Clinical and experimental studies of obesity

我们建议继续进行一项最完整的前瞻性纵向研究， 儿童肥胖症高危人群的健康发展。这项研究对72名9至10岁的儿童进行了研究， 年龄，选择的基础上，母亲超重或瘦，实现了其最初的目标，否定了 人们普遍认为，一个较低的总能量消耗预测身体的大小和组成，早在一 年龄。研究发现，在2岁时，超重母亲的33名儿童与超重母亲的儿童没有差异。 37个孩子的瘦母亲在任何方面的身体组成。到4岁时，高危儿童 更大的体重、体重指数（BMI）、皮褶厚度和瘦体重。到6岁时， 有显着更高的水平（25%对19%）（6.7公斤至4.8）的身体脂肪。10个超过了85个 BMI百分位数（比值比15.7）。 我们现在建议研究这些受试者进入青春期的发展，重点是行为 身体大小的决定因素：能量摄入和体力活动。我们先来评估一下 家庭脆弱性对生长和发育的影响。接下来，我们将测试食物摄入量的影响， 身体活动对身体成分的影响，并确定在何种程度上的影响， 脆弱性是由这些行为介导的。能量摄入将通过食物记录、召回、 实验室方案和2份问卷。身体活动将通过活动监测器进行评估， 电视和电脑使用的监视器和召回。这些努力将得到加强， 样本维持率，10年时为92%（最初78例受试者中的72例），期间无受试者丢失 了过去5年家长们表示，他们将继续到补助期结束。这些受试者将 使其有可能评估行为因素随着时间的推移在一个队列中的影响， 肥胖的高风险，从而阐明关键的基因-环境相互作用。

We propose to continue one of the most complete prospective longitudinal studies of growth and development yet undertaken of children at high risk of obesity. The study of 72 children now 9 to 10 years of age, selected on the basis on maternal overweight or leanness, achieved its initial goal, disconfirming the widely held belief that a low total energy expenditure predicted body size and composition as early as one year of age. It has since found that, at 2 years of age, 33 children of overweight mothers did not differ from 37 children of lean mothers in any aspect of body composition. By 4 years of age, high risk children had greater weight, body mass index (BMI), skinfold thickness and lean body mass. By 6 years of age they also had significantly greater levels (25% vs. 19%) (6.7 kg to 4.8) of body fat. Ten had exceeded the 85th percentile for BMI (odds ratio 15.7). We now propose to study the development of these subjects into adolescence focusing on behavioral determinants of body size: energy intake and physical activity. We will first evaluate the powerful influence of familial vulnerability on growth and development. Next, we will test the influence of food intake and physical activity on body composition, and determine the extent to which the influence of familial vulnerability is mediated by these behaviors. Energy intake will be assessed by food records, recalls, laboratory protocols and 2 questionnaires. Physical activity will be assessed with activity monitors and with monitors of television and computer use and by recalls. These efforts will be enhanced by the remarkable sample maintenance, 92% at 10 years (72 out of the original 78 subjects) and no subject has been lost during the past 5 years. Parents report that they will continue to the end of the grant period. These subjects will make it possible to assess the effects of behavioral factors over time in a cohort that has been identified as being at high risk for obesity and thereby elucidate critical gene-environmental interactions.