Low glycemic diets in Latino children at risk for type 2 diabetes

描述(由申请人提供)： 申请者是一名儿科医生，拥有公共卫生博士学位，在儿童国家医学中心和乔治华盛顿大学担任初级医生。米孜博士在服务不足人群的儿科和公共卫生营养方面拥有丰富的临床经验。这一奖项将使她能够获得培训和指导，成为儿童肥胖症领域的独立临床研究员。教育计划包括授课课程，以增强米孜博士的分析能力，以及更深入地了解儿童肥胖及其并发症的分子和生物学方面。该研究项目将使米孜博士能够发展干预方法和项目管理方面的技能，并为她提供以家庭为基础的营养干预的实践经验。超重在美国的西班牙裔儿童中非常普遍，在有2型糖尿病(T2 DM)家族史的儿童中，超重通常伴随着胰岛素抵抗和高胰岛素血症。低血糖负荷(GL)饮食已被提出以降低儿童的高胰岛素血症和体重。然而，目前尚不清楚减少拉美裔美国儿童的GL是否会改善胰岛素敏感性或减轻超重。该研究项目的目标是比较低甘油三酯饮食和低脂肪饮食对患有T2 DM的超重拉美裔美国儿童的胰岛素敏感性、身体成分和代谢风险标记物的短期和长期影响。假设是，与低脂饮食相比，食用低血糖饮食将导致胰岛素敏感性的更大改善，BMI z评分和体脂的更大下降，以及代谢风险因素和炎症反应的更高下降。84名年龄在7-14岁、体重指数为95百分位数且有患2型糖尿病风险的儿童将被随机分配到低血糖或低脂肪饮食计划中。受试者还将参加一项具有文化能力的、以家庭为基础的干预计划，其中包括行为矫正和加强体育活动。将比较两组饮食在胰岛素敏感性、BMI z评分、体脂和代谢综合征方面的变化。对于高危少数民族青年来说，迫切需要成功的干预措施来预防2型糖尿病的发病。通过这个职业发展奖，米孜博士希望成为一名独立的研究员，并成为儿童肥胖和临床营养领域的领导者。

DESCRIPTION (provided by Applicant): The applicant is a pediatrician with a doctorate in public health, who holds primary appointments at the Children's National Medical Center and the George Washington University. Dr. Mirza has extensive clinical experience in pediatrics and public health nutrition in underserved populations. This award will enable her to obtain the training and mentoring to become an independent clinical investigator in the area of childhood obesity. The educational plan includes didactic courses to enhance Dr. Mirza's analytical capabilities, as well as a deeper understanding of the molecular and biological aspects of childhood obesity and its complications. The research project will enable Dr. Mirza to develop skills in intervention methodology and project management, and also provide her with hands-on experience in family-based nutrition interventions. Overweight is highly prevalent among Hispanic children in the U.S., and is commonly accompanied by insulin resistance and hyperinsulinemia in children with a family history of type 2 diabetes mellitus (T2DM). Low-glycemic load (GL) diets have been proposed to reduce hyperinsulinemia and body weight in children. However, it is unknown if reducing GL in Hispanic American children will improve insulin sensitivity or reduce overweight. The objectives of the research project are to compare the short- and long-term effects of a low-GL versus a low-fat diet on insulin sensitivity, body composition, and markers of metabolic risk in overweight Hispanic-American children at risk for T2DM. The hypothesis is that consumption of a low-GL diet will result in greater improvement in insulin sensitivity, greater decrease in BMI z-score and body fat, and a higher reduction in metabolic risk factors and inflammatory response compared to a low-fat diet. 84 children age 7-14y with BMI>95th percentile and at-risk for T2DM will be randomly assigned either to a low-GL or a low-fat dietary plan for 2y. Subjects will also participate in a culturally competent, family-based intervention program which includes behavior modification and enhanced physical activity. Changes in insulin sensitivity, BMI z-score, body fat, and aspects of the metabolic syndrome in the two dietary groups will be compared. Successful interventions to prevent the onset of T2DM are urgently needed for at-risk minority youth. Through this career development award, Dr. Mirza expects to become established as an independent investigator and a leader in pediatric obesity and clinical nutrition.