Balancing the Risk and Benefits of Rapid Weight Gain in Infancy

描述(申请人提供)：曼迪·布朗·贝尔福，医学硕士，波士顿儿童医院新生儿专家，哈佛医学院儿科讲师。这份K23导师职业发展奖的申请将结构化的指导和培训与详细的研究计划结合在一起。这项提议的总体目标是培训贝尔福特博士，使其成为一名独立的、以患者为导向的研究人员，专注于早期生命发育和营养的长期结果。在足月儿中，婴儿的快速增长与超重和高血压等长期风险有关，但早产儿的快速体重增加是否也同样有害尚不清楚。快速体重增加也可能是有益的，例如对早产儿的神经发育；快速体重增加是否有利于足月人群的神经发育尚不清楚。更好地了解与足月和早产婴儿体重快速增加相关的风险和利益的平衡，将为指导这些人群的最佳婴儿体重增加模式提供指导。对于这一奖项，贝尔福特博士的目标是首先评估两个大型、成熟的足月儿和早产儿队列中与肥胖相关的风险和学龄儿童体重增加带来的神经认知益处。然后，贝尔福特博士将建立一个决策分析模型，估计足月儿和早产儿的最佳体重增加率，平衡与肥胖相关的风险和成年后的神经认知益处。这项研究计划直接建立在贝尔福特博士以前在流行病学和卫生服务研究方面的培训以及她在新生儿方面的临床专业知识的基础上。她的发现将提供有关体重增加模式的关键信息，以优化足月和早产人群的长期健康。Belfort博士的独特资源包括一支支持性的、有成就的多学科指导团队；接触到两个庞大的、成熟的、纵向的足月和早产儿童队列；以及流行病学和决策分析方面的高级课程。拟议的奖励将使贝尔福特博士能够做出重大的科学贡献，并发展她作为一名独立研究员的职业生涯。

DESCRIPTION (provided by applicant): Mandy Brown Belfort, MD MPH is a neonatologist at Children's Hospital Boston and Instructor of Pediatrics at Harvard Medical School. This application for a K23 mentored career development award combines structured mentorship and training with a detailed research plan. The overall goal of this proposal is to train Dr. Belfort for a career as an independent patient-oriented researcher focused on the long term outcomes of early-life growth and nutrition. In full term infants, rapid infant gain is associated with long-term risks, such as overweight and high blood pressure, but whether rapid weight gain is similarly harmful in preterm infants is unclear. Rapid weight gain may also be beneficial, for example to neurodevelopment in preterm infants; whether rapid weight gain benefits neurodevelopment in full term populations is poorly understood. A better understanding of the balance of risks and benefits associated with rapid infant weight gain in both full term and preterm populations would inform guidelines for optimal infant weight gain patterns in these populations. For this award, Dr. Belfort aims first to assess the adiposity-related risks and neurocognitive benefits at school age associated with infant weight gain in 2 large, established cohorts of full term and preterm infants. Dr. Belfort will then build a decision analytic model to estimate the optimal rate of weight gain for full term and preterm infants, balancing adiposity-related risks with neurocognitive benefits through adulthood. This research plan builds directly on Dr. Belfort's previous training in epidemiology and health services research and her clinical expertise in neonatology. Her findings will provide critical information regarding patterns of weight gain that optimize long term health in full term and preterm populations. Dr. Belfort's unique resources include a supportive, accomplished multi-disciplinary mentorship team; access to 2 large, established, longitudinal cohorts of full term and preterm children; and advanced coursework in epidemiology and decision analysis. The proposed award will enable Dr. Belfort to make a substantial scientific contribution and to develop her career as an independent investigator.