rates of obesity and diabetes among kids are rising.

The diabetes association recommends that children and adolescents should be screened for Type 2 diabetes starting at age 10 if they are overweight or have obesity or another risk factor for the disease. Focusing on healthy diet, exercise and other lifestyle factors is key, noted Hafida.

“It’s still a call to action,” she said. “There will likely be a surge in early onset Type 2 diabetes that we are not prepared to deal with.”

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

When the likes of Wolverine, Cyclops, Nightcrawler and Storm convert the downtown Minneapolis Club into Professor Charles Xavier’s renowned institute for mutant superheroes this weekend, Daryl Lawrence will be there with pride, but not just because of the colorful sessions he oversees as program director for “The Uncanny Experience,” a two-day immersive fandom convention celebrating all things X-Men.

This is the third year “The Uncanny Experience” has geeked out in the Twin Cities, but it’s the first year Lawrence will host a book launch for his 512-page reference guide to a fan-favorite Marvel Comics series from the 1980s and ’90s.

Frederick Melo

There have been more than 130 distinct mutant superhero spin-off series since the first “X-Men” comic launched in 1963, but if you’re assuming that “True North,” his issue-by-issue comic book tell-all, focuses on a popular X-title like the “X-Men,” “X-Men Unlimited,” “X-Factor” or “X-Force,” you’d be wrong, eh?

Lawrence — not only an author but the facilities manager for the University of Minnesota’s Bell Museum — started running down a distinctly Canadian rabbit hole a decade ago.

It was the same rabbit hole I fell down around September 1985. As a youngster growing up in Boston, I was an awkward 8-year-old at the time, entering fourth grade a year young, and the colorful comic book rack in the Dedham Mall magazine stand glowed at me reassuringly.

The 1985 “X-Men/Alpha Flight” crossover ran $1.50 per comic — no small sacrifice for my working-class parents — and by the time I was halfway done with the two-part mini-series, I was completely hooked, but not on the X-Men.

Like Lawrence, I was smitten with the X-Men’s emotionally fraught Canadian counterparts, a barely-holding-its-own superhero team known as Alpha Flight, who were constantly bumping heads with their government handlers in Ottawa while darting around Vancouver, Toronto, Quebec and the Yukon.

The cover page from “True North: A Complete Reference Guide and Analysis of Alpha Flight’s First Volume,” by Daryl Lawrence, the facilities manager for the University of Minnesota’s Bell Museum. (Courtesy of Daryl Lawrence)

There was the diminutive Puck, whose tiny body could hurdle through foes like a bowling ball, and Sasquatch, the scientist Walter Langkowski who transformed into a Hulk-like mythical Great Beast of the North with but a thought. And then there was Snowbird, an Inuit demi-goddess whose mission on Earth was to slay the mythical Great Beasts of the North. (If you want to see how that storyline plays out, pick up issue No. 23, circa mid-1985).

Led by a man in a super-suit, code name Guardian, and quickly replaced by his widow, code name Vindicator, the troubled team debuted in the pages of the X-Men comics in April 1979, where they made a failed attempt to retrieve their former teammate, Wolverine. They gained their own ongoing monthly series in 1983, and what a series of dramatic mishaps followed!

Superheroes when I needed them

The semi-tragic “Alpha Flight” — which still draws fan pages on Facebook and across the Internet — was penned and drawn for its first 28 glorious issues by comics genius John Byrne, who was born in England but spent most of his childhood moving about Canada. Byrne is perhaps better known for his work on the “X-Men” and “Superman,” but he and subsequent writers — notably the talented Bill Mantlo — struck a kind of storytelling gold in the first 60 issues or so of the original “Alpha Flight,” which ran for 130 issues from 1983 to 1994.

I have those first 60 issues bagged and boxed in my basement, where they live on, testament to a childhood that saw its share of upheaval. You see, for a time, Alpha Flight was like surrogate family. In sixth grade, I shifted from being bused to various under-resourced and fight-prone Boston public schools to being a day student at a suburban boarding school that was even more academically and culturally challenging.

My parents, Caribbean immigrants who ran a home daycare, had no way of preparing me for these posh young students and their unfathomable stories about ski vacations and summer trips abroad. Then, a few months into that sixth grade year, a fire destroyed our home and business, leaving us destitute. I was at the mercy of the wind, or so it felt, and I’d spend the rest of the school year wafting from home to home, living with whatever kind family would take me in — my grandmother’s pastor, my mother’s church friend, my older sister’s school teacher, a middle school classmate.

None to my knowledge were Canadian, but they were superheroes when I needed them.

