Infant diet and cardiometabolic risk among children born preterm

早产儿的婴儿饮食和心脏代谢风险

• 批准号: 10716587
• 负责人: Mandy Brown Belfort
• 金额: $ 75.31万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-23 至 2028-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10716587
• 关键词: 2 year old; 5 year old; Acceleration; Address; Age; American Heart Association; Biological Markers; Biometry; Birth; Brain; C-reactive protein; Cardiology; Cardiometabolic Disease; Child; Childhood; Chronic; Clinical; Clinical Trials; Collaborations; Conceptions; Data; Development; Developmental Process; Diabetes Mellitus; Diet; Discipline of obstetrics; Disease; Endocrinology; Energy Intake; Ensure; Exhibits; Fatty acid glycerol esters; Fetal Development; Fetus; Future; Glucose; Goals; Growth; Health; Hospitalization; Hospitals; Human Milk; Hypertension; Impairment; Individual; Infant; Insulin; Intake; Intervention; Intervention Trial; Leptin; Life; Life course epidemiology; Lipids; Macronutrients Nutrition; Malnutrition; Measures; Metabolic syndrome; Monitor; Morbidity - disease rate; Neonatal Intensive Care Units; Neonatology; Nutrient; Nutritional Support; Obesity; Outcome; Participant; Pattern; Physiology; Population; Pregnancy; Premature Infant; Preventive; Proteins; Randomized, Controlled Trials; Recommendation; Recording of previous events; Research; Risk Factors; Serum; Survivors; Testing; Third Pregnancy Trimester; Visit; Vulnerable Populations; Weight Gain; Work; adiponectin; blood pressure reduction; cardiometabolic risk; cardiometabolism; cardiovascular health; clinical care; cohort; design; dietary; early childhood; experience; extreme prematurity; follow-up; fortification; improved; infant nutrition; infant outcome; innovation; meetings; metabolomics; modifiable risk; neonatal care; neurodevelopment; obesity risk; obstetric care; point of care; postnatal; protein intake; public health relevance; standard of care; targeted delivery; theories; young adult

Project Summary / Abstract Each year, over 63,000 U.S. infants are born very preterm, prior to 32 weeks of gestation. With >90% now surviving to discharge due to better obstetrical and neonatal intensive care unit (NICU) management, the present challenge is to reduce short- and long-term morbidities experienced by survivors, including the two- to four-fold increased risk of obesity, diabetes, hypertension, and metabolic syndrome that manifest by young adulthood. The Developmental Origins of Health and Disease (DOHaD) framework posits that chronic conditions result from adverse exposures during vulnerable developmental stages known as “critical” or “sensitive” periods. Of particular importance is the first 1000 days of life, when key developmental processes set the stage for lifelong health. Very preterm infants are an especially vulnerable population, as they require NICU support for 2-4 months after birth, coinciding with the 3rd trimester – an established sensitive period for programming of obesity and cardiometabolic risk. In this context, the most highly modifiable and relevant exposure is diet during the NICU hospitalization, which may contribute to the accelerated accretion of fat mass relative to fat-free mass. Hospitalized very preterm infants typically experience impaired weight gain, stunted linear growth, and excess fat accretion relative to the typical fetus. To offset these issues and support brain development, dietary fortification of human milk is provided as standard of care. However, the consequences of dietary fortification for cardiometabolic health in this population are poorly understood. This proposal seeks to uncover the extent to which diet-based interventions that promote physical growth and brain development during a sensitive period may also contribute to cardiometabolic risk. We will study 130 infants born 24-31 weeks of gestation who are participating in the Nourish Study (R01HD097327l; PI: Belfort), an ongoing randomized controlled trial testing the effect of individually targeted human milk fortification vs. standard of care during the NICU hospitalization. By extending follow-up of this cohort and adding cardiometabolic biomarkers at 2 and 5 years of age, we have a unique opportunity to investigate how macronutrient and energy delivery during a sensitive period contributes to, or protects from, cardiometabolic risk during childhood. We are further poised to address key questions about NICU growth patterns in relation to cardiometabolic health in this population. Findings from this work have strong potential to impact clinical care by informing dietary strategies during a sensitive window in development to optimize lifelong health for a vulnerable population.

项目摘要/摘要