Obesity Prevention Targets for Down Syndrome

项目总结摘要 唐氏综合征(DS)儿童受肥胖症流行的影响不成比例，表现为 目前尚未满足的预防挑战。尽管预期寿命有所改善，但患有DS的人有经验 10患有DS的儿童和成人的超重/肥胖率(OW/OB)显著高于 其他原因致残的人11或一般人群。12这些风险根植于 在患有DS2-4和DS2-4的儿童中，在2到6岁之间观察到OW/OB迅速增加 儿童期OW/OB导致成年后OW/OB的风险更高。2，3然而，一项研究调查了年轻人 患有DS+OW/OB的儿童主要关注患病率，使用回顾的临床数据， 对可修改的预防目标的关注微乎其微。2、11、13因此，关于DS如何 共生条件、运动延迟和喂养困难等表型因素会导致OW/OB 风险仍未得到回应。尽管是肥胖的特定高危人群，但没有预期的， 纵向DS研究已经全面表征了OW/OB预测指标，以指导有效 在儿童早期进行预防，这样的努力可能会改善下游的健康结果。桥接 这一知识差距最近被著名的DS研究人员强调，18我们的团队代表着早期的专业知识 DS的发展、营养和DS的肥胖、体力活动(PA)和睡眠将采用纵向设计 确定DS儿童的OW/OB早期预防目标。使用交错波浪法，我们 将在第1/Y1年中登记和评估1/3的样本，并在第2年和第3年年进行年度跟踪访问(+1个月)，使用 对第二波(Y2-4)和第三波(Y3-5)采取相同的方法，从而随着时间的推移减少招聘需求 场地(总项目n=160个)。在T1-3，我们将收集关于(A)儿童因素的数据-客观测量的PA、运动 能力(粗略、精细、运动计划)、睡眠、体重/身高，以及照顾者报告的儿童膳食摄入量 (能量、大量营养素和饮食质量)、儿童发育和病史以及喂养能力；以及 (B)照料因素--照顾者喂养和PA做法、家庭动态、照顾者体重/身高和社会经济地位。 在T1，我们将招募照顾者和他们年龄在18-40个月、走路15英尺以上的DS儿童 独立的。年龄范围确保参与者的年龄与以下各项保持一致：(1)全面的发展变异性 预计在DS儿童中，95%的DS儿童在18-40岁之间达到这个行走的里程碑 两个月(中位数=24个月)，5岁和(2)观察到DS患者2-6岁体重增加，2-4岁 4-6岁的儿童患肥胖症的可能性比2-3岁的儿童高61%。2项目的总体目标是 了解DS中OW/OB风险的变异性，并确定DS儿童的预防目标。我们的 长期目标是在儿童早期开发和提供肥胖预防，以降低OW/OB和 患有DS的个体在整个生命周期内都会有相关的医学后遗症。

PROJECT SUMMARY ABSTRACT Children with Down syndrome (DS) are disproportionately affected by the obesity epidemic, presenting a prevention challenge that is currently unmet. Despite improved life expectancies, people with DS experience poor health.10 Children and adults with DS have significantly higher rates of overweight/obesity (OW/OB) than those with intellectual disability from other causes11 or the general population.12 These risks are rooted in childhood, with rapid increases in OW/OB observed between ages 2 and 6 years in children with DS2–4 and childhood OW/OB conferring a higher risk for OW/OB in adulthood.2,3 However, research examining young children with DS+OW/OB has primarily focused on prevalence rates using retrospective clinical data, with minimal attention to modifiable prevention targets.2,11,13 Consequently, critical questions regarding how DS phenotypic factors such as co-occurring conditions, motor delays, and feeding challenges contribute to OW/OB risk remain unanswered. Despite being a specific, high-risk population for obesity, no prospective, longitudinal DS research has comprehensively characterized OW/OB predictors to guide effective prevention in early childhood when such efforts may enhance downstream health outcomes. Bridging this knowledge gap recently highlighted by prominent DS researchers,18 our team representing expertise in early development in DS, nutrition, and obesity in DS, physical activity (PA), and sleep, will use a longitudinal design to identify early OW/OB prevention targets for young children with DS. Using a staggered wave approach, we will enroll and assess 1/3 of the sample in Wave 1/Y1, with annual follow-up visits (+ 1 month) in Y2&3, using the same approach for Wave 2 (Y2-4) and Wave 3 (Y3-5), thus reducing recruitment demands over time and sites (total project n=160). At T1-3, we will collect data on (a) child factors—objectively measured PA, motor abilities (gross, fine, motor planning), sleep, and weight/height, plus caregiver-reported child dietary intake (energy, macronutrients, and dietary quality), child developmental and medical history, and feeding abilities; and (b) caregiving factors—caregiver feeding and PA practices, family dynamics, caregiver weight/height, and SES. At T1, we will recruit caregivers and their child with DS chronological ages 18-40 months, who walk 15+ feet independently. The age range ensures participant ages align with: (1) the full range of developmental variability expected in children with DS given that 95% of children with DS reach this walking milestone between 18-40 months (median = 24 months),5 and (2) observed weight gain increases between 2 to 6 years of age in DS,2–4 with 4-6 year-olds 61% more likely to have OB than those aged 2-3 years.2 The overarching project goal is to understand variability in risks for OW/OB in DS and identify prevention targets in young children with DS. Our long-term goal is to develop and deliver obesity prevention in early childhood to reduce risks for OW/OB and associated medical sequelae across the lifespan for individuals with DS.