It’s a fascinating thing to bounce from home to home in quick succession like an unofficial foster child. One particular host, my friend and classmate Patrick Keefe, would go on to become a true-crime author of much renown. His family fed me my first taste of asparagus, which I spit up in disgust and hid in my napkin on his dining room table. Pat’s 2018 best seller, “Say Nothing,” about the lives of unlikely militants in the Irish Republican Army, is now an FX television series of the same name.

What does any of this have to do with a dysfunctional family of Canadian superheroes, and why does “True North: A Complete Reference Guide and Analysis of Alpha Flight’s First Volume” run to 512 pages?

The answer for me is that my “Alpha Flight” collection was the one treasured possession I carted from house to house that tumultuous sixth grade year. The comics were full of stories that had to be read and re-read, absorbed — as Lawrence pointed out to me this week — like a soap opera.

Character in the closet

For “True North,” Lawrence interviewed six artists, editors and writers from the series, but not the elusive Byrne or the prolific Mantlo, a competitive rollerblader who suffered permanent brain damage after being struck by a car in 1992. Their analysis peppers all 512 pages, which offer insight into the choices made across all 130 issues, two annuals and guest appearances in other Byrne and Mantlo comics like “The Incredible Hulk” and “Rom: Spaceknight.”

For instance, Lawrence maintains that a particularly complex character — the abrasive Northstar, a competitive skier and former Quebec separatist with a sharp tongue and Spock-like elven ears — was written from the start by Byrne and fellow “Alpha Flight” creator Chris Claremont to be gay — Marvel’s first homosexual superhero! — 13 years before Northstar officially came out of the closet in 1992.

“John Byrne wrote him as a gay man, but the recently-departed (Marvel editor) Jim Shooter said ‘No, we can’t say that,’” said Lawrence, who noted Marvel writers found a way to hint at his sexuality as far back as 1986. “Under Bill Mantlo, he starts getting sick and starts coughing a lot.”

Northstar’s unnamed illness — the subject of an eight-issue story arc — seemed to mirror the nation’s AIDS epidemic at the time, catching the interest of gay magazines like The Advocate, who were soon to be disappointed.

In issue No. 50, Loki — yes, that Loki — reveals the origin of Northstar’s mystery disease: He’s actually an ailing elf.

“Loki says, you’re really an elf and you need to go back to your people and they will help you out because you have an ‘elf sickness,’” said Lawrence, noting some fans never forgave Mantlo for doing what he had to do to appease his higher-ups. “That whole storyline was designed for him to get AIDS and die of it.”

Given the opportunity to address one of the most serious and sensitive issues of the day, Marvel had blinked.

To the chagrin of The Advocate and probably more than a few Marvel writers, the closeted Northstar lived on, eventually joining the X-Men, and, much like myself, getting married around 2012 and enjoying a long and colorful life.

Lawrence’s softcover “True North” retails for $30 at Barnes & Noble. My Christmas wish-list is set!

IF YOU GO

The Uncanny Experience runs 10 a.m. to 5 p.m. Saturday and Sunday at the Minneapolis Club, 729 Second Ave. S.

Tickets start at around $100 or $11.50 for kids 12 and under.

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Stories of the Lake Phalen dragon, MPR raccoon and Hamm’s Beer Bear will be brought to life on St. Paul sidewalks this summer. The second season of Hidden Herald, a series of St. Paul-inspired audio plays, is launching Friday.

The project is created by Wonderlust Productions, a theater storytelling organization in Frogtown. More than 36 QR codes will be scattered throughout downtown St. Paul and Payne-Phalen this year. The QR codes link to short audio plays that take place where the listener is standing. The plays all begin with an introduction from the pigeon Herald, the project’s mascot.

“It’s a great opportunity to have an excuse to explore your city more,” said Alan Berks, Co-Artistic Director of Wonderlust Productions. “It’s kind of fun to stand in a spot and suddenly have a different way of looking at what happens in that place.”

This year’s project includes two series targeted towards kids. One is inspired by “Spy Kids” and another tells tales of the Lake Phalen dragon. Berks said the project will also feature a “Twilight Zone” inspired series.

Season two of Hidden Herald will kick off with a scavenger hunt from this weekend, July 11-13. Participants who complete the scavenger hunt will be entered in a raffle to win tickets to Pangea World Theater, Ten Thousand Things, Jungle Theater and the History Theatre.

People can sign up online at wlproductions.org to receive an email Friday with details of the scavenger hunt.

