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

描述（申请人提供）： 申请人是一名儿科医生，拥有公共卫生博士学位，在儿童国家医疗中心和乔治华盛顿大学担任主要职务。Mirza博士在儿科和公共卫生营养方面拥有丰富的临床经验。该奖项将使她能够获得培训和指导，成为儿童肥胖领域的独立临床研究者。教育计划包括教学课程，以提高米尔扎博士的分析能力，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。该研究项目将使米尔扎博士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方面的实践经验。超重在美国的西班牙裔儿童中非常普遍，并且在具有2型糖尿病（T2 DM）家族史的儿童中通常伴有胰岛素抵抗和高胰岛素血症。低血糖负荷（GL）饮食已被提出，以减少高胰岛素血症和体重的儿童。然而，尚不清楚降低西班牙裔美国儿童的GL是否会改善胰岛素敏感性或减少超重。该研究项目的目的是比较低GL与低脂饮食对有T2 DM风险的超重西班牙裔美国儿童的胰岛素敏感性、身体组成和代谢风险标志物的短期和长期影响。该假设是，与低脂饮食相比，低GL饮食将导致胰岛素敏感性的更大改善，BMI z评分和体脂的更大降低，以及代谢风险因素和炎症反应的更大降低。将84名BMI>第95百分位数且有T2 DM风险的7- 14岁儿童随机分配至低GL或低脂饮食计划，为期2年。受试者还将参加一个文化能力，以家庭为基础的干预计划，其中包括行为矫正和增强体力活动。将比较两个饮食组中胰岛素敏感性、BMI z评分、体脂和代谢综合征方面的变化。成功的干预措施，以防止T2 DM的发病是迫切需要的高危少数民族青年。通过这个职业发展奖，米尔扎博士希望成为一个独立的研究者和儿童肥胖和临床营养的领导者。

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.