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Impact of a Postpartum Lifestyle Intervention on Lactation outcomes, Breastmilk Composition and Infant Growth

产后生活方式干预对哺乳结果、母乳成分和婴儿生长的影响

基本信息

批准号：
10427595
负责人：
Patrick Catalano
金额：
$ 26.52万
依托单位：
BRIGHAM AND WOMEN'S HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-09-20 至 2024-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10427595
关键词：
Abbreviations Address Adherence Attenuated Body mass index Breast Feeding C-reactive protein Caloric Restriction Child Child Health Clinical Control Groups Data Energy Metabolism Environment Exclusive Breastfeeding Exercise Failure Fatty Acids Fatty acid glycerol esters Generations Goals Growth Health Hospitals Human Milk Infant Infant Health Inflammation Inflammatory Insulin Resistance Intake Intention Interleukins Intervention Knowledge Lactation Length Leptin Life Style Malignant neoplasm of ovary Maternal Health Maternal and Child Health Measurement Measures Mediating Mediator of activation protein Medical center Mediterranean Diet Metabolic Methods Moderate Exercise Mothers Nutritional Obesity Oligosaccharides Outcome Overweight Parents Patient Recruitments Pattern Phase Postpartum Period Pregnancy Preparation Principal Component Analysis Protocols documentation Proxy Public Health Questionnaires Randomized Randomized Controlled Trials Rest Sampling Subgroup Supervision Thinness Time Variant Visit Weight Woman cardiometabolism critical period diabetes risk dietary exercise intervention experience group intervention improved improved outcome indexing infant adiposity inflammatory marker insulin sensitivity lifestyle intervention malignant breast neoplasm maternal obesity metabolomics mother nutrition nutrition offspring pediatrician recruit response standard care systemic inflammatory response trial design

项目摘要

PROJECT SUMMARY/ABSTRACT Over 50% of women in the U.S. are overweight or obese when they enter pregnancy. Women with obesity are 2.6 times more likely to experience lactation failure, independent of intention to breastfeed, contributing to adverse health outcomes for two generations. Inflammation, a metabolic hallmark of obesity, has been associated with lactation failure, but mechanistic studies evaluating the mechanisms underlying lactation failure in women are sparse. We now have a unique opportunity to address this knowledge gap through The Lifestyle Intervention in Preparation for Pregnancy (LIPP) study, a randomized controlled trial of a lifestyle (nutritional and exercise) intervention in women with overweight and class I obesity who are planning a subsequent pregnancy in the next two years. LIPP participants are recruited three months post-partum and after baseline metabolic measurements, are randomized to a closely supervised lifestyle intervention, consisting of caloric restriction with a shift to a Mediterranean diet pattern and exercise for 9-21 months, or standard care. The LIPP Lactation study seeks to understand the impact of this intervention on lactation outcomes and breastmilk composition. Our overall hypothesis is that a favorable post-partum metabolic environment has a durable impact on the metabolic health of two generations through longer lactation duration and altered breastmilk fatty acid composition. We will evaluate this hypothesis through the following specific aims: Aim 1. To quantify the effect of a post-partum lifestyle intervention on lactation duration and identify underlying mechanisms; Aim 2. To determine the impact of a lifestyle intervention and subsequent dietary and energy expenditure patterns on breastmilk fatty acid composition and infant growth; Exploratory Aim 3. To identify the impact of maternal lifestyle intervention on breastmilk metabolomic patterns. The post-partum period has been under-leveraged as a critical period to improve lifelong maternal and infant health. Scientifically, the LIPP Lactation study will fundamentally and rigorously inform our understanding of the mechanisms underlying lactation outcomes and the maternal predictors of breastmilk composition by leveraging the RCT design of the parent LIPP study. From a public health standpoint, LIPP Lactation provides a unique opportunity to identify discrete metabolic targets for intervention in women with obesity, to improve the lifelong health of two generations.

项目总结/文摘