Preventing Obesity through Intervention during Infancy

通过婴儿期干预预防肥胖

• 批准号: 8607543
• 负责人: Ian M Paul
• 金额: $ 37.45万
• 依托单位: PENNSYLVANIA STATE UNIVERSITY, THE
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-03-17 至 2014-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8607543
• 关键词: 3 year old; Address; Adult; Affect; Age; Attenuated; Behavioral; Betula Genus; Birth; Body mass index; Breast; Breast Feeding; Child; Clinical Research; Cognitive; Comorbidity; Control Groups; Coronary heart disease; Crying; Cues; Data; Development; Diet; Distress; Early Intervention; Eating; Educational process of instructing; Emotional; Environment; Epidemic; Evaluation; Experimental Designs; Family; Finding by Cause; Food; Force Feedings; Fostering; Frequencies; Funding; Growth; Health; Health Food; Home environment; Home visitation; House Call; Human Milk; Hunger; Hyperphagia; Hypertension; Infant; Infant Behavior; Infant Mortality; Informal Social Control; Instruction; Intake; Intervention; Lead; Length; Life; Link; Measures; Mediating; Mediator of activation protein; Metabolic; Milk; Mothers; National Health and Nutrition Examination Survey; National Institute of Diabetes and Digestive and Kidney Diseases; Non-Insulin-Dependent Diabetes Mellitus; Nurses; Obesity; Outcome; Overweight; Parenting behavior; Parents; Pattern; Pilot Projects; Pregnancy; Prevention program; Prevention strategy; Preventive Intervention; Process; Randomized; Research; Risk; Safety; Sampling; Satiation; Self Efficacy; Self-control as a personality trait; Sleep; Solid; Techniques; Testing; Time; Toddler; United States; Vegetables; Visit; Visiting Nurse; Weight; Weight Gain; arm; base; clinical practice; critical period; developmental plasticity; eating in absence of hunger; efficacy testing; feeding; good diet; group intervention; improved; infancy; innovation; insight; intervention effect; intervention program; novel; obesity in children; obesity prevention; obesity risk; preference; prevent; primary outcome; programs; public health relevance; randomized trial; rapid growth; response; social; success; therapy design; trait; universal prevention

DESCRIPTION (provided by applicant): This research will test the effects of a novel early intervention program to prevent childhood obesity. Nurses will deliver interventions to first-time parents and their infants at three home visits in the first year after birth followed by annual clinical research center visits until age 3. National Health and Nutrition Examination Survey (NHANES) data demonstrate the need for early intervention to prevent obesity: from 2007 to 2008, over 10 percent of children less than 2 years were already obese and over 20 percent of children between ages 2 and 5 years were overweight or obese. These findings are cause for concern because overweight infants and toddlers and those with rapid infant growth are at increased risk of obesity and its co-morbidities later in life. Further, attempts to prevent and treat obesity with older children have had limited success. In contrast, infancy may be an opportune time to begin obesity prevention. It is a critical period of rapid growth and developmental plasticity with long-lasting metabolic and behavioral consequences. Based on promising pilot study results and using an ecological/developmental framework, the proposed research seeks to deliver and test a program to prevent childhood obesity in a two arm randomized trial that includes a child safety control program. The obesity prevention program focuses on messages of responsive feeding, division of feeding responsibility, and healthy dietary choices that extend from infancy through age 3 years. As such, the intervention will teach first-time parents a) to recognize infant hunger and satiety cues and use feeding more selectively in response only to hunger, b) to use alternative soothing strategies to feeding for the fussy, but non-hungry infant and toddler, c) to provide children with appropriate portions of healthy foods and allow children to determine the amount consumed, and d) how to improve acceptance of developmentally appropriate foods such as vegetables through repeated exposure. This information is especially important during the first year after birth as infants make a dramatic dietary transition from the initial exclusive milk diet to one with many foods of the adult diet of their culture. During this transition, as foods are being introduced to children, there are numerous opportunities to address dietary content as well as parent feeding style. We propose to investigate the impact of our intervention on both intent to breastfeed and intent to formula feed mother-infant dyads. The intervention program is hypothesized to show efficacy in both breast and formula fed infants as measured by the primary outcome, body mass index (BMI) percentile at age 3 years. This outcome provides significant insight into long-term obesity risk.

描述（由申请人提供）：本研究将测试一种新型早期干预计划对预防儿童肥胖的影响。护士将在婴儿出生后的第一年进行三次家访，然后每年到临床研究中心进行一次干预，直到3岁。国家健康和营养检查调查（NHANES）的数据表明，需要进行早期干预以预防肥胖：从2007年到2008年，超过10%的2岁以下儿童已经肥胖，超过20%的2至5岁儿童超重或肥胖。这些发现引起了人们的关注，因为超重的婴儿和学步儿童以及婴儿生长迅速的婴儿在以后的生活中患肥胖症及其并发症的风险更高。此外，预防和治疗大龄儿童肥胖的尝试收效甚微。相反，婴儿期可能是开始预防肥胖的好时机。这是一个快速生长和发育可塑性的关键时期，具有长期的代谢和行为后果。基于有希望的试点研究结果，并使用生态/发展框架，拟议的研究旨在提供和测试一个预防儿童肥胖的项目，在一个两组随机试验中，包括一个儿童安全控制项目。肥胖预防计划的重点是反应性喂养、喂养责任分工和健康饮食选择，这些信息从婴儿期延伸到3岁。因此，干预将教会首次父母a)识别婴儿饥饿和饱腹感的线索，并更有选择性地只对饥饿做出反应，b)使用其他安抚策略来喂养挑剔但不饥饿的婴幼儿，c)为儿童提供适当份量的健康食品，并允许儿童决定摄入量。d)如何通过反复接触提高对蔬菜等适合发育的食物的接受度。这一信息在出生后的第一年尤其重要，因为婴儿的饮食从最初的纯牛奶饮食转变为他们文化中成人饮食的许多食物。在这一转变过程中，随着食物被介绍给儿童，有很多机会来解决饮食内容以及父母的喂养方式。我们建议调查我们的干预对母乳喂养意图和配方奶粉喂养母婴的意图的影响。假设干预方案对母乳喂养和配方奶粉喂养的婴儿都有效，主要指标是3岁时的身体质量指数（BMI）百分位数。这一结果为长期肥胖风险提供了重要的见解。