ENERGY EXPENDITURE AND THE INCIDENCE OF OBESITY

少女青春期是肥胖发展的关键时期。减少能源消耗是一个很大的风险因素。我们继续每年跟踪一个队列（最初为197名月经前期女孩），这些女孩参加了（1990-1993）能量消耗及其与肥胖发展关系的纵向研究。159名女孩（80.7%）仍然活跃在研究中。在这159例受试者中，59例已完成研究，另外100例继续每年接受研究。完成了身体成分、静息代谢率、每日总能量消耗和最大摄氧量的基线测量。饮食和活动的措施，从7天的食物记录，7天的活动记录，和活动问卷。自入组以来，每年对女孩进行一次访视，直至她们在月经初潮后4年退出研究。在他们的年度访问中，通过人体测量获得饮食、活动、生长和身体组成的测量结果。抽血是为了测量性激素和胰岛素。在该拟定的资助期结束时，除5名女孩外，所有女孩将在月经初潮后4年退出研究。到那时，我们将确定基线能量消耗（每日总能量消耗、静息能量消耗、非静息能量消耗百分比或最大摄氧量）的减少是否与女孩成熟时体脂的增加有关。我们还将确定种族差异或父母肥胖是否会导致女孩子队列中体脂的变化，先前在月经初潮时通过MRI测量内脏脂肪。在MRI检查时，重复测量身体成分和人体测量，抽血测量性激素，并完成问卷调查，对饮食、活动和吸烟和酗酒等行为进行评级。我们将在这些女孩的出院访视中重复这些措施。这项研究将使我们能够确定哪些因素导致青春期女孩的内脏脂肪沉积。这些研究将阐明能量消耗在肥胖发展中的作用，并确定导致内脏脂肪沉积的因素。确定导致肥胖和中心脂肪分布的因素将有助于制定旨在降低青少年肥胖发病率和发病率的计划。

Adolescence in girls is a critical period for the development of obesity. Reduced energy expenditure represents a strong risk factor. We are continuing to follow annually a cohort (originally 197 pre- menarcheal girls) who were enrolled (1990-1993) in a longitudinal study of energy expenditure and its relationship to the development of obesity. One hundred and fifty-nine girls (80.7%) remain active in the study. Of these 159 subjects, 59 have completed the study and the other 100 continue to seen annually. A baseline measures of body composition, resting metabolic rate, total daily energy expenditure, and VO2 max were completed. Measures of diet and activity were obtained from a 7-day food record, a 7-day activity record, and activity questionnaires. Since enrollment, girls are seen annually until 4 years after menarche when they exit the study. At their annual visit, measures of diet, activity, growth and body composition by anthropometric measures are obtained. Blood is drawn for the measurement of sex hormones and insulin. At the end of this proposed grant period, all but five girls will be 4 years post menarcheal and will exit the study. At that time we will have determined whether reductions in energy expenditure at baseline (total daily energy expenditures, resting energy expenditure, percent non- resting energy expenditure or VO2 max) are associated with increases in body fat as girls mature. We will also determine whether differences in ethnicity, or parental obesity contribute to the changes in body fat in a subcohort of girls, visceral fat was previously measured at menarche by MRI. At the time of the MRI, measures of body composition and anthropometry were repeated, blood was drawn for the measurement of sex hormones, and questionnaires were completed rating to diet, activity and behaviors such as smoking and alcohol abuse. We will repeat these measures in these girls at their exit visit. This study will allow us to determine what factors contribute to visceral fat deposition in girls during puberty. These studies will clarify the role of energy expenditure in the development of obesity and identify factors that contribute to the deposition of visceral fat. Identification of factors which contribute to the development of obesity and central fat distribution will aid in the development of programs designed to reduce the incidence and morbidity associated with adolescent obesity.