Increased Protein at Breakfast for Weight Management in Overweight Adolescents

项目摘要/摘要： 青少年肥胖仍然是一个主要的公共卫生问题，因为患肥胖症的风险增加。 慢性疾病，包括但不限于2型糖尿病。因此，战略至关重要，需要以此为目标。 体重管理和血糖控制，扭转肥胖流行趋势，预防和/或延缓严重肥胖 年轻人的健康并发症。每天吃早餐被吹捧为必不可少的一部分 预防和/或治疗肥胖症的饮食。虽然早餐曾被认为是世界上最重要的一餐 时至今日，由于缺乏现有的因果证据，这一概念最近受到了挑战。此外, 对早餐和体重管理研究的兴趣凸显了大量营养素的重要性 食物中的蛋白质含量，特别是早餐时增加的食物蛋白质，是一个关键因素。试点数据表明 每日摄入高脂后体内脂肪质量的减少和血糖控制的改善 超重青少年的短期蛋白质早餐。然而，目前还不清楚这些是否会 将在长期内产生影响，以及哪些行动机制有助于改善 这些健康后果。目标1将确定早餐之间是否存在因果联系，特别是 富含膳食蛋白质，对年轻人的体重管理有帮助。要做到这一点，150超重，习惯性 不吃早餐--不吃早餐的青少年将完成以下长期随机、严格控制的早餐 审判。参与者将随机获得高蛋白早餐(350千卡；34%蛋白质(30克蛋白质)， 40%的CHO和26%的脂肪)；等热量的正常蛋白质早餐(350千卡；11%的蛋白质(10g蛋白质)，63%的CHO， 和26%的脂肪)；或者将继续不吃早餐6个月。基线，3和6体重，身体成分， 并对自由生活的血糖控制进行评估。此外，每天的摄入量，特别是晚上 零食行为，也将在基线、3和6个月进行测量。目标2将确定食欲，荷尔蒙， 蛋白质早餐调节进食(即进食)行为和体重的神经信号 管理层。为了实现这一目标，150个(n=75)人的一个子集将在基线期间完成10小时的测试， 3和6个月。反复评估感知的食欲、饱腹感、食物渴望以及食欲-- 调节激素反应(即血浆Ghrelin、GLP-1、PYY和HVA(主要的多巴胺 代谢物))全天进行测量。在另一天，早餐后和晚餐前提供服务 还将完成(FMRI)脑扫描，以确定大脑皮质-边缘脑对食物刺激的神经激活情况 已知的调节食物动机、奖励和渴望的区域。目标3将确定特定的胃口， 荷尔蒙和神经信号是摄食行为和体重管理的有力预测因素。这个 目标2中收集的指标将结合食物选择、每日摄入量、体重减轻和 6个月干预后体脂的减少。总而言之，这个项目将提供新的证据 测试食用高蛋白早餐作为对抗年轻人肥胖的饮食策略。

Project Summary/Abstract: Adolescent obesity continues to be a major public health concern due to the increased risk of developing chronic diseases, including, but not limited to, type 2 diabetes. Thus, strategies are vitally needed that target weight management and glycemic control to reverse the obesity epidemic and prevent and/or delay serious health complications in young people. The daily consumption of breakfast has been touted as an essential part of the diet to prevent and/or treat obesity. While breakfast was once thought to be `the most important meal of the day', this notion has recently been challenged due to the paucity of existing causal evidence. In addition, interest in the study of breakfast and weight management has highlighted the importance of macronutrient content, particularly increased dietary protein at breakfast, as a critical factor. Pilot data has illustrated reductions in body fat mass and improvements in glycemic control following the daily consumption of high protein breakfasts over a short period in overweight adolescents. However, it is unclear as to whether these effects would occur over the long-term and what mechanisms-of-action contribute to the improvements in these health outcomes. Aim 1 will determine whether a causal link exists between breakfast, particularly one rich in dietary protein, and weight management in young people. To accomplish this, 150 overweight, habitual breakfast-skipping adolescents will complete the following long-term randomized, tightly-controlled breakfast trial. Participants will be randomly provided with high protein breakfasts (350kcal; 34% protein (30g protein), 40% CHO, and 26% fat); isocaloric normal protein breakfasts (350kcal; 11% protein (10g protein), 63% CHO, and 26% fat); or will continue to skip breakfast for 6 mo. Baseline, 3, and 6 body weight, body composition, and free-living glycemic control will be assessed. In addition, daily intake, with particular focus on evening snacking behavior, will also be measured at baseline, 3, and 6 mo. Aim 2 will identify the appetitive, hormonal, and neural signals by which a protein breakfast modulates ingestive (i.e., eating) behavior and weight management. To address this aim, a sub-set of the 150 (n=75) will complete 10-h testing days during baseline, 3, and 6 mo. Repeated assessments of perceived appetite, satiety, and food cravings along with appetite- regulating hormonal responses (i.e., plasma ghrelin, GLP-1, PYY, and HVA (the primary dopamine metabolite)) will be measured throughout the day. On a separate day, post-breakfast and pre-dinner functional (fMRI) brain scans will also be completed to identify neural activation to food stimuli in cortico-limbic brain regions known to modulate food motivation, reward, and cravings. Aim 3 will identify specific appetitive, hormonal, and neural signals as strong predictors of ingestive behavior and weight management. The measures collected in Aim 2 will be analyzed in combination with food choice, daily intake, weight loss, and reductions in body fat following the 6-mo interventions. Collectively, this project will provide novel evidence testing the consumption of a high protein breakfast as a dietary strategy to combat obesity in young people.