Increased Protein at Breakfast for Weight Management in Overweight Adolescents

项目概要/摘要： 青少年肥胖症仍然是一个主要的公共卫生问题，由于发展的风险增加， 慢性疾病，包括但不限于2型糖尿病。因此，迫切需要制定战略， 体重管理和血糖控制，以扭转肥胖症的流行，并防止和/或延迟严重的 年轻人的健康并发症。早餐的日常消费一直被吹捧为必不可少的一部分 来预防和/或治疗肥胖症。虽然早餐一度被认为是“最重要的一餐”， 然而，由于缺乏现有的因果证据，这一概念最近受到了挑战。此外，本发明还提供了一种方法， 对早餐和体重管理研究的兴趣突出了大量营养素的重要性。 内容，特别是增加膳食蛋白质在早餐，作为一个关键因素。试点数据表明， 减少身体脂肪量和改善血糖控制后，每天消耗高 蛋白质早餐在短期内超重的青少年。然而，目前尚不清楚这些 影响将发生在长期和什么作用机制有助于改善 这些健康结果。目标1将确定早餐之间是否存在因果联系，特别是 丰富的膳食蛋白质，以及年轻人的体重管理。为了实现这一目标，150超重，习惯性 不吃早餐的青少年将完成以下长期随机、严格控制的早餐 审判参与者将被随机提供高蛋白早餐（350千卡; 34%蛋白质（30克蛋白质）， 40%CHO和26%脂肪）;等热量正常蛋白质早餐（350千卡; 11%蛋白质（10克蛋白质），63%CHO， 和26%的脂肪）;或将继续不吃早餐6个月。基线、第3和第6天体重、身体组成， 并评估自由生活血糖控制。此外，每日摄入量，特别是晚上 还将在基线、3个月和6个月测量吃零食行为。目标2将确定食欲，激素， 以及蛋白质早餐调节摄取的神经信号（即，饮食）行为和体重 管理为了实现这一目标，150名受试者中的一个子集（n=75）将在基线期间完成10小时的测试日， 3和6个月。重复评估感知的食欲、饱腹感和食物渴望沿着食欲- 调节激素反应（即，血浆ghrelin、GLP-1、PYY和HVA（主要多巴胺 代谢物））将全天测量。在单独的一天，早餐后和晚餐前功能 功能磁共振成像（fMRI）的大脑扫描也将完成，以确定神经激活的食物刺激，在皮质边缘脑 已知调节食物动机、奖励和渴望的区域。目标3将确定特定的食欲， 激素和神经信号作为摄食行为和体重管理的强预测因子。的 目标2中收集的指标将结合食物选择、每日摄入量、体重减轻和 6个月干预后体脂减少。总的来说，这个项目将提供新的证据 测试食用高蛋白早餐作为对抗年轻人肥胖的饮食策略。

Project Summary/Abstract: Adolescent obesity continues to be a major public health concern due to the increased risk of developing chronic diseases, including, but not limited to, type 2 diabetes. Thus, strategies are vitally needed that target weight management and glycemic control to reverse the obesity epidemic and prevent and/or delay serious health complications in young people. The daily consumption of breakfast has been touted as an essential part of the diet to prevent and/or treat obesity. While breakfast was once thought to be `the most important meal of the day', this notion has recently been challenged due to the paucity of existing causal evidence. In addition, interest in the study of breakfast and weight management has highlighted the importance of macronutrient content, particularly increased dietary protein at breakfast, as a critical factor. Pilot data has illustrated reductions in body fat mass and improvements in glycemic control following the daily consumption of high protein breakfasts over a short period in overweight adolescents. However, it is unclear as to whether these effects would occur over the long-term and what mechanisms-of-action contribute to the improvements in these health outcomes. Aim 1 will determine whether a causal link exists between breakfast, particularly one rich in dietary protein, and weight management in young people. To accomplish this, 150 overweight, habitual breakfast-skipping adolescents will complete the following long-term randomized, tightly-controlled breakfast trial. Participants will be randomly provided with high protein breakfasts (350kcal; 34% protein (30g protein), 40% CHO, and 26% fat); isocaloric normal protein breakfasts (350kcal; 11% protein (10g protein), 63% CHO, and 26% fat); or will continue to skip breakfast for 6 mo. Baseline, 3, and 6 body weight, body composition, and free-living glycemic control will be assessed. In addition, daily intake, with particular focus on evening snacking behavior, will also be measured at baseline, 3, and 6 mo. Aim 2 will identify the appetitive, hormonal, and neural signals by which a protein breakfast modulates ingestive (i.e., eating) behavior and weight management. To address this aim, a sub-set of the 150 (n=75) will complete 10-h testing days during baseline, 3, and 6 mo. Repeated assessments of perceived appetite, satiety, and food cravings along with appetite- regulating hormonal responses (i.e., plasma ghrelin, GLP-1, PYY, and HVA (the primary dopamine metabolite)) will be measured throughout the day. On a separate day, post-breakfast and pre-dinner functional (fMRI) brain scans will also be completed to identify neural activation to food stimuli in cortico-limbic brain regions known to modulate food motivation, reward, and cravings. Aim 3 will identify specific appetitive, hormonal, and neural signals as strong predictors of ingestive behavior and weight management. The measures collected in Aim 2 will be analyzed in combination with food choice, daily intake, weight loss, and reductions in body fat following the 6-mo interventions. Collectively, this project will provide novel evidence testing the consumption of a high protein breakfast as a dietary strategy to combat obesity in young people.