Diet Quality and CVD Risk Factors in a Family Based Weight Management Study

基于家庭的体重管理研究中的饮食质量和 CVD 危险因素

• 批准号: 8516566
• 负责人: ALICE H LICHTENSTEIN
• 金额: $ 30.95万
• 依托单位: TUFTS UNIVERSITY BOSTON
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-08-02 至 2016-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8516566
• 关键词: 12 year old; Address; Adherence; Age; Aliquot; Ancillary Study; Archives; Area; Biological Markers; Blood Pressure; Body Weight; Body mass index; C-reactive protein; Carotenoids; Cell Separation; Child; Communities; Consult; Counseling; Dairy Products; Data; Diet; Disadvantaged; Eating Behavior; Educational Background; Educational Curriculum; Effectiveness; Erythrocytes; Family; Family member; Fasting; Fatty Acids; Fatty acid glycerol esters; Female; Fishes; Food; Funding; Future; Generations; Glucose; Goals; Health; Healthcare Systems; Healthy People 2010; High Density Lipoprotein Cholesterol; Hispanics; Home visitation; House Call; Household; Hypertriglyceridemia; Individual; Institution; Insulin; Intake; Intervention; Intervention Studies; LDL Cholesterol Lipoproteins; Label; Life; Life Style; Measures; Meat; Milk; Minority; Mothers; Newsletter; Outcome; Outcome Measure; Pamphlets; Parents; Physical activity; Pigments; Plasma; Poverty; Prevention program; Printing; Process; Public Health; Randomized; Recommendation; Recruitment Activity; Reporting; Resources; Risk Factors; Sampling; Savory; Site; Social support; Subgroup; Telephone; Time; Trans Fatty Acids; Tube; Vegetable Oils; Visit; Vitamin K 1; Weight Gain; Weight maintenance regimen; Work; abstracting; base; cardiovascular disorder risk; cost; design; effectiveness measure; fruits and vegetables; group intervention; health disparity; high risk; improved; indexing; inner city; insulin sensitivity; lifestyle intervention; member; obesity in children; obesity prevention; parent grant; pi bond; post intervention; prevent; programs; public health relevance; response; sex; stem; therapy design; waist circumference

DESCRIPTION (provided by applicant): The Family Weight Management Study (FamWtStudy) (1R18-DK075981) is designed to evaluate the effects of a 12-month, family-based intervention designed to improve BMI z-scores and CVD risk factors in children ages 7-12 years living in a community with a high minority representation, who have a BMI z-score >85th percentile. The families recruited will be randomized to either the Control or Experimental Intervention group. The Control Intervention group will receive a booklet with targets for healthy eating behaviors, a handout on how to increase physical activity, and quarterly visits that will include a brief review of lifestyle recommendations. The Experimental Intervention group will receive weekly sessions for 3 months that include a core diet and physical activity curriculum followed by monthly post-core sessions for 9 months promoting adherence to the curriculum. Targeted diet strategies in the core curriculum include increasing highly pigmented fruit and vegetable, and fish intake; substituting non-fat and low-fat for full-fat milk and dairy products; and reducing meat, fried food and savory snack intakes. During the one-year intervention period social support and tailored individualized counseling will be provided to the families, augmented with telephone calls and home visits addressing barriers to adherence. The goal of this ancillary study application is to expand the scope of the FamWtStudy to include 1) measures of diet quality biomarkers in child-mother/female guardian pairs, 2) measures of CVD risk factors in children and mothers/female guardians, and 3) assessment of associations within child-mother/female guardian pairs for diet quality biomarkers and CVD risk factors pre-intervention and post-intervention change. Each biomarker for diet quality was chosen because it is an indicator of a different component of the diet targeted by the parent study and can provide an indication of adherence - red blood cell (RBC) 18:3n-3, 20:4n-6, 20:5n-3 and 22:6n-3 for vegetable oil, meat and fish; plasma carotenoids and phylloquinone for highly pigmented fruits and vegetables; RBC 15:0 for full-fat milk and dairy products; and RBC trans fatty acids and plasma dihydrophylloquinone for fried food and savory snacks. Measuring the CVD risk factors (total, HDL and LDL cholesterol, triglyceride, hsCRP, glucose and insulin concentrations, blood pressure and waist circumference) in the children and mothers/female guardians, will allow for an assessment of 'spill-over' effect within families and concordance within child-mother/female guardian pairs. Regardless of the outcomes, the results will provide critical data with which to design subsequent interventions in minority communities to increase the impact of family-based obesity prevention programs and public health importance because the data will provide information in an area that continues to challenge current efforts to stem the tide of childhood obesity in a high-risk subgroup and an area that threatens to overwhelm our healthcare system. The response is time-sensitive because the FamWtStudy intervention started in August, 2009 and it is critical to have resources to collect, process, archive, transfer and analyze plasma and RBC samples.

描述(由申请人提供)：家庭体重管理研究(FamWtStudy)(1R18-DK075981)旨在评估为期12个月的以家庭为基础的干预措施的效果，旨在改善7-12岁儿童的BMI z得分和心血管疾病风险因素，这些儿童生活在一个少数族裔比例较高的社区，他们的BMI z得分为85百分位数。被招募的家庭将被随机分为对照组或实验干预组。控制干预组将收到一本小册子，里面有健康饮食行为的目标，一份关于如何增加体力活动的讲义，以及每季度一次的访问，其中将包括对生活方式建议的简要审查。实验干预组将接受为期3个月的每周课程，其中包括核心饮食和体力活动课程，然后是为期9个月的每月核心后课程，以促进对课程的遵守。核心课程中有针对性的饮食战略包括增加高度色素的水果和蔬菜以及鱼类的摄入量；用脱脂和低脂取代全脂牛奶和乳制品；减少肉类、油炸食品和可口小吃的摄入量。在为期一年的干预期间，将向家庭提供社会支持和量身定做的个性化咨询，并通过电话和家访解决遵守障碍的问题。这项辅助研究应用的目的是扩大FamWtStudy的范围，包括1)测量儿童-母亲/女性监护人对的饮食质量生物标记物，2)测量儿童和母亲/女性监护人的心血管疾病风险因素，以及3)评估儿童-母亲/女性监护人对饮食质量生物标记物和心血管疾病危险因素干预前和干预后的变化的相关性。之所以选择每个反映饮食质量的生物标志物，是因为它们反映了家长研究目标饮食的不同成分，并能提供粘附性的指示--植物油、肉和鱼的红细胞(RBC)18：3n-3、20：4n-6、20：5n-3和22：6n-3；色素含量高的水果和蔬菜的血浆胡萝卜素和叶黄素；全脂奶和乳制品的RBC 15：0；油炸食品和美味零食的RBC反式脂肪酸和血浆二氢叶黄素。测量儿童和母亲/女性监护人的心血管疾病风险因素(总胆固醇、高密度脂蛋白和低密度脂蛋白、甘油三酯、hsCRP、血糖和胰岛素浓度、血压和腰围)，将能够评估家庭内的“溢出”效应和儿童-母亲/女性监护人对的一致性。无论结果如何，结果都将提供关键数据，以便在少数族裔社区设计后续干预措施，以增加以家庭为基础的肥胖预防计划的影响和公共卫生的重要性，因为这些数据将提供一个领域的信息，该领域继续挑战当前在高危人群中遏制儿童肥胖浪潮的努力，以及一个有可能使我们的医疗体系不堪重负的领域。这一反应具有时间敏感性，因为FamWtStudy干预始于2009年8月，拥有收集、处理、存档、转移和分析血浆和红细胞样本的资源至关重要。