Clinical and experimental studies of obesity

描述（由申请人提供）：我们建议继续进行一项最完整的关于肥胖高危儿童生长发育的前瞻性纵向研究。这项研究选取了72名年龄在9至10岁之间的儿童，并根据母亲的体重超重或偏瘦进行了选择。研究结果达到了最初的目标，推翻了人们普遍认为的总能量消耗低就能预测1岁儿童的体型和身体成分的观点。研究发现，在两岁时，33名超重母亲的孩子与37名瘦母亲的孩子在身体组成的任何方面都没有区别。到4岁时，高风险儿童的体重、体重指数（BMI）、皮褶厚度和瘦体重都更高。到6岁时，他们的体脂水平也显著提高（25%对19%）（6.7公斤对4.8公斤）。10例患者的BMI超过第85百分位（优势比15.7）。我们现在建议研究这些对象进入青春期的发展，重点关注身体大小的行为决定因素：能量摄入和身体活动。我们将首先评估家庭脆弱性对成长和发展的强大影响。接下来，我们将测试食物摄入和身体活动对身体成分的影响，并确定这些行为在多大程度上介导了家庭脆弱性的影响。能量摄入将通过食物记录、召回、实验室规程和两份问卷进行评估。身体活动将通过活动监测器，电视和电脑使用监测器以及召回来评估。这些努力将通过出色的样本维护得到加强，在10年达到92%（原始78名受试者中有72名），并且在过去5年中没有受试者丢失。家长报告说，他们将继续到补助金期结束。这些研究对象将有可能评估行为因素在一段时间内对肥胖高风险人群的影响，从而阐明关键的基因-环境相互作用。

DESCRIPTION (provided by applicant): We propose to continue one of the most complete prospective longitudinal studies of growth and development yet undertaken of children at high risk of obesity. The study of 72 children now 9 to 10 years of age, selected on the basis on maternal overweight or leanness, achieved its initial goal, disconfirming the widely held belief that a low total energy expenditure predicted body size and composition as early as one year of age. It has since found that, at 2 years of age, 33 children of overweight mothers did not differ from 37 children of lean mothers in any aspect of body composition. By 4 years of age, high risk children had greater weight, body mass index (BMI), skinfold thickness and lean body mass. By 6 years of age they also had significantly greater levels (25% vs. 19%) (6.7 kg to 4.8) of body fat. Ten had exceeded the 85th percentile for BMI (odds ratio 15.7). We now propose to study the development of these subjects into adolescence focusing on behavioral determinants of body size: energy intake and physical activity. We will first evaluate the powerful influence of familial vulnerability on growth and development. Next, we will test the influence of food intake and physical activity on body composition, and determine the extent to which the influence of familial vulnerability is mediated by these behaviors. Energy intake will be assessed by food records, recalls, laboratory protocols and 2 questionnaires. Physical activity will be assessed with activity monitors and with monitors of television and computer use and by recalls. These efforts will be enhanced by the remarkable sample maintenance, 92% at 10 years (72 out of the original 78 subjects) and no subject has been lost during the past 5 years. Parents report that they will continue to the end of the grant period. These subjects will make it possible to assess the effects of behavioral factors over time in a cohort that has been identified as being at high risk for obesity and thereby elucidate critical gene-environmental interactions.