Physical Activity in Pregnancy for Intergenerational Obesity Prevention

孕期体力活动预防代际肥胖

• 批准号: 9032925
• 负责人: Samantha F Ehrlich
• 金额: $ 14.82万
• 依托单位: UNIVERSITY OF TENNESSEE KNOXVILLE
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-21 至 2020-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9032925
• 关键词: 1 year old; Affect; Age; Age-Months; Area; Award; Behavioral; Birth; Body Composition; Body Size; Body Weight decreased; Body fat; Child; Child health care; Childhood; Counseling; Data; Data Sources; Development; Diabetes Mellitus; Diabetes prevention; Diet; Dietary Assessment; Discipline of obstetrics; Doctor of Philosophy; Electronic Health Record; Ensure; Epidemic; Epidemiology; Epigenetic Process; Ethnic Origin; Evaluation; Exercise; Fatty acid glycerol esters; First Pregnancy Trimester; Foundations; Future; Gestational Age; Goals; Gold; Growth; Health system; Healthcare; Individual; Infant; Institute of Medicine (U.S.); Insulin; Intervention; Knowledge; Life; Manuscripts; Measures; Mediating; Medical center; Mentors; Methods; Monitor; Mothers; National Research Council; Obesity; Observational Study; Overweight; Patients; Physical activity; Physicians; Population; Postpartum Period; Pregnancy; Prenatal care; Prevalence; Prevention; Provider; Race; Recommendation; Research; Risk Factors; Role; Scientist; Statistical Methods; Third Pregnancy Trimester; Time; Training; Weight; Weight Gain; Woman; World Health; base; career; cohort; comparative effectiveness; effectiveness research; evidence base; fetal; gestational weight gain; improved; in utero; infancy; innovation; intergenerational; lifestyle factors; lifestyle intervention; novel; nutrition; obesity in children; obesity prevention; offspring; prevention evaluation; programs; public health relevance; reproductive

 DESCRIPTION (provided by applicant): To curb the continuing obesity epidemic, `upstream' prevention efforts are desperately needed. To inform such prevention efforts, increased scientific knowledge of the following is required: 1) the mechanisms through which physical activity (PA) in pregnancy, a modifiable lifestyle factor, may impact body size and composition in infancy, and 2) improved methods for evaluating health system based lifestyle interventions to improve maternal gestational weight gain (GWG) and infant birthweight. This K01 will provide Dr. Samantha F. Ehrlich Ph.D., with the expertise needed to achieve her career goals of reducing obesity and diabetes in women and children by promoting and ultimately increasing participation in PA at the population level, particularly through interventions implemented at the health system level. The central hypothesis of this proposal is that increasing PA during pregnancy may mitigate the development of obesity in both the mother (i.e., through appropriate GWG) and child (i.e., through appropriate birthweight and reduced body fat at birth, and developmental programming for appropriate weight/fat mass gains in infancy). The specific aims are as follows. Aim 1: To estimate the effects of PA during pregnancy on infant growth from birth to 1 year of age using novel methods that permit causal inference to be drawn from observational data. Aim 2: To estimate the effects of PA regime during pregnancy (i.e., objectively measured PA in early and late pregnancy) on infant body composition (i.e., percent body fat) from birth to 1 year of age using novel methods that permit causal inference to be drawn from observational data with time-dependent confounding (i.e., measures of PA, diet, and fat mass in early and late pregnancy). Aim 3: To efficiently evaluate a physician-initiated intervention promoting PA and appropriate weight gain in pregnancy implemented at a single medical center by estimating its effects on maternal GWG and infant birthweight as compared to matched patients from non-intervention medical centers. Aim 3 uses existing historical data to match at the medical center level and existing electronic health record data to match on individual-level variables. This research will expand knowledge of potential targets for real world interventions of `upstream' obesity prevention, and use novel methods for evaluating one such intervention. Dr. Assiamira Ferrara MD, Ph.D., Senior Research Scientist and Chief of the Women's and Children's Health Section at the KPNC Division of Research, will be my Primary Mentor (obesity prevention). Co-mentors with complementary expertise include Drs. David Bassett, Jr. (objectively measured PA), Hollie A. Raynor (nutrition and behavioral aspects of obesity prevention), and Romain Neugebauer (causal inference-based methods of analysis); Dr. Kelley Pettee Gabriel (PA epidemiology) is a Consultant. The research, new training and professional developmental afforded by this award will ensure Dr. Ehrlich's successful transition to research independence in the area of PA during pregnancy for intergenerational obesity and diabetes prevention.

 描述（由申请人提供）：为了遏制持续的肥胖流行病，迫切需要“上游”预防工作。为了告知这种预防工作，需要增加以下方面的科学知识：1）怀孕期间的身体活动（PA），一种可改变的生活方式因素，可能会影响婴儿期的身体大小和组成的机制，以及2）改进评估基于卫生系统的生活方式干预措施的方法，以改善孕产妇妊娠期体重增加（GWG）和婴儿出生体重。K 01将为Samantha F.埃利希博士，她拥有实现其职业目标所需的专业知识，即通过促进并最终增加人口一级对PA的参与，特别是通过在卫生系统一级实施的干预措施，减少妇女和儿童的肥胖和糖尿病。该建议的中心假设是，在怀孕期间增加PA可以减轻母亲（即，通过适当的GWG）和儿童（即，通过适当的出生体重和出生时减少体脂，以及婴儿期适当体重/脂肪量增加的发育规划）。具体目标如下。目标1：使用允许从观察数据中得出因果推断的新方法，估计妊娠期间PA对婴儿从出生到1岁生长的影响。目的2：评估妊娠期间PA方案的效果（即，在怀孕早期和晚期客观测量的PA）对婴儿身体组成的影响（即，体脂百分比）从出生到1岁使用新的方法，该方法允许从具有时间依赖性混杂的观察数据中得出因果推断（即，在怀孕早期和晚期测量PA、饮食和脂肪量）。目标3：通过与来自非干预医疗中心的匹配患者相比，估计其对母亲GWG和婴儿出生体重的影响，有效评价在单个医疗中心实施的促进PA和适当妊娠体重增加的医生启动的干预。目标3使用现有的历史数据在医疗中心水平上进行匹配，并使用现有的电子健康记录数据在个人水平上进行匹配。这项研究将扩大知识的潜在目标为真实的世界 “上游”肥胖预防的干预措施，并使用新的方法来评估这样的干预措施。Assiamira费拉拉博士，医学博士，KPNC研究部的高级研究科学家和妇女儿童健康科科长将是我的主要导师（预防肥胖）。具有互补专业知识的共同导师包括小大卫巴塞特博士。（客观测量的PA），Hollie A. Raynor（肥胖预防的营养和行为方面）和Romain Neugebauer（基于因果推理的分析方法）; Kelley Pettee Gabriel博士（PA流行病学）是顾问。该奖项提供的研究，新的培训和专业发展将确保埃利希博士成功过渡到研究独立的PA在怀孕期间的跨代肥胖和糖尿病预防领域。