Targeting added sugar to improve dietary intake in high-risk adolescents

项目摘要 本K01提案的总体目标是为Gina Tripicchio，PhD，MSEd提供培训， 指导建立一个独立的研究计划，重点是创新的行为干预， 改善高危青少年的饮食摄入。添加糖（AS）是饮食干预的主要目标， 青少年;它提供多余的热量，没有营养益处，青少年消耗更多的AS， 任何其他年龄组。高危青少年（例如，来自低收入社区的种族/族裔少数群体）， 肥胖和与饮食有关的慢性疾病的发病率高得不成比例， 替补演员为这一高危人群开展有效试验的一个关键限制是缺乏信息 与AS摄入量相关的关键因素。为了解决这一差距，该项目旨在描述关键驱动因素 使用生态瞬时评估（EMA）的高风险青少年AS摄入量。EMA允许 实时检查特定的饮食影响，同时减少回忆偏差和参与者 负担这些丰富的信息可以用来指导开发量身定制的、突出的行为 干预此外，最近出现了AS的客观稳定同位素生物标志物，可以用于 解决饮食干预中自我报告结果的关键局限性。将进行两项研究， 达到这个项目的目的。研究1（1 - 2年）将从40名青少年中收集EMA，并检查 目标样品中δ 13 C生物标志物的可行性和可接受性。研究2（3 - 5年），将实施一项 试点随机对照试验，在70名12 - 16岁的青少年样本中测试一种情境定制的、技术丰富的干预措施 来自费城北部的一个低收入社区。为期3个月的行为干预，包括 以小组为基础的会议，互动短信和家长支持，将旨在减少AS摄入量相比， 一个教育比较组。通过δ 13 C生物标志物测量的AS变化将评估为 主要结果和饮食质量的总体变化将作为次要结果进行检查。严格的 培训计划将补充拟议的研究，促进导师谁是营养，饮食， 行为，数字干预，统计和儿科人群的行为试验。具体培训 目标包括：1）生态瞬时评估，2）多层次统计建模，3）评估 客观的营养生物标志物和4）设计和实施行为干预，以解决 差距。天普大学的肥胖研究和教育中心是这项工作的理想场所， 它提供广泛的研究资源，并接触到各种各样的高危青年。K01将 提供关于高危青少年AS摄入的新信息，并测试有针对性的定制干预措施， 减少消费。研究结果将支持完全把握度R01试验的应用。该奖项持有 对公共卫生影响的重大潜力，并将使特里皮奇奥博士建立一个严格的计划， 开展研究，以改善易受伤害青少年的饮食摄入，减少与饮食有关的慢性病风险。

PROJECT ABSTRACT The overall goal of this K01 proposal is to provide Gina Tripicchio, PhD, MSEd, with the training and mentorship to establish an independent program of research focused on innovative behavioral interventions to improve dietary intake in high-risk adolescents. Added sugar (AS) is a prime target for dietary intervention in adolescents; it contributes excess calories with no nutritional benefits, and adolescents consume more AS than any other age group. High-risk adolescents (e.g., racial/ethnic minorities from low-income communities), experience disproportionately higher rates of obesity and diet-related chronic diseases yet remain understudied. A key limitation in developing efficacious trials for this high-risk group is the dearth of information about key factors associated with AS intake. To address this gap, this project aims to characterize key drivers of AS intake in high-risk adolescents using ecological momentary assessment (EMA). EMA allows for the examination of contextually specific dietary influences in real-time, while reducing recall bias and participant burden. This rich information can be used to guide the development of a tailored, salient behavioral intervention. Additionally, an objective stable isotope biomarker of AS has recently emerged and can be used to address key limitations of self-reported outcomes in dietary interventions. Two studies will be employed to meet the aims of this project. Study 1 (years 1-2), will collect EMA from 40 adolescents and examine the feasibility and acceptability of the δ13C biomarker in the target sample. Study 2 (years 3-5), will implement a pilot RCT to test a contextually tailored, technology-enriched intervention in a sample of 70 adolescents, 12-16 years of age, from a low-income community in north Philadelphia. A 3-month behavioral intervention, including group-based sessions, interactive text messaging and parent support, will aim to reduce AS intake compared to an educational comparison group. Changes in AS, as measured by the δ13C biomarker, will be assessed as the primary outcome and total changes in diet quality will be examined as a secondary outcome. A rigorous training plan will complement the proposed research, facilitated by mentors who are experts in nutrition, eating behavior, digital interventions, statistics, and behavioral trials in pediatric populations. Specific training objectives include: 1) ecological momentary assessment, 2) multi-level statistical modeling, 3) assessment of objective nutritional biomarkers and 4) designing and implementing behavioral interventions to address disparities. Temple University's Center for Obesity Research and Education is an ideal setting for this work as it provides extensive research resources and access to a population of diverse, high-risk youth. This K01 will provide novel information about AS intake in high-risk adolescents and test a targeted, tailored intervention to reduce consumption. Findings will support the application of a fully powered R01 trial. This award holds significant potential for public health impact and will enable Dr. Tripicchio to establish a rigorous program of research to improve dietary intake and reduce diet-related chronic disease risk in vulnerable adolescents.