Obesity Prevention Targets for Down Syndrome

项目摘要 患有唐氏综合症（DS）的儿童不成比例地受到肥胖流行病的影响， 这是目前尚未解决的问题。尽管预期寿命有所提高，但患有DS的人 10患有DS的儿童和成人的超重/肥胖（OW/OB）率显著高于 这些风险的根源在于： 儿童期，在2 - 6岁的DS 2 -4儿童中观察到OW/OB快速增加， 儿童OW/OB在成年后具有更高的OW/OB风险。2，3然而，研究 DS+OW/OB儿童主要关注使用回顾性临床数据的患病率， 对可修改的预防目标的关注最少。2，11，13因此，关于DS如何 表型因素，如共同发生的条件，运动延迟，和喂养的挑战，有助于OW/OB 风险仍未得到解决。尽管是一个特定的，高风险的肥胖人群，没有前瞻性， 纵向DS研究全面表征了OW/OB预测因子， 在儿童早期进行预防，因为这种努力可能会提高下游的健康成果。桥接 最近，著名的DS研究人员强调了这一知识差距，18我们的团队代表了早期 DS的发展，营养，DS中的肥胖，体力活动（PA）和睡眠，将使用纵向设计 为患有DS的幼儿确定早期OW/OB预防目标。使用交错波方法，我们 将在第1波/第1年招募并评估1/3的样本，并在第2年和第3年进行年度随访（+ 1个月），使用 对第二阶段（Y2-4）和第三阶段（Y3-5）采用同样的办法，从而随着时间的推移减少征聘需求， 研究中心（项目总数n=160）。在T1-3，我们将收集（a）儿童因素-客观测量的PA，运动 能力（粗、细、运动计划）、睡眠和体重/身高，加上所有报告的儿童饮食摄入量 （能量、常量营养素和膳食质量）、儿童发育和病史以及喂养能力;以及 (b)影响因素-照顾者喂养和PA的做法，家庭动力学，照顾者的体重/身高，和SES。 在T1阶段，我们将招募护理人员和他们的儿童，年龄在18-40个月之间，行走15英尺以上 独立地。年龄范围确保参与者年龄符合：（1）发育变异的全方位 考虑到95%的DS儿童在18-40岁之间达到这一步行里程碑，预计DS儿童会达到这一里程碑 个月（中位数= 24个月），5和（2）在DS中观察到2至6岁之间的体重增加，2-4 4-6岁儿童患OB的可能性比2-3岁儿童高61%。2总体项目目标是 了解DS中OW/OB风险的变化，并确定DS幼儿的预防目标。我们 长期目标是在儿童早期开发和提供肥胖预防，以降低OW/OB的风险， DS患者在整个生命周期中的相关医学后遗症。

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.