Targeting added sugar to improve dietary intake in high-risk adolescents

项目摘要 此K01提案的总体目标是为Gina Tripicchio博士、MSED提供培训和 指导建立一个独立的研究计划，专注于创新的行为干预，以 改善高危青少年的膳食摄入量。添加糖(AS)是饮食干预的主要目标 青少年；它提供了多余的卡路里，没有营养价值，青少年摄入的热量比 任何其他年龄段的人。高危青少年(例如，来自低收入社区的少数族裔)， 肥胖率和与饮食相关的慢性病的比例仍然高得不成比例 未得到充分研究。为这一高危人群开发有效试验的一个关键限制是缺乏信息 关于与AS摄入量相关的关键因素。为了解决这一差距，该项目旨在确定关键驱动因素 应用生态瞬时评估(EMA)研究高危青少年的砷摄入量。EMA允许 实时检查特定背景的饮食影响，同时减少回忆偏差和参与者 负担。这些丰富的信息可以用来指导制定量身定做的、突出的行为 干预。此外，最近出现了一种客观稳定的AS同位素生物标志物，可以使用。 解决饮食干预中自我报告结果的关键限制。将采用两项研究来 达到这个项目的目标。研究1(1-2年级)将收集40名青少年的EMA，并检查 δ13C生物标记物在目标样本中的可行性和可接受性。研究2(3-5年级)将实施 试点随机对照试验，在70名12-16岁的青少年中测试针对具体情况量身定做的技术丰富的干预措施 几岁，来自费城北部的一个低收入社区。为期3个月的行为干预，包括 基于小组的会议、互动短信和家长支持将旨在减少吸食量 给一个教育比较小组。由δ13C生物标记物测量的As的变化将被评估为 主要结果和饮食质量的总体变化将作为次要结果进行检查。严谨的 培训计划将补充拟议的研究，由营养、饮食方面的专家导师协助 儿科人群中的行为、数字干预、统计和行为试验。具体培训 目标包括：1)生态瞬时评估，2)多层次统计建模，3)评估 目标营养生物标记物和4)设计和实施行为干预措施 差距。坦普尔大学肥胖研究和教育中心是这项工作的理想环境，因为 它提供了广泛的研究资源，并提供了接触多样化、高危青年的机会。这款K01将 提供有关高危青少年AS摄入量的新信息，并测试有针对性的量身定制干预措施，以 减少消费。研究结果将支持应用全功率R01试验。本奖项适用于 对公共卫生的重大潜在影响，并将使Tripicchio博士能够建立一个严格的计划， 研究改善弱势青少年的饮食摄入量和降低与饮食相关的慢性病风险。

PROJECT ABSTRACT The overall goal of this K01 proposal is to provide Gina Tripicchio, PhD, MSEd, with the training and mentorship to establish an independent program of research focused on innovative behavioral interventions to improve dietary intake in high-risk adolescents. Added sugar (AS) is a prime target for dietary intervention in adolescents; it contributes excess calories with no nutritional benefits, and adolescents consume more AS than any other age group. High-risk adolescents (e.g., racial/ethnic minorities from low-income communities), experience disproportionately higher rates of obesity and diet-related chronic diseases yet remain understudied. A key limitation in developing efficacious trials for this high-risk group is the dearth of information about key factors associated with AS intake. To address this gap, this project aims to characterize key drivers of AS intake in high-risk adolescents using ecological momentary assessment (EMA). EMA allows for the examination of contextually specific dietary influences in real-time, while reducing recall bias and participant burden. This rich information can be used to guide the development of a tailored, salient behavioral intervention. Additionally, an objective stable isotope biomarker of AS has recently emerged and can be used to address key limitations of self-reported outcomes in dietary interventions. Two studies will be employed to meet the aims of this project. Study 1 (years 1-2), will collect EMA from 40 adolescents and examine the feasibility and acceptability of the δ13C biomarker in the target sample. Study 2 (years 3-5), will implement a pilot RCT to test a contextually tailored, technology-enriched intervention in a sample of 70 adolescents, 12-16 years of age, from a low-income community in north Philadelphia. A 3-month behavioral intervention, including group-based sessions, interactive text messaging and parent support, will aim to reduce AS intake compared to an educational comparison group. Changes in AS, as measured by the δ13C biomarker, will be assessed as the primary outcome and total changes in diet quality will be examined as a secondary outcome. A rigorous training plan will complement the proposed research, facilitated by mentors who are experts in nutrition, eating behavior, digital interventions, statistics, and behavioral trials in pediatric populations. Specific training objectives include: 1) ecological momentary assessment, 2) multi-level statistical modeling, 3) assessment of objective nutritional biomarkers and 4) designing and implementing behavioral interventions to address disparities. Temple University's Center for Obesity Research and Education is an ideal setting for this work as it provides extensive research resources and access to a population of diverse, high-risk youth. This K01 will provide novel information about AS intake in high-risk adolescents and test a targeted, tailored intervention to reduce consumption. Findings will support the application of a fully powered R01 trial. This award holds significant potential for public health impact and will enable Dr. Tripicchio to establish a rigorous program of research to improve dietary intake and reduce diet-related chronic disease risk in vulnerable adolescents.