A Novel Diet-Phenotype Interaction Affecting Body Weight

影响体重的新型饮食-表型相互作用

• 批准号: 8528565
• 负责人: DAVID S LUDWIG
• 金额: $ 59.33万
• 依托单位: BOSTON CHILDREN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-07-01 至 2015-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8528565
• 关键词: 2-cyclopentyl-5-(5-isoquinolylsulfonyl)-6-nitro-1H-benzo(D)imidazole; Abdomen; Affect; Animals; Attention; Behavior; Behavioral; Biological; Biological Factors; Blood Pressure; Body Weight; Body Weight decreased; Body fat; Boston; C-reactive protein; Carbohydrates; Classification; Counseling; Diabetes Mellitus; Diet; Dietary intake; Dietitian; Dual-Energy X-Ray Absorptiometry; Educational workshop; Enrollment; Fat-Restricted Diet; Fatty acid glycerol esters; Fostering; Glucose; High Density Lipoprotein Cholesterol; Hour; Human; Hunger; Individual; Individual Differences; Ingestion; Insulin; Intervention; Interview; LDL Cholesterol Lipoproteins; Measurement; Measures; Metabolic syndrome; Methods; Molecular; Molecular Analysis; Molecular Profiling; Motivation; North Carolina; Nutritional Support; Obesity; Observational Study; Oral; Outcome; Participant; Pediatric Hospitals; Phenotype; Physical activity; Physiological; Plasma; Plasminogen Activator Inhibitor 1; Play; Population Decreases; Process Measure; Proteins; Protocols documentation; Psychological Factors; Randomized; Randomized Controlled Trials; Reproducibility; Research; Risk Factors; Role; Scanning; Schedule; Serum; Site; Telephone; Testing; Translations; Triglycerides; Universities; Variant; Waist-Hip Ratio; Weight; Work; abdominal fat; base; cardiovascular risk factor; clinical application; clinical practice; computerized data processing; diabetes risk; follow-up; improved; insight; insulin mediators; insulin secretion; insulin sensitivity; meetings; metabolomics; novel; nutrition education; obesity treatment; public health relevance; response; satisfaction; young adult

DESCRIPTION (provided by applicant): In recent years, diets of widely varying composition have been used in the treatment of obesity. While none of these diets has produced consistent, long-term weight loss, some individuals on virtually all types of diets do remarkably well. One explanation for this variation among individuals is differences in motivation and behavior. However, underlying biological differences may also play an important role. Previous work has identified insulin secretion (as quantified by serum insulin concentration at 30 minutes following a standard 75-gram oral glucose load) as an important biological determinant. This randomized-controlled, multi-center trial aims to test the hypothesis that insulin secretion will predict which type of diet will work best for each individual. A total of 160 obese young adults (18 to 40 years) will be assigned to one of two diets: low-fat (60% carbohydrate, 20% fat, 20% protein) or low-glycemic load (45% carbohydrate, 35% fat, 20% protein). Participants will be enrolled at two sites (Children's Hospital Boston or University of North Carolina-Chapel Hill) and assigned to diet groups according to baseline insulin secretion status. The protocol will include an intensive 6-month intervention period and a 12-month follow-up period. Registered dietitians will provide nutrition education and behavioral counseling during group workshops and scheduled telephone calls. In an effort to avoid confounding, close attention will be paid to control for treatment intensity, physical activity prescriptions, and behavioral methods between groups. The primary endpoint will be percent body fat by DXA scan. Secondary endpoints will include cardiovascular and diabetes risk factors. Repeated, 24-hour dietary and physical activity recall interviews will provide process data. Metabolomic profiling and molecular analysis of identified metabolites will be conducted to characterize phenotype and explore potential physiological mechanisms.

描述（由申请人提供）：近年来，不同组成的饮食已被用于治疗肥胖症。虽然这些饮食都没有产生持续、长期的减肥效果，但一些人在几乎所有类型的饮食中都取得了非常好的效果。对个体之间这种差异的一种解释是动机和行为的差异。然而，潜在的生物学差异也可能发挥重要作用。先前的研究已将胰岛素分泌（通过标准 75 克口服葡萄糖负荷后 30 分钟的血清胰岛素浓度进行量化）确定为重要的生物决定因素。这项随机对照、多中心试验旨在检验胰岛素分泌将预测哪种饮食最适合每个人的假设。总共 160 名肥胖年轻人（18 至 40 岁）将被分配到两种饮食中的一种：低脂（60% 碳水化合物、20% 脂肪、20% 蛋白质）或低血糖负荷（45% 碳水化合物、35% 脂肪、20% 蛋白质）。参与者将在两个地点（波士顿儿童医院或北卡罗来纳大学教堂山分校）进行登记，并根据基线胰岛素分泌状态分配到饮食组。该方案将包括为期 6 个月的强化干预期和 12 个月的随访期。注册营养师将在小组研讨会和预定的电话会议期间提供营养教育和行为咨询。为了避免混淆，将密切关注组间治疗强度、身体活动处方和行为方法的控制。主要终点是 DXA 扫描的体脂百分比。次要终点将包括心血管和糖尿病危险因素。重复的 24 小时饮食和身体活动回忆访谈将提供过程数据。将对已鉴定的代谢物进行代谢组学分析和分子分析，以表征表型并探索潜在的生理机制。