Effect of exercise modality during pregnancy on childhood obesity risk

项目摘要 子宫内的环境，包括母亲的体重增加和运动习惯，可以“编程”一个孩子朝着 出生后和成年后的疾病或健康。肥胖的代际循环始于 在怀孕期间和整个过程中，有相当数量的女性超重或肥胖（OW/OB） 怀孕;这些妇女更有可能生下巨大的婴儿。5岁时超重（OW） 儿童已经具有代谢综合征和心血管疾病风险的迹象（例如肥胖， 高脂血症、高血糖症、高胰岛素血症和高血压）。虽然研究表明， 有氧运动和阻力运动的孕妇，以及减少肥胖和改善 运动/心脏功能的婴儿，没有研究已经完成，以确定哪些运动模式是最 当一个女人在怀孕时超重或肥胖时，对母亲和婴儿都有好处。针对成人的 一般来说，有氧运动和阻力运动相结合（AERE）提供了最大的代谢改善（例如， 增加胰岛素敏感性、改善心脏功能、减少肥胖）。因此，本研究的目的 确定哪种产前锻炼类型将对母婴健康产生最大的积极影响 同时相对于不运动的孕妇，降低了OW/OB孕妇的代谢风险标志物。使用 随机设计，284名孕妇将接受运动干预（AE，RE，AERE）， 入组（妊娠约13-16周）直至分娩（妊娠约40周）。这项研究的核心假设是 添加RE可以改善结果;因此，有氧运动和阻力运动的组合不仅会 与单独AE相比，改善婴儿心脏代谢健康结局，但具有最佳依从性， 所有团体。我们将通过两个具体的目标来检验这一假设：（1）确定不同运动的影响 OW/OB妊娠期间的模式对婴儿心脏代谢健康和生长轨迹的影响;以及（2）确定 OW/OB妊娠期最有效的运动方式对改善母体心脏代谢健康。方法 将包括测量，如体重，腹围，血压，血脂，和其他 母亲和婴儿的生物标志物。这项研究还将跟踪母亲和婴儿的心脏代谢结果 从产后到12个月。这项工作有可能影响临床实践， 揭示了最早和最有效的干预，以减少代谢的代际循环， 包括肥胖症在内的女性和儿童的功能障碍。 .

Project Abstract The in-utero environment, including maternal weight gain and exercise habits, can “program” a child towards disease or health after birth and into adulthood. The often-intergenerational cycle of obesity begins with a significant number of women who are overweight or obese (OW/OB) at the time of conception and throughout pregnancy; these women are more likely to give birth to infants who are macrosomic. By age 5, overweight (OW) children already have signs of metabolic syndrome and cardiovascular disease risks (e.g. obesity, hyperlipidemia, hyperglycemia, hyperinsulinemia, and hypertension). While research has demonstrated benefits of both aerobic and resistance exercise for pregnant women as well as decreased adiposity and improved motor/heart function in their infants, no studies have been done to determine which exercise modes are most beneficial for mother and baby when a woman is overweight or obese at the time of conception. For adults in general, combined aerobic and resistance exercise (AERE) delivers the greatest metabolic improvements (e.g. increased insulin sensitivity, improved heart function, decreased adiposity). Therefore, the purpose of this study is to identify which prenatal exercise type(s) will elicit the greatest positive impact on maternal and infant health while reducing metabolic risk markers in OW/OB pregnant women relative to non-exercising counterparts. Using a randomized design, 284 pregnant women will undergo an exercise intervention (AE, RE, AERE) from enrollment (~13-16 weeks gestation) until delivery (~40 weeks gestation). The central hypothesis of this study is that adding RE improves outcomes; thus, the COMBINATION of aerobic and resistance exercise not only will improve infant cardiometabolic health outcomes, as compared to AE alone, but will have the best compliance of all groups. We will test this hypothesis with two specific aims to: (1) Determine the influence of different exercise modes during OW/OB pregnancy on infant cardiometabolic health and growth trajectories; and (2) Determine the most effective exercise mode in OW/OB pregnancy on improving maternal cardiometabolic health. Methods will include measurements such as weight, abdominal circumference, blood pressure, lipids, and other biomarkers for both mothers and infants. The study will also track maternal and infant cardiometabolic outcomes through the post-partum period, up to 12 months. This work has the potential to impact clinical practice by revealing the earliest and most effective intervention to reduce the intergenerational cycle of metabolic dysfunction, including obesity, in women and children. .