This year, people can access a digital map of the QR codes (wlproductions.org/hidden-herald/) or they can pick up a free printed map at the following St. Paul locations:

Kendall’s Ace Hardware, 840 Payne Ave.
Lost Fox, 213 Fourth St. E. #100
Gallery of Wood Art, Landmark Center, 75 W. Fifth St.
Landmark Jewelers, 402 St. Peter St.
MetroNOME Brewery, 385 Broadway St.
St. Paul Farmer’s Market, every Saturday, 7 a.m. to 1 p.m., and Sunday, 8 a.m. to 1 p.m., 290 Fifth St. E.
Kick it at Kellogg event, 10 to 11 a.m. Saturday, 62 Kellogg Blvd

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By HOLLY RAMER and MIKE CATALINI, Associated Press

CONCORD, N.H. (AP) — The legal fight over President Donald Trump’s order ending birthright citizenship is advancing on a path toward the U.S. Supreme Court.

A New Hampshire federal judge on Thursday issued a ruling prohibiting the president’s January executive order ending birthright citizenship for children born to those without legal status from taking effect anywhere in the U.S.

The judge’s preliminary injunction and certification of a class-action lawsuit blocks the order, though it included a seven-day stay to allow for appeal.

The district court judge’s decision comes less than a month after the Supreme Court limited lower courts from issuing nationwide injunctions without settling the underlying question of the constitutionality of the president’s order. The high court also left open the possibility that birthright citizenship challenges could remain blocked nationwide.

Here’s what to know about birthright citizenship and what happens next.

What birthright citizenship means

Birthright citizenship makes anyone born in the United States an American citizen, including children born to mothers in the country illegally.

The practice goes back to soon after the Civil War, when Congress ratified the Constitution’s 14th Amendment, in part to ensure that Black people, including former slaves, had citizenship.

“All persons born or naturalized in the United States and subject to the jurisdiction thereof, are citizens of the United States,” the amendment states.

Thirty years later, Wong Kim Ark, a man born in the U.S. to Chinese parents, was refused reentry into the U.S. after traveling overseas. His lawsuit led to the Supreme Court explicitly ruling that the amendment gives citizenship to anyone born in the U.S., no matter their parents’ legal status.

It has been seen since then as an intrinsic part of U.S. law, with only a handful of exceptions, such as for children born in the U.S. to foreign diplomats.

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Trump has long said he wants to do away with birthright citizenship

Trump’s executive order, signed in January, seeks to deny citizenship to children who are born to people who are living in the U.S. illegally or temporarily. It is part of the hard-line immigration agenda of the president, who has called birthright citizenship a “magnet for illegal immigration.”

Trump and his supporters focus on one phrase in the amendment — “subject to the jurisdiction thereof” – saying it means the U.S. can deny citizenship to babies born to women in the country illegally.

A series of federal judges have said that is not true, and issued nationwide injunctions stopping his order from taking effect.

“I’ve been on the bench for over four decades. I can’t remember another case where the question presented was as clear as this one is. This is a blatantly unconstitutional order,” U.S. District Judge John Coughenour said at a hearing earlier this year in his Seattle courtroom.

The justices didn’t say if Trump’s order is constitutional

The high court’s ruling was a major victory for the Trump administration in that it limited an individual judge’s authority in granting nationwide injunctions based on individual plaintiffs.

The administration hailed the ruling as a monumental check on the powers of individual district court judges, whom Trump supporters have argued want to usurp the president’s authority with rulings blocking his priorities around immigration and other matters.

But the Supreme Court did not address the merits of Trump’s bid to enforce his birthright citizenship executive order, and it left the door open for class action lawsuits challenging it.

The Supreme Court said district judges generally can’t issue nationwide injunctions. But the court didn’t rule out whether judges could accomplish much the same thing by a different legal means, a class action.

Various legal pathways

New Hampshire District Court Judge Joseph Laplante’s decision comes amid legal challenges to the president’s order in district and appellate courts across the country.

Among the other cases pending are lawsuits brought by some two dozen states and cities, immigrant rights advocates and mothers and mothers-to-be.

A district court judge in Maryland is considering arguments over how to proceed since the Supreme Court’s opinion limiting nationwide injunctions.

New Jersey and other states’ attorneys general are arguing a nationwide pause of the order is warranted under the high court’s recent opinion and that it’s up to federal government to propose other remedies for the courts to consider.

Boston College law professor Daniel Kanstroom, an immigration law expert, said he thinks the case is bound for the Supreme Court.

“The stakes in this case could not possibly be higher,” he said. “It affects millions of people. It affects the whole nature of our immigration system. And it in many ways, it affects the continuing question of how we reacted to slavery and to the Civil War and what the 14th Amendment was about in the first place.”

Associated Press writers Tim Sullivan, Alanna Durkin Richer, Mark Sherman and Lindsay Whitehurst in Washington contributed to this report.