Maternal-Offspring Metabolics: Family Intervention Trial (MOMFIT)

描述(申请人提供)：在过去的二十年里，肥胖症在美国的流行程度急剧上升，并迅速上升，过早地对健康造成不利影响。育龄妇女，特别是少数群体和社会经济地位较低的妇女，由于妊娠体重增加过多而面临不良妊娠结局的风险，这进一步加剧了儿童肥胖率和糖尿病的惊人比率。预防过多的GWG可以减少妊娠并发症，改善妇女及其后代的长期健康。孕期体重控制研究正在兴起，但大多数研究都模仿了传统的体重控制计划，通过饮食咨询和/或增加活动来进行，但持续坚持的证据有限。需要新的方法来限制体重增加到医学研究所(IOM)的目标，并帮助新妈妈坚持推荐的饮食、体育活动和生活方式行为，她们可以为家人树立榜样。拟议的研究将开发和测试一种新的方法，通过一种行为适应、营养密集、能量平衡的生活方式来预防肥胖症，这种生活方式可以在临床上实施，通过技术先进的自我监测方法进行客观评估并长期持续。这项随机对照临床试验与标准护理、超重和肥胖孕妇的GWG进行了比较，这些孕妇参与了个性化、激励性指导和小组会议的生活方式干预 发展长期自我监控推荐饮食和体力活动行为。人体测量、代谢、饮食、活动和生活方式的结果将在产前和产后至少12个月进行评估。西北妇产科每年为12,000多名不同种族的产科患者提供护理，其中许多人参加了临床试验，这是由功能强大的产科研究基础设施推动的。我们的多学科团队在产科和预防研究方面经验丰富，他们提出创新的技术和增强的自我监控技能，以记录新妈妈是否能够更好地准备好为家人和自己制定和示范饮食和能量平衡的生活方式行为，并长期减少和预防肥胖。 公共卫生相关性：拟议的研究将促进人们对旨在控制GWG的行为干预措施的有效性的理解，这些干预措施旨在控制大量不同种族的超重/和肥胖妇女。饮食和体力活动的改变是否能在怀孕期间和产后持续有效和安全地实施，以及对后代肥胖的影响，将被探索。

DESCRIPTION (provided by applicant): The prevalence of obesity has increased dramatically in the US over the last two decades, with rapidly rising and premature adverse health consequences. Women of reproductive age, especially minorities and those of low socioeconomic status, are at risk of adverse pregnancy outcomes due to excessive gestational weight gain (GWG) and this further contributes to alarming rates of childhood obesity and diabetes. Preventing excessive GWG could reduce pregnancy complications and improve long term health of women and their offspring. Weight control studies in pregnancy are emerging but most studies have emulated traditional weight control programs through diet counseling and/or increased activity with limited evidence of sustained adherence. Novel approaches are needed to limit weight gain to Institute of Medicine (IOM) goals, and to help new-mothers adhere to recommended diet, physical activity and lifestyle behaviors they can model for their families. The proposed research will develop and test a new approach to primary and secondary prevention of obesity through a behaviorally adapted, nutrient-dense, energy-balanced lifestyle that can be implemented clinically, assessed objectively and sustained long term through technologically-advanced self-monitoring methods. This randomized controlled clinical trial compares with standard care, the GWG of overweight and obese pregnant women who participate in lifestyle intervention with individualized, motivational coaching and group sessions to develop self-monitoring of recommended diet and physical activity behavior long term. Anthropometric, metabolic, diet, activity and lifestyle outcomes will be assessed prenatally and for at least 12 months post delivery. The Northwestern Department of Obstetrics and Gynecology provides care for over 12,000 ethnically diverse obstetric patients a year, many of whom participate in clinical trials, facilitated by a highly functional obstetric research infrastructure. Our multidisciplinary team, experienced in obstetrics and prevention research, propose innovative technology and enhanced self-monitoring skills to document whether new mothers can be better prepared to develop and model diet and energy-balanced lifestyle behaviors for their families and themselves and reduce and prevent obesity long term. PUBLIC HEALTH RELEVANCE: The proposed study will advance understanding of the effectiveness of behavioral interventions aimed at controlling GWG in a large population of ethnically diverse overweight/ and obese women. Whether changes in diet and physical activity can effectively and safely be implemented during pregnancy and sustained postpartum will be explored, as well as impact on the adiposity of the offspring.