Novel interventions to reduce stress induced non-homeostatic eating

减少压力引起的非稳态饮食的新干预措施

• 批准号: 7938818
• 负责人: NANCY E ADLER
• 金额: $ 114.03万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-25 至 2014-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7938818
• 关键词: Address; Adherence; Affect; Animal Model; Awareness; Basic Science; Behavioral; Binge Eating; Biological Markers; Birth; Body Weight Changes; Body Weight decreased; Central obesity; Clinical Trials Data Monitoring Committees; Cues; Data; Deposition; Desire for food; Development; Diet; Dose; Eating; Eating Behavior; Emotions; Fatty acid glycerol esters; Focus Groups; Food; Foundations; Future; Group Interviews; Health; Human; Hunger; Hydrocortisone; Hyperphagia; Individual; Informal Social Control; Intake; Intervention; Intervention Studies; Lead; Link; Low income; Maintenance; Manuals; Measures; Mediator of activation protein; Minority; Modeling; Naltrexone; Nature; Neurobiology; Neurosciences; Obesity; Opioid; Opioid Receptor; Outcome; Pathway interactions; Pattern; Phase; Physiology; Pilot Projects; Plant Roots; Population; Postpartum Period; Pregnancy; Pregnant Women; Prevention program; Principal Investigator; Process; Psychology; Public Health; Randomized; Recruitment Activity; Relative (related person); Research; Research Personnel; Rewards; Risk; Sampling; Satiation; Science; Scientist; Signal Transduction; Source; Stress; Symptoms; System; Target Populations; Testing; Time; Weight; Weight Gain; Woman; Work; abdominal fat; abstracting; active control; addiction; base; behavior change; biological adaptation to stress; cohort; control trial; critical period; design; diet and exercise; dosage; effective intervention; efficacy testing; efficacy trial; endogenous opioids; high risk; improved; indexing; insight; insulin sensitivity; intervention program; meetings; member; mindfulness; next generation; novel; nutrition education; offspring; pleasure; post intervention; pregnant; programs; reproductive; response; skills training; success; successful intervention; sugar; translational approach; transmission process; weight maintenance

DESCRIPTION (provided by applicant): This application brings together a strong interdisciplinary team of scientists at the UCSF Center for Obesity Assessment, Study and Treatment (COAST) with researchers at Kaiser-Permanente to test novel interventions based on the physiology by which stress and reward from palatable food influence eating behaviors and abdominal fat deposition. This type of eating is typically non-homeostatic (not meeting caloric deficit). We plan to reduce this type of intake through proof-of-concept and intervention strategies tailored for obese lower income women prior to pregnancy, a critical period for intervention, which may affect gestational weight gain, postpartum weight retention, and offspring weight. Our translational approach draws from the psychology of eating and behavior change, and neuroscience of stress, appetite and reward, to test whether modulating the reward and stress response systems reduces abdominal obesity and weight. In Phase 1 & 2, we will develop and compare two distinct interventions that target diet, activity, and stress but with different conceptual bases: (1): Developmental Skills Training (DST) designed to curb addictions through promoting self-regulation of emotions and eating behavior. (2); Mindfulness and Diet (MIND) aimed to reduce stress and improve awareness of hunger-satiety cues and automatic eating patterns through mindfulness and mindful eating. Preliminary data on each intervention are promising. We will also test an indirect measure of endogenous opioid tone that may provide insight into mechanisms of weight loss. Pilot research has shown that response to a naltrexone "opioid probe" is linked to indices of non-homeostatic eating and predicts weight loss. We will test the utility of this opioid probe to determine if it changes during treatment and predicts change in eating and abdominal fat. In Phase 2, we will randomize 80 obese women intending to become pregnant to a 3 month proof-of-concept trial of DST and MIND, to compare relative effects on proposed mechanisms (stress, opioid tone), and feasibility. In Phase 3, we will refine and test the efficacy of the most successful intervention then randomize 120 pre-pregnant obese women to the selected intervention or active control condition (diet and exercise alone). These efforts will produce promising intervention strategies for curbing obesity in women during their reproductive years. All phases will be informed by input from a Scientific Advisory panel and Data Safety and Monitoring Board. Accomplishing the aims of this proposal will expand current understanding of the mechanisms that lead to sustained weight reduction, and will inform further study of alternative strategies for obesity intervention. RELEVANCE: The proposed research develops new obesity interventions based on the science of how stress influences the rewarding value of food, and promotes compulsive eating. We will test promising interventions, with women intending to become pregnant that will result in a new prevention programs that are more effective for sustained weight loss maintenance than what is currently available. This program could have a broad public health impact by improving maternal heath and potentially benefiting the next generation. (End of Abstract)

描述（由申请人提供）： 该应用程序汇集了UCSF肥胖评估，研究和治疗中心（COAST）的强大跨学科科学家团队与Kaiser-Permanente的研究人员，以测试基于生理学的新型干预措施，通过该生理学，可口食物的压力和奖励影响饮食行为和腹部脂肪沉积。这种类型的饮食通常是非稳态的（不满足热量不足）。我们计划通过为怀孕前的肥胖低收入妇女量身定制的概念验证和干预策略来减少这种类型的摄入量，这是干预的关键时期，可能会影响妊娠期体重增加，产后体重保持和后代体重。我们的转化方法借鉴了饮食和行为改变的心理学，以及压力，食欲和奖励的神经科学，以测试调节奖励和压力反应系统是否可以减少腹部肥胖和体重。在第一阶段和第二阶段，我们将开发和比较两种不同的干预措施，针对饮食，活动和压力，但具有不同的概念基础：（1）：发展技能训练（DST）旨在通过促进情绪和饮食行为的自我调节来抑制成瘾。(2)正念和饮食（MIND）旨在通过正念和正念饮食来减轻压力，提高对饥饿感和自动饮食模式的认识。每项干预措施的初步数据都很有希望。我们还将测试内源性阿片张力的间接测量，这可能有助于了解减肥的机制。初步研究表明，对纳洛酮“阿片探针”的反应与非稳态饮食指数有关，并预测体重减轻。我们将测试这种阿片探针的效用，以确定它在治疗期间是否发生变化，并预测进食和腹部脂肪的变化。在第2阶段，我们将随机选择80名打算怀孕的肥胖女性进行为期3个月的DST和MIND概念验证试验，以比较对拟议机制（压力，阿片类药物张力）的相对影响和可行性。在第3阶段，我们将完善和测试最成功的干预措施的有效性，然后将120名孕前肥胖妇女随机分配到选定的干预或积极控制条件（仅饮食和运动）。这些努力将产生有希望的干预战略，以遏制育龄妇女的肥胖。所有阶段都将由科学顾问小组和数据安全和监测委员会提供信息。实现这一建议的目标将扩大目前对导致持续减肥的机制的理解，并将为进一步研究肥胖干预的替代策略提供信息。相关性：这项拟议中的研究开发了新的肥胖干预措施，其基础是压力如何影响食物的奖励价值，并促进强迫性进食。我们将测试有希望的干预措施，与打算怀孕的妇女，这将导致一个新的预防计划，更有效的持续减肥维护比目前可用的。该方案可以通过改善孕产妇健康并可能使下一代受益来产生广泛的公共卫生影响。(End摘要）