The Snack Study

零食研究

• 批准号: 9005859
• 负责人: Paula Catherine Chandler-Laney
• 金额: $ 6.82万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-02-04 至 2018-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9005859
• 关键词: Abdomen; Adherence; African American; Award; Behavioral; Beverages; Biogenesis; Calories; Child; Consumption; Data; Development; Diet; Dietary Intervention; Eating; Economics; Energy Intake; Environment; Evaluation; Exposure to; Fasting; Fetal Growth; Fetus; Focus Groups; Food; Future; Future Generations; Glucose; Glycemic Index; Goals; Growth; Health; Hour; Individual; Infant; Insulin; Intake; Intervention; Life; Literature; Low income; Measures; Metabolic; Metabolism; Methodology; Modeling; Mothers; Nutritional; Obesity; Outcome; Pathway interactions; Pattern; Perception; Perinatal Exposure; Phase; Placenta; Play; Population; Pregnancy; Prevention; Publishing; Randomized Controlled Trials; Regulation; Research; Research Support; Risk; Risk Factors; Role; Sleep; Target Populations; Testing; Third Pregnancy Trimester; Time; Weight; Weight Gain; Woman; base; behavior change; behavior influence; biobehavior; experience; fetal; fetal programming; follow-up; food consumption; glucose tolerance; high risk; improved; infant outcome; lifestyle intervention; maternal diabetes; neonate; neurodevelopment; next generation; non-diabetic; obesity risk; offspring; pregnant; prevent; programs; shift work; social; standard care; transmission process; trial design

 DESCRIPTION (provided by applicant): Existing research supports a role for the intrauterine environment in modifying risk for obesity in offspring. Maternal obesity and relatively high glucose concentrations are two commonly cited predictors of obesity in the next generation, potentially via the delivery of excess fuel across the placenta to the developing fetus, which in turn, may program fetal metabolism in a manner that promotes excess weight gain in the future. Although a number of lifestyle interventions to improve maternal and infant outcomes have previously been attempted, results are often modest at best. Furthermore, few studies have proved to be efficacious among low income African American women who have high risk for the transmission of obesity to future generations. Research previously conducted by the PI (K01DK090126; DRC pilot award), has discovered that late-night consumption of high glycemic index (GI) foods is very prevalent in late pregnancy among African American women who are obese. Consistent with the existing literature describing adverse metabolic consequences of shift-work and late-night eating, this diurnal pattern of intake was associated with reduced glucose tolerance in the mothers, and a number of infant outcomes that are themselves associated with future obesity. The overall goal of this study is to follow-up this previous research by examining the feasibility of developing an intervention to reduce late-night intake of high-GI foods and beverages among obese African American women, in order to improve maternal glucose tolerance and reduce excess fetal growth in late gestation. This goal will be achieved with a two-phase study. First, focus groups will be conducted with pregnant African American women who are obese, in order to identify reasons for late-night consumption of high-GI foods, barriers against changing this behavior, and perceptions of an intervention to reduce late-night high-GI intake. Second, a randomized control trial (RCT) design will be used to examine the feasibility of conducting an intervention to reduce late-night high-GI consumption among obese women during the third trimester. The intervention will provide lower-GI alternatives to replace the high-GI foods and beverages that are typically consumed by the target population. Changes in free-living glycemic variability, glucose tolerance, and fetal abdominal growth, during the intervention will be measured and compared to those of women in a control (i.e. standard care) group. At the conclusion of this study, it is anticipated that suffiient preliminary data will have been obtained with which to inform a larger and more comprehensive RCT. Furthermore, this study will support the PI's transition to independence by providing an opportunity to experimentally examine the biobehavioral mechanisms underlying the development of obesity following intrauterine exposure to maternal obesity and/or high glucose concentrations.

 描述（由申请人提供）：现有研究支持宫内环境在改变后代肥胖风险中的作用。母体肥胖和相对较高的葡萄糖浓度是下一代肥胖的两个常见预测因素，可能通过胎盘向发育中的胎儿输送过量的燃料，这反过来可能会以促进未来体重增加的方式编程胎儿代谢。虽然以前曾尝试过一些改善母婴结局的生活方式干预措施，但效果往往最好。此外，很少有研究证明是有效的低收入非洲裔美国妇女谁有高风险的肥胖症传播给后代。PI先前进行的研究（K 01 DK 090126; DRC试点奖）发现，深夜食用高血糖指数（GI）食物在肥胖的非裔美国妇女中非常普遍。与现有文献描述的倒班工作和深夜进食的不良代谢后果一致，这种昼夜摄入模式与母亲葡萄糖耐量降低有关，并且许多婴儿结局本身与未来肥胖有关。本研究的总体目标是通过研究开发干预措施的可行性来跟踪先前的研究，以减少肥胖的非洲裔美国妇女深夜摄入高GI食物和饮料，以改善母体葡萄糖耐量并减少妊娠后期胎儿的过度生长。这一目标将通过两阶段研究实现。首先，将对肥胖的非裔美国孕妇进行焦点小组调查，以确定深夜食用高GI食物的原因，改变这种行为的障碍，以及对减少深夜高GI摄入的干预措施的看法。其次，将采用随机对照试验（RCT）设计来研究进行干预以减少妊娠晚期肥胖妇女深夜高GI摄入的可行性。该干预措施将提供低GI替代品，以取代目标人群通常消费的高GI食品和饮料。将测量干预期间自由生活血糖变异性、葡萄糖耐量和胎儿腹部生长的变化，并与对照（即标准护理）组中的女性进行比较。在本研究结束时，预计将获得足够的初步数据，为更大、更全面的RCT提供信息。此外，这项研究将通过提供一个机会来实验性检查宫内暴露于母体肥胖和/或高葡萄糖浓度后肥胖发展的生物行为机制，支持PI向独立的转